Real-time video telemedicine applications in the emergency department: a scoping review of literature

AbstractObjectivesTo collect and synthesize the literature describing the use of real-time video-based technologies to provide support in the care of patients presenting to emergency departments.Data SourceSix electronic databases were searched, including Medline, CINAHL, Embase, the Cochrane Database, DARE, and PubMed for all publications since the earliest date available in each database to February 2016.Study SelectionSelected articles were full text articles addressing the use of telemedicine to support patient care in pre-hospital or emergency department settings. The search yielded 2976 articles for review with 11 studies eligible for inclusion after application of the inclusion and exclusion criteria. A scoping review of the selected articles was performed to better understand the different systems in place around the world and the current state of evidence supporting telemedicine use in the emergency department.ConclusionsTelemedicine support for emergency department physicians is an application with significant potential but is still lacking evidence supporting improved patient outcomes. Advances in technology, combined with more attractive price-points have resulted in widespread interest and implementation around the world. Applications of this technology that are currently being studied include support for minor treatment centres, patient transfer decision-making, management of acutely ill patients and scheduled teleconsultations.

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Global neurosurgery: a scoping review detailing the current state of international neurosurgical outreach

Journal of Neurosurgery ◽

10.3171/2020.2.jns192517 ◽

2020 ◽

pp. 1-9

Author(s):

Anthony T. Fuller ◽

Ariana Barkley ◽

Robin Du ◽

Cyrus Elahi ◽

Ali R. Tafreshi ◽

...

Keyword(s):

Scoping Review ◽

Data Extraction ◽

Medical Personnel ◽

The United States ◽

Middle Income ◽

Middle Income Countries ◽

Gray Literature ◽

Current State ◽

Study Selection ◽

Research And Education

OBJECTIVEGlobal neurosurgery is a rapidly emerging field that aims to address the worldwide shortages in neurosurgical care. Many published outreach efforts and initiatives exist to address the global disparity in neurosurgical care; however, there is no centralized report detailing these efforts. This scoping review aims to characterize the field of global neurosurgery by identifying partnerships between high-income countries (HICs) and low- and/or middle-income countries (LMICs) that seek to increase neurosurgical capacity.METHODSA scoping review was conducted using the Arksey and O’Malley framework. A search was conducted in five electronic databases and the gray literature, defined as literature not published through traditional commercial or academic means, to identify studies describing global neurosurgery partnerships. Study selection and data extraction were performed by four independent reviewers, and any disagreements were settled by the team and ultimately the team lead.RESULTSThe original database search produced 2221 articles, which was reduced to 183 final articles after applying inclusion and exclusion criteria. These final articles, along with 9 additional gray literature references, captured 169 unique global neurosurgery collaborations between HICs and LMICs. Of this total, 103 (61%) collaborations involved surgical intervention, while local training of medical personnel, research, and education were done in 48%, 38%, and 30% of efforts, respectively. Many of the collaborations (100 [59%]) are ongoing, and 93 (55%) of them resulted in an increase in capacity within the LMIC involved. The largest proportion of efforts began between 2005–2009 (28%) and 2010–2014 (17%). The most frequently involved HICs were the United States, Canada, and France, whereas the most frequently involved LMICs were Uganda, Tanzania, and Kenya.CONCLUSIONSThis review provides a detailed overview of current global neurosurgery efforts, elucidates gaps in the existing literature, and identifies the LMICs that may benefit from further efforts to improve accessibility to essential neurosurgical care worldwide.

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The Grief and Bereavement Experiences of Informal Caregivers: A Scoping Review of the North American Literature

Journal of Palliative Care ◽

10.1177/08258597211052269 ◽

2021 ◽

pp. 082585972110522

Author(s):

Neerjah Skantharajah ◽

Carol Barrie ◽

Sharon Baxter ◽

M. Carolina Borja ◽

Anica Butters ◽

...

Keyword(s):

American Literature ◽

Scoping Review ◽

Informal Caregivers ◽

Exclusion Criteria ◽

The North ◽

Current State ◽

Grief And Bereavement ◽

Hospice And Palliative Care ◽

The Impact

Background Informal caregivers are a significant part of the hospice and palliative care landscape as members of the interdisciplinary care team. Despite this, little is known about the impact this responsibility has on informal caregivers’ experiences of grief and bereavement. To address this, a scoping review of the literature was conducted to explore the current state of knowledge toward grief and bereavement of informal caregivers of adult/geriatric patients in the hospice and palliative/end-of-life care realm within North America. Methods Using Arksey and O’Malley's 5-step framework, key electronic health care and social sciences databases (eg, CINAHL, MEDLINE, ProQuest Sociological Abstracts, PsycINFO) alongside gray literature sources were searched and screened against inclusion and exclusion criteria. A thematic content analysis was used to identify key themes. Results 29 articles met the final inclusion criteria with 3 central themes emerging: (1) mediators of grief, (2) grief experiences, and (3) types of grief. Discussion Informal caregivers encounter unique grief and bereavement experiences: The range of psychosocial outcomes, both negative and positive, can be affected by various mediators such as caregiver burden, demographics, disease type of the patient being cared for, etc. Bereavement interventions must be designed with the mediators of grief in mind. Conclusions Understanding the nuances of informal caregivers’ experiences with grief and bereavement will inform and advance practice, policy, and research. Practitioners/clinicians should be further educated on how to properly acknowledge the complexity of grief and bereavement for informal caregivers, specifically paying attention to mediators. Further research needs to consider the role of culture.

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Are butyrophenones effective for the treatment of primary headache in the emergency department?

CJEM ◽

10.2310/8000.2011.100301 ◽

2011 ◽

Vol 13 (02) ◽

pp. 96-104 ◽

Cited By ~ 4

Author(s):

Lim Beng Leong ◽

Anne-Maree Kelly

Keyword(s):

Emergency Department ◽

Side Effects ◽

Randomized Trials ◽

Data Extraction ◽

Primary Headache ◽

Data Synthesis ◽

Study Selection ◽

Headache Relief ◽

Scale Scores ◽

Data Source

ABSTRACTObjectives:Butyrophenones have been reported to provide effective migraine relief in the emergency department (ED). We conducted a systematic review of the evidence for their use in the ED.Data source:We searched theCochrane,Medline,Embase, andCINAHLdatabases.Study selection:Included studies were randomized trials of a parenteral butyrophenone (droperidol, haloperidol) versus placebo or a comparator in migraine or benign headache with results available in English. Study quality was determined using the Jadad score. Six articles were included.Data extraction:Primary outcomes were subjective or objective headache relief (> 50% improvement in visual analogue scale scores). Secondary outcomes included side effects. We reported pooled odds ratios (ORs) with their 95% confidence intervals (CIs) for subjective or objective headache relief for butyrophenones versus placebo or comparator agents.Data synthesis:Three studies reported subjective headache relief with a butyrophenone versus placebo or meperidine in migraine. Two studies reported objective headache relief with droperidol versus prochlorperazine, whereas one study compared droperidol versus olanzapine in benign headache. The pooled OR for subjective headache relief was 8.08 (95% CI 1.54–42.30) for a butyrophenone versus placebo, whereas it was 1.50 (95% CI 0.33–6.77) for droperidol versus meperidine in migraine. The pooled OR for objective headache relief was 2.96 (95% CI 1.36–6.43) for droperidol versus prochlorperazine in benign headache. Rates of side effects were 10 to 45%; akathesia and sedation were the most common.Conclusions:Butyrophenones are effective for the relief of migraine or benign headache. However, adverse effects make it difficult to recommend butyrophenones above agents with similar effectiveness and fewer problems.

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A Plea for Critical Changes to the Electronic Medical Record

Telehealth and Medicine Today ◽

10.30953/tmt.v2.22 ◽

2018 ◽

Vol 2 (4) ◽

Author(s):

M. Ted Braid

Keyword(s):

Emergency Department ◽

Medical Record ◽

Electronic Medical Record ◽

Medical Devices ◽

Health Data ◽

Absolute Property ◽

Current State ◽

Data Source ◽

Trusted Data ◽

Information Today

The electronic medical record (EMR) is significantly more than a digitalized format for converting patient data into easily stored and recalled information. Today, each patient’s EMR is a vast, growing accumulation of health data sourced from physicians and professional medical devices. And, according to HIPAA, it is the absolute property of the patient. At its best, the EMR is a trusted data source that contributes to improved patient care. It is my concern that in its current state and considering existing legislation, the very thing we are building will fall in upon itself long before its potential is realized. It must change or the promise of national access to critical care data in the emergency department (ED), for example, may never be realized.

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Exploring the operationalisation and implementation of outreach in community settings with hard-to-reach and hidden populations: protocol for a scoping review

BMJ Open ◽

10.1136/bmjopen-2020-039451 ◽

2021 ◽

Vol 11 (2) ◽

pp. e039451

Author(s):

Janina Krabbe ◽

Sunny Jiao ◽

Adrian Guta ◽

Allie Slemon ◽

Aman Ahluwalia Cameron ◽

...

Keyword(s):

Scoping Review ◽

Sex Workers ◽

Successful Implementation ◽

Community Settings ◽

Hidden Populations ◽

Exclusion Criteria ◽

Prevention And Health Promotion ◽

Core Components ◽

Data Source ◽

Review Criteria

IntroductionOutreach is regularly identified as an effective strategy to engage underserved, hard-to-reach and hidden populations with essential life-sustaining health services. Despite the increasing expansion of outreach programmes, particularly in HIV prevention and health promotion with youth, sex workers, people living with mental health and substance use challenges, and those affected by homelessness, there has been limited synthesis of the evidence concerning the core components of outreach programming or indicators of its successful implementation. Without this understanding, current outreach programmes may be limited in achieving the desired aims. The aim of this scoping review is to explore how outreach has been operationalised and implemented in various community settings with people underserved in current healthcare contexts. Understanding the state of knowledge pertaining to outreach as programming and as practice involving the engagement of people considered hard-to-reach will enable the identification of promising trends and limitations in the field.Methods and analysisThis scoping review follows the Arksey and O’Malley’s framework. CINAHL, MEDLINE, PsycINFO and PubMed databases will be searched for peer-reviewed references focused on outreach with hard-to-reach and hidden groups from 1 January 2008 to 30 April 2020. Guided by explicit inclusion and exclusion criteria, three reviewers will independently assess references in two successive stages. Titles and abstracts will be reviewed followed by full-text assessment of papers meeting the review criteria. A descriptive overview, tabular and/or graphical summaries and a thematic analysis will be carried out on extracted data.Ethics and disseminationEthics approval was not required as the only data source was peer-reviewed documents. Outreach knowledge users who are members of the project team will participate in all aspects of study design, implementation and result dissemination strategies.

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DEVELOPMENT OF THE WORLD MARKET OF SERVICES IN TURBULENCE CONDITIONS AND CHANGES

International scientific journal Internauka ◽

10.25313/2520-2057-2020-18-6559 ◽

2017 ◽

Author(s):

Larysa Nosach ◽

◽

Victoria Morgun ◽

Keyword(s):

Economic Development ◽

International Trade ◽

Service Sector ◽

World Market ◽

Global Dimension ◽

Trade In Services ◽

Current State ◽

The World

The author's research of the current state and features of the development of the world market for services in conditions of turbulence of world processes was carried; the world leaders of the service sector in the global dimension and leaders of the most dynamic articles of service categories were identified; the share of world exports of services by countries by the level of their economic development was justified; weaknesses in the assessment of indicators of international trade in services were identified; the research is based on UNCTAD statistics.

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