scholarly journals The birth of British geriatric medicine and its struggle for survival as a medical specialty

2021 ◽  
Vol 51 (1) ◽  
pp. 184-191
Author(s):  
Alistair Ritch
Keyword(s):  
Geriatric Medicine ◽  
Medical Specialty

Geriatric Medicine

2019 ◽  
Author(s):  
Dan Furmedge
Keyword(s):  
Inner City ◽  
Nursing Care ◽  
Geriatric Medicine ◽  
Medical Specialty ◽  
Life Care ◽  
Acute Medical Unit ◽  
The United Kingdom ◽  
Co Morbidity ◽  
Hospital At Home ◽  
Medical Wards

Geriatric medicine is the largest ‘medical’ specialty in the United Kingdom, with the number of geriatricians expanding at a huge rate with significant demand. Pragmatic specialists in frailty and complex co- morbidity, the work of geriatricians reaches across geriatric medicine wards, the acute medical unit, emergency departments and acute frailty units, surgical wards, and tertiary medical wards and in the community from inner city London to rural Scotland. They can be found in residential and nursing care homes, rehabilitation teams, and hospital at home teams. Frailty, falls, delirium, dementia, continence, immobility, rehabilitation, polypharmacy, nutrition, end- of- life care, advanced care planning, com­munity medicine, and legal and ethical medicine are all core features of a geriatrician’s day. In this chapter, the questions give a taste of some of these concepts and will also demonstrate how geriatric medicine crosses almost every specialty.

Modelling In-Patient Bed Usage Behaviour in a Department of Geriatric Medicine

1993 ◽  
Vol 32 (01) ◽  
pp. 79-81 ◽  
Author(s):  
P. Millard ◽  
S. McClean
Keyword(s):  
Census Data ◽  
Geriatric Medicine ◽  
Temporal Trends ◽  
Exponential Model ◽  
Bed Occupancy ◽  
Lengths Of Stay ◽  
Geriatric Hospital ◽  
Using Data ◽  
Acute Patients

Abstract:The flow of patients through geriatric hospitals has been previously described in terms of acute and long-stay states where the bed occupancy at a census point is modelled by a mixed exponential model. Using data for sixteen years the model was fitted to successive annual census points, in order to provide a description of temporal trends. While the number of acute patients has remained fairly stable during the period, the model shows that there has been a decrease in the number of long-stay patients. Mean lengths of stay in our geriatric hospital before death or discharge have decreased during the study period for both acute and long-stay patients.Using these fits of the mixed exponential model to census data, a method is provided for predicting future turnover of patients. These predictions are reasonably good, except when the turnover patterns go through a period of flux in which assumption of stability no longer holds. Overall, a methodology is presented which relates census analysis to the behaviour of admission cohorts, thus producing a means of predicting future behaviour of patients and identifying where there is a change in patterns.

Organizational aspects of osteopathic care provision in a specialized clinic of Moscow

2018 ◽  
pp. 6-13
Author(s):  
D. E. Mokhov ◽  
M. Y. Gerasimenko ◽  
O. V. Yaschina ◽  
L. V. Tumbinskaya ◽  
E. S. Tregubova
Keyword(s):  
Quality Criteria ◽  
Medical Specialty ◽  
Organizational Analysis ◽  
Care Provision ◽  
Sources Of Information ◽  
Research Papers ◽  
Regulatory Documents ◽  
Methodological Approaches ◽  
Intensive Development ◽  
Osteopathic Physicians

Introduction. Nowadays osteopathy is an offi cial medical specialty. Many years of experience accumulated by osteopathic physicians in our country have proven its effectiveness. The analysis of research papers of those countries where osteopathy is widely used allows to draw the following conclusion: osteopathy is one of the least dangerous therapeutic methods provided that patients deal with well-trained and certifi ed specialists who work in the frame of possibilities of osteopathy. Due to the intensive development of this specialty in Russia it is necessary to provide scientifi c justifi cation to organizational and methodological approaches aimed at ensuring effective and high-quality osteopathic care to the population.Goal of research - to develop proposals in order to improve the quality and effectiveness of osteopathic care provision for the population, taking into account the current situation in health care.Materials and methods. Authors used the following research methods: historical and medico-organizational analysis, literary data analysis, content analysis as well as methods of descriptive statistics.Results. The research presents characteristics of clinics declaring osteopathic care provision, as well as qualities of osteopathic physicians. It also describes patients seeking osteopathic care, and sources of information they use.Conclusion. Authors propose a number of measures aimed at improving the availability and effectiveness of osteopathic care for patients such as training of doctors, creating of regulatory documents, developing quality criteria for osteopathic care provision and popularization of osteopathy among patients.

Survey on European postgraduate medical assessments by the Council for European Medical Specialty Assessments (UEMS-CESMA)

MedEdPublish ◽  
2014 ◽  
Author(s):  
John Boorman ◽  
Danny G.P. Mathysen ◽  
Julie-Lyn Noël ◽  
Konrad Bloch ◽  
Jean-Baptiste Rouffet ◽  
...  
Keyword(s):  
Medical Specialty

Variation in the management of Kawasaki disease

2019 ◽  
Vol 105 (10) ◽  
pp. 1004-1006 ◽  
Author(s):  
Audrey Dionne ◽  
David Burgner ◽  
Sarah De Ferranti ◽  
Davinder Singh-Grewal ◽  
Jane Newburger ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Initial Treatment ◽  
Coronary Aneurysm ◽  
Medical Specialty ◽  
Primary Treatment ◽  
Management Options ◽  
Necrosis Factor Alpha ◽  
Coronary Aneurysms ◽  
Factor Alpha ◽  
Collaborative Efforts

Intravenous immunoglobulin (IVIG) reduces coronary aneurysms in patients with Kawasaki disease (KD), but additional management options remain challenging, with no generalisable evidence-based recommendations. We performed a survey of 724 physicians from 73 countries to assess variation in practice. IVIG was the preferred initial treatment by 659 (91%) of respondents. Criteria for adjunctive primary treatment varied considerably and definitions of IVIG resistance varied markedly by geographical continent, Human Development Index tiers and medical specialty. A second dose of IVIG was used most often for patients with coronary aneurysm non-responsive to initial treatment (572, 79%), but corticosteroids (379, 52%) and tumour necrosis factor alpha inhibitors (208, 29%) were also frequently used. Our findings highlight the need for international collaborative efforts to optimise management of patients with KD worldwide.

scholarly journals Decreased Medical Care During the COVID-19 Pandemic – A Comprehensive Analysis of Radiological Examinations

2021 ◽  
Author(s):  
Annette Aigner ◽  
Bernd Hamm ◽  
Florian Nima Fleckenstein ◽  
Tazio Maleitzke ◽  
Georg Böning ◽  
...  
Keyword(s):  
Medical Care ◽  
Control Period ◽  
Surrogate Marker ◽  
Medical Specialty ◽  
Case Volume ◽  
Medical Specialties ◽  
Key Points ◽  
Depth Analysis ◽  
The Impact ◽  
Radiological Examinations

Objectives As a cross-section discipline within the hospital infrastructure, radiological departments might be able to provide important information regarding the impact of the COVID-19 pandemic on healthcare. The goal of this study was to quantify changes in medical care during the first wave of the pandemic using radiological examinations as a comprehensive surrogate marker and to determine potential future workload. Methods A retrospective analysis of all radiological examinations during the first wave of the pandemic was performed. The number of examinations was compared to time-matched control periods. Furthermore, an in-depth analysis of radiological examinations attributed to various medical specialties was conducted and postponed examinations were extrapolated to calculate additional workload in the near future. Results A total of 596,760 examinations were analyzed. Overall case volumes decreased by an average of 41 % during the shutdown compared to the control period. The most affected radiological modalities were sonography (–54 %), X-ray (–47 %) followed by MRI (–42 %). The most affected medical specialty was trauma and orthopedics (–60 % case volume) followed by general surgery (–49 %). Examination numbers increased during the post-shutdown period leading to a predicted additional workload of up to 22 %. Conclusion This study shows a marked decrease in radiological examinations in total and among several core medical specialties, indicating a significant reduction in medical care during the first COVID-19 shutdown. Key Points: Citation Format

scholarly journals Outcomes of non-COVID-19 critically ill patients during the COVID-19 pandemic

2021 ◽  
Author(s):  
Răzvan Bologheanu ◽  
Mathias Maleczek ◽  
Daniel Laxar ◽  
Oliver Kimberger
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Medical Specialty ◽  
Routine Care ◽  
Treatment Pathways ◽  
Icu Length Of Stay ◽  
Matched Study ◽  
The Impact

Summary Background Coronavirus disease 2019 (COVID-19) disrupts routine care and alters treatment pathways in every medical specialty, including intensive care medicine, which has been at the core of the pandemic response. The impact of the pandemic is inevitably not limited to patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and their outcomes; however, the impact of COVID-19 on intensive care has not yet been analyzed. Methods The objective of this propensity score-matched study was to compare the clinical outcomes of non-COVID-19 critically ill patients with the outcomes of prepandemic patients. Critically ill, non-COVID-19 patients admitted to the intensive care unit (ICU) during the first wave of the pandemic were matched with patients admitted in the previous year. Mortality, length of stay, and rate of readmission were compared between the two groups after matching. Results A total of 211 critically ill SARS-CoV‑2 negative patients admitted between 13 March 2020 and 16 May 2020 were matched to 211 controls, selected from a matching pool of 1421 eligible patients admitted to the ICU in 2019. After matching, the outcomes were not significantly different between the two groups: ICU mortality was 5.2% in 2019 and 8.5% in 2020, p = 0.248, while intrahospital mortality was 10.9% in 2019 and 14.2% in 2020, p = 0.378. The median ICU length of stay was similar in 2019: 4 days (IQR 2–6) compared to 2020: 4 days (IQR 2–7), p = 0.196. The rate of ICU readmission was 15.6% in 2019 and 10.9% in 2020, p = 0.344. Conclusion In this retrospective single center study, mortality, ICU length of stay, and rate of ICU readmission did not differ significantly between patients admitted to the ICU during the implementation of hospital-wide COVID-19 contingency planning and patients admitted to the ICU before the pandemic.

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