bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of a Modified 2-Rescuer Cardiopulmonary Resuscitation Technique Using a Bag-Mask for Less Experienced Health Care Providers: A Randomised Controlled Simulation Study
Authors: Shim Hw , Park So , Lee Yh , Yoo Yb , Hong Dy , Baek Kj , Lee Kr
Published: December 2017

Objective

To determine if a modified 2-rescuer cardiopulmonary resuscitation (CPR) method, in which the first rescuer performs chest compressions and squeezes the bag-mask during pauses in compression, and the second resuscitator uses 2 hands to provide an open airway, is useful for less experienced health-care providers (HCPs).

Methods

In this randomised control simulation study using a manikin, 82 less experienced HCPs were enrolled. After training on the conventional 2-rescuer CPR method (CM) (n=42) and the modified 2-rescuer CPR method (MM) (n=42), each participant performed 2-rescuer CPR for 5 cycles using their respective methods. All data were recorded in a personal computer and then analysed.

Results

The MM group generated a higher mean tidal volume (TV) (675.2 mL versus 320.0 mL for the CM) and higher median numbers of ventilation with the correct TV over 5 cycles (7 versus 3 breaths for the CM) (all p<0.001). However, there was no significant difference in the quality of chest compression and related interruption between the CM and MM groups. However, relatively higher median number of ventilations with large TV (2 versus 0 breaths for the CM) and higher median number of ventilations (3 versus 0 breaths for the CM) over 5 cycles were delivered in the MM group (all p<0.001).

Conclusions

Modified 2-rescuer CPR method (the first rescuer performs chest compressions and squeezes the bag-mask during pauses in compression, and the second resuscitator uses 2 hands to provide an open airway) can be useful as an alternative CPR method and is preferable to the conventional 2-rescuer CPR method for less experienced health-care providers. (Hong Kong j.emerg.med. 2015;22:23-30)
Supraglottic Foreign Body Aspiration: Delayed Diagnosis and Lesson Learnt
Authors: Maryam Mf , Rusydi W , Jaafar Mj , Goh Bs
Published: December 2017

Foreign body aspiration is a clinical emergency requiring prompt action to ensure speedy recovery and minimise complications. Foreign body aspiration is common among children below 3 years old but sometimes there is significant delay until the diagnosis is made. Clinical diagnosis requires a high degree of suspicion in the medical history, especially when the choking event is unclear in the history as physical examination and radiological findings have a low sensitivity. Herein, we present a case of 8-month-old baby boy who presented with dysphonia in which the diagnosis of foreign body aspiration was missed during the first consultation. (Hong Kong j.emerg.med. 2015;22:57-59)
Intravenous Lipid Emulsion as Antidote: Experience in Hong Kong
Authors: Tse Cw , Chan Yc , Lau Fl
Published: December 2017

Objective

Intravenous lipid emulsion (ILE) is an emerging therapy in the field of toxicology. The purpose of this study was to report the accumulated local experience on using ILE in the management of patients suffering from poisoning by pharmaceutical agents other than local anaesthetics.

Design

Case series.

Setting

Local poison information centre.

Methods

Ten patients were identified from the database of Hong Kong Poison Information Centre. The patients were managed in 6 Hong Kong public hospitals during a 4-year study period (July 2008-June 2012).

Results

Nine of them presented with drug-induced cardiotoxicity, defined as either cardiac arrest (n=3) or hypotension refractory to other treatments (n=6). The overall survival rate is 30%. Possible adverse events from ILE included mild derangement of liver function, elevated amylase and hyperlipidaemia were observed.

Conclusions

About 30% of severe poison-induced cardiotoxicity treated with ILE can survive with no major adverse effects. The use of ILE remains to be a treatment option for lipid-soluble drug induced severe toxicity not responsive to standard resuscitation measures. (Hong Kong j. emerg.med. 2015;22:100-107)
Left Ventricular Noncompaction Associated with Wolf-Parkinson-White Syndrome and Acute Heart Failure in Two Adult Patients
Authors: Alonso Jv , López Ma , Garcia Jp , Ruiz Dj López , Navarro C
Published: December 2017

Left ventricular noncompaction is a relatively newly defined disorder of the endomyocardium characterized by prominent ventricular trabeculations and deep intertrabecular recesses. It is important that clinician can recognise and differentiate this condition from other forms of cardiomyopathy as treatment and prognosis may differ significantly. We report two cases of left ventricular non-compaction in the emergency department with different forms of presentations. (Hong Kong j.emerg.med. 2015;22:108-112)
Isolated Traumatic Duodenal Rupture Due to Bicycle Handlebar Injury in an Adult Patient
Authors: Wang Ay , Lin Th , Chen Sc
Published: December 2017

Because of the well-developed abdominal musculature, the possibility of injury of the retroperitoneal organs such as the duodenum is not as high as that in children. Adult cases of isolated traumatic duodenal rupture caused by bicycle handlebar injury are extremely rare. We report a patient who experienced persistent abdominal pain after having a bicycle handlebar injury. Since the injury is hard to identify, abdominal computed tomography is performed to confirm the diagnosis. We also present a management flow chart to help physicians managing handlebar injuries in adults. (Hong Kong j.emerg.med. 2015;22:113-117)
Pneumoperitoneum after Cardiopulmonary Resuscitation: The Roles of Bystander-Provided BLS and Laryngeal Mask Airway
Authors: Tsai Cwc , Lin Hj , Chen Kt
Published: December 2017

We present a case of post-resuscitative pneumoperitoneum following bystander cardiopulmonary resuscitation and artificial ventilation via a laryngeal mask airway. Artificial ventilation can result in gastric distention and contribute to subsequent gastric perforation. Among the various approaches to ventilating patients in respiratory failure, mouth-to-mouth and bag-valve-mask are much more likely to cause gastric inflation than ventilating with a laryngeal mask airway. Abdominal distention, haematemesis, and bloody gastric aspiration are common manifestations of post-resuscitative gastric perforation in which pneumoperitoneum is discovered in the majority of these patients by a roentgenogram of the chest after successful resuscitation. (Hong Kong j.emerg.med. 2015;22:126-129)
Clinical use of Serial Mean Platelet Volume Measurement for Diagnosis of Non-ST Segment Elevation Myocardial Infarction in Patients Visiting Emergency Department with Acute Chest Pain
Authors: özcan Ks , Ekmekçi A , Güngör B , şener S , Osmonov D , Altay S , Aruğraslan E , çinar T , Sayar N , Orhan Al , Eren M
Published: December 2017

Objective

We aim to demonstrate diagnostic accuracy of serial MPV measuring and to assess its correlation with cardiac troponin I (cTnI) levels.

Design

Cross-sectional study.

Methods

Consecutive patients presenting to emergency department with new onset chest pain started in the last four hours without electrocardiographic ST segment and T wave changes, pathological q waves were included in study. Complete blood count and cTnI levels were studied on admission and six hours after presentation. Patients with cTnI levels higher than 0.06 ng/ml were diagnosed as non-ST elevation myocardial infarction (NSTEMI) and other patients were matched as the control group.

Results

NSTEMI group had significantly higher levels of MPV on admission and at the sixth hour. The increase in MPV was corraleted with elevation of cTnI levels. At six hours follow up, the increase in MPV levels predicted myocardial ischaemia (corrected r2=0.36; p=0.001) in linear regression analysis. The corresponding area under the receiver operating characteristic curve (ROC) for admission MPV, sixth hour MPV and increase in MPV levels in predicting myocardial ischaemia in patients with increased cTnI were 0.652, 0.727 and 0.896 respectively. If MPV threshold was selected as ≥0.10 fL during follow up, myocardial ischaemia was predicted with a sensitivity of 75% and specificity of 88%.

Conclusions

Elevation of MPV levels in patients with acute chest pain may be an indicator of myocardial ischaemia. Serial MPV measurement can be used to complement serial cTnI measurements to diagnose NSTEMI.
Early Detection of a Rare Case: Idiopathic Spontaneous Superior Mesenteric Artery Dissection, by Duplex Ultrasonography
Authors: Chang Cj , Hsieh Th , Fan Cm , Lin Ms , Huang Cc , Sun Jt
Published: December 2017

Spontaneous dissection of the superior mesenteric artery (SMA) without involvement of the aorta is an extremely rare condition. It could be a surgical emergency because ischaemic intestine due to artery occlusion is life-threatening and the prognosis is time-dependent. We present a 55-year-old man with a 5-day history of progressive abdominal pain. He had a negative laboratory work-up and pan-endoscopy showed multiple gastric ulcers. Despite treatment, he had persistent severe epigastric pain disproportionate to physical findings. Bedside duplex ultrasonography revealed the absence of color signal in the proximal SMA. Angiography confirmed the diagnosis of SMA dissection. Mesenteric vascular emergency including arterial dissection should be taken into consideration in patients who present with severe abdominal pain of unknown origin. Abdominal bruit may be the only vital clue but is usually difficult in the noisy emergency department. Duplex ultrasonography can be helpful to detect blood flow abnormality whenever in doubt. (Hong Kong j. emerg.med. 2015;22:189-193)
The use of the Airtraq® in Awake Tracheal Intubation: A Case Series
Authors: Tai FMT , Ho YL , Cheng BCP , Mui KSY , Chan MTV , Wong OF
Published: December 2017

Objective

To report the clinical experience in using the Airtraq® in awake tracheal intubation in patients with known or potential difficult airway, or unstable cervical spine.

Methods

Case series study. Twenty patients with known or potential difficult airway, or unstable cervical spine who underwent elective operations and might require awake fibreoptic intubation were recruited. After standardised topical anaesthesia of the airway, awake intubation was performed using the Airtraq®. The duration of the intubation procedure, the intubation difficulty scale (IDS), the rate of successful placement of endotracheal tube and patient's satisfaction were recorded.

Results

Fifteen out of the twenty patients were successfully intubated with the Airtraq® under awake condition leading to an overall success rate of 75%. Eleven of them were intubated in the first attempt. The mean duration of intubation was 1 min 33 s. Concerning the degree of difficulty of intubation using the Airtraq®, as evaluated with the IDS, 20% was ranked as easy and 80% was slightly difficult. Excessive secretion, patient gagging, inability to cooperate and inadequate view of larynx were the major reasons of failed intubation. Eighty percent of the patients considered the intubating procedure with the Airtraq® under awake condition acceptable. In general, patients felt mild pain and discomfort and were satisfied with the intubation process.

Conclusion

Airtraq® may be a useful alternative of flexible bronchoscope for awake intubation with low rate of minor complications in the elective operation setting. (Hong Kong j.emerg.med. 2015;22:248‐255)
Orbital Emphysema and Orbital Floor Fracture following a Severe and Prolonged Sneezing Attack
Authors: Yilmaz F , Özlem M , Aslan Ö , Yel C
Published: December 2017

We present here a rare case of barotraumatic orbital blowout fracture. An 18‐year‐old man with sudden swelling of the right orbital region after severe and prolonged sneezing attack presented to our emergency department. Computed tomographic examination demonstrated a blowout fracture of the right orbital floor, which led to orbital emphysema and herniation of the orbital soft tissue. He was managed with nasal decongestants, steroids, anti‐inflammatory drugs and an antibiotic. He developed no visual disturbance subsequently. (Hong Kong j.emerg.med. 2015;22:256‐258)
The Academic Contribution of Emergency Departments in Taiwan: Data on Scientific Publications, 1992‐2011
Authors: Lee CH , Chaou CH
Published: December 2017

Introduction

This study aimed to evaluate the academic contribution of emergency departments (EDs) in Taiwan by analysing scientific publications during the past 20 years.

Methods

This was an observational study. All data were collected from the 2010 Journal Citation Reports (JCR) and the SciVerse Scopus database. Three groups of publications were enrolled: (1) publications from Taiwan EDs in emergency medicine (EM) journals; (2) publications from Taiwan EDs in non‐EM journals; (3) publications from Taiwan who were not affiliated with EDs in EM journals. We collected data regarding the name and category of the journal, the publication year, the publication type, and the number of citations for further analysis.

Results

A total of 475 publications affiliated with Taiwan EDs appeared in EM journals and 735 appeared in non‐EM journals. A total of 389 publications in EM journals affiliated with departments other than EM. The number of publications showed an increasing trend (all p‐value <0.001). The number of publications from Taiwan EDs in EM and non‐EM journals changed in opposite directions since 2008. Researches from Taiwan EDs were published in 68 categories of journals in addition to EM. Publications in non‐EM journals were more frequently cited than were the publications in EM journals.

conclusions

During the past 20 years, the academic contribution of EDs in Taiwan has increased substantially. The bidirectional change in publication numbers since 2008 constitutes a milestone in the development of EM in Taiwan, and improvements are evident in the quality, quantity, and breadth of research. (Hong Kong j.emerg.med. 2016;23:28‐34)
Does the Bed Frame Deflection Occur along with Mattress Deflection during In‐Hospital Cardiopulmonary Resuscitation? an Experiment Using Mechanical Devices
Authors: Oh JH , Kim CW , Kim SE , Lee DH
Published: December 2017

Objectives

When we perform chest compression on a patient on a bed, the mattress and bed frame can be depressed together with the patient's chest. This study was conducted to assess whether bed frame deflection occurred during chest compressions.

Methods

We designed a firm bed (“bed like the ground,” BLG) to assess the bed frame deflection in the Stryker Trauma Stretcher (STS) and the ER stretcher cart (ER‐SC). The STS included a soft mattress and the ER‐SC a hard mattress. We performed 50 continuous chest compressions on the Resusci Anne Skill Reporter with CPRmeter in each experiment. The experiments were done in four settings. Test 1 included the BLG; test 2 included a mattress and backboard on each bed; test 3 included the mattress of each bed and a backboard on the BLG; and test 4 included the mattress of each bed on the BLG. We calculated the mattress and bed frame deflections using the gaps of compression depths between the values measured by Resusci Anne and CPRmeter.

Results

The mattress deflections of the STS and ER‐SC mattress were determined to be 11.2 and 0.67 mm, respectively. The bed frame deflection for the STS and ER‐SC were 0.95 and 5.17 mm, respectively.

Conclusion

The study confirms that bed frame deflection will occur when we perform chest compressions on the manikin lying on a bed. Additionally, the bed frame deflections differ depending on the type of bed. (Hong Kong j.emerg.med. 2016;23:35‐41)
Efficacy of Early Noninvasive Ventilation in Three Cases of Nonfatal Drowning with Pulmonary Oedema in the Paediatric Emergency Department
Authors: Çağlar A , Er A , Özden Ö , Karaarslan U , Akgul F , Koroğlu TF , Duman M
Published: December 2017

Drowning is still one of the most important causes of the preventable mortality worldwide. Some patients should be treated with noninvasive ventilation immediately in the emergency department (ED). The practice of noninvasive ventilation has been increased recently in the paediatric ED. We present here three nonfatal drowning patients with pulmonary oedema and hypoxia who were successfully treated with noninvasive ventilation in the paediatric emergency department. All of the patients had aspirated sea water during swimming. In addition, two of the patients had aspirated water during snorkeling. Noninvasive ventilation was applied to the patients immediately in paediatric emergency service. All of the patient's clinical and radiological findings recovered rapidly. There are limited reports about use of noninvasive ventilation in nonfatal drowning cases in the paediatric emergency department. We emphasize that the early application of noninvasive ventilation should be a preventive method for reducing the morbidity of nonfatal drowning cases. (Hong Kong j.emerg.med. 2016;23:42‐46)
A Case of Pyrethroid Poisoning with Clinical Presentation Mimicking Organophosphate Poisoning
Authors: Cham EYK , Tse JCL , Chong YK , Chen ML , Wong OF , Fung HT
Published: December 2017

We report an 89‐year‐old retired farmer with prolonged bradycardia and hypotension after pyrethroid insecticides ingestion in a suicidal attempt. This patient also had a clinical manifestation mimicking organophosphate poisoning, included confusion, lacrimation and salivation. He required intensive care support, atropine and inotrope infusions treatments. Only metabolites of synthetic pyrethroid insecticides (3‐phenoxybenzoic acid and 3‐phenoxybenzaldehyde) were detected in the urine sample. In the serum toxicology screening, specific analysis for organophosphate pesticides was negative. He eventually recovered without major sequela. (Hong Kong j.emerg.med. 2016;23:47‐51)
Ischaemic Lumbosacral Plexopathy following an Acute Thrombosed Abdominal Aortic Aneurysm Mimicking Stroke: A Case Report
Authors: Yun S
Published: December 2017

Neuropathy is a disease affecting the nerves that can be caused by infectious, ischaemic, or autoimmune disease. Aortic thrombosis may develop neurologic symptoms; however, when unilateral paraplegia is the first main symptom, it could be misinterpreted as a neuropathy. An 82‐year‐old man with a history of intracranial haemorrhage complained of motor weakness in the right lower extremity. Magnetic resonance imaging did not show any evidence of cerebral infarction or haemorrhage. A subsequent computed tomography angiogram confirmed the diagnosis of an acutely thrombosed abdominal aortic aneurysm and revealed thrombosed common, internal and external iliac arteries bilaterally including the left femoral artery. Aortobifemoral bypass surgery with open thrombectomy was performed. The patient recovered successfully despite a tendency for bleeding due to the use of anticoagulants. In conclusion, this is a rare case with the initial predominant presentation being painless unilateral paraplegia mimicking stroke. (Hong Kong j.emerg. med. 2016;23:52‐56)
A Runny Nose: Rhinitis or Rhinorrhoea?
Authors: Simsek G , Kozan E , Guneysel O
Published: December 2017

Rhinitis, whether allergic, infectious, or due to another aetiology, is an exceedingly common symptom in the population. Cerebrospinal fluid (CSF) rhinorrhoea occurs when there is a fistula between the dura and the skull base with discharge of CSF from the nose. Spontaneous CSF rhinorrhoea should be considered in the differential diagnosis of persistent nasal discharge called ‘runny nose’. We describe one case of CSF rhinorrhoea occurring in association with allergic rhinitis and sinusitis. A 46‐year‐old, obese female presented with a 1‐week history of bilateral clear nasal discharge, undocumented fever, and postural headache. She described her nasal discharge as watery, and just like flows from the tap. A collected sample of her nasal discharge was tested for glucose and protein. CSF rhinorrhoea was considered as the primary diagnosis. Despite the whole work up, the origin of the CSF fistula could not be identified. She was discharged well for close follow up with no clinical sequelae. (Hong Kong j.emerg.med. 2016;23:57‐60)
Clinical Practice and Risk Factors for Immediate Complications of Endotracheal Intubation by Intensive Care Unit Doctors in a Regional Hospital in Hong Kong
Authors: Cham EYK , Wong OF , Yip KH
Published: December 2017

Background

Endotracheal intubation in critically ill patients is often challenging and is associated with a high complication rate. Intensive Care Unit (ICU) doctors are often responsible for emergency intubation but local data about their experience is lacking.

Objective

To describe the ICU team's practice of endotracheal intubation in critically ill patients in a regional hospital; to evaluate the incidence of immediate complications; and to identify risk factors for complications and predictors for successful intubation.

Design

Retrospective, observational study

Patients

All patients who received endotracheal intubation by the ICU team of the study centre between the 1st July 2013 and 31st December 2013.

Results

Complete data from 325 endotracheal intubations were analyzed. The commonest diagnosis was pneumonia (41.5%) and the mostly frequently cited indication for endotracheal intubation was respiratory failure (50.8%). Complications occurred in 25.5% of all intubations including 4 cases of cardiac arrest after the procedure. Haemodynamic alterations (hypotension and hypertension occurred in 9.2% and 7.4% respectively) were the most common complications. Overall, 96.6% of intubations were successful on the first two attempts. Logistic regression analyses showed that reduced mouth opening was a significant risk factor for immediate complications (odds ratio [OR] 15.98, 95% confidence interval [CI]: 2.71 to 94.41, P=0.006). Cormack-Lehane laryngoscope grading below 2b (OR 0.2, 95% CI: 0.07-0.59, P=0.003) and operator with more than 6 months of formal anaesthetic training (OR 7.06, 95% CI: 1.63 to 30.62, P=0.009) were independent predictors for successful intubation.

Conclusion

The ICU team achieves a high successful rate of emergency endotracheal intubation. High rates of anticipated and unanticipated difficult airway are encountered. Reduced mouth opening is a significant risk factor for complications occurrence. Cormack-Lehane laryngoscopic grading below 2b and intubation performer with more than 6 months of formal anaesthetic training are significant independent predictors for successful intubation. (Hong Kong j.emerg.med. 2016;23:135-144)
The Effect of Telephone Advice on Cardiopulmonary Resuscitation (CPR) on the Rate of Bystander CPR in Out-of-Hospital Cardiopulmonary Arrest in a Typical Urban Area
Authors: Moriwaki Y , Tahara Y , Kosuge T , Suzuki N
Published: December 2017

Introduction

The frequency of telephone advice for cardiopulmonary resuscitation (T-CPR) and its effect are unclear. We have few data concerning how many persons who are willing to perform CPR under the setting of the T-CPR system. Most of these data were from action reports in the pre-hospital EMS records. Methods: This study was a population-based observational case series of out-of-hospital cardiopulmonary arrest (OHCPA). The primary outcome was the acceptability of a bystander to perform CPR according to T-CPR. In our emergency department, one medical doctor interviewed the bystanders regarding T-CPR and CPR; this doctor was devoted to obtaining information from the patients.

Results

Of the 803 patients in, T-CPR advice was provided in 47% and CPR was actually performed in 47% independent of T-CPR guidance. Of the 373 cases in which lay persons received T-CPR, 95% provided CPR. Dispatchers could more easily provide T-CPR to family members compared with friends and passengers. Twenty-one percent of callers made emergency calls after consulting with others (indirect call). In non-traumatic victims who underwent bystander CPR, 43% experienced the return of spontaneous circulation, and 5% were discharged with a mild disorder or no neurological abnormality.

Conclusions

We conclude that 95% of bystanders are willing to perform CPR under the T-CPR system, but we cannot conclude that bystander CPR may not affect the survival rate. These findings indicate that bystanders should be guided with T-CPR. (Hong Kong j.emerg. med. 2016;23:220-226)
Case Report: Unusual Radiation Risks in the Emergency Department –125I beads
Authors: Kang HM , Seth P , Ponampalam R , Somanesan S
Published: December 2017

The use of radioactive substances in medicine accounts for the largest radiation exposure to the population from non‐natural sources worldwide. The use in healthcare confers many benefits, but inappropriate or unskilled use can result in health hazards and safety issues for both patients and healthcare workers. We present two cases of radiation safety issues related to patients presenting to our emergency department after receiving non‐conventional brachytherapy in the form of radiation seeds being implanted in the abdominal wall. These were done for presumed treatment of metastatic cancer in another Asian country. We share our cases to all emergency department staff to heighten their alertness for potential exposure to radiation from patients with radionuclides.
The 100 Top-Cited Articles Published in Emergency Medicine Journals: A Bibliometric Analysis
Authors: Shao JF , Zheng XT
Published: December 2017

Background

The number of citations that an article has received can reflect its importance in a specialty. The purpose of this study was to analyse the characteristics of top-cited articles published in 24 emergency medicine (EM) journals in the Thomson Reuters Web of Science (WoS).

Method

WoS were used to identify the 100 top-cited articles published in EM journals. Basic information, including title, authors, country of origin (based on the first author), institution, publication year, journal name, language, document type, citation times and impact factor, was collected and analysed.

Results

The 100 top-cited articles in EM journals, cited from 175 to 530 times, were published between 1979 and 2010, with most articles published between 2001 and 2005. All articles were written in English, and the United States contributed the most. The articles were distributed in seven different EM journals, led by Annals of Emergency Medicine with 45 articles. Resuscitation medicine was the most discussed topic.

Conclusion

The bibliometric analysis on the 100 top-cited articles in EM journals from WoS demonstrates some significant points, which can have important implications for researchers in evaluating and orienting their research.
Benefits of Visual Feedback on Cardiopulmonary Resuscitation Training: A Non‐Randomised Manikin Study with Bystanders
Authors: Abelairas‐Gómez C , Gili‐Roig C , López‐García S , Palacios‐Aguilar J , Romo‐Pérez V , Barcala‐Furelos R
Published: December 2017

Introduction

Cardiopulmonary resuscitation (CPR) is vital for the survival of people who has suffered a cardiac arrest. In order to achieve a good quality CPR performance, rescuer needs a good training which could be gotten with the use of feedback devices. The aim of this study was to compare the use of visual feedback device in CPR training to learning without feedback.

Methods

Ninety‐nine subjects without basic life support knowledge participating in the study were divided into three groups. All of them carried out two tests: 2 minutes of CPR with compressions and ventilations. First two groups received trainings on CPR between the tests (experimental groups): one group with instructor‐led training and the other one with visual feedback device. The third group did not receive any training between the tests (control group).

Results

In the first test no differences among the three groups were found. The experimental groups improved their scores in the last test. The number of correct chest compressions by hand position and depth, and the number of correct rescue breaths was increased. The experimental group with visual feedback CPR training achieved better scores of quality CPR in the second test than the instructor‐led training group.

Conclusions

The visual feedback and instruction‐led training have positive effects on the quality CPR. The use of visual feedback during learning has greater benefits than instruction‐led training in the three variables analysed.
Spirituality and religious education: Reflecting on teacher practice
Authors: Madden Rina
Published: December 2017

Young people today embrace the freedom and responsibility for constructing their identity and beliefs. In Catholic schools these young people from diverse cultures and experiences come together and are able to express a myriad of views, seeking to understand themselves, others and the spirituality that lies at the heart of religious expression. Religious educators in Catholic schools encounter those who are spiritually attuned, have no spiritual awareness or have different spiritual expressions that may or may not relate to religious affiliation. Befriending this diversity creates a context for rich dialogue that can open up questions of meaning, identity, faith and spirituality. This article explores data from interviews with teachers of religious education at three Catholic primary schools in the Archdiocese of Melbourne who deal with this context every day. I gather their reflections around six themes that emerged: spirituality as relationship with God, as connection to tradition, compassion, wellbeing, curiosity and innocence. I share what’s working well in their practice and I identify three areas of focus for ongoing teacher professional learning in religious education and spiritual development: intentionality, diversity and complexity.
The search for Baptist saints
Authors: Rees Frank D.
Published: December 2017

This article reports on a project of the Commission on Baptist Doctrine and Christian Unity, within the Baptist World Alliance, to identify Baptist saints. The project seeks to apply the methodology proposed by James McClendon’s Biography as Theology. The article situates the search for Baptist saints within the growing interest of Baptist scholars in a ‘Baptist catholicity’, specifically relating it to the priesthood of all the faithful. The methodology drawn from McClendon’s work is outlined in some detail, focusing the study upon the convictions which give character to particular lives. Brief summaries are then presented of papers already received, offering examples from Germany, India, Jamaica and then a more detailed example from Australia. This example seeks also to demonstrate both the methodology and its application to a particular instance, Rev. Ron Ham, an Australian Baptist pastor. The article proposes that his life was shaped by the conviction that we live in God’s world with God’s people, and draws implications from this study for Baptist doctrine and for Christian unity.
Infectious necrotic hepatitis caused by Clostridium novyi type B in a horse: case report and review of the literature
Authors: Nyaoke Akinyi C. , Navarro Mauricio A. , Beingesser Juliann , Uzal Francisco A.
Published: December 2017

A 14-y-old bay Quarter Horse gelding was presented with progressive neurologic signs, elevated rectal temperature, and icterus for 3 d prior to death. Postmortem examination revealed icterus, large amounts of serosanguineous fluid in the abdominal cavity, widespread petechiae and ecchymoses in several organs, and a large, pale, and well-demarcated focus of necrosis in the liver. Histologically, there was coagulative necrosis surrounded by a rim of inflammatory cells and large numbers of gram-positive rods, which were identified as Clostridium novyi by immunohistochemistry. Liver samples tested by PCR were positive for C. novyi type B flagellin and alpha toxin genes, but negative for Clostridium haemolyticum and other clostridia. Based on postmortem findings and ancillary tests, a definitive diagnosis of infectious necrotic hepatitis (INH) was made. Mostly a disease of ruminants, also known as black disease, INH has rarely been reported in horses, and a definitive etiologic diagnosis has not been achieved previously; the etiology of all cases reported to date was identified as C. novyi but the type was not determined. Animals are predisposed to clostridial hepatitis when hepatic anaerobiosis is established. Such conditions allow germination and proliferation of bacterial spores, resulting in production and release of toxins. INH, caused by C. novyi type B, and bacillary hemoglobinuria, caused by C. haemolyticum, are mechanistically and pathologically almost indistinguishable. Because these 2 microorganisms are closely related, differentiation requires molecular tools.
Combining Accreditation and Education: An Interdisciplinary Public Health Law Course
Authors: Berman Micah L.
Published: December 2017

This article discusses an interdisciplinary and community-engaged public health law course that was developed as part of The Future of Public Health Law Education faculty fellowship program. Law and public health students worked collaboratively to assist a local health department in preparing for the law-related aspects of Public Health Accreditation Board review.
Promoting Diversity in Public Health Law through Online Education
Authors: Boies Kimberly Cogdell
Published: December 2017

This fellowship project addressed the need to increase diversity in public health law. Non-traditional delivery methods of education, such as synchronous online classes and offering courses during an intersession between regular semesters and in the evenings, expanded the opportunities for diverse students to learn about the field and have meaningful internship experiences in public health law. Synchronous distance education is the wave of the future for law teaching and has particular significance in the teaching of public health law.
Educating the New Public Health Law Professional
Authors: Davis Sarah
Published: December 2017

This article outlines the author's experience designing and implementing an asynchronous online course. Designed as a complement to public health law externships at any location, the course addresses professionalism and strategic lawyering. The article further describes the author's fellowship journey, which emboldened her view that faculty must attempt to live the expectations we have for our students, and also declare our professional values, especially when teaching about policymaking which is fraught with values conflicts. It concludes with a call for others to pilot innovative teaching approaches to address both the crisis in legal education and pressing societal issues, thereby contributing to the health of our legal community.
Teaching Population Health Outcomes Research, Advocacy, and the Population Health Perspective in Public Health Law
Authors: Gatter Robert
Published: December 2017

The goal of this project was to expand an existing public health law curriculum to incorporate lessons on population health outcomes research, extra-legal advocacy, and the population health perspective. The project also created opportunities for students not only to read about and discuss concepts, but also to employ the lessons more practically through exercises and by writing white papers on public health law reform topics relevant to population health in Missouri. To do this, the project expanded an existing didactic course and created a new credit-bearing, experiential “Lab.”
Best Practices for Teaching Public Health Law: Two Online Resource Libraries
Authors: Kershner Stacie P.
Published: December 2017

Georgia State University College of Law, through the Center for Law, Health & Society, developed a pair of online libraries for faculty teaching public health law in schools of law or public health. Development of these libraries was funded by a grant from the Robert Wood Johnson Foundation as part of The Future of Public Health Law Education: Faculty Fellowship Program. This article describes the goals of the program addressed by the libraries, the development process, the resources included, and how faculty may benefit from the materials and provide materials benefitting other faculty across the country.
Infants with Trisomy 18 and Complex Congenital Heart Defects Should Not Undergo Open Heart Surgery
Authors: Graham Eric M.
Published: December 2017

Aggressive medical and surgical interventions have not been clearly demonstrated to improve survival in neonates with trisomy 18; there are no data that demonstrates improved quality of life for these children after these interventions; and these interventions are clearly associated with significant morbidity, resource allocation, and cost.
Ethical and Legal Challenges Associated with Public Molecular Autopsies
Authors: Moore Quianta L. , Majumder Mary A. , Rutherford Lindsey K. , McGuire Amy L.
Published: December 2017

There is a national movement supporting the retention and use of bio-specimens from deceased individuals for the purpose of genetic testing. This manuscript discusses the significance of postmortem genetic testing in the context of death determination by medical examiners (i.e., public molecular autopsies). We highlight distinctive concerns that are raised in the areas of consent, confidentiality, and return of results when genetic testing is performed as part of a public molecular autopsy. We believe our manuscript will contribute to the development of a robust ethical and legal framework for genetic testing in this context.
The End of the HIPAA Privacy Rule?
Authors: Rothstein Mark A.
Published: December 2017

The HIPAA Privacy Rule is notoriously weak because of its incomplete coverage, numerous exclusions and exemptions, and limited rights for individuals. The three areas in which it provides the most protection are fundraising, marketing, and research. Provisions of the 21st Century Cures Act, pending in Congress, and the Notice of Proposed Rulemaking to amend the federal research regulations (Common Rule), awaiting final regulatory action, would weaken the privacy protections for research. If these measures are adopted, the HIPAA Privacy Rule would have so little value that it might not be worth the aggravation and burden.
Minding Ps and Qs: The Political and Policy Questions Framing Health Care Spending
Authors: Sage William M.
Published: December 2017

Tracing the evolution of political conversations about health care spending and their relationship to the formation of policy is a valuable exercise. Health care spending is about science and ethics, markets and government, freedom and community. By the late 1980s the unique upward trajectory of post-Medicare U.S. health care spending had been established, recessions and tax cuts were eroding federal and state budgets, and efforts to harness market forces to serve policy goals were accelerating. From the initial writings on “managed competition,” through the failed Clinton health reform effort in the early 1990s, to the passage of the Affordable Care Act in 2010, the policy narrative of health spending acquired a superficial consistency. On closer examination, however, it becomes apparent that the cost problem has been repeatedly reframed in political discourse even during this relatively brief period. The clearest transition has been from a narrative centered on rationing necessary care to one committed to reducing wasteful care – although the role of accumulated law and regulation in perpetuating waste remains largely unrecognized and the recently articulated commitment to population health seems an imperfect proxy for explicitly developing social solidarity with respect to health and health care in the United States.
Moving to the Next Phase of Reform
Authors: Butler Stuart M.
Published: December 2017

Better health requires sectors like housing and education, and healthcare, to collaborate. That needs three strategies. Make full use of waivers to foster experimentation. Use techniques to encourage agencies at all levels to work together. And use new incentives to foster local partnerships.
Gender-Based Violence Among HIV-Positive Women in Kazakhstan: Prevalence, Types, and Associated Risk and Protective Factors
Authors: Jiwatram-Negrón Tina , El-Bassel Nabila , Primbetova Sholpan , Terlikbayeva Assel
Published: December 2017

This article examines the prevalence and associated multilevel risk and protective factors of intimate and nonintimate partner violence among a sample of 249 HIV-positive women in Kazakhstan. We found high prevalence of both lifetime intimate partner violence (52%) and nonintimate partner violence (30%). Together, nearly 60% experienced at least one incident of violence by either an intimate or nonintimate partner (gender-based violence [GBV]). In the multivariate analyses, we found associations between several individual, interpersonal, and socio-structural risk factors and GBV. Findings provide direction for practice, policy, and future research to address the intersection of GBV and HIV in Kazakhstan.
Increased cerebrospinal fluid albumin and immunoglobulin A fractions forecast cortical atrophy and longitudinal functional deterioration in relapsing-remitting multiple sclerosis
Authors: Kroth Julia , Ciolac Dumitru , Fleischer Vinzenz , Koirala Nabin , Krämer Julia , Muthuraman Muthuraman , Luessi Felix , Bittner Stefan , Gonzalez-Escamilla Gabriel , Zipp Frauke , Meuth Sven G. , Groppa Sergiu
Published: December 2017

Background:

Currently, no unequivocal predictors of disease evolution exist in patients with multiple sclerosis (MS). Cortical atrophy measurements are, however, closely associated with cumulative disability.

Objective:

Here, we aim to forecast longitudinal magnetic resonance imaging (MRI)-driven cortical atrophy and clinical disability from cerebrospinal fluid (CSF) markers.

Methods:

We analyzed CSF fractions of albumin and immunoglobulins (Ig) A, G, and M and their CSF to serum quotients.

Results:

Widespread atrophy was highly associated with increased baseline CSF concentrations and quotients of albumin and IgA. Patients with increased CSFIgA and CSFIgM showed higher functional disability at follow-up.

Conclusion:

CSF markers of blood–brain barrier integrity and specific immune response forecast emerging gray matter pathology and disease progression in MS.
Technological Citizenship: Perspectives in the Recent Work of Manuel Castells and Paul Virilio
Authors: Stevenson Nick
Published: December 2017

This article draws out the different models of technological citizenship that are available in the writing of Castells and Virilio. Particular attention is paid to the importance of local ecological struggles against the imperatives of technological capitalism. However both Castells and Virilio contain strengths and weaknesses in this respect. Whereas Castells emphasises the contested nature of modernity, Virilio emphasis the dominance of technological reason over the life-world. Further both agree that the defence of local space has a key role to play in the construction of alternative citizenships. In contrast I argue that there can be no local solutions to global problems. Here I look at a number of cosmopolitan perspectives and argue that the claims of justice, sustainability and democracy requires new global institutions. However the blind spot in the cosmopolitan argument remains a top down approach to politics and imperviousness as to how to link radical politics to the contours of everyday life.
People with dementia, contributing to learning and teaching in higher education: Innovative practice
Authors: Russell Christopher William
Published: December 2017

Patients and service users have a well-established role in teaching and learning on professional qualifying programmes such as such as social work and nursing. However, the role of people with dementia in contributing to educational initiatives at higher educational level remains under explored. Four people with dementia were recruited as Expert by Lived Experience Tutors for the Foundation Degree in Dementia Studies at a University in the United Kingdom. They met students regularly to support their learning. We were interested in researching whether and how this enhanced the ability of students to enable people to live well with dementia. However, we also discovered that the initiative gave insight into psychosocial aspects of dementia, and a new opportunity to explore personhood, co-production and social citizenship. That is the focus of this article.
Finding positives in caregiving: The unique experiences of Chinese spousal caregivers of persons with young-onset dementia
Authors: Pang Rebecca CK , Lee Diana TF
Published: December 2017

The experience of taking care of spouses with young-onset dementia has been identified as unique and merits considerations. However, current knowledge about this area in Chinese spousal caregivers is scarce. A qualitative descriptive study was therefore conducted to explore the experience of spousal caregivers of persons with young-onset dementia in Hong Kong. A total of six spousal caregivers of persons diagnosed with dementia before the age of 65 participated in this study. Three major categories were identified: coming to terms with an unexpected diagnosis; multiple unanticipated and ‘early’ losses and finding positives and meaning. This study has highlighted the influence of sociocultural values on the spousal caregiving experience in young-onset dementia caregiving. The findings also have significant implications for the development of interventions to facilitate the spousal caregivers to accept and sustain their caregiving role.
What makes extra care housing an appropriate setting for people with dementia? An exploration of staff decision-making
Authors: Verbeek Hilde , Tucker and Sue , Wilberforce Mark , Brand Christian , Abendstern Michele , Challis David
Published: December 2017

Extra care housing facilities in the UK are intended to offer a community-based alternative to care home placement. However, little is known about staff’s views of the appropriateness of extra care housing for people with dementia. This paper describes a mixed-methods study which explored this issue using statistical modelling of frontline staff’s recommendations of the best care setting for care home entrants; thematic analysis of transcripts from a simulated Resource Allocation Management Panel meeting; and content analysis of care coordinators’ reasons for not considering extra care housing in actual care home applications. Frontline practitioners saw extra care housing as a valuable alternative for a significant minority of care home entrants. However, extra care housing was not recommended if people needed care at night. Social care managers expressed general support for the idea of extra care housing, but appeared overwhelmingly focused on maintaining people at home and unsure where in the care pathway extra care housing sat. More evidence is needed on whether extra care housing can be an alternative to care homes and how services should be arranged to meet the needs of people living in extra care housing.
The Nun Study and Alzheimer’s disease: Quality of vocation as a potential protective factor?
Authors: Keohane Kieran , Balfe Myles
Published: December 2017

Data from the Nun Study, the most famous longitudinal epidemiology of Alzheimer’s disease to date, are analyzed and reformulated in terms of Max Weber’s discussion of the centrality of beruf – “calling” – fulfilling a life task in pursuit of a vocation. Qualitative differences in the Nuns’ vocations are uncovered, which are correlated to their resilience to dementia. Extrapolating, we argue that Alzheimer’s disease and the dementia reputed to it should be understood as a social pathology of contemporary civilization related to the loss of moral foundations from which coherent, meaningful life-projects can be conducted.