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Khan A, Zhang X, Hu D, Ma X, Ding R, Attia J, Boyle A. Increasing Mortality from Ischaemic Heart Disease in China from 2004 - 2010: 438 Million Person-Years Follow Up. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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77
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Emami M, Barlow M, Leitch J, Wilsmore B, Mills M, Cambourn M, Meakes S, Davies A, Attia J, Boyle A, Jackson N. Body Mass Index and Ablation for Atrial Fibrillation Predicts Vascular Access Complications in Electrophysiology Procedures. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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78
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Khan A, Williams T, Savage L, Stewart P, Bhagwandeen R, Fletcher P, Boyle A. Pre-Hospital Thrombolysis and Transfer Achieves Optimal. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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79
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Centofanti J, Swinton M, Dionne J, Barefah A, Boyle A, Woods A, Shears M, Heels-Ansdell D, Cook D. Resident reflections on end-of-life education: a mixed-methods study of the 3 Wishes Project. BMJ Open 2016; 6:e010626. [PMID: 27033962 PMCID: PMC4823392 DOI: 10.1136/bmjopen-2015-010626] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 02/22/2016] [Accepted: 03/09/2016] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The objectives of this study were to describe residents' experiences with end-of-life (EOL) education during a rotation in the intensive care unit (ICU), and to understand the possible influence of the 3 Wishes Project. DESIGN We enrolled dying patients, their families and 1-3 of their clinicians in the 3 Wishes Project, eliciting and honouring a set of 3 wishes to bring peace to the final days of a critically ill patient's life, and ease the grieving process for families. We conducted semistructured interviews with 33 residents who had cared for 50 dying patients to understand their experiences with the project. Interviews were recorded, transcribed verbatim, then analysed using a qualitative descriptive approach. SETTING 21-bed medical surgical ICU in a tertiary care, university-affiliated hospital. RESULTS 33 residents participated from internal medicine (24, 72.7%), anaesthesia (8, 24.2%) and laboratory medicine (1, 3.0%) programmes in postgraduate years 1-3. 3 categories and associated themes emerged. (1) EOL care is a challenging component of training in that (a) death in the ICU can invoke helplessness, (b) EOL education is inadequate, (c) personal connections with dying patients is difficult in the ICU and (d) EOL skills are valued by residents. (2) The project reframes the dying process for residents by (a) humanising this aspect of practice, (b) identifying that family engagement is central to the dying process, (c) increasing emotional responsiveness and (d) showing that care shifts, not stops. (3) The project offers experiential education by (a) intentional role modelling, (b) facilitating EOL dialogue, (c) empowering residents to care in a tangible way and (d) encouraging reflection. CONCLUSIONS For residents, the 3 Wishes Project integrated many forms of active learning for residents. Practice-based rather than classroom-based programmes may engage trainees to develop EOL skills transferable to other settings.
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Cook D, Swinton M, Toledo F, Clarke F, Rose T, Hand-Breckenridge T, Boyle A, Woods A, Zytaruk N, Heels-Ansdell D, Sheppard R. Personalizing death in the intensive care unit: the 3 Wishes Project: a mixed-methods study. Ann Intern Med 2015; 163:271-9. [PMID: 26167721 DOI: 10.7326/m15-0502] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Dying in the complex, efficiency-driven environment of the intensive care unit can be dehumanizing for the patient and have profound, long-lasting consequences for all persons attendant to that death. OBJECTIVE To bring peace to the final days of a patient's life and to ease the grieving process. DESIGN Mixed-methods study. SETTING 21-bed medical-surgical intensive care unit. PARTICIPANTS Dying patients and their families and clinicians. INTERVENTION To honor each patient, a set of wishes was generated by patients, family members, or clinicians. The wishes were implemented before or after death by patients, families, clinicians (6 of whom were project team members), or the project team. MEASUREMENTS Quantitative data included demographic characteristics, processes of care, and scores on the Quality of End-of-Life Care-10 instrument. Semistructured interviews of family members and clinicians were transcribed verbatim, and qualitative description was used to analyze them. RESULTS Participants included 40 decedents, at least 1 family member per patient, and 3 clinicians per patient. The 159 wishes were implemented and classified into 5 categories: humanizing the environment, tributes, family reconnections, observances, and "paying it forward." Scores on the Quality of End-of-Life Care-10 instrument were high. The central theme from 160 interviews of 170 persons was how the 3 Wishes Project personalized the dying process. For patients, eliciting and customizing the wishes honored them by celebrating their lives and dignifying their deaths. For families, it created positive memories and individualized end-of-life care for their loved ones. For clinicians, it promoted interprofessional care and humanism in practice. LIMITATION Impaired consciousness limited understanding of patients' viewpoints. CONCLUSION The 3 Wishes Project facilitated personalization of the dying process through explicit integration of palliative and spiritual care into critical care practice. PRIMARY FUNDING SOURCE Hamilton Academy of Health Science Research Organization, Canadian Intensive Care Foundation.
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Lorello O, Foster DL, Levine DG, Boyle A, Engiles J, Orsini JA. Clinical treatment and prognosis of equine odontoclastic tooth resorption and hypercementosis. Equine Vet J 2015; 48:188-94. [DOI: 10.1111/evj.12406] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 12/17/2014] [Indexed: 11/29/2022]
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82
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Rajaratnam A, Kwa M, Ryan P, Phillips S, Pither E, Parsonage L, Boyle A. Pre-hospital assessment for Primary Angioplasty (PAPA) reduces reperfusion times in ST Elevation Myocardial Infarction (STEMI) - A report from the Hunter New England Local Health District. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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83
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Davies A, Thambar S, Boyle A. Simultaneous thrombosis of two coronary arteries in STEMI: Successful treatment with thrombus aspiration and primary angioplasty. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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84
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Hamid UI, Conlon J, Spence S, Boyle A, Fitzgerald M, Shyamsundar M, Krasnodembskaya A, Kissenpfennig A, Verghis R, Scott C, McAuley D, O'Kane C. T1 Aspirin reduces pulmonary inflammation in an inhaled lipopolysaccharide model of acute respiratory distress syndrome (ARDS) in healthy volunteers and in a human ex vivo lung perfusion model of ARDS. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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85
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Estes TS, Short N, Bowser D, Boyle A. An evidence-based quality improvement perspective for a chronic obstructive pulmonary disease case-finding program. Chron Respir Dis 2014; 11:131-138. [PMID: 24948387 DOI: 10.1177/1479972314538979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a persistent progressive respiratory disease that is increasing in prevalence and cost in the United States health care system. Delays in recognition, diagnosis, and treatment are associated with poorer clinical outcomes. These delays are seen more often in populations experiencing economic hardship, lack of access to care, and lack of insurance, such as those seen in an indigent care clinic. The COPD case-finding program was planned as an evidence-based quality improvement project with a prospective, descriptive design generating a convenience sample of patients meeting modified screening criteria (i.e. patients 40 years of age with a smoking history and no pulmonary disease history) in a community-based indigent care clinic which was not screening for COPD. Practice change recommendations were guided by the Diffusion of Innovations Model. Descriptive statistics were used to describe the sample (i.e. age, ethnicity, race, gender, income, and selected comorbidities). Sensitivity, specificity, positive predictive value, negative predictive value, prevalence, and receiver operator characteristics curve COPD Questionnaire were calculated for this sample.
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Boyle A, Ariel B, Weinborn C. CAN AMBULANCE DATA BE USED TO REDUCE COMMUNITY VIOLENCE? EXPLORATORY RECORD LINKAGE STUDY. Arch Emerg Med 2013. [DOI: 10.1136/emermed-2013-203113.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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87
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Boyle A, Coleman J, Sultan Y, Dhakshinamoorthy V, O'Keeffe J, Raut P, Beniuk K. VALIDATING THE ICMED (INTERNATIONAL CROWDING MEASURE IN EMERGENCY DEPARTMENTS): Abstract 007 Table 1. Arch Emerg Med 2013. [DOI: 10.1136/emermed-2013-203113.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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88
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Bhow A, Roberts R, Boyle A, Henroid D, Ferdon D. Hotel Style Room Service Leads to Increased Energy and Protein Intake in Chemotherapy and Hematopoietic Stem Cell Transplant Patients. J Acad Nutr Diet 2013. [DOI: 10.1016/j.jand.2013.06.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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89
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Koch E, Ryan C, Leitch M, Del Piero F, Boyle A. Magnetic resonance imaging of a solid, multilobular ameloblastoma in the mandible of a pony. EQUINE VET EDUC 2012. [DOI: 10.1111/j.2042-3292.2012.00456.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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90
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Crespo-Leiro M, Schulz U, Zuckermann A, Bara C, Mohacsi P, Bogaev R, Boyle A, Ross H, Parameshwar J, Zakliczynski M, Fiocchi R, Stypmann J, Hoefer D, Lehmkuhl H, Deng M, Leprince P, Yee J, Vanhaecke J. 81 Prediction of Allograft Clinical Outcomes and Risk of Acute Cellular Rejection with a Non-Invasive Gene-Expression Profiling Test (AlloMap): Results from the Cargo 2 European-Based Multicenter Trial. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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91
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Watanabe M, See F, Kompa A, Wang B, Lekawanvijit S, Gilbert R, Connelly K, Boyle A, Kelly D, Krum H. Tranilast Reduces Pathological Cardiac Fibrosis and Improves Diastolic Function Following Kidney Dysfunction: Implication for Cardio-Renal Syndrome. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.05.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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92
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Solomon P, Marshall D, Boyle A, Burns S, Casimiro LM, Hall P, Weaver L. Establishing face and content validity of the McMaster-Ottawa team observed structured clinical encounter (TOSCE). J Interprof Care 2011; 25:302-4. [PMID: 21554064 DOI: 10.3109/13561820.2011.571353] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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93
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Thompson C, Hayhurst C, Boyle A. How have changes to out-of-hours primary care services since 2004 affected emergency department attendances at a UK District General Hospital? A longitudinal study. Emerg Med J 2011; 27:22-5. [PMID: 20029001 DOI: 10.1136/emj.2008.068817] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The delivery of out-of-hours primary medical care in the United Kingdom has changed substantially since 2004, and there has been little examination of the effect that this has on secondary care. AIM The authors aimed to quantify the change in patient type presenting to our emergency department. METHODS In this study, routinely collected coding data before, during and after the changes were analysed. Each September and October between 1999 and 2006 were included. RESULTS There was a steady increase in all attendances at our emergency department. The number and proportions of patients with non-traumatic conditions rose steadily throughout the study period. The number of patients presenting with traumatic conditions stayed the same. The number of patients presenting with non-traumatic conditions out-of-hours rose after the changes were implemented. INTERPRETATION The changes to the provision of out-of-hours primary care have been associated with an increase in patients with non-traumatic attendances presenting to our emergency department. This effect is most marked outside of office hours.
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Boyle A, Dixon V, Fenu E, Heinz P. Sedation of children in the emergency department for short painful procedures compared with theatre, how much does it save? Economic evaluation. Emerg Med J 2010; 28:383-6. [DOI: 10.1136/emj.2010.092965] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Major R, Girling S, Boyle A. Ultrasound measurement of optic nerve sheath diameter in patients with a clinical suspicion of raised intracranial pressure. Emerg Med J 2010; 28:679-81. [DOI: 10.1136/emj.2009.087353] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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96
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Boyle A, Frith C, Edgcumbe D, McDougall C. What factors are associated with repeated domestic assault in patients attending an emergency department? A cohort study. Emerg Med J 2010; 27:203-6. [DOI: 10.1136/emj.2009.072033] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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97
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Boyle A, McKenzie C, Yassin S, McLuckie A, Wyncoll D. Outcomes and incidence of bleeding events associated with drotrecogin alfa: a single-centre experience of 440 patients. Crit Care 2010. [PMCID: PMC2934071 DOI: 10.1186/cc8636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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98
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Boyle A, Wee N, Harris R, Tompkins A, Soper M, Porter C. Alcohol-related emergency department attendances, preloading and where are they drinking? Cross-sectional survey. Emerg Med J 2009. [DOI: 10.1136/emj.2009.082099a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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99
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Boyle A, Staniciu D, Lewis S, Hugman A, Bauza-Rodriguez B, Kirby D, Scoffings D. Can middle grade and consultant emergency physicians accurately interpret computed tomography scans performed for head trauma? Cross-sectional study. Emerg Med J 2009; 26:583-5. [DOI: 10.1136/emj.2008.067074] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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100
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Boyle A, John R, Moazami N, Ewald G, Salerno C, Walsh M, Teuteberg J, Kormos R, Anyanwu A, Pinney S, Desai S, Burton N, Kirklin J, Pamboukian S, Park S, Redfield M, Ascheim D, Parides M, Rawiel U, Moquete E, Joyce L, Gelijns A, O'Connell J, McGee E, Sun B, Feldman D, Camacho M, Zucker M. 45: U.S. Experience with a Novel Centrifugal LVAD in Bridge to Transplant (BTT) Patients. J Heart Lung Transplant 2009. [DOI: 10.1016/j.healun.2008.11.051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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