Open Journals at Memorial University
Not a member yet
1472 research outputs found
Sort by
To Philosophize is To Learn How to Live with Others: Notes on the Works of Anton Wilhelm Amo
No full text
Assessing Clinical Appropriateness: A retrospective audit of CTEs performed in St. John’s, Newfoundland and Labrador, during 2022.
No full textObjectives: Computed tomography enterography (CTE) is an abdominopelvic computed tomography specifically designed to evaluate the small bowel. Guidelines exist regarding what clinical situations warrant CTE. This study intends to assess how CTE is currently used locally in St. John’s, Newfoundland and Labrador (NL) and compare the results to the literature to determine whether CTEs are being requested following best practices. Such results will inform referring healthcare providers as to whether they are requesting CTE appropriately.
Methods: This study consisted of a retrospective audit of all CTEs (422) performed in St. John’s, NL in 2022. Extracted information included the patient’s clinical history, age and sex, and results of the imaging study.
Results: 114 studies were requested to investigate iron deficiency anemia, of which 92 did not identify a lesion to account for the patient’s symptoms; 13 showed small bowel angiodysplasia. 92 studies were ordered to investigate the small bowel in patients with known Crohn’s diagnosis; 56 identified findings of active disease. 79 studies were ordered to investigate suspected small bowel inflammatory disease; 56 demonstrated no evidence of the same. 28 studies were ordered to investigate vascular symptomatology, of which 27 did not localize a small bowel cause.
Conclusions: CTE is, undoubtably, a valuable imaging modality to visualize the small bowel. Most of the clinical indications prompting CTE requests within the St. John's region aligned with published indications for CTE referral. However, the majority of studies did not identify a small bowel cause for the patient’s symptoms
Utilization of POCUS in Acute Pulmonary Embolism with Hemodynamic Instability: A Case Presentation
No full textIntroduction: A pulmonary embolism (PE) is a life-threatening condition requiring rapid identification and treatment. However, the non-specific symptoms associated with the acute onset of a PE make clinical diagnosis difficult. Point of care ultrasound (POCUS) is a readily available and evolving technique that allows for rapid identification of a PE.
Case Presentation: 57-year-old patient presented to the Emergency Department (ED) hemodynamically unstable following an acute onset of shortness of breath and syncope. Ultrasonography revealed right ventricle (RV) dysfunction, abnormal tricuspid annular plane systolic excursion (TAPSE), and intravascular thrombosis, indicating a PE. Subsequently, the computed tomography pulmonary angiogram (CTPA) showed large bilateral pulmonary emboli and the patient received tissue plasminogen activator (TPA).
Discussion: The dependence of EDs on CTPA to rule in a PE before initiating thrombolytics may delay life-saving treatment. This case demonstrates the valuable addition of POCUS to the diagnostic protocol for PEs and reduces the waiting period in hemodynamically unstable patients to initiate empiric reperfusion therapy.
Conclusion: This case report demonstrates the benefits of POCUS in clinical decision making and highlights the advantages of its utility in the ED
School-based Reading Specialists in Newfoundland and Labrador: Optimally positioned to lead change
Full text linkThis qualitative study focused on the literacy leadership of School-based Reading Specialists (SbRSs) in Newfoundland and Labrador, Canada. Research on reading specialists is scant, particularly in Canada. Studies completed thus far agree that the role is not clearly defined, and more research is needed. This study aimed to understand the experiences and perspectives of the participants through an examination of leadership, specifically how reading specialists describe and position themselves as instructional leaders. Thirteen SbRSs participated in two virtual focus groups in October and November 2023 to discuss their experiences. The focus groups' discussions were structured around three research questions: What evidence is there that reading specialists view themselves as literacy leaders? What do they perceive as potentially supporting their leadership? What do they perceive as potential barriers to their leadership