Publisher: Cambridge University Press   (Total: 386 journals)

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Showing 1 - 200 of 386 Journals sorted alphabetically
Acta Neuropsychiatrica     Hybrid Journal   (Followers: 6, SJR: 0.733, CiteScore: 2)
Acta Numerica     Hybrid Journal   (Followers: 5, SJR: 6.709, CiteScore: 10)
Advances in Animal Biosciences     Full-text available via subscription   (Followers: 14)
Advances in Applied Mathematics and Mechanics     Full-text available via subscription   (Followers: 2, SJR: 0.441, CiteScore: 1)
Aeronautical J., The     Hybrid Journal   (Followers: 7)
Africa     Hybrid Journal   (Followers: 24, SJR: 0.582, CiteScore: 1)
African Studies Review     Full-text available via subscription   (Followers: 21, SJR: 0.437, CiteScore: 1)
Ageing & Society     Hybrid Journal   (Followers: 43, SJR: 0.756, CiteScore: 2)
Agricultural and Resource Economics Review     Open Access   (Followers: 7, SJR: 0.414, CiteScore: 1)
AI EDAM     Hybrid Journal   (Followers: 2, SJR: 0.375, CiteScore: 1)
AJIL Unbound     Open Access  
AJS Review     Full-text available via subscription   (Followers: 4, SJR: 0.128, CiteScore: 0)
American Political Science Review     Hybrid Journal   (Followers: 340, SJR: 5.587, CiteScore: 4)
Anatolian Studies     Full-text available via subscription   (Followers: 5, SJR: 0.528, CiteScore: 1)
Ancient Mesoamerica     Hybrid Journal   (Followers: 12, SJR: 0.478, CiteScore: 1)
Anglo-Saxon England     Hybrid Journal   (Followers: 36, SJR: 0.1, CiteScore: 0)
animal     Hybrid Journal   (Followers: 4, SJR: 0.842, CiteScore: 2)
Animal Health Research Reviews     Hybrid Journal   (Followers: 3, SJR: 0.69, CiteScore: 2)
Animal Science     Full-text available via subscription   (Followers: 10)
Annals of Actuarial Science     Full-text available via subscription   (Followers: 1)
Annual of the British School at Athens     Full-text available via subscription   (Followers: 16, SJR: 0.177, CiteScore: 0)
Annual Review of Applied Linguistics     Hybrid Journal   (Followers: 45, SJR: 3.223, CiteScore: 4)
Antarctic Science     Hybrid Journal   (Followers: 1, SJR: 0.643, CiteScore: 1)
Antichthon     Full-text available via subscription   (Followers: 3, SJR: 0.101, CiteScore: 0)
Antiquaries J., The     Full-text available via subscription   (Followers: 11, SJR: 0.106, CiteScore: 0)
Antiquity     Hybrid Journal   (Followers: 33)
ANZIAM J.     Open Access   (Followers: 1, SJR: 0.216, CiteScore: 0)
Applied Psycholinguistics     Hybrid Journal   (Followers: 25, SJR: 0.945, CiteScore: 2)
APSIPA Transactions on Signal and Information Processing     Open Access   (Followers: 9, SJR: 0.404, CiteScore: 2)
Arabic Sciences and Philosophy     Hybrid Journal   (Followers: 9, SJR: 0.101, CiteScore: 0)
Arbor Clinical Nutrition Updates     Full-text available via subscription   (Followers: 5)
Archaeological Dialogues     Hybrid Journal   (Followers: 35, SJR: 0.898, CiteScore: 1)
Archaeological Reports     Full-text available via subscription   (Followers: 5, SJR: 0.128, CiteScore: 0)
Architectural History     Full-text available via subscription  
arq: Architectural Research Quarterly     Hybrid Journal   (Followers: 7, SJR: 0.123, CiteScore: 0)
Art Libraries J.     Full-text available via subscription   (Followers: 1)
Asian J. of Comparative Law     Hybrid Journal   (Followers: 11, SJR: 0.129, CiteScore: 0)
Asian J. of Intl. Law     Hybrid Journal   (Followers: 17, SJR: 0.135, CiteScore: 0)
Asian J. of Law and Society     Hybrid Journal   (Followers: 7, SJR: 0.195, CiteScore: 0)
Astin Bulletin     Full-text available via subscription   (Followers: 1, SJR: 0.878, CiteScore: 1)
Australasian J. of Organisational Psychology     Hybrid Journal   (Followers: 9, SJR: 0.154, CiteScore: 1)
Australian J. of Environmental Education     Full-text available via subscription   (Followers: 9, SJR: 0.403, CiteScore: 1)
Australian J. of Indigenous Education, The     Full-text available via subscription   (Followers: 11, SJR: 0.26, CiteScore: 1)
Australian J. of Rehabilitation Counseling     Full-text available via subscription   (Followers: 6, SJR: 0.144, CiteScore: 0)
Austrian History Yearbook     Full-text available via subscription   (Followers: 11, SJR: 0.161, CiteScore: 0)
Behavioral and Brain Sciences     Hybrid Journal   (Followers: 38, SJR: 0.595, CiteScore: 1)
Behaviour Change     Full-text available via subscription   (Followers: 13, SJR: 0.508, CiteScore: 1)
Behavioural and Cognitive Psychotherapy     Hybrid Journal   (Followers: 187, SJR: 0.976, CiteScore: 2)
Bilingualism: Language and Cognition     Hybrid Journal   (Followers: 45, SJR: 1.446, CiteScore: 2)
Biofilms     Full-text available via subscription   (Followers: 2)
Bird Conservation Intl.     Hybrid Journal   (Followers: 25, SJR: 0.581, CiteScore: 1)
BJPsych Advances     Full-text available via subscription   (Followers: 57, SJR: 0.275, CiteScore: 0)
BJPsych Intl.     Open Access   (Followers: 2)
BJPsych Open     Open Access   (Followers: 3)
Brain Impairment     Full-text available via subscription   (Followers: 2, SJR: 0.321, CiteScore: 1)
Breast Cancer Online     Full-text available via subscription   (Followers: 6)
Britannia     Full-text available via subscription   (Followers: 11, SJR: 0.111, CiteScore: 0)
British Actuarial J.     Full-text available via subscription  
British Catholic History     Hybrid Journal   (Followers: 2, SJR: 0.133, CiteScore: 1)
British J. for the History of Science     Hybrid Journal   (Followers: 25, SJR: 0.235, CiteScore: 0)
British J. of Anaesthetic and Recovery Nursing     Full-text available via subscription   (Followers: 8)
British J. of Music Education     Hybrid Journal   (Followers: 24, SJR: 0.564, CiteScore: 1)
British J. Of Nutrition     Hybrid Journal   (Followers: 95, SJR: 1.612, CiteScore: 4)
British J. of Political Science     Hybrid Journal   (Followers: 229, SJR: 4.661, CiteScore: 4)
British J. of Psychiatry     Hybrid Journal   (Followers: 241, SJR: 2.844, CiteScore: 3)
Bulletin of Entomological Research     Hybrid Journal   (Followers: 13, SJR: 0.805, CiteScore: 2)
Bulletin of Symbolic Logic     Full-text available via subscription   (Followers: 2, SJR: 0.555, CiteScore: 1)
Bulletin of the Australian Mathematical Society     Full-text available via subscription   (Followers: 2, SJR: 0.44, CiteScore: 0)
Bulletin of the School of Oriental and African Studies     Hybrid Journal   (Followers: 21, SJR: 0.146, CiteScore: 0)
Business and Human Rights J.     Full-text available via subscription   (Followers: 4, SJR: 0.536, CiteScore: 1)
Business Ethics Quarterly     Full-text available via subscription   (Followers: 18, SJR: 1.098, CiteScore: 2)
Business History Review     Hybrid Journal   (Followers: 16, SJR: 0.347, CiteScore: 1)
Cambridge Archaeological J.     Hybrid Journal   (Followers: 165, SJR: 1.121, CiteScore: 1)
Cambridge Classical J.     Full-text available via subscription   (Followers: 24, SJR: 0.101, CiteScore: 0)
Cambridge J. of Postcolonial Literary Inquiry     Hybrid Journal   (Followers: 7)
Cambridge Law J.     Hybrid Journal   (Followers: 217, SJR: 0.213, CiteScore: 0)
Cambridge Opera J.     Hybrid Journal   (Followers: 4, SJR: 0.14, CiteScore: 0)
Cambridge Quarterly of Healthcare Ethics     Hybrid Journal   (Followers: 12, SJR: 0.299, CiteScore: 1)
Cambridge Yearbook of European Legal Studies     Full-text available via subscription  
Camden Fifth Series     Full-text available via subscription   (Followers: 3)
Canadian Entomologist     Hybrid Journal   (Followers: 5, SJR: 0.482, CiteScore: 1)
Canadian J. of Emergency Medicine     Hybrid Journal   (Followers: 13, SJR: 0.624, CiteScore: 1)
Canadian J. of Law & Jurisprudence     Full-text available via subscription   (Followers: 9, SJR: 0.237, CiteScore: 0)
Canadian J. of Law and Society     Hybrid Journal   (Followers: 21, SJR: 0.259, CiteScore: 1)
Canadian J. of Mathematics / J. canadien de mathĂ©matiques     Hybrid Journal  
Canadian J. of Neurological Sciences     Full-text available via subscription   (SJR: 0.549, CiteScore: 1)
Canadian J. of Political Science/Revue canadienne de science politique     Full-text available via subscription   (Followers: 25, SJR: 0.385, CiteScore: 1)
Canadian J. on Aging     Hybrid Journal   (Followers: 14, SJR: 0.426, CiteScore: 1)
Canadian Mathematical Bulletin     Hybrid Journal  
Canadian Yearbook of Intl. Law / Annuaire canadien de droit international     Full-text available via subscription   (Followers: 3)
Cardiology in the Young     Hybrid Journal   (Followers: 34, SJR: 0.372, CiteScore: 1)
Central European History     Full-text available via subscription   (Followers: 33, SJR: 0.159, CiteScore: 0)
Children Australia     Partially Free   (Followers: 2, SJR: 0.255, CiteScore: 0)
China Quarterly     Hybrid Journal   (Followers: 54, SJR: 2.289, CiteScore: 3)
Chinese J. of Agricultural Biotechnology     Full-text available via subscription   (Followers: 4)
Church History : Studies in Christianity and Culture     Full-text available via subscription   (Followers: 77, SJR: 0.106, CiteScore: 0)
Classical Quarterly     Full-text available via subscription   (Followers: 36, SJR: 0.204, CiteScore: 0)
Classical Review     Full-text available via subscription   (Followers: 29)
CNS Spectrums     Hybrid Journal   (Followers: 3, SJR: 1.391, CiteScore: 3)
Cognitive Behaviour Therapist     Hybrid Journal   (Followers: 14)
Combinatorics, Probability and Computing     Hybrid Journal   (Followers: 4, SJR: 0.839, CiteScore: 1)
Communications in Computational Physics     Full-text available via subscription   (Followers: 3, SJR: 1.048, CiteScore: 2)
Comparative Studies in Society and History     Full-text available via subscription   (Followers: 50, SJR: 0.585, CiteScore: 1)
Compositio Mathematica     Full-text available via subscription   (SJR: 3.139, CiteScore: 1)
Contemporary European History     Hybrid Journal   (Followers: 36, SJR: 0.263, CiteScore: 1)
Continuity and Change     Hybrid Journal   (Followers: 12, SJR: 0.107, CiteScore: 0)
Dance Research J.     Full-text available via subscription   (Followers: 17, SJR: 0.211, CiteScore: 0)
Development and Psychopathology     Hybrid Journal   (Followers: 10, SJR: 2.068, CiteScore: 4)
Dialogue Canadian Philosophical Review/Revue canadienne de philosophie     Full-text available via subscription   (Followers: 5, SJR: 0.156, CiteScore: 0)
Diamond Light Source Proceedings     Full-text available via subscription   (Followers: 1)
Disaster Medicine and Public Health Preparedness     Hybrid Journal   (Followers: 15, SJR: 0.471, CiteScore: 1)
Du Bois Review: Social Science Research on Race     Full-text available via subscription   (Followers: 10, SJR: 0.561, CiteScore: 1)
Early China     Hybrid Journal   (Followers: 3)
Early Music History     Hybrid Journal   (Followers: 9, SJR: 0.101, CiteScore: 0)
Earth and Environmental Science Transactions of the Royal Society of Edinburgh     Hybrid Journal   (Followers: 5)
East Asian J. on Applied Mathematics     Full-text available via subscription   (SJR: 0.418, CiteScore: 1)
Ecclesiastical Law J.     Full-text available via subscription   (Followers: 6, SJR: 0.114, CiteScore: 0)
Econometric Theory     Hybrid Journal   (Followers: 20, SJR: 2.915, CiteScore: 1)
Economics and Philosophy     Hybrid Journal   (Followers: 19, SJR: 0.622, CiteScore: 1)
Edinburgh J. of Botany     Hybrid Journal   (SJR: 0.283, CiteScore: 1)
Educational and Developmental Psychologist     Full-text available via subscription   (Followers: 10, SJR: 0.146, CiteScore: 0)
Eighteenth-Century Music     Hybrid Journal   (Followers: 15, SJR: 0.113, CiteScore: 0)
English Language and Linguistics     Hybrid Journal   (Followers: 24, SJR: 0.52, CiteScore: 1)
English Profile J.     Hybrid Journal   (Followers: 2)
English Today     Hybrid Journal   (Followers: 13, SJR: 0.279, CiteScore: 0)
Enterprise & Society : The Intl. J. of Business History     Hybrid Journal   (Followers: 18, SJR: 0.245, CiteScore: 1)
Environment and Development Economics     Hybrid Journal   (Followers: 39, SJR: 0.617, CiteScore: 1)
Environmental Conservation     Hybrid Journal   (Followers: 60, SJR: 1.028, CiteScore: 2)
Environmental Practice     Full-text available via subscription   (Followers: 3, SJR: 0.145, CiteScore: 0)
Epidemiology & Infection     Hybrid Journal   (Followers: 22, SJR: 1.128, CiteScore: 2)
Epidemiology and Psychiatric Sciences     Hybrid Journal   (Followers: 3, SJR: 1.494, CiteScore: 2)
Episteme     Hybrid Journal   (Followers: 12, SJR: 0.756, CiteScore: 1)
Ergodic Theory and Dynamical Systems     Hybrid Journal   (Followers: 2, SJR: 1.193, CiteScore: 1)
Ethics & Intl. Affairs     Full-text available via subscription   (Followers: 17, SJR: 0.557, CiteScore: 1)
European Constitutional Law Review (EuConst)     Full-text available via subscription   (Followers: 36, SJR: 1.009, CiteScore: 1)
European J. of Applied Mathematics     Hybrid Journal   (SJR: 0.52, CiteScore: 1)
European J. of Intl. Security     Hybrid Journal   (Followers: 1)
European J. of Sociology     Hybrid Journal   (Followers: 37, SJR: 0.643, CiteScore: 1)
European Political Science Review     Hybrid Journal   (Followers: 27, SJR: 1.816, CiteScore: 2)
European Review     Hybrid Journal   (Followers: 19, SJR: 0.131, CiteScore: 0)
Evolutionary Human Sciences     Open Access   (Followers: 1)
Experimental Agriculture     Hybrid Journal   (Followers: 14, SJR: 0.542, CiteScore: 1)
Expert Reviews in Molecular Medicine     Hybrid Journal   (Followers: 1, SJR: 1.647, CiteScore: 4)
Fetal and Maternal Medicine Review     Hybrid Journal   (Followers: 6)
Financial History Review     Full-text available via subscription   (Followers: 15, SJR: 0.238, CiteScore: 1)
Foreign Policy Bulletin     Hybrid Journal   (Followers: 6)
Forum of Mathematics, Pi     Open Access   (Followers: 1)
Forum of Mathematics, Sigma     Open Access   (Followers: 1)
Genetics Research     Hybrid Journal   (Followers: 4, SJR: 0.483, CiteScore: 1)
Geological Magazine     Hybrid Journal   (Followers: 16, SJR: 0.966, CiteScore: 2)
Glasgow Mathematical J.     Full-text available via subscription   (SJR: 0.604, CiteScore: 0)
Global Constitutionalism     Hybrid Journal   (Followers: 17)
Global Mental Health     Open Access   (Followers: 9)
Global Sustainability     Open Access   (Followers: 1)
Government and Opposition     Full-text available via subscription   (Followers: 24, SJR: 0.965, CiteScore: 2)
Greece & Rome     Partially Free   (Followers: 30, SJR: 0.113, CiteScore: 0)
Hague J. on the Rule of Law     Full-text available via subscription   (Followers: 14, SJR: 0.271, CiteScore: 1)
Harvard Theological Review     Full-text available via subscription   (Followers: 78, SJR: 0.165, CiteScore: 0)
Health Economics, Policy and Law     Hybrid Journal   (Followers: 29, SJR: 0.745, CiteScore: 1)
Hegel Bulletin     Full-text available via subscription   (Followers: 2)
High Power Laser Science and Engineering     Open Access   (Followers: 4, SJR: 0.901, CiteScore: 3)
Historical J.     Hybrid Journal   (Followers: 42, SJR: 0.247, CiteScore: 1)
History in Africa     Full-text available via subscription   (Followers: 9)
Horizons     Partially Free   (Followers: 1, SJR: 0.129, CiteScore: 0)
Industrial and Organizational Psychology     Hybrid Journal   (Followers: 27, SJR: 0.916, CiteScore: 1)
Infection Control and Hospital Epidemiology     Full-text available via subscription   (Followers: 49, SJR: 1.97, CiteScore: 3)
Intl. & Comparative Law Quarterly     Full-text available via subscription   (Followers: 261, SJR: 0.369, CiteScore: 1)
Intl. Annals of Criminology     Full-text available via subscription  
Intl. J. of Asian Studies     Hybrid Journal   (Followers: 13, SJR: 0.143, CiteScore: 0)
Intl. J. of Astrobiology     Hybrid Journal   (Followers: 4, SJR: 0.548, CiteScore: 1)
Intl. J. of Cultural Property     Full-text available via subscription   (Followers: 14, SJR: 0.253, CiteScore: 1)
Intl. J. of Disability Management Research     Full-text available via subscription   (Followers: 9, SJR: 0.105, CiteScore: 0)
Intl. J. of Law in Context     Hybrid Journal   (Followers: 17, SJR: 0.275, CiteScore: 1)
Intl. J. of Legal Information     Full-text available via subscription   (Followers: 345)
Intl. J. of Microwave and Wireless Technologies     Hybrid Journal   (Followers: 10, SJR: 0.184, CiteScore: 1)
Intl. J. of Middle East Studies     Hybrid Journal   (Followers: 72, SJR: 0.434, CiteScore: 0)
Intl. J. of Technology Assessment in Health Care     Hybrid Journal   (Followers: 14, SJR: 0.714, CiteScore: 1)
Intl. Labor and Working-Class History     Full-text available via subscription   (Followers: 14, SJR: 0.182, CiteScore: 0)
Intl. Organization     Full-text available via subscription   (Followers: 108, SJR: 8.527, CiteScore: 5)
Intl. Psychogeriatrics     Hybrid Journal   (Followers: 12, SJR: 1.048, CiteScore: 2)
Intl. Review of Social History     Full-text available via subscription   (Followers: 29, SJR: 0.315, CiteScore: 1)
Intl. Review of the Red Cross     Full-text available via subscription   (Followers: 12, SJR: 0.214, CiteScore: 0)
Intl. Theory: A J. of Intl. Politics, Law and Philosophy     Hybrid Journal   (Followers: 19, SJR: 2.293, CiteScore: 2)
Iraq     Full-text available via subscription   (Followers: 5)
Irish Historical Studies     Hybrid Journal   (Followers: 7, SJR: 0.103, CiteScore: 0)
Irish J. of Psychological Medicine     Hybrid Journal   (Followers: 2, SJR: 0.221, CiteScore: 0)
Israel Law Review     Hybrid Journal   (Followers: 2, SJR: 0.165, CiteScore: 0)
Italian Political Science Review / Rivista Italiana di Scienza Politica     Hybrid Journal   (Followers: 1)
Itinerario     Full-text available via subscription   (Followers: 11, SJR: 0.158, CiteScore: 0)
J. of African History     Hybrid Journal   (Followers: 23, SJR: 0.348, CiteScore: 1)
J. of African Law     Full-text available via subscription   (Followers: 3, SJR: 0.113, CiteScore: 0)
J. of Agricultural and Applied Economics     Open Access   (Followers: 4, SJR: 0.263, CiteScore: 1)
J. of Agricultural Science     Full-text available via subscription   (Followers: 8, SJR: 0.563, CiteScore: 1)
J. of American Studies     Hybrid Journal   (Followers: 21, SJR: 0.164, CiteScore: 0)
J. of Anglican Studies     Hybrid Journal   (Followers: 8, SJR: 0.101, CiteScore: 0)
J. of Applied Animal Nutrition     Hybrid Journal   (Followers: 4)
J. of Asian Studies     Full-text available via subscription   (Followers: 42, SJR: 0.591, CiteScore: 1)
J. of Benefit-Cost Analysis     Hybrid Journal   (Followers: 4)
J. of Biosocial Science     Hybrid Journal   (Followers: 5, SJR: 0.48, CiteScore: 1)
J. of British Studies     Full-text available via subscription   (Followers: 34, SJR: 0.246, CiteScore: 0)

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Journal Cover
Canadian Journal of Emergency Medicine
Journal Prestige (SJR): 0.624
Citation Impact (citeScore): 1
Number of Followers: 13  
 
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ISSN (Online) 1481-8035
Published by Cambridge University Press Homepage  [386 journals]
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    • Authors: Hugo Langlois; Monique Cormier, Eric Villeneuve, Robert S. Hoffman, Cristina Longo, Sophie Gosselin
      Pages: 165 - 169
      Abstract: ObjectivesAlthough alcohol withdrawal is common, the recognition of benzodiazepine-resistant alcohol withdrawal is a relatively new concept. To provide a framework for both literature review and future research, we assessed clinicians’ personal definition of resistant alcohol withdrawal.MethodWe developed a cross-sectional web-based survey. Administrators from collaborating toxicology and emergency medicine associations deployed the survey directly to their respective memberships. Only physicians, pharmacists, and other clinicians routinely treating alcohol withdrawal were eligible to participate. Respondents selected their preferred definition among the three most common author sources – JB Hack, NJ Benedict, D Hughes – or provided their own. Additional criteria to define resistant alcohol withdrawal were explored.Results384 individuals answered the survey. Respondents were mostly attending physicians (79%), in full-time practice (90%), in emergency medicine (70%), and from North America (90%). The majority (64%) described resistant alcohol withdrawal as a high benzodiazepine dosage. Seizures (26%) and persistent tachycardia (16%) were also main characteristics. The median dose to describe high benzodiazepine dose (n = 146) was 40 mg per hour of diazepam equivalents (IQR 20–50). Available definitions were ranked equally as the preferred one: Hack (27%); Benedict (28%); Hughes (28%).ConclusionOur results did not identify one single preferred definition for resistant alcohol withdrawal even though a high total dose of benzodiazepine is a major component. Hourly requirements of 40 mg of diazepam equivalents or more emerged as a possible threshold. These findings serve as a base to explore consensus guidelines or future research.
      PubDate: 2020-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2019.421
      Issue No: Vol. 22, No. 2 (2020)
       
  • Identification of emergency department patients for referral to
           rapid-access addiction services
    • Authors: Jessica Hann; Howie Wu, Aliyah Gauri, Kathryn Dong, Ni Lam, Jeffrey A. Bakal, Allison Kirkham
      Pages: 170 - 177
      Abstract: ObjectivesSubstance-related emergency department (ED) visits are rapidly increasing. Despite this finding, many EDs do not have access to on-site addiction services. This study characterized substance-related ED presentations and assessed the ED health care team's perceived need for an on-site rapid-access addiction clinic for direct patient referral from the ED.MethodsThis prospectively enrolled cohort study was conducted at an urban tertiary care ED from June to August 2018. Adult ED patients with problematic or high-risk substance use were enrolled by ED staff using a one-page form. The electronic and paper records from the index ED visit were reviewed. The primary outcome evaluated whether the ED health care team would have referred the patient to an on-site rapid-access addiction clinic, if one were available.ResultsWe received 557 enrolment forms and 458 were included in the analysis. Median age was 35 years, and 64% of included patients were male. Alcohol was the most commonly reported substance of problematic or high-risk use (60%). Previous ED visits within 7 days of the index visit were made by 28% of patients. The ED health care team indicated “Yes” for rapid-access addiction clinic referral from the ED for 66% of patients, with a mean of 4.3 patients referred per day during the study period.ConclusionsAt least four patients per day would have been referred to an on-site rapid-access addiction clinic from the ED, had one been available. This indicates a gap in care and collaborating with other sites that have successfully implemented this clinic model is an important next step.
      PubDate: 2020-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2019.453
      Issue No: Vol. 22, No. 2 (2020)
       
  • Naloxone dosing in the era of ultra-potent opioid overdoses: a systematic
           review
    • Authors: Jessica Moe; Jesse Godwin, Roy Purssell, Fiona O'Sullivan, Jeffrey P. Hau, Elizabeth Purssell, Jason Curran, Mary M. Doyle-Waters, Penelope M.A. Brasher, Jane A. Buxton, Corinne M. Hohl
      Pages: 178 - 186
      Abstract: ObjectivesEvaluate the relationship between naloxone dose (initial and cumulative) and opioid toxicity reversal and adverse events in undifferentiated and presumed fentanyl/ultra-potent opioid overdoses.MethodsWe searched Embase, MEDLINE, Cochrane Central Register of Controlled Trials, DARE, CINAHL, Science Citation Index, reference lists, toxicology websites, and conference proceedings (1972 to 2018). We included interventional, observational, and case studies/series reporting on naloxone dose and opioid toxicity reversal or adverse events in people >12 years old.ResultsA total of 174 studies (110 case reports/series, 57 observational, 7 interventional) with 26,660 subjects (median age 35 years; 74% male). Heterogeneity precluded meta-analysis. Where reported, we abstracted naloxone dose and proportion of patients with toxicity reversal. Among patients with presumed exposure to fentanyl/ultra-potent opioids, 56.9% (617/1,085) responded to an initial naloxone dose ≤0.4 mg compared with 80.2% (170/212) of heroin users, and 30.4% (7/23) responded to an initial naloxone dose >0.4 mg compared with 59.1% (1,434/2,428) of heroin users. Among patients who responded, median cumulative naloxone doses were higher for presumed fentanyl/ultra-potent opioids than heroin overdoses in North America, both before 2015 (fentanyl/ultra-potent opioids: 1.8 mg [interquartile interval {IQI}, 1.0, 4.0]; heroin: 0.8 mg [IQI, 0.4, 0.8]) and after 2015 (fentanyl/ultra-potent opioids: 3.4 mg [IQI, 3.0, 4.1]); heroin: 2 mg [IQI, 1.4, 2.0]). Where adverse events were reported, 11% (490/4,414) of subjects experienced withdrawal. Variable reporting, heterogeneity and poor-quality studies limit conclusions.ConclusionsPractitioners have used higher initial doses, and in some cases higher cumulative naloxone doses to reverse toxicity due to presumed fentanyl/ultra-potent opioid exposure compared with other opioids. High-quality comparative naloxone dosing studies assessing effectiveness and safety are needed.
      PubDate: 2020-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2019.471
      Issue No: Vol. 22, No. 2 (2020)
       
  • CAEP 2019 Academic Symposium: Got competence' Best practices in
           trainee progress decisions
    • Authors: Warren J. Cheung; Teresa M. Chan, Karen E. Hauer, Robert A. Woods, Jill McEwen, Lynsey J. Martin, Catherine Patocka, Sandy L. Dong, Munsif Bhimani, Tamara McColl
      Pages: 187 - 193
      Abstract: BackgroundCompetence committees play a key role in a competency-based system of assessment. These committees are tasked with reviewing and synthesizing clinical performance data to make judgments regarding residents’ competence. Canadian emergency medicine (EM) postgraduate training programs recently implemented competence committees; however, a paucity of literature guides their work.ObjectiveThe objective of this study was to develop consensus-based recommendations to optimize the function and decisions of competence committees in Canadian EM training programs.MethodsSemi-structured interviews of EM competence committee chairs were conducted and analyzed. The interview guide was informed by a literature review of competence committee structure, processes, and best practices. Inductive thematic analysis of interview transcripts was conducted to identify emerging themes. Preliminary recommendations, based on themes, were drafted and presented at the 2019 CAEP Academic Symposium on Education. Through a live presentation and survey poll, symposium attendees representing the national EM community participated in a facilitated discussion of the recommendations. The authors incorporated this feedback and identified consensus among symposium attendees on a final set of nine high-yield recommendations.ConclusionThe Canadian EM community used a structured process to develop nine best practice recommendations for competence committees addressing: committee membership, meeting processes, decision outcomes, use of high-quality performance data, and ongoing quality improvement. These recommendations can inform the structure and processes of competence committees in Canadian EM training programs.
      PubDate: 2020-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2019.480
      Issue No: Vol. 22, No. 2 (2020)
       
  • Harnessing the power of simulation for assessment: Consensus
           recommendations for the use of simulation-based assessment in emergency
           medicine
    • Authors: Andrew K. Hall; Timothy Chaplin, Tamara McColl, Andrew Petrosoniak, Kyla Caners, Nicole Rocca, Carlyn Gardner, Farhan Bhanji, Rob Woods
      Pages: 194 - 203
      Abstract: ObjectivesTo address the increasing demand for the use of simulation for assessment, our objective was to review the literature pertaining to simulation-based assessment and develop a set of consensus-based expert-informed recommendations on the use of simulation-based assessment as presented at the 2019 Canadian Association of Emergency Physicians (CAEP) Academic Symposium on Education.MethodsA panel of Emergency Medicine (EM) physicians from across Canada, with leadership roles in simulation and/or assessment, was formed to develop the recommendations. An initial scoping literature review was conducted to extract principles of simulation-based assessment. These principles were refined via thematic analysis, and then used to derive a set of recommendations for the use of simulation-based assessment, organized by the Consensus Framework for Good Assessment. This was reviewed and revised via a national stakeholder survey, and then the recommendations were presented and revised at the consensus conference to generate a final set of recommendations on the use of simulation-based assessment in EM.ConclusionWe developed a set of recommendations for simulation-based assessment, using consensus-based expert-informed methods, across the domains of validity, reproducibility, feasibility, educational and catalytic effects, acceptability, and programmatic assessment. While the precise role of simulation-based assessment will be a subject of continued debate, we propose that these recommendations be used to assist educators and program leaders as they incorporate simulation-based assessment into their programs of assessment.
      PubDate: 2020-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2019.488
      Issue No: Vol. 22, No. 2 (2020)
       
  • Outcomes in the age of competency-based medical education: Recommendations
           for emergency medicine training in Canada from the 2019 symposium of
           academic emergency physicians
    • Authors: Teresa M. Chan; Quinten S. Paterson, Andrew K. Hall, Fareen Zaver, Robert A. Woods, Stanley J. Hamstra, Alexandra Stefan, Daniel K. Ting, Brent Thoma
      Pages: 204 - 214
      Abstract: ObjectivesThe national implementation of competency-based medical education (CBME) has prompted an increased interest in identifying and tracking clinical and educational outcomes for emergency medicine training programs. For the 2019 Canadian Association of Emergency Physicians (CAEP) Academic Symposium, we developed recommendations for measuring outcomes in emergency medicine training in the context of CBME to assist educational leaders and systems designers in program evaluation.MethodsWe conducted a three-phase study to generate educational and clinical outcomes for emergency medicine (EM) education in Canada. First, we elicited expert and community perspectives on the best educational and clinical outcomes through a structured consultation process using a targeted online survey. We then qualitatively analyzed these responses to generate a list of suggested outcomes. Last, we presented these outcomes to a diverse assembly of educators, trainees, and clinicians at the CAEP Academic Symposium for feedback and endorsement through a voting process.ConclusionAcademic Symposium attendees endorsed the measurement and linkage of CBME educational and clinical outcomes. Twenty-five outcomes (15 educational, 10 clinical) were derived from the qualitative analysis of the survey results and the most important short- and long-term outcomes (both educational and clinical) were identified. These outcomes can be used to help measure the impact of CBME on the practice of Emergency Medicine in Canada to ensure that it meets both trainee and patient needs.
      PubDate: 2020-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2019.491
      Issue No: Vol. 22, No. 2 (2020)
       
  • A transparent and defensible process for applicant selection within a
           Canadian emergency medicine residency program
    • Authors: Quinten S. Paterson; Riley Hartmann, Rob Woods, Lynsey J. Martin, Brent Thoma
      Pages: 215 - 223
      Abstract: ObjectivesThe Canadian Resident Matching Service (CaRMS) selection process has come under scrutiny due to the increasing number of unmatched medical graduates. In response, we outline our residency program's selection process including how we have incorporated best practices and novel techniques.MethodsWe selected file reviewers and interviewers to mitigate gender bias and increase diversity. Four residents and two attending physicians rated each file using a standardized, cloud-based file review template to allow simultaneous rating. We interviewed applicants using four standardized stations with two or three interviewers per station. We used heat maps to review rating discrepancies and eliminated rating variance using Z-scores. The number of person-hours that we required to conduct our selection process was quantified and the process outcomes were described statistically and graphically.ResultsWe received between 75 and 90 CaRMS applications during each application cycle between 2017 and 2019. Our overall process required 320 person-hours annually, excluding attendance at the social events and administrative assistant duties. Our preliminary interview and rank lists were developed using weighted Z-scores and modified through an organized discussion informed by heat mapped data. The difference between the Z-scores of applicants surrounding the interview invitation threshold was 0.18-0.3 standard deviations. Interview performance significantly impacted the final rank list.ConclusionsWe describe a rigorous resident selection process for our emergency medicine training program which incorporated simultaneous cloud-based rating, Z-scores, and heat maps. This standardized approach could inform other programs looking to adopt a rigorous selection process while providing applicants guidance and reassurance of a fair assessment.
      PubDate: 2020-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2019.460
      Issue No: Vol. 22, No. 2 (2020)
       
  • Residents’ perspective of quality improvement and patient safety
           education in Canadian emergency medicine residency programs
    • Authors: Sachin V. Trivedi; Riley J. Hartmann, Justin N. Hall, Laila Nasser, Danielle Porplycia, Edmund S. H. Kwok, Lucas B. Chartier
      Pages: 224 - 231
      Abstract: ObjectivesQuality improvement and patient safety (QIPS) competencies are increasingly important in emergency medicine (EM) and are now included in the CanMEDS framework. We conducted a survey aimed at determining the Canadian EM residents’ perspectives on the level of QIPS education and support available to them.MethodsAn electronic survey was distributed to all Canadian EM residents from the Royal College and Family Medicine training streams. The survey consisted of multiple-choice, Likert, and free-text entry questions aimed at understanding familiarity with QIPS, local opportunities for QIPS projects and mentorship, and the desire for further QIPS education and involvement.ResultsOf 535 EM residents, 189 (35.3%) completed the survey, representing all 17 medical schools; 77.2% of respondents were from the Royal College stream; 17.5% of respondents reported that QIPS methodologies were formally taught in their residency program; 54.7% of respondents reported being “somewhat” or “very” familiar with QIPS; 47.2% and 51.5% of respondents reported either “not knowing” or “not having readily available” opportunities for QIPS projects and QIPS mentorship, respectively; 66.9% of respondents indicated a desire for increased QIPS teaching; and 70.4% were interested in becoming involved with QIPS training and initiatives.ConclusionsMany Canadian EM residents perceive a lack of QIPS educational opportunities and support in their local setting. They are interested in receiving more QIPS education, as well as project and mentorship opportunities. Supporting residents with a robust QIPS educational and mentorship framework may build a cohort of providers who can enhance the local delivery of care.
      PubDate: 2020-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2019.465
      Issue No: Vol. 22, No. 2 (2020)
       
  • Emergency department use in people who experience imprisonment in Ontario,
           Canada
    • Authors: John Tuinema; Aaron M. Orkin, Stephanie Y. Cheng, Kinwah Fung, Fiona G. Kouyoumdjian
      Pages: 232 - 240
      Abstract: ObjectivesThe aims of this study were to describe emergency department (ED) utilization by people in provincial prison and on release, and to compare with ED utilization for the general population.MethodsWe linked correctional and health administrative data for people released from provincial prison in Ontario in 2010. We matched each person by age and sex with four people in the general population. We compared ED utilization rates using generalized estimating equations, by sex and for high urgency and ambulatory care sensitive conditions.ResultsPeople who experienced imprisonment (N = 48,861) had higher ED utilization rates compared with the general population (N = 195,444), with rate ratios of 3.2 (95% CI 3.0–4.4) for men and 6.5 (95% CI 5.6–7.5) for women in prison and a range of rate ratios between 3.1 and 7.7 for men and 4.2 and 8.8 for women over the 2 years after release. Most ED visits were high urgency, and between 1.0% and 5.1% of visits were for ambulatory care sensitive conditions. ED utilization rates increased on release from prison.ConclusionsPeople experiencing imprisonment in Ontario have higher ED utilization compared with matched people in the general population, primarily for urgent issues, and particularly in women and in the week after release. Providing high-quality ED care and implementing prison- and ED-based interventions could improve health for this population and prevent the need for ED use.
      PubDate: 2020-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2019.401
      Issue No: Vol. 22, No. 2 (2020)
       
  • Emergency department referrals from a provincial medical call centre: Is
           it more than just 1-800-go-to-emerg'
    • Authors: Jonathon Nataraj; James Stempien, Stuart Netherton, Mark Yosri Wahba, Taofiq Olusegun Oyedokun
      Pages: 241 - 244
      Abstract: ObjectiveHealthLine is Saskatchewan's provincial 24-hour health information and support telephone line. A proportion of HealthLine's callers are referred to the emergency department (ED) for further assessment. The purpose of this study was to gain insight into the appropriateness of these referrals and assess whether they increased the burden on an already strained ED system.MethodsA list of callers referred from HealthLine to Saskatoon EDs from January 1, 2014, to March 31, 2014 was obtained. This list was cross-referenced with Saskatoon Health Region registration data to determine which of those callers had been registered in one of the three Saskatoon EDs within 48 hours of the original call.ResultsDuring the 90-day time period in question, 707/3,938 (17.9%) of callers were referred by HealthLine to the ED. Out of those referred, 601 were identifiable and 358 attended the ED. Hospital charts were pulled for full data extraction and analysis of the 276 who met inclusion criteria. Of those who presented to the ED and met inclusion criteria, 60% had investigations performed while 66% received some form of treatment. The overall admission rate for the patient population studied was 12.0% v. 16% for non-referred patients. Referred pediatric patients had fewer investigations and treatments with a lower admission rate compared with the adult patients.ConclusionThe Saskatchewan HealthLine is doing an effective job at directing callers both to and away from EDs in Saskatoon and not overburdening our local EDs with unnecessary referrals.
      PubDate: 2020-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2019.420
      Issue No: Vol. 22, No. 2 (2020)
       
  • Patient race, ethnicity, and care in the emergency department: A scoping
           review
    • Authors: Allison Owens; Brian R. Holroyd, Patrick McLane
      Pages: 245 - 253
      Abstract: ObjectivesHealth disparities between racial and ethnic groups have been documented in Canada, the United States, and Australia. Despite evidence that differences in emergency department (ED) care based on patient race and ethnicity exist, there are no comprehensive literature reviews in this area. The objective of this review is to provide an overview of the literature on the impact of patient ethnicity and race on the processes of ED care.MethodsA scoping review was conducted to capture the broad nature of the literature. A database search was conducted in MEDLINE/PubMed, EMBASE, CINAHL Plus, Social Sciences Citation Index, SCOPUS, and JSTOR. Five journals and reference lists of included articles were hand searched. Inclusion and exclusion criteria were defined iteratively to ensure literature captured was relevant to our research question. Data were extracted using predetermined variables, and additional extraction variables were added as familiarity with the literature developed.ResultsSearching yielded 1,157 citations, reduced to 153 following removal of duplicates, and title and abstract screening. After full-text screening, 83 articles were included. Included articles report that, in EDs, patient race and ethnicity impact analgesia, triage scores, wait times, treatments, diagnostic procedure utilization, rates of patients leaving without being seen, and patient subjective experiences.
      Authors of included studies propose a variety of possible causes for these disparities.ConclusionsFurther research on the existence of disparities in care within EDs is warranted to explore the causes behind observed disparities for particular health conditions and population groups in specific contexts.
      PubDate: 2020-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2019.458
      Issue No: Vol. 22, No. 2 (2020)
       
  • An unexpected birth: neonatal resuscitation following a vaginal delivery
           by an unsuspecting mother in the emergency department: a case report
    • Authors: Jonathan E.G. Taylor; Kyle C. Harper, Nicholas D. Harrower, Adam Parent
      Pages: 254 - 256
      PubDate: 2020-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2019.443
      Issue No: Vol. 22, No. 2 (2020)
       
  • Ticked off: A case of a tick involving the lower eyelid
    • Authors: Kah Wai Lai; Dawn K. A. Lim, Blanche X. H. Lim, Yew Sen Yuen, Chris H. L. Lim
      Pages: 257 - 260
      PubDate: 2020-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2019.466
      Issue No: Vol. 22, No. 2 (2020)
       
  • To listen is to understand
    • Authors: Jorden Arbour
      Pages: 261 - 262
      PubDate: 2020-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2019.374
      Issue No: Vol. 22, No. 2 (2020)
       
  • Filling the gaps
    • Authors: Leo R. Carroll
      Pages: 263 - 264
      PubDate: 2020-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2019.414
      Issue No: Vol. 22, No. 2 (2020)
       
  • Global Research Highlights
    • Pages: 265 - 268
      Abstract: Editor's note: CJEM has partnered with a small group of selected journals of international emergency medicine societies to share from each a highlighted research study, as selected monthly by their editors. Our goals are to increase awareness of our readership to research developments in the international emergency medicine literature, promote collaboration among the selected international emergency medicine journals, and support the improvement of emergency medicine world-wide, as described in the WAME statement at http://www.wame.org/about/policy-statements#Promoting%20Global%20Health. s are reproduced as published in the respective participating journals and are not peer reviewed or edited by CJEM.
      PubDate: 2020-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2020.20
      Issue No: Vol. 22, No. 2 (2020)
       
 
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