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Related Concept Videos

Traumatic Memory01:20

Traumatic Memory

Emotionally traumatic events often lead to memories that are exceptionally vivid and enduring, sometimes persisting with remarkable clarity throughout an individual's life. A classic example of this phenomenon is a person who survives a car accident. Even years later, they may recall every detail of the event with startling accuracy — the screeching of the tires, the jarring impact, and the acrid smell of burning rubber. Such vividness contrasts sharply with how an individual remembers mundane...
Post-traumatic Stress Disorder01:27

Post-traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) is a psychiatric condition that arises following exposure to traumatic events such as natural disasters, forced displacement, or severe accidents. It significantly impairs individuals' ability to cope with daily activities and disrupts their emotional and psychological equilibrium.
Symptoms and Behavioral Manifestations
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Traumatic Brain Injury l: Introduction01:28

Traumatic Brain Injury l: Introduction

DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...
Dissociative Disorders01:27

Dissociative Disorders

Dissociative disorders represent complex psychological conditions characterized by disruptions in consciousness, memory, identity, or perception. These disruptions cause individuals to experience a disconnection from their thoughts, emotions, and memories. The phenomenon is not merely an occasional lapse in attention but a profound alteration in mental functioning that can severely impact daily life.
Dissociative Fugue
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Repressed Memory01:16

Repressed Memory

Repressed memories are a psychological phenomenon where memories of traumatic events are unconsciously blocked from a person's awareness. This process occurs as a defense mechanism, protecting the mind from the emotional impact of distressing or painful experiences. For example, a person who has experienced childhood trauma may grow up with no conscious recollection of the event. In such cases, the memories are thought to be buried deep within the subconscious, inaccessible to the conscious...
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Introduction to Stress and Lifestyle

Stress is a multifaceted response to events perceived as challenging or threatening, highlighting physical, emotional, cognitive, and behavioral reactions. Physically, stress can lead to fatigue, sleep disruptions, and various health issues such as frequent colds, chest pains, and nausea. Emotionally, it can manifest as anxiety, depression, irritability, and anger triggered by both minor and major life events. Cognitively, it may result in difficulty in concentration, memory, and...

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Use of a Psychophysiological Script-driven Imagery Experiment to Study Trauma-related Dissociation in Borderline Personality Disorder
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The "July phenomenon": is trauma the exception?

Thomas J Schroeppel1, Peter E Fischer, Louis J Magnotti

  • 1Department of Surgery, University of Tennessee Health Science Center, Memphis, TN 38163, USA. tschroep@utmem.edu

Journal of the American College of Surgeons
|September 1, 2009
PubMed
Summary

The "July phenomenon," an increase in medical errors due to new residents, was not observed in this Level I trauma center study. Patient outcomes, including mortality and resource utilization, showed no significant monthly variations, even with attending supervision.

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Area of Science:

  • Trauma Surgery
  • Medical Error Research
  • Healthcare Quality Improvement

Background:

  • The "July phenomenon" suggests increased medical errors and mortality with new resident physicians starting in July.
  • Previous studies have shown a rise in mortality during July and August for general surgery patients.
  • This study investigates the existence of the July phenomenon in a Level I trauma center with continuous attending physician presence.

Purpose of the Study:

  • To determine if the July phenomenon impacts patient outcomes at a Level I trauma center.
  • To assess if increased medical errors or mortality occur in July due to resident physician changes.
  • To evaluate the effect of continuous in-hospital attending supervision on the July phenomenon.

Main Methods:

  • Retrospective cohort study of blunt trauma patients over a 5-year period at an academic Level I trauma center.
  • Comparison of patient outcomes (mortality, ventilator days, ICU days, resuscitation room time) by month and quarter.
  • Statistical analyses included chi-square, ANOVA, and multivariable linear and logistic regression, adjusting for patient severity and demographics.

Main Results:

  • Analysis of 12,525 (by month) and 14,798 (by quarter) patients revealed no significant monthly variation in mortality.
  • Multivariable regression indicated that the month or quarter of the year was not an independent predictor of mortality.
  • No significant monthly differences were found in ventilator support days, ICU days, or resuscitation room minutes.

Conclusions:

  • The July phenomenon, characterized by increased medical errors or mortality, does not appear to exist at this Level I trauma center.
  • Continuous in-hospital attending supervision may mitigate the impact of resident physician transitions on patient safety.
  • Patient outcomes in trauma care are not demonstrably affected by the timing of resident physician rotations in this setting.