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"hand off"

Brian M Davis, Evelina R Loghin, Kenneth R Conway, Xiaohua Zhang
Pluripotent stem cell suspension aggregates have proven to be an efficient and phenotypically stable means for expansion and directed differentiation. Bioreactor systems with automation of perfusion, fluidization, and gas exchange are essential for scaling up pluripotent stem cell cultures. Since stem cell pluripotency and differentiation are affected by both chemical and physical signals, we investigated a low-shear method for the expansion of cells in a rocking-motion bioreactor. The rocking motion drives continual mixing and aeration, and the single-use disposable bioreactors avoid issues around contamination during seeding, medium exchange, passage, and cell harvest...
February 1, 2018: SLAS Technology
Christopher A Adin, Callie A Fogle, Steven L Marks
To ensure patient safety and protect the well-being of interns and residents, the Accreditation Council for Graduate Medical Education (ACGME) issued guidelines in 2003 limiting the working hours of physician trainees. Although many supported the goals of the ACGME, institutions struggled to restructure their programs and hire staff required by this unfunded mandate. Numerous studies have analyzed the effects of duty hours restrictions on patient outcomes and physician training over the past 15 years. Most agree that duty hours restrictions improved well-being of house officers, but these improvements came at the expense of continuity, and patient hand-offs led to medical errors...
February 19, 2018: Veterinary Surgery: VS
Adhisakthi Rajalatchumi, Thanjavur S Ravikumar, Kaliaperumal Muruganandham, Mahalakshmy Thulasingam, Kalaiselvi Selvaraj, Mahendra M Reddy, Balachander Jayaraman
Introduction: Patient safety is a global concern and is the most important domains of health-care quality. Medical error is a major patient safety concern, causing increase in health-care cost due to mortality, morbidity, or prolonged hospital stay. Aim: The aim of the study was to assess the perceptions on patient safety culture among health-care providers (HCPs) at a public sector tertiary care hospital in South India. Settings and Design: A hospital-based cross-sectional study was conducted 1 year after patient safety initiatives were implemented...
January 2018: Journal of Natural Science, Biology, and Medicine
Teresa Arias, Kirstie Coxon
BACKGROUND AND OBJECTIVE: the limited availability of high quality evidence related to second stage management of the perineum (SSMP) combined with a perceived shift in UK practice towards a 'hands off' the perineum/fetal head approach are likely to have impacted significantly on student midwives' understanding of SSMP. This paper presents a classroom based educational session using low fidelity simulation, which was designed in response to student feedback and aimed to improve confidence in this skill...
February 13, 2018: Midwifery
Carmen Alvarez, Katrina Debnam, Amber Clough, Kamila Alexander, Nancy E Glass
Supportive care for survivors of intimate partner violence (IPV) remains limited in primary care settings. Low-income and Spanish-speaking survivors of IPV are even more disadvantaged, given the dearth of linguistically and culturally appropriate interventions for IPV. We conducted semi-structured individual interviews with 17 healthcare workers, including physicians, nurses, and social workers, to describe how healthcare workers serving primarily low-income, Latina populations are currently screening and responding to IPV disclosure, and to explore the acceptability of integrating an interactive, personalized safety decision aid application-myPlan app-into the clinic setting...
February 14, 2018: Research in Nursing & Health
Woo Jin Jung, Sung Oh Hwang, Hyung Il Kim, Yong Sung Cha, Oh Hyun Kim, Hyun Kim, Kang Hyun Lee, Kyoung-Chul Cha
OBJECTIVE: We designed a new chest compression technique, the 'knocking-fingers' chest compression (KF) technique, for a single rescuer in infant cardiac arrest. We compared the effectiveness and feasibility between the KF technique and the two-finger (TF) and two-thumb encircling hands (TT) techniques. PARTICIPANTS AND METHODS: A prospective, randomized, crossover study was carried out to compare the quality of chest compression and ventilation between the KF, TF, and TT techniques using a 30 : 2 compression-to-ventilation ratio and mouth-to-mouth ventilation...
January 30, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Edith D Gurewitsch Allen
Mastery of shoulder dystocia management skills acquired via simulation training can reduce neonatal brachial plexus injury by 66% to 90%. However, the correlation between simulation drills and reduction in clinical injuries has been inconsistently replicated, and establishing a causal relationship between simulation training and reduction of adverse clinical events from shoulder dystocia is infeasible due to ethical limitations. Nevertheless, professional liability insurance carriers increasingly are mandating simulation-based rehearsal and competency assessment of their covered obstetric providers' shoulder dystocia management skills-a high-stakes demand that will require rapid scaling up of access to quality shoulder dystocia simulation...
January 29, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
Dawn Krimminger, Carrie Sona, Elaine Thomas-Horton, Marilyn Schallom
: Background: Handover from the operating room (OR) staff to the ICU staff is a critical transition time for patients, in which the potential for error and miscommunication is high. Therefore, minimization of extraneous interruptions during the exchange of crucial information between the anesthesia and surgical teams and the nursing, respiratory therapy, and medical teams is imperative. OBJECTIVES: The aim of this quality improvement (QI) initiative was, first, to examine the impact of a standardized handover process between the OR and the ICU on process and information-sharing errors, and second, to examine provider satisfaction with the handover process...
February 2018: American Journal of Nursing
Magdalena Jansova, Vladimir Kalis, Zdenek Rusavy, Sari Räisänen, Libor Lobovsky, Katariina Laine
OBJECTIVE: The aim of this study was to evaluate whether a previously identified modification of Viennese method of perineal protection remains most effective for reduction of perineal tension in cases with substantially smaller or larger fetal heads. METHODS: A previously designed finite element model was used to compare perineal tension of different modifications of the Viennese method of perineal protection to "hands-off" technique for three different sizes of the fetal head...
2017: PloS One
Ben A Blomberg, Rebekah C Mulligan, Stephen J Staub, Laura C Hanson, Margaret A Drickamer, Maureen C Dale
OBJECTIVES: To improve assessment and documentation of function, cognition, and advance care planning (ACP) in admission and discharge notes on an Acute Care of the Elderly (ACE) unit. DESIGN: Continuous quality improvement intervention with episodic data review. SETTING: ACE unit of an 866-bed academic tertiary hospital. PARTICIPANTS: Housestaff physicians rotating on the ACE unit (N = 31). INTERVENTION: Introduction of templated notes, housestaff education, leadership outreach, and posted reminders...
February 2018: Journal of the American Geriatrics Society
Jasper D Bier, Wendy G M Scholten-Peeters, J Bart Staal, Jan Pool, Maurits W van Tulder, Emmylou Beekman, Jesper Knoop, Guus Meerhoff, Arianne P Verhagen
The Royal Dutch Society for Physical Therapy (KNGF) issued a clinical practice guideline for physical therapists that addresses the assessment and treatment of patients with nonspecific neck pain, including cervical radiculopathy, in Dutch primary care. Recommendations were based on a review of published systematic reviews.During the intake, the patient is screened for serious pathologies and corresponding patterns. Patients with cervical radiculopathy can be included or excluded through corresponding signs and symptoms and possibly diagnostic tests (Spurling test, traction/distraction test, and Upper Limb Tension Test)...
March 1, 2018: Physical Therapy
Rachel Jia Min Ko, Swee Han Lim, Vivien Xi Wu, Tak Yam Leong, Sok Ying Liaw
INTRODUCTION: Simplifying the learning of cardiopulmonary resuscitation (CPR) is advocated to improve skill acquisition and retention. A simplified CPR training programme focusing on continuous chest compression, with a simple landmark tracing technique, was introduced to laypeople. The study aimed to examine the effectiveness of the simplified CPR training in improving lay rescuers' CPR performance as compared to standard CPR. METHODS: 85 laypeople (aged 21-60 years) were recruited and randomly assigned to undertake either a two-hour simplified CPR training or standard CPR training...
November 13, 2017: Singapore Medical Journal
Matthew Bratkowski, Ilona Christy Unarta, Lizhe Zhu, Murtada Shubbar, Xuhui Huang, Xin Liu
Functional crosstalk between the promoter and terminator of a gene has long been noted. Promoters and terminators are juxtaposed to form gene loops in several organisms and gene looping is thought to be involved in transcriptional regulation. The general transcription factor II B (TFIIB) and the C-terminal domain phosphatase Ssu72, essential factors of the transcription pre-initiation complex and the mRNA processing and polyadenylation complex, respectively, are important for gene loop formation. TFIIB and Ssu72 interact both genetically and physically, but the molecular basis of this interaction is not known...
November 20, 2017: Journal of Biological Chemistry
M A Nebsbjerg, S E Rasmussen, K B Bomholt, L Q Krogh, K Krogh, J A Povlsen, I S Riddervold, T Grøfte, H Kirkegaard, B Løfgren
BACKGROUND: Dispatcher assisted cardiopulmonary resuscitation (DA-CPR) increase the rate of bystander CPR. The aim of the study was to compare the performance of DA-CPR and attainable skills following CPR training between young and elderly laypersons. METHODS: Volunteer laypersons (young: 18-40 years; elderly: > 65 years) participated. Single rescuer CPR was performed in a simulated DA-CPR cardiac arrest scenario and after CPR training. Data were obtained from a manikin and from video recordings...
January 2018: Acta Anaesthesiologica Scandinavica
Luke Robinson, Jonathon Spanyer, Zachary Yenna, Patrick Burchell, Andrew Garber, John Riehl
Arthroscopic education research recently has been focused on the use of skills labs to facilitate resident education and objective measure development to gauge technical skill. This study evaluates the effectiveness of three different teaching methods. Medical students were randomized into three groups. The first group received only classroom-based lecture. The second group received the same lecture and 28 minutes of lab-based hands-off arthroscopy instruction using a cadaver and arthroscopy setup. The final group received the same lecture and 7 minutes of hands-on arthroscopy instruction in the lab on a cadaver knee...
October 2017: Journal of Surgical Orthopaedic Advances
Amelia Yeo, Iasmine Ledesma, Mitchell J Nathan, Martha W Alibali, R Breckinridge Church
During mathematics instruction, teachers often make links between different representations of mathematical information, and they sometimes use gestures to refer to the representations that they link. In this research, we investigated the role of such gestures in students' learning from lessons about links between linear equations and corresponding graphs. Eighty-two middle-school students completed a pretest, viewed a video lesson, and then completed a posttest comparable to the pretest. In all of the video lessons, the teacher explained the links between equations and graphs in speech...
2017: Cognitive Research: Principles and Implications
James Lamb, Minsong Cao, Amar Kishan, Nzhde Agazaryan, David H Thomas, Narek Shaverdian, Yingli Yang, Suzette Ray, Daniel A Low, Ann Raldow, Michael L Steinberg, Percy Lee
Onboard magnetic resonance imaging (MRI) guided radiotherapy is now clinically available in nine centers in the world. This technology has facilitated the clinical implementation of online adaptive radiotherapy (OART), or the ability to alter the daily treatment plan based on tumor and anatomical changes in real-time while the patient is on the treatment table. However, due to the time sensitive nature of OART, implementation in a large and busy clinic has many potential obstacles as well as patient-related safety considerations...
August 27, 2017: Curēus
Shu-Hui Yang, Jih-Shuin Jerng, Li-Chin Chen, Yu-Tsu Li, Hsiao-Fang Huang, Chao-Ling Wu, Jing-Yuan Chan, Szu-Fen Huang, Huey-Wen Liang, Jui-Sheng Sun
BACKGROUND: Intra-hospital transportation (IHT) might compromise patient safety because of different care settings and higher demand on the human operation. Reports regarding the incidence of IHT-related patient safety events and human failures remain limited. OBJECTIVE: To perform a retrospective analysis of IHT-related events, human failures and unsafe acts. SETTING: A hospital-wide process for the IHT and database from the incident reporting system in a medical centre in Taiwan...
November 3, 2017: BMJ Open
Stijn J M Niessen, Katarina Hazuchova, Sonya L Powney, Javier Guitian, Antonius P M Niessen, Paul D Pion, James A Shaw, David B Church
Current pet diabetes mellitus (DM) treatment necessitates the active daily involvement of owners and can be costly. The current study aimed to investigate the owner population which opts for euthanasia instead of DM treatment. A survey was designed using multiple feedback steps and made available online to veterinarians world-wide. A total of 1192 veterinarians completed the survey and suggested a median one in 10 diabetic pets are euthanased at diagnosis; a further median one in 10 within one year because of lack of success or compliance...
May 14, 2017: Veterinary Sciences
Punnag Padhy, Mohammad Asif Zaman, Paul Hansen, Lambertus Hesselink
Nanoparticles trapped on resonant near-field apertures/engravings carved in plasmonic films experience optical forces due to the steep intensity gradient field of the aperture/engraving as well as the image like interaction with the substrate. For non-resonant nanoparticles the contribution of the substrate interaction to the trapping force in the vicinity of the trap (aperture/engraving) mode is negligible. But, in the case of plasmonic nanoparticles, the contribution of the substrate interaction to the low frequency stable trapping mode of the coupled particle-trap system increases as their resonance is tuned to the trap resonance...
October 16, 2017: Optics Express
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