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https://www.readbyqxmd.com/read/28434554/the-simulation-based-assessment-of-pediatric-rapid-response-teams
#1
James J Fehr, Mary E McBride, John R Boulet, David J Murray
OBJECTIVE: To create scenarios of simulated decompensating pediatric patients to train pediatric rapid response teams (RRTs) and to determine whether the scenario scores provide a valid assessment of RRT performance with the hypothesis that RRTs led by intensivists-in-training would be better prepared to manage the scenarios than teams led by nurse practitioners. STUDY DESIGN: A set of 10 simulated scenarios was designed for the training and assessment of pediatric RRTs...
April 20, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28434131/knowing-how-and-knowing-why-testing-the-effect-of-instruction-designed-for-cognitive-integration-on-procedural-skills-transfer
#2
Jeffrey J H Cheung, Kulamakan M Kulasegaram, Nicole N Woods, Carol-Anne Moulton, Charlotte V Ringsted, Ryan Brydges
Transfer is a desired outcome of simulation-based training, yet evidence for how instructional design features promote transfer is lacking. In clinical reasoning, transfer is improved when trainees experience instruction integrating basic science explanations with clinical signs and symptoms. To test whether integrated instruction has similar effects in procedural skills (i.e., psychomotor skills) training, we studied the impact of instruction that integrates conceptual (why) and procedural (how) knowledge on the retention and transfer of simulation-based lumbar puncture (LP) skill...
April 22, 2017: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/28409648/assessment-of-simulated-emergency-scenarios-are-trained-observers-necessary
#3
Juliane Noveanu, Felix Amsler, Wolfgang Ummenhofer, Thomas von Wyl, Mathias Zuercher
OBJECTIVES: Simulation-based medical training is associated with superior educational outcomes and improved cost efficiency. Self- and peer-assessment may be a cost-effective and flexible alternative to expert-led assessment. We compared accuracy of self- and peer-assessment of untrained raters using basic evaluation tools to expert assessment using advanced validation tools including validated questionnaires and post hoc video-based analysis. METHODS: Twenty-eight simulated emergency airway management scenarios were observed and video-recorded for further assessment...
April 14, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28403837/effect-of-individualized-communication-skills-training-on-physicians-discussion-of-clinical-trials-in-oncology-results-from-a-randomized-controlled-trial
#4
Alexander Wuensch, Tanja Goelz, Gabriele Ihorst, Darcey D Terris, Hartmut Bertz, Juergen Bengel, Michael Wirsching, Kurt Fritzsche
BACKGROUND: Discussing randomized clinical trials (RCTs) with cancer patients is one of the most challenging communication tasks a physician faces. Only two prior Communication Skills Trainings (CSTs) focused on RCTs in oncology have been reported. Their results demonstrated the need for further improvement. We developed and evaluated an enhanced, individually-tailored CST focused on improving physicians' communication during discussions of RCTs. METHODS: The CST focused on personal learning goals derived from video pre-assessment that were addressed in a 1...
April 13, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28401340/seizure-threshold-increases-can-be-predicted-by-eeg-quality-in-right-unilateral-ultrabrief-ect
#5
Verònica Gálvez, Dusan Hadzi-Pavlovic, Susan Waite, Colleen K Loo
Increases in seizure threshold (ST) over a course of brief pulse ECT can be predicted by decreases in EEG quality, informing ECT dose adjustment to maintain adequate supra-threshold dosing. ST increases also occur over a course of right unilateral ultrabrief (RUL UB) ECT, but no data exist on the relationship between ST increases and EEG indices. This study (n = 35) investigated if increases in ST over RUL UB ECT treatments could be predicted by a decline in seizure quality. ST titration was performed at ECT session one and seven, with treatment dosing maintained stable (at 6-8 times ST) in intervening sessions...
April 11, 2017: European Archives of Psychiatry and Clinical Neuroscience
https://www.readbyqxmd.com/read/28398192/an-interventionist-adherence-scale-for-a-specialized-brief-negotiation-interview-focused-on-treatment-engagement-for-opioid-use-disorders
#6
Michael V Pantalon, James Dziura, Fang-Yong Li, Patricia H Owens, Patrick G O'Connor, Gail D'Onofrio
BACKGROUND: No psychometrically validated instrument for evaluating the extent to which interventionists correctly implement brief interventions designed to motivate treatment engagement for opioid use disorders has been reported in the literature. The objective of this study was to develop and examine the psychometric properties of the Brief Negotiation Interview (BNI) Adherence Scale for Opioid Use Disorders (BAS-O). METHODS: In the context of a randomized controlled trial evaluating the efficacy of 3 models of emergency department care for opioid use disorders, the authors developed and subsequently examined the psychometric properties of the BAS-O, a 38-item scale that required raters to answer whether or not ("Yes" or "No") each of the critical actions of the BNI was correctly implemented by the research interventionist...
February 23, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28392490/robust-automated-constellation-based-landmark-detection-in-human-brain-imaging
#7
REVIEW
Ali Ghayoor, Jatin G Vaidya, Hans J Johnson
A robust fully automated algorithm for identifying an arbitrary number of landmark points in the human brain is described and validated. The proposed method combines statistical shape models with trained brain morphometric measures to estimate midbrain landmark positions reliably and accurately. Gross morphometric constraints provided by automatically identified eye centers and the center of the head mass are shown to provide robust initialization in the presence of large rotations in the initial head orientation...
April 6, 2017: NeuroImage
https://www.readbyqxmd.com/read/28391191/automatic-quality-assessment-of-echocardiograms-using-convolutional-neural-networks-feasibility-on-the-apical-four-chamber-view
#8
Amir Abdi, Christina Luong, Teresa Tsang, John Jue, Dale Hawley, Sarah Fleming, Kenneth Gin, Jody Swift, Robert Rohling, Purang Abolmaesumi
Echocardiography (echo) is a skilled technical procedure that depends on the experience of the operator. The aim of this work is to reduce user variability in data acquisition by automatically computing a score of echo quality for operator feedback. To do this, a deep convolutional neural network model, trained on a large set of samples, was developed for scoring apical four-chamber (A4C) echo. In this research, 6,916 end-systolic echo images were manually studied by an expert cardiologist and were assigned a score between 0 (not acceptable) and 5 (excellent)...
April 4, 2017: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/28389700/the-predictability-of-ocriplasmin-treatment-effects-is-there-consensus-among-retinal-experts-results-from-the-export-study
#9
Thomas Bertelmann, Joachim Wachtlin, Stefan Mennel, Michael J Koss, Mathias M Maier, Ricarda G Schumann, Sara Kazerounian, Hanna Daniel, Steffen Schmitz-Valckenberg
PURPOSE: To evaluate the agreement and predictability of ocriplasmin treatment effects among retinal experts (raters) by assessment of retinal imaging data of eyes treated for vitreomacular traction in nine different centers in Germany and Austria. METHODS: Retrospective cohort study. Combined confocal near-infrared scanning laser ophthalmoscopy and spectral-domain optical coherence tomography images (Spectralis® device, Heidelberg Engineering GmbH, Germany) from 136 eyes of 135 subjects were reviewed by 14 raters using an internet-based grading database and a standardized questionnaire...
April 7, 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/28384524/reliability-and-validity-of-the-dsm-5-anxious-distress-specifier-interview
#10
Mark Zimmerman, Heather Clark, Patrick McGonigal, Lauren Harris, Carolina Guzman Holst, Jacob Martin
BACKGROUND: To acknowledge the clinical significance of anxiety in depressed patients, DSM-5 included an anxious distress specifier for major depressive disorder (MDD). In the present report we describe the reliability and validity of a semi-structured interview assessing the features of the anxious distress specifier. Our goal was to develop an instrument that could be used for both diagnostic and outcome measurement purposes. METHODS: One hundred seventy-three psychiatric patients with MDD were interviewed by a trained diagnostic rater who administered the Structured Clinical Interview for DSM-IV (SCID) supplemented with questions from the DSM-5 Anxious Distress Specifier Interview (DADSI)...
March 2, 2017: Comprehensive Psychiatry
https://www.readbyqxmd.com/read/28384301/effects-of-cognitive-bias-modification-on-social-anxiety-a-meta-analysis
#11
Haining Liu, Xianwen Li, Buxin Han, Xiaoqian Liu
BACKGROUND: Cognitive bias modification (CBM), a set of techniques for modifying bias in information processing-is considered a novel intervention for social anxiety disorder (SAD), which has drawn considerable interest from researchers. However, the effects of CBM on SAD are not consistent. Some studies have demonstrated significant positive effects compared to control groups, while others have found no such effects. AIMS: We conducted a meta-analysis aimed at quantitatively assessing the effects of CBM on SAD at post-test...
2017: PloS One
https://www.readbyqxmd.com/read/28377445/can-visible-signs-predict-concussion-diagnosis-in-the-national-hockey-league
#12
Ruben J Echemendia, Jared M Bruce, Willem Meeuwisse, Michael G Hutchison, Paul Comper, Mark Aubry
BACKGROUND: Early identification and evaluation of concussions is critical. We examined the utility of using visible signs (VS) of concussion in predicting subsequent diagnosis of concussion in NHL players. METHODS: VS of concussion were identified through video review. Coders were trained to detect and record specific visual signs while viewing videos of NHL regular season games. 2460 games were reviewed by at least two independent coders across two seasons. The reliability, sensitivity and specificity of these VS were examined...
April 4, 2017: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/28377115/this-is-your-new-normal-a-qualitative-study-of-barriers-and-facilitators-to-physical-activity-in-veterans-with-lower-extremity-loss
#13
Alyson J Littman, Erin D Bouldin, Jodie K Haselkorn
BACKGROUND: Regular physical activity (PA) is essential for aging well with a disability, preventing the onset or worsening of chronic conditions, functional loss, and maintaining or improving quality of life, yet PA levels are low in those with disabilities, including those with a lower extremity amputation (LEA). OBJECTIVE: To determine methods for promoting PA in this population, our objective was to better understand the barriers and facilitators to PA that persons with LEA face...
March 22, 2017: Disability and Health Journal
https://www.readbyqxmd.com/read/28376246/non-technical-skills-of-surgeons-and-anaesthetists-in-simulated-operating-theatre-crises
#14
A G Doumouras, M Hamidi, K Lung, C L Tarola, M W Tsao, J W Scott, D S Smink, S Yule
BACKGROUND: Deficiencies in non-technical skills (NTS) have been increasingly implicated in avoidable operating theatre errors. Accordingly, this study sought to characterize the impact of surgeon and anaesthetist non-technical skills on time to crisis resolution in a simulated operating theatre. METHODS: Non-technical skills were assessed during 26 simulated crises (haemorrhage and airway emergency) performed by surgical teams. Teams consisted of surgeons, anaesthetists and nurses...
April 4, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28376020/head-camera-video-recordings-of-trauma-core-competency-procedures-can-evaluate-surgical-resident-s-technical-performance-as-well-as-co-located-evaluators
#15
Colin F Mackenzie, Jason Pasley, Evan Garofalo, Stacy Shackelford, Hegang Chen, Nyaradzo Longinaker, Guinevere Granite, Kristy Pugh, George Hagegeorge, Samuel A Tisherman
BACKGROUND: Unbiased evaluation of trauma core competency procedures is necessary to determine if residency and pre-deployment training courses are useful. We tested whether a previously validated Individual Procedure Score (IPS) for individual procedure vascular exposure and fasciotomy (FAS) performance skills, could discriminate training status, by comparing IPS of evaluators co-located with surgeons to blind video evaluations. METHODS: Performance of axillary (AA), brachial (BA) and femoral artery (FA) vascular exposures and lower extremity FAS on fresh cadavers by 40 PGY 2-6 residents was video recorded from head- mounted cameras...
April 4, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28374867/dysphagia-screening-in-subacute-care-settings-using-the-italian-version-of-the-royal-brisbane-and-women-s-hospital-i-rbwh-dysphagia-screening-tool
#16
F Mozzanica, L Scarponi, S Pedrali, N Pizzorni, C Pinotti, F Foieni, G Zuccotti, A Schindler
The large majority of the available dysphagia screening tools has been developed for the stroke population. Only few screening tools are suitable for heterogeneous groups of patients admitted to a subacute care unit. The Royal Brisbane and Women's Hospital (RBWH) dysphagia screening tool is a nurse-administered, evidence-based swallow screening tool for generic acute hospital use that demonstrates excellent sensitivity and specificity. No Italian version of this tool is available to date. The aim of this study was to determine the reliability and screening accuracy of the Italian version of the RBWH (I-RBWH) dysphagia screening tool...
February 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28370856/validation-of-adapted-dartmouth-operative-conditions-scale-for-sedation-during-pediatric-esophagogastroduodenoscopy
#17
Vanmathi Chandran, Barath Jagadisan, Barani Ganth
AIMS: Pediatric esophagogastroduodenoscopy requires deep sedation as it involves stimulation of the airway. Frequency of adverse events is higher with esophagogastroduodenoscopy. Hence, monitoring needs sedation scales like the Dartmouth Operative Condition Scale that identifies safe states of sedation. This study aims at validating the Adapted Dartmouth Operative Condition Scale for sedation rating by pediatricians during pediatric esophagogastroduodenoscopy. METHODS: Items in the Dartmouth Operating Conditions Scale were adapted for pediatric esophagogastroduodenoscopy...
April 3, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28370143/inter-rater-reliability-of-sonographic-optic-nerve-sheath-diameter-measurements-by-emergency-medicine-physicians
#18
Stephanie Oberfoell, David Murphy, Andrew French, Stacy Trent, David Richards
OBJECTIVES: To compare the degree of agreement of sonographic optic nerve sheath diameter (ONSD) measurements by ultrasound fellowship-trained and resident emergency medicine (EM) physicians. METHODS: Ten ultrasound fellowship-trained EM attending physicians from multiple institutions and 51 resident EM physicians at a single residency were enrolled to measure the ONSD using a computerized ruler on five separate still-frame sonograms of adult eyes that included the retrobulbar optic nerve...
April 3, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28365204/individualized-exergame-training-improves-postural-control-in-advanced-degenerative-spinocerebellar-ataxia-a-rater-blinded-intra-individually-controlled-trial
#19
Cornelia Schatton, Matthis Synofzik, Zofia Fleszar, Martin A Giese, Ludger Schöls, Winfried Ilg
BACKGROUND: Treatment options are rare in degenerative ataxias, especially in advanced, multisystemic disease. Exergame training might offer a novel treatment strategy, but its effectiveness has not been investigated in advanced stages. METHODS: We examined the effectiveness of a 12-week home-based training with body-controlled videogames in 10 young subjects with advanced degenerative ataxia unable or barely able to stand. Training was structured in two 6-weeks phases, allowing to adapt the training according to individual training progress...
March 28, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28364548/distinct-brain-imaging-characteristics-of-autoantibody-mediated-cns-conditions-and-multiple-sclerosis
#20
Maciej Jurynczyk, Ruth Geraldes, Fay Probert, Mark R Woodhall, Patrick Waters, George Tackley, Gabriele DeLuca, Saleel Chandratre, Maria I Leite, Angela Vincent, Jacqueline Palace
Brain imaging characteristics of MOG antibody disease are largely unknown and it is unclear whether they differ from those of multiple sclerosis and AQP4 antibody disease. The aim of this study was to identify brain imaging discriminators between those three inflammatory central nervous system diseases in adults and children to support diagnostic decisions, drive antibody testing and generate disease mechanism hypotheses. Clinical brain scans of 83 patients with brain lesions (67 in the training and 16 in the validation cohort, 65 adults and 18 children) with MOG antibody (n = 26), AQP4 antibody disease (n = 26) and multiple sclerosis (n = 31) recruited from Oxford neuromyelitis optica and multiple sclerosis clinical services were retrospectively and anonymously scored on a set of 29 predefined magnetic resonance imaging features by two independent raters...
March 1, 2017: Brain: a Journal of Neurology
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