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https://www.readbyqxmd.com/read/28709415/assessing-anesthesiology-residents-out-of-the-operating-room-ooor-emergent-airway-management
#1
Lauryn R Rochlen, Michelle Housey, Ian Gannon, Shannon Mitchell, Deborah M Rooney, Alan R Tait, Milo Engoren
BACKGROUND: At many academic institutions, anesthesiology residents are responsible for managing emergent intubations outside of the operating room (OOOR), with complications estimated to be as high as 39%. In order to create an OOOR training curriculum, we evaluated residents' familiarity with the content and correct adherence to the American Society of Anesthesiologists' Difficult Airway Algorithm (ASA DAA). METHODS: Residents completed a pre-simulation multiple-choice survey measuring their understanding and use of the DAA...
July 15, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28700450/comparison-of-thirty-day-complications-between-navigated-and-conventional-single-level-instrumented-posterior-lumbar-fusion-a-propensity-score-matched-analysis
#2
Patawut Bovonratwet, Stephen J Nelson, Nathaniel T Ondeck, Benjamin J Geddes, Jonathan N Grauer
STUDY DESIGN: cohort comparison study. OBJECTIVE: To compare perioperative outcomes between navigated and conventional single-level instrumented posterior lumbar fusions in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. SUMMARY OF BACKGROUND DATA: Although multiple studies have investigated the accuracy of pedicle screw placement and radiation exposure with navigation, no study has compared perioperative complications between navigated and conventional posterior lumbar fusion...
July 11, 2017: Spine
https://www.readbyqxmd.com/read/28697017/risk-factors-for-deep-vein-thrombosis-and-pulmonary-embolism-after-traumatic-injury-a-competing-risks-analysis
#3
Jan-Michael Van Gent, Richard Y Calvo, Ashley L Zander, Erik J Olson, C Beth Sise, Michael J Sise, Steven R Shackford
BACKGROUND: Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is typically reported as a composite measure of the quality of trauma center care. Given recent data suggesting post-injury DVT and PE are distinct clinical processes, a better understanding may result from analyzing them as independent, competing events. Using competing risks analysis, we evaluated our hypothesis that the risk factors and timing of post-injury DVT and PE are different...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28690941/a-simulation-based-quality-improvement-approach-to-improve-pediatric-resident-competency-with-required-procedures
#4
Michelle Starr, Taylor Sawyer, Maya Jones, Maneesh Batra, Heather McPhillips
INTRODUCTION: Pediatric residents report a lack of confidence and competence with procedural skills at graduation. Training programs could benefit from improved approaches to target these needs. Using the Institute for Healthcare Improvement (IHI) Model for Improvement and three Plan-Do-Study-Act (PDSA) cycles, we examined the impact of a procedure simulation boot camp on self-reported procedural confidence and competence as well as the longitudinal impacts of these sequential interventions on Accreditation Council for Graduate Medical Education (ACGME) Graduating Resident Survey (GRS) results...
June 3, 2017: Curēus
https://www.readbyqxmd.com/read/28690015/causes-of-failure-of-pallidal-deep-brain-stimulation-in-cases-with-pre-operative-diagnosis-of-isolated-dystonia
#5
K Amande M Pauls, Joachim K Krauss, Constanze E Kämpfer, Andrea A Kühn, Christoph Schrader, Martin Südmeyer, Niels Allert, Rainer Benecke, Christian Blahak, Jana K Boller, Gereon R Fink, Wolfgang Fogel, Thomas Liebig, Faycal El Majdoub, Philipp Mahlknecht, Josef Kessler, Joerg Mueller, Juergen Voges, Matthias Wittstock, Alexander Wolters, Mohammad Maarouf, Elena Moro, Jens Volkmann, Kailash P Bhatia, Lars Timmermann
INTRODUCTION: Pallidal deep brain stimulation (GPi-DBS) is an effective therapy for isolated dystonia, but 10-20% of patients show improvement below 25-30%. We here investigated causes of insufficient response to GPi-DBS in isolated dystonia in a cross-sectional study. METHODS: Patients with isolated dystonia at time of surgery, and <30% improvement on the Burke-Fahn-Marsden dystonia-rating-scale (BFMDRS) after ≥6 months of continuous GPi-DBS were videotaped ON and OFF stimulation, and history, preoperative videos, brain MRI, medical records, stimulation settings, stimulation system integrity, lead location, and genetic information were obtained and reviewed by an expert panel...
June 28, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28689047/major-regional-differences-in-automated-external-defibrillator-placement-and-basic-life-support-training-in-france-further-needs-for-coordinated-implementation
#6
Nicole Karam, Kumar Narayanan, Wulfran Bougouin, Nordine Benameur, Frankie Beganton, Daniel Jost, Lionel Lamhaut, Marie-Cécile Perier, Alain Cariou, David S Celermajer, Eloi Marijon, Xavier Jouven
BACKGROUND: Public Access Defibrillation (PAD) programs have emerged since mid-1990s with the aim of improving survival from Out-of-Hospital Cardiac Arrest (OHCA). The extent to which their implementation in the community differs among different areas has not been evaluated. METHODS: We carried out a 5-year prospective national evaluation of PAD programs in 51 French districts (29.3 million inhabitants), through the cumulative density of Automated External Defibrillator (AEDs) and the proportion of persons educated in Basic Life Support (BLS)...
July 5, 2017: Resuscitation
https://www.readbyqxmd.com/read/28688550/a-quality-study-of-family-centered-care-coordination-to-improve-care-for-children-undergoing-tracheostomy-and-the-quality-of-life-for-their-caregivers
#7
Christopher Hartnick, Gillian Diercks, Vanessa De Guzman, Elizabeth Hartnick, Jeanne Van Cleave, Kevin Callans
IMPORTANCE: Approximately 4000 U.S. children undergo tracheostomy yearly [1], and these surgeries often result in hospital re-admissions that have definite cost and caregiver burdens due to complications that are avoidable with proper training and support. OBJECTIVE: To assess the impact of a Family-Centered Care Coordination (FCCC) program on the quality of care received by children undergoing tracheostomy and their caregivers. DESIGN: Caregivers of children undergoing tracheostomies from January 2012 to January 2013 and then a different set of caregivers of children undergoing tracheostomies from January 2015 to January 2016 completed both the Pediatric Tracheostomy Health Status Instrument (PTHSI) 1 month after discharge and the Medical Complications Associated with Pediatric Tracheostomy (MCAT) questionnaire 6 months after initial tracheostomy...
August 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28687709/the-effects-of-public-access-defibrillation-on-survival-after-out-of-hospital-cardiac-arrest-a-systematic-review-of-observational-studies
#8
Josefine Bækgaard, Søren Viereck, Thea Møller, Annette Ersbøll, Freddy Lippert, Fredrik Folke
Background -Despite recent advances, the average survival after out-of-hospital cardiac arrest (OHCA) remains below 10%. Early defibrillation by an automated external defibrillator (AED) is the most important intervention for OHCA patients, showing survival proportions above 50%. Accordingly, placement of AEDs in the community as part of a public access defibrillation program (PAD) is recommended by international guidelines. However, different strategies have been proposed on how exactly to increase and make use of public available AEDs...
July 7, 2017: Circulation
https://www.readbyqxmd.com/read/28685812/simulation-based-training-program-with-deliberate-practice-for-ultrasound-guided-jugular-central-venous-catheter-placement
#9
M A Corvetto, J C Pedemonte, D Varas, C Fuentes, F R Altermatt
BACKGROUND: Current evidence supports the utility of simulation training for bedside procedures such as ultrasound-guided jugular central venous catheter (CVC) insertion. However, a standardized methodology to teach procedural skills has not been determined yet. The aim of this study was to evaluate the effectiveness of a simulation-based training program for improving novice technical performance during ultrasound-guided internal jugular CVC placement. METHODS: Postgraduate year 1 (PGY-1) residents from anesthesiology, emergency medicine, cardiology, ICU, and nephrology specialties were trained in four deliberate practice sessions...
July 6, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28677917/recovery-of-atrioventricular-conduction-in-patients-with-heart-block-after-transcatheter-aortic-valve-replacement
#10
Colin A Raelson, James Gabriels, Jonathan Ruan, James E Ip, George Thomas, Christopher F Liu, Jim W Cheung, Bruce B Lerman, Apoor Patel, Steven M Markowitz
INTRODUCTION: Recovery of conduction has been demonstrated in >50% of patients who receive pacemakers (PPMs) for high-degree atrioventricular block (HD-AVB) after transcatheter aortic valve replacement (TAVR). Little information is available about the time course of conduction recovery in these patients and if any features predict early recovery of conduction. METHODS: A retrospective review was performed of patients who underwent TAVR with balloon and self-expanding valves who required PPMs for HD-AVB...
July 5, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28665719/eimeria-oocyst-concentrations-and-species-composition-in-litter-from-commercial-broiler-farms-during-anticoccidial-drug-or-live-eimeria-oocyst-vaccine-control-programs
#11
Mark C Jenkins, Carolyn Parker, Donald Ritter
The purpose of this study was to determine if Eimeria oocyst concentrations and species composition in commercial broiler house litter changed during different cycles of anticoccidial drug (ACD) or live Eimeria oocyst vaccine (VAC) control programs and if there was a correlation between Eimeria oocyst levels and broiler performance. Litter samples were collected from a total of 15 different broiler farms encompassing a total of 45 individual houses during at least one complete grow-out cycle over a 21-mo period...
June 2017: Avian Diseases
https://www.readbyqxmd.com/read/28663932/enhancing-community-health-by-improving-physician-participation
#12
Casey Crump, Guedy Arniella, Neil S Calman
Leading medical associations have called for renewed standards of medical professionalism, including stronger public advocacy, a commitment to social justice in health care, and greater community engagement. New strategies are needed to enhance community participation among physicians, which can improve public trust in the medical profession and contribute needed expertise and teamwork to matters of community health. One strategy is to incorporate community participation and leadership in medical training through community-based organization (CBO) placement of residents...
October 2016: Journal of Community Medicine & Health Education
https://www.readbyqxmd.com/read/28660180/constructing-a-global-learning-partnership-in-physiotherapy-an-ireland-uganda-initiative
#13
Cliona O'Sullivan, Herman Kazibwe, Zillah Whitehouse, Catherine Blake
BACKGROUND AND AIM: There is a strong correlation between disability and poverty and it is acknowledged that until disability issues are addressed, the goal of poverty reduction in low-income countries is unlikely to be achieved. Despite the high prevalence of disability in developing countries, there remains a significant shortage of rehabilitation professionals as highlighted by the WHO report, Human resources for Health (2006). The purpose of this project was to develop a collaborative and sustainable partnership to strengthen educational and research capacity in global health, disability, and rehabilitation between two physiotherapy schools; University College Dublin, Ireland, and Mbarara University of Science and Technology, Uganda...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28658017/rethinking-the-match-a-proposal-for-modern-match-making
#14
Chris Ray, Steven E Bishop, Alan W Dow
Since the 1950s, the National Resident Matching Program, or "the Match," has governed the placement of medical students into residencies. The Match was created to protect students in an era when residency positions outnumbered applicants and hospitals pressured students early in their academic careers to commit to a residency position. Now, however, applicants outnumber positions, applicants are applying to increasing numbers of programs, and the costs of the Match for applicants and programs are high. Meanwhile, medical education is evolving toward a competency-based approach, a U...
June 27, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28652920/perception-of-and-attitude-toward-ethical-issues-among-korean-occupational-physicians
#15
Junghye Choi, Chunhui Suh, Jong-Tae Lee, Segyeong Lee, Chae-Kwan Lee, Gyeong-Jin Lee, Taekjoong Kim, Byung-Chul Son, Jeong-Ho Kim, Kunhyung Kim, Dae Hwan Kim, Ji Young Ryu
BACKGROUND: Occupational physicians (OPs) have complex relationships with employees, employers, and the general public. OPs may have simultaneous obligations towards third parties, which can lead to variable conflicts of interests. Among the various studies of ethical issues related to OPs, few have focused on the Korean OPs. The aim of the present survey was to investigate the ethical contexts, the practical resolutions, and the ethical principles for the Korean OPs. METHODS: An email with a self-administered questionnaire was sent to members of the Korean Society of Occupational and Environmental Medicine, comprising 150 specialists and 130 residents...
2017: Annals of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28643568/process-mining-based-method-of-designing-and-optimizing-the-layouts-of-emergency-departments-in-hospitals
#16
Farhood Rismanchian, Young Hoon Lee
OBJECTIVE: This article proposes an approach to help designers analyze complex care processes and identify the optimal layout of an emergency department (ED) considering several objectives simultaneously. These objectives include minimizing the distances traveled by patients, maximizing design preferences, and minimizing the relocation costs. BACKGROUND: Rising demand for healthcare services leads to increasing demand for new hospital buildings as well as renovating existing ones...
July 2017: HERD
https://www.readbyqxmd.com/read/28635436/changes-in-the-nature-and-intensity-of-stress-following-employment-among-people-with-severe-mental-illness-receiving-individual-placement-and-support-services-an-exploratory-qualitative-study
#17
Christine Besse, Daniel Poremski, Vincent Laliberté, Eric Latimer
BACKGROUND: Most people with severe mental illness (SMI) want to work. Individual placement and support (IPS) programs have proven effective in helping them obtain and keep competitive jobs. Yet, practitioners often fear that competitive jobs might be too stressful. AIMS: To explore how the nature and intensity of stress experienced by IPS clients changed after the transition from looking for work to being employed. METHODS: Semi-structured interviews explored the experiences of 16 clients of an IPS program who had recently been competitively employed...
March 1, 2017: Journal of Mental Health
https://www.readbyqxmd.com/read/28622589/improving-outcomes-for-babies-and-toddlers-in-child-welfare-a-model-for-infant-mental-health-intervention-and-collaboration
#18
Susan Chinitz, Hazel Guzman, Ellen Amstutz, Joaniko Kohchi, Miriam Alkon
Children under three comprise a sizable and growing proportion of foster care placements. Very young children who enter the child welfare system experience disruptions of critical attachments that are essential to this formative stage of brain development, as well as other traumatic events, leaving them at great risk for lifelong impairments. To reverse these concerning outcomes, babies who have been removed from their homes require intensive, relationship-based interventions that promote secure attachment to a primary caregiver and holistic attention the child's developmental needs...
June 13, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28617908/validation-of-single-c-arm-fluoroscopic-technique-for-measuring-in-vivo-abdominal-wall-deformation
#19
Lindsey G Kahan, Charlotte Guertler, Jeffrey A Blatnik, Spencer P Lake
Hernia meshes significantly reduce the recurrence rates in hernia repair. It is known that they affect the abdominal wall postimplantation, yet the understanding of in vivo mechanics in the mesh placement area is lacking. We established a single C-arm biplane fluoroscopic system to study strains at the interface between the mesh and repaired abdominal tissues. We aimed to validate this system for future porcine hernia repair studies. Custom matlab programs were written to correct for pincushion distortion, and direct linear transformation (DLT) reconstructed objects in 3D...
August 1, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/28616642/-identification-of-common-locations-of-out-of-hospital-cardiac-arrests-in-a%C3%A2-german-metropolis
#20
C Hanefeld, F Rosbund, A Kloppe, C Kloppe
BACKGROUND: Most patients who suffer a sudden cardiac arrest initially have a shockable rhythm. Fast defibrillation and correctly performed cardiopulmonary resuscitation (CPR) are key factors for patient survival. These can be carried out by bystanders if an automated external defibrillator (AED) is available even in the absence of emergency services. AIM: The place and time of CPRs in a German city were investigated and the strategic placement of emergency medical services and AEDs necessary were evaluated...
June 14, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
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