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Crisis decision making

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https://www.readbyqxmd.com/read/28493407/first-person-perspective-video-to-enhance-simulation
#1
Junaid Fukuta, Justin Morgan
BACKGROUND: Simulation training is increasingly being used as part of the undergraduate medical curriculum, but it remains time and faculty member intensive. To improve efficacy, videos have been used prior to the simulation of practical procedures; however, using videos prior to simulation training concerning the management of patients who are unwell has not been investigated. The aim of this project was to see whether clinical decision-making and non-technical skills can be improved if a video is used prior to simulation training, and uniquely to enhance the authenticity we filmed it using a first-person perspective...
May 10, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28462731/constructing-ebola-transmission-chains-from-west-africa-and-estimating-model-parameters-using-internet-sources
#2
W B P Pettey, M E Carter, D J A Toth, M H Samore, A V Gundlapalli
During the recent Ebola crisis in West Africa, individual person-level details of disease onset, transmissions, and outcomes such as survival or death were reported in online news media. We set out to document disease transmission chains for Ebola, with the goal of generating a timely account that could be used for surveillance, mathematical modeling, and public health decision-making. By accessing public web pages only, such as locally produced newspapers and blogs, we created a transmission chain involving two Ebola clusters in West Africa that compared favorably with other published transmission chains, and derived parameters for a mathematical model of Ebola disease transmission that were not statistically different from those derived from published sources...
May 2, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28441505/error-detection-based-model-to-assess-educational-outcomes-in-crisis-resource-management-training-a-pilot-study
#3
Sarah Bouhabel, Emily Kay-Rivest, Carol Nhan, Ilana Bank, Peter Nugus, Rachel Fisher, Lily Hp Nguyen
Otolaryngology-head and neck surgery (OTL-HNS) residents face a variety of difficult, high-stress situations, which may occur early in their training. Since these events occur infrequently, simulation-based learning has become an important part of residents' training and is already well established in fields such as anesthesia and emergency medicine. In the domain of OTL-HNS, it is gradually gaining in popularity. Crisis Resource Management (CRM), a program adapted from the aviation industry, aims to improve outcomes of crisis situations by attempting to mitigate human errors...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28422795/trial-design-and-endpoint-evaluation-in-clinical-studies-addressing-chronic-back-pain
#4
Peter Staats
STUDY DESIGN: A review of the literature evaluating clinical trials of chronic back pain. OBJECTIVE: To assist physicians in assessing the quality of clinical trial data to make the most informed treatment decisions. SUMMARY OF BACKGROUND DATA: Chronic pain is a tremendous public health issue, affecting close to 100 million adults in the United States, and costs the American people billions of dollars. One traditional treatment approach, the long-term use of opiate medications, has recently come under intense scrutiny for problems with complications, diversion, abuse, addiction and lack of efficacy...
April 18, 2017: Spine
https://www.readbyqxmd.com/read/28417931/upstreaming-and-normalizing-advance-care-planning-conversations-a-public-health-approach
#5
Maryjo Prince-Paul, Evelina DiFranco
As a society, we simply don't talk about this universal experience called dying and death; in fact, we ignore it until we have to face it. Thus, it is often in a crisis experience when we have to make decisions while we are laden with uncertainty and intense emotions. Sixty percent of people say making sure their family is not burdened by tough decisions is extremely important, yet 56% of them have not held a conversation about its context. Instead of waiting to make end-of-life decisions, let us begin to think about what matters most while we are living, what we value most, and how we translate these values into conversations about what is important...
April 12, 2017: Behavioral Sciences
https://www.readbyqxmd.com/read/28403172/a-first-estimate-of-the-structure-and-density-of-the-populations-of-pet-cats-and-dogs-across-great-britain
#6
James Aegerter, David Fouracre, Graham C Smith
Policy development, implementation, and effective contingency response rely on a strong evidence base to ensure success and cost-effectiveness. Where this includes preventing the establishment or spread of zoonotic or veterinary diseases infecting companion cats and dogs, descriptions of the structure and density of the populations of these pets are useful. Similarly, such descriptions may help in supporting diverse fields of study such as; evidence-based veterinary practice, veterinary epidemiology, public health and ecology...
2017: PloS One
https://www.readbyqxmd.com/read/28376998/overcoming-psychological-barriers-to-plan-invocation
#7
Alan Elwood
Although very few - if any - crisis management, business continuity or incident response plans fail to include procedures to cover their instigation, there are many instances when these procedures are not enacted as intended or do not produce the expected results. In such circumstances, the gravity of the situation may well be appreciated at various levels, but for complex reasons, the teams or structures envisaged as being required are nonetheless not established fully. This paper explores this phenomenon, considering the nature of the problem and its significance, as well as the challenges faced by those making invocation decisions...
December 1, 2017: Journal of Business Continuity & Emergency Planning
https://www.readbyqxmd.com/read/28366250/-emergency-plans-in-crisis-situations
#8
Laure Alhanati, Hugues Lefort, Noémie Galinou, Catherine Rivet, Stéphane Travers, Jean-Pierre Tourtier
In November 2015, in Paris, a wave of terrorist attacks brought horror to France. The medical and nursing teams were severely tested but demonstrated efficiency and courage. The organisation of the emergency response requires fast and essential decision making and actions.
April 2017: Revue de L'infirmière
https://www.readbyqxmd.com/read/28366114/facilitation-of-psychiatric-advance-directives-by-peers-and-clinicians-on-assertive-community-treatment-teams
#9
Michele M Easter, Jeffrey W Swanson, Allison G Robertson, Lorna L Moser, Marvin S Swartz
OBJECTIVE: Psychiatric advance directives (PADs) provide a legal mechanism for competent adults to document care preferences and authorize a surrogate to make treatment decisions. In a controlled research setting, an evidence-based intervention, the facilitated psychiatric advance directive (FPAD), was previously shown to overcome most barriers to PAD completion. This study examined implementation of the FPAD intervention in usual care settings as delivered by peer support specialists and nonpeer clinicians on assertive community treatment (ACT) teams...
April 3, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28365884/de-escalating-antibiotic-use-in-the-inpatient-setting-strategies-controversies-and-challenges
#10
REVIEW
J Daniel Markley, Shaina Bernard, Gonzalo Bearman, Michael P Stevens
PURPOSE OF REVIEW: Antibiotic de-escalation (ADE) is widely accepted as an integral strategy to curtail the global antibiotic resistance crisis. However, there is significant uncertainty regarding the ideal ADE strategy and its true impact on antibiotic resistance. Rapid diagnostic testing has the potential to enhance ADE strategies. Herein, we aim to discuss the current strategies, controversies, and challenges of ADE in the inpatient setting. RECENT FINDINGS: A consensus definition of ADE remains elusive at this time...
April 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28349858/potentially-preventable-hospitalizations-in-dementia-family-caregiver-experiences
#11
Tatiana Sadak, Susan Foster Zdon, Emily Ishado, Oleg Zaslavsky, Soo Borson
BACKGROUND: Health crises in persons living with dementia challenge their caregivers to make pivotal decisions, often under pressure, and to act in new ways on behalf of their care recipient. Disruption of everyday routines and heightened stress are familiar consequences of these events. Hospitalization for acute illness or injury is a familiar health crisis in dementia. The focus of this study is to describe the lived experience of dementia family caregivers whose care recipients had a recent unplanned admission, and to identify potential opportunities for developing preventive interventions...
March 28, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28349228/biofeedback-training-in-crisis-managers-a-randomized-controlled-trial
#12
A Janka, C Adler, B Brunner, S Oppenrieder, S Duschek
Working in crisis environments represents a major challenge, especially for executive personnel engaged in directing disaster operations, i.e. crisis managers. Crisis management involves operating under conditions of extreme stress resulting, for instance, from high-level decision-making, principal responsibility for personnel, multitasking or working under conditions of risk and time pressure. The present study aimed to investigate the efficacy of a newly developed biofeedback training procedure based on electrodermal activity, especially designed for the target group of crisis managers...
March 27, 2017: Applied Psychophysiology and Biofeedback
https://www.readbyqxmd.com/read/28320376/how-to-make-carer-involvement-in-mental-health-inpatient-units-happen-a-focus-group-study-with-patients-carers-and-clinicians
#13
Domenico Giacco, Aysegul Dirik, Justina Kaselionyte, Stefan Priebe
BACKGROUND: Carers are family members or friends who support people with a mental health problem without being paid. Carer involvement in mental health treatment has been consistently supported by research evidence and promoted by policies but its implementation rates are poor. Particularly when patients are treated in inpatient units, carers often report being left without information or being excluded from decisions about treatment. In this study we have explored, along with staff perspectives, views of patients and carers who had a recent experience of inpatient mental health care on how to improve the implementation of carer involvement in inpatient care...
March 21, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28300527/the-development-of-an-evacuation-protocol-for-patients-with-ventricular-assist-devices-during-a-disaster
#14
Katherine J Davis, Joseph Suyama, Jennifer Lingler, Michael Beach
Introduction Health care providers are on the forefront of delivering care and allocating resources during a disaster; however, very few are adequately trained to respond in these situations. Furthermore, there is a void in the literature regarding the specific care needs of patients with ventricular assist devices (VADs) in a disaster setting. This project aimed to develop an evidenced-based protocol to aid health care providers during the evacuation of patients with VADs during a disaster. METHODS: This is a qualitative study that used expert review, tabletop discussion, and a survey of health care professionals to develop and evaluate an evacuation protocol...
March 16, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28295461/what-do-uk-medical-students-value-most-in-their-careers-a-discrete-choice-experiment
#15
Jennifer A Cleland, Peter Johnston, Verity Watson, Nicolas Krucien, Diane Skåtun
CONTEXT: Many individual- and job-related factors are known to influence medical careers decision making. Previous research has extensively studied medical trainees' (residents') and students' views of the factors that are important. However, how trainees and students trade off these factors at times of important careers-related decision making is under-researched. Information about trade-offs is crucial to the development of effective policies to enhance the recruitment and retention of junior doctors...
March 14, 2017: Medical Education
https://www.readbyqxmd.com/read/28289516/biochemical-changes-in-the-injured-brain
#16
EDITORIAL
Seelora Sahu, Deb Sanjay Nag, Amlan Swain, Devi Prasad Samaddar
Brain metabolism is an energy intensive phenomenon involving a wide spectrum of chemical intermediaries. Various injury states have a detrimental effect on the biochemical processes involved in the homeostatic and electrophysiological properties of the brain. The biochemical markers of brain injury are a recent addition in the armamentarium of neuro-clinicians and are being increasingly used in the routine management of neuro-pathological entities such as traumatic brain injury, stroke, subarachnoid haemorrhage and intracranial space occupying lesions...
February 26, 2017: World Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28286699/rural-women-s-experience-of-living-and-giving-birth-in-relief-camps-in-pakistan
#17
Humaira Maheen, Elizabeth Hoban
BACKGROUND: Women are more vulnerable than men in the same natural disaster setting. Preexisting gender inequality, socio-cultural community dynamics and poverty puts women at significant risk of mortality. Pregnant women are particularly vulnerable because of their limited or no access to prenatal and obstetric care during any disaster or humanitarian emergency setting. METHODS: In-depth interviews were conducted with 15 women who gave birth during the 2011 floods in Sindh Province, Pakistan...
January 31, 2017: PLoS Currents
https://www.readbyqxmd.com/read/28285860/a-discussion-about-public-health-lead-and-legionella-pneumophila-in-drinking-water-supplies-in-the-united-states
#18
Michael B Rosen, Lok R Pokhrel, Mark H Weir
Lead (Pb) in public drinking water supplies has garnered much attention since the outset of the Flint water crisis. Pb is a known hazard in multiple environmental matrices, exposure from which results in long-term deleterious health effects in humans. This discussion paper aims to provide a succinct account of environmental Pb exposures with a focus on water Pb levels (WLLs) in the United States. It is understood that there is a strong correlation between WLLs and blood Pb levels (BLLs), and the associated health effects...
March 9, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28257538/multidisciplinary-approach-to-complicated-pregnancy
#19
Josip Andelo Borovac, Josko Bozic, Tina Ticinovic Kurir, Nikola Zaja, Kresimir Kolic, Vedran Hrboka
A nulliparous pregnant woman in her mid-20s and in the 32nd week of gestation presented to the emergency department with severe headache and vomiting. She had an uneventful medical history; however, the physical examination upon hospital admission revealed a hypertensive emergency, papilledema, and 2+ dipstick proteinuria. Upon establishing the diagnosis of preeclampsia, aggressive therapy with corticosteroids, antihypertensive medication, and seizure prophylaxis was initiated. Hemodynamic stability was achieved within 24 hours and the patient remained in the observation unit located within the gynecology clinic...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28238300/penetrating-abdominal-injuries-during-the-syrian-war-patterns-and-factors-affecting-mortality-rates
#20
Shawqi Arafat, Mhd Belal Alsabek, Mousa Ahmad, Iman Hamo, Eskander Munder
BACKGROUND: A large number of innocent Syrians were injured or killed during the years of war. This retrospective study investigates the differences in patterns of injury and factors affecting the mortality rate in 324 patients coming to Damascus Hospital with penetrating abdominal trauma, and illustrates the difficulties of diagnosis and decision making in crisis situations. METHODS: A retrospective study was registered from patient's records between October 2012 and June 2013 in Damascus Hospital...
February 14, 2017: Injury
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