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https://www.readbyqxmd.com/read/29217389/competencies-for-engaging-high-needs-patients-in-primary-care
#1
Michael J Yedidia
BACKGROUND: Patients who heavily utilize hospitals and emergency departments frequently have complex needs requiring services spanning medical, behavioral, and social service sectors. This study identifies essential competencies for caring for high-needs patients and highlights their importance to primary care delivery. METHODS: Transcripts of in-depth interviews with 30 clinical and administrative staff at 23 complex care programs across the United States were analyzed using standard qualitative techniques...
December 4, 2017: Healthcare
https://www.readbyqxmd.com/read/29202338/cranial-trauma-in-handgun-executions-experimental-data-using-polyurethane-proxies
#2
Seth C Taylor, Elena F Kranioti
Gun violence is a global phenomenon with regional variation in frequency and severity. Handguns are often used in violent deaths such as suicides and homicides. Hence, ballistic trauma is a critical subject of forensic investigations. Trauma patterns are fundamental evidence for the reconstruction of the incident and for the determination of the manner of death. This study investigated the differences in trauma patterns with a series of experiments using six different calibers (.22 LR, .38 Special, .380 ACP, 9×19mm, ...
November 27, 2017: Forensic Science International
https://www.readbyqxmd.com/read/29194491/healthcare-providers-perceptions-of-a-situational-awareness-display-for-emergency-department-resuscitation-a-simulation-qualitative-study
#3
Lisa A Calder, Abhi Bhandari, George Mastoras, Kathleen Day, Kathryn Momtahan, Matthew Falconer, Brian Weitzman, Benjamin Sohmer, A Adam Cwinn, Stanley J Hamstra, Avi Parush
Importance: Emergency resuscitation of critically ill patients can challenge team communication and situational awareness. Tools facilitating team performance may enhance patient safety. Objectives: To determine resuscitation team members' perceptions of the Situational Awareness Display's utility. Design: We conducted focus groups with healthcare providers during Situational Awareness Display development. After simulations assessing the display, we conducted debriefs with participants...
November 29, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29193022/experimental-study-of-delivery-of-humidified-warm-carbon-dioxide-during-open-abdominal-surgery
#4
S Carpinteri, S Sampurno, J Malaterre, R Millen, M Dean, J Kong, T Chittleborough, A Heriot, A C Lynch, R G Ramsay
BACKGROUND: The aim of this study was to monitor the effect of humidified-warm carbon dioxide (HWCO2 ) delivered into the open abdomen of mice, simulating laparotomy. METHODS: Mice were anaesthetized, ventilated and subjected to an abdominal incision followed by wound retraction. In the experimental group, a diffuser device was used to deliver HWCO2 ; the control group was exposed to passive air flow. In each group of mice, surgical damage was produced on one side of the peritoneal wall...
November 28, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/29185783/comparison-of-recidivism-rates-for-a-teenage-trauma-prevention-program-after-the-addition-of-high-fidelity-patient-simulation
#5
Marjorie Lee White, J Lynn Zinkan, Geni Smith, Dawn Taylor Peterson, Amber Q Youngblood, Ashley Dodd, Walter Parker, Samuel Strachan, Peter Sloane, Nancy Tofil
OBJECTIVES: We evaluated benefits of adding high-fidelity simulation to a teenage trauma prevention program to decrease recidivism rates and encourage teens to discuss actionable steps towards safe driving. METHODS: A simulated pediatric trauma scenario was integrated into an established trauma prevention program. Participants were recruited because they were court-ordered to attend this program after misdemeanor convictions for moving violations. The teenage participants viewed this simulation from the Emergency Medical Services (EMS) handoff to complete trauma care...
November 29, 2017: Traffic Injury Prevention
https://www.readbyqxmd.com/read/29180189/impact-of-triage-guidelines-on-prehospital-triage-comparison-of-guidelines-with-a-statistical-model
#6
Priti P Parikh, Pratik Parikh, Bradley Guthrie, Logan Mamer, Melissa Whitmill, Timothy Erskine, Randy Woods, Jonathan Saxe
BACKGROUND: The American College of Surgeons developed the National Field Triage Decision Scheme (NFTDS) that has been adapted by many trauma centers in the nation, but quantitative evidence of its efficacy is unclear. We compare the NFTDS and state of Ohio guidelines to the "observed" rates and with rates derived using a statistical model. METHODS: We used 4757 trauma records from 2008-2012 available from the state and calculated undertriage (UT) and overtriage (OT) rates...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29176329/inflammatory-processes-during-acute-respiratory-distress-syndrome-a-complex-system
#7
Lucy K Reiss, Andreas Schuppert, Stefan Uhlig
PURPOSE OF REVIEW: ARDS is a severe pulmonary disease characterized by inflammation. However, inflammation-directed therapies have yet failed to improve the outcome in ARDS patients. One of the reasons may be the underestimated complexity of inflammation. Here, we summarize recent insights into the complex interrelations between inflammatory circuits. RECENT FINDINGS: Gene expression analysis from animal models or from patients with ARDS, sepsis or trauma show an enormous number of differentially expressed genes with highly significant overlaps between the various conditions...
November 15, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29170740/tip-design-for-safety-of-steerable-needles-for-robot-controlled-brain-insertion
#8
Craig A Lehocky, Wendy Fellows-Mayle, Johnathan A Engh, Cameron N Riviere
Background: Current practice in neurosurgical needle insertion is limited by the straight trajectories inherent with rigid probes. One technique allowing curvilinear trajectories involves flexible bevel-tipped needles, which bend during insertion due to their asymmetry. In the brain, safety will require avoidance of the sharp tips often used in laboratory studies, in favor of a more rounded profile. Steering performance, on the other hand, requires maximal asymmetry. Design of safe bevel-tipped brain needles thus involves management of this tradeoff by adjusting needle gauge, bevel angle, and fillet (or tip) radius to arrive at a design that is suitably asymmetrical while producing strain, strain rate, and stress below the levels that would damage brain tissue...
2017: Robotic Surgery: Research and Reviews
https://www.readbyqxmd.com/read/29160926/electro-mechanical-response-of-a-3d-nerve-bundle-model-to-mechanical-loads-leading-to-axonal-injury
#9
I Cinelli, M Destrade, M Duffy, P McHugh
OBJECTIVE: Traumatic brain injuries and damage are major causes of death and disability. We propose a 3D fully coupled electro-mechanical model of a nerve bundle to investigate the electrophysiological impairments due to trauma at the cellular level. METHODS: The coupling is based on a thermal analogy of the neural electrical activity by using the finite element software Abaqus CAE 6.13-3. The model includes a real-time coupling, modulated threshold for spiking activation and independent alteration of the electrical properties for each 3-layer fibre within a nerve bundle as a function of strain...
November 21, 2017: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/29160091/probabilistic-description-of-infant-head-kinematics-in-abusive-head-trauma
#10
T O Lintern, M P Nash, P Kelly, F H Bloomfield, A J Taberner, P M F Nielsen
Abusive head trauma (AHT) is a potentially fatal result of child abuse, but the mechanisms by which injury occur are often unclear. To investigate the contention that shaking alone can elicit the injuries observed, effective computational models are necessary. The aim of this study was to develop a probabilistic model describing infant head kinematics in AHT. A deterministic model incorporating an infant's mechanical properties, subjected to different shaking motions, was developed in OpenSim. A Monte Carlo analysis was used to simulate the range of infant kinematics produced as a result of varying both the mechanical properties and the type of shaking motions...
November 21, 2017: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/29153980/why-saying-what-you-mean-matters-an-analysis-of-trauma-team-communication
#11
Hee Soo Jung, Charles Warner-Hillard, Ryan Thompson, Krista Haines, Brooke Moungey, Anne LeGare, David Williamson Shaffer, Carla Pugh, Suresh Agarwal, Sarah Sullivan
BACKGROUND: We hypothesized that team communication with unmatched grammatical form and communicative intent (mixed mode communication) would correlate with worse trauma teamwork. METHODS: Interdisciplinary trauma simulations were conducted. Team performance was rated using the TEAM tool. Team communication was coded for grammatical form and communicative intent. The rate of mixed mode communication (MMC) was calculated. MMC rates were compared to overall TEAM scores...
November 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29131053/an-experimental-study-to-measure-the-mechanical-properties-of-the-human-liver
#12
Alireza Karimi, Ahmad Shojaei
BACKGROUND: Since the liver is one of the most important organs of the body that can be injured during trauma, that is, during accidents like car crashes, understanding its mechanical properties is of great interest. Experimental data is needed to address the mechanical properties of the liver to be used for a variety of applications, such as the numerical simulations for medical purposes, including the virtual reality simulators, trauma research, diagnosis objectives, as well as injury biomechanics...
October 31, 2017: Digestive Diseases
https://www.readbyqxmd.com/read/29126452/high-performing-trauma-teams-frequency-of-behavioral-markers-of-a-shared-mental-model-displayed-by-team-leaders-and-quality-of-medical-performance
#13
Bjørn Helge Johnsen, Heidi Kristina Westli, Roar Espevik, Torben Wisborg, Guttorm Brattebø
BACKGROUND: High quality team leadership is important for the outcome of medical emergencies. However, the behavioral marker of leadership are not well defined. The present study investigated frequency of behavioral markers of shared mental models (SMM) on quality of medical management. METHOD: Training video recordings of 27 trauma teams simulating emergencies were analyzed according to team -leader's frequency of shared mental model behavioral markers. RESULTS: The results showed a positive correlation of quality of medical management with leaders sharing information without an explicit demand for the information ("push" of information) and with leaders communicating their situational awareness (SA) and demonstrating implicit supporting behavior...
November 10, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29125417/loss-of-mechanosensitive-sclerostin-may-accelerate-cranial-bone-growth-and-regeneration
#14
Kyung Shin Kang, Jeff Lastfogel, Laurie L Ackerman, Andrew Jea, Alexander G Robling, Sunil S Tholpady
OBJECTIVE Cranial defects can result from trauma, infection, congenital malformations, and iatrogenic causes and represent a surgical challenge. The current standard of care is cranioplasty, with either autologous or allogeneic material. In either case, the intrinsic vascularity of the surrounding tissues allows for bone healing. The objective of this study was to determine if mechanotransductive gene manipulation would yield non-weight-bearing bone regeneration in a critical size calvarial defect in mice. METHODS A mouse model of Sost deletion in Sost knockout (KO) mice was created in which the osteocytes do not express sclerostin...
November 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29117760/the-benefits-of-trauma-simulation-for-medical-students-experiences-from-the-university-of-bristol
#15
Liddy Ellis, Jessica Emerson
No abstract text is available yet for this article.
November 9, 2017: Medical Teacher
https://www.readbyqxmd.com/read/29117057/efast-simulation-training-for-trauma-providers
#16
(no author information available yet)
No abstract text is available yet for this article.
November 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29117056/efast-simulation-training-for-trauma-providers
#17
Kristie Pencil
Current trauma recommendations include completing chest and pelvis radiographs and Focused Abdominal Sonography in Trauma (FAST) examination in the trauma bay; however, expanding literature indicates that thoracic ultrasound scans are more sensitive than chest radiography in the detection of pneumothorax. In an urban, Level II trauma center in central Ohio, the author implemented an evidence-based practice project. This project focused on a lack of provider knowledge of the expanded Focused Abdominal Sonography in Trauma (eFAST) examination...
November 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29103789/an-in-situ-simulation-based-educational-outreach-project-for-pediatric-trauma-care-in-a-rural-trauma-system
#18
Lilly Bayouth, Sarah Ashley, Jackie Brady, Bryan Lake, Morgan Keeter, David Schiller, Walter C Robey, Stephen Charles, Kari M Beasley, Eric A Toschlog, Shannon W Longshore
BACKGROUND: Outcome disparities between urban and rural pediatric trauma patients persist, despite regionalization of trauma systems. Rural patients are initially transported to the nearest emergency department (ED), where pediatric care is infrequent. We aim to identify educational intervention targets and increase provider experience via pediatric trauma simulation. METHODS: Prospective study of simulation-based pediatric trauma resuscitation was performed at three community EDs...
October 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29100919/identifying-nontechnical-skill-deficits-in-trainees-through-interdisciplinary-trauma-simulation
#19
Sarah Sullivan, Krystle Campbell, Joshua C Ross, Ryan Thompson, Alyson Underwood, Anne LeGare, Ingie Osman, Suresh K Agarwal, Hee Soo Jung
OBJECTIVE: The goal of this study was to investigate nontechnical skills in a simulated trauma setting both before and after a debriefing session in order to better understand areas to target for the development of educational interventions. DESIGN: Wilcoxon signed rank tests were used to compare scores on the 5 domains of the T-NOTECHS pre- and postdebriefings. A qualitative analysis using the PEARLS debriefing framework was performed to provide a rich description of the strategies used by the debriefing facilitators...
October 31, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29100197/using-simulated-family-presence-to-decrease-agitation-in-older-hospitalized-delirious-patients-a-randomized-controlled-trial
#20
Christine M Waszynski, Kerry A Milner, Ilene Staff, Sheila L Molony
BACKGROUND: Simulated family presence has been shown to be an effective nonpharmacological intervention to reduce agitation in persons with dementia in nursing homes. Hyperactive or mixed delirium is a common and serious complication experienced by hospitalized patients, a key feature of which is agitation. Effective nonpharmacological interventions to manage delirium are needed. OBJECTIVES: To examine the effect of simulated family presence through pre-recorded video messages on the agitation level of hospitalized, delirious, acutely agitated patients...
October 7, 2017: International Journal of Nursing Studies
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