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just in time training

Thomas Hildebrandt, Seher Emir, Alexander Boosz, Matthias W Beckmann, Andreas Müller
PURPOSE: Surgical training usually means inexperienced physicians initially doing operations supervised by an experienced physician, to gain the experience and skills needed to conduct surgery independently. Various issues arise here for both hospitals and patients. Are training procedures associated with higher complication rates, blood losses, and transfusion rates? What does training in the operating room ultimately cost in terms of valuable surgical time? Do longer hospitalization periods potentially mean financial losses for the hospital under the diagnosis-related groups (DRG) system? METHODS: A retrospective analysis was carried out of data for 571 patients who underwent total laparoscopic hysterectomy (TLH) in the Department of Gynecology at the University of Erlangen from 2009 to 2012, with/without adnexectomy, due to benign indication; and of data for 255 patients who underwent the same procedures in Karlsruhe Municipal Hospital in 2013-2014...
August 11, 2018: Archives of Gynecology and Obstetrics
J M Beasley, M A Sevick, L Kirshner, M Mangold, J Chodosh
BACKGROUND: Through diet and exercise interventions, community centers offer an opportunity to address health-related issues for some of the oldest, most vulnerable members of our society. OBJECTIVES: The purpose of this investigation is to draw upon nationwide data to better characterize the population served by the congregate meals program and to gather more detailed information on a local level to identify opportunities for service enhancement to improve the health and well-being of older adults...
2018: Journal of Frailty & Aging
Çigdem Yayla Abide, Meryem Kurek Eken, Enis Ozkaya, Ilter Yenidede, Evrim Bostanci Ergen, Cetin Kilicci, Ilhan Sanverdi, Mustafa Eroğlu
AIM: Prostaglandins have a dual action of cervical ripening and induction of uterine contraction. This study was designed to compare the effectiveness of vaginal washing just before insertion of intravaginal dinoprostone. METHODS: A randomized controlled trial was conducted at the Zeynep Kamil Women and Children's Health Training and Research Hospital. One hundred and ninety-one women with singleton, term pregnancy who underwent labor induction were randomly assigned to two groups: Group 1 consisted of 95 pregnant women with vaginal washing before intravaginal dinoprostone (Propess system for slow release system of 10 mg of dinoprostone) insertion (study group), and 96 pregnant women constituted the control group who did not undergo vaginal washing before intravaginal dinoprostone insertion...
August 10, 2018: Journal of Obstetrics and Gynaecology Research
K Weigand
Organ donation has reached a new low in Germany. The number of organ donations dropped from 1296 in 2010 to just 797 organ donations in 2017. This represents a decrease of 916 kidney transplants in the last six years. Thus, Germany occupies the penultimate position in the Eurotransplant association with the number of organ donors per million inhabitants. Only Luxembourg has fewer because of foreigners proportion of 47.5% and many of them lives in the neighboring european countries. However, Germany is not only far behind in the Eurotransplant association with the number of organ donors, but Germany is also at the bottom in comparison with other European countries with comparable political, ethical, religious and social structures-are we so different from our European neighbors? Germany is a country with one of the best health care systems in the world, but not in the field of organ donation...
August 2, 2018: Der Urologe. Ausg. A
Craig A Goolsby, Kandra Strauss-Riggs, Victoria Klimczak, Kelly Gulley, Luis Rojas, Cassandra Godar, Sorana Raiciulescu, Arthur L Kellermann, Thomas D Kirsch
Objective: The objective was to determine whether brief, Web-based instruction several weeks prior to tourniquet application improves layperson success compared to utilizing just-in-time (JiT) instructions alone. Background: Stop the Bleed is a campaign to educate laypeople to stop life-threatening hemorrhage. It is based on U.S. military experience with lifesaving tourniquet use. While previous research shows simple JiT instructions boost laypeople's success with tourniquet application, the optimal approach to educate the public is not yet known...
April 2018: AEM education and training
Mark X Cicero, Travis Whitfill, Barbara Walsh, Maria Carmen Diaz, Grace Arteaga, Daniel J Scherzer, Scott Goldberg, Manu Madhok, Angela Bowen, Geno Paesano, Michael Redlener, Kevin Munjal, David Kessler, Marc Auerbach
Objectives: Paramedics and emergency medical technicians (EMTs) perform triage at disaster sites. There is a need for disaster triage training. Live simulation training is costly and difficult to deliver. Screen-based simulations may overcome these training barriers. We hypothesized that a screen-based simulation, 60 Seconds to Survival (60S), would be associated with in-game improvements in triage accuracy. Methods: This was a prospective cohort study of a screen-based simulation intervention, 60S...
April 2018: AEM education and training
Johanna E Hall, Dhruv P Patel, John W Thomas, Catherine A Richards, Philip E Rogers, Christopher M Pruitt
OBJECTIVE: The objective of this study is to evaluate the impact of certified child life specialists (CCLSs) on the emotional responses of children undergoing laceration repair in the emergency department (ED). METHODS: Patients 4 to 12 years of age who required laceration repair by suturing were prospectively enrolled at an urban tertiary pediatric ED. Certified child life specialists are not available at all times in our institution, allowing for a priori categorization of subjects into 2 comparison groups, those with and those without CCLS involvement...
July 24, 2018: Pediatric Emergency Care
Jennifer Deventer, Oliver Lüdtke, Gabriel Nagy, Jan Retelsdorf, Jenny Wagner
Personality development in emerging adults who do not attend college after high school has been largely overlooked so far. In this study, we investigated personality development in emerging German adults (NT 1  = 1,886, MageT1  = 18.01 years, 29% female) undergoing vocational education and training (VET). The trainees were assessed at the start of VET, 1.5 years later, and another 1.5 years after that, just before graduation. Longitudinal latent change score analyses were applied. Bivariate analyses investigated life satisfaction and job strain as social and work-related aspects that are potentially reciprocally related to personality development...
July 25, 2018: British Journal of Psychology
Mark Roe, John C Murphy, Conor Gissane, Catherine Blake
Managing injury risk requires an understanding of how and when athletes sustain certain injuries. Such information guides organisations in establishing evidence-based priorities and expectations for managing injury risk. In order to minimise the impact of sports injuries, attention should be directed towards injuries that occur frequently, induce substantial time-loss, and elevate future risk. Thus, the current study aimed to investigate the rate at which elite Gaelic football players sustain different time-loss injuries during match-play and training activities...
2018: PeerJ
Valério S Carvalho, Miguel R Picanço, André Volschan, Daniel C Bezerra
Background Stroke is a leading cause of morbidity and mortality in Brazil, where there are significant imbalances in access to specialized stroke care. Telemedicine networks allow patients to receive neurological evaluation and intravenous thrombolysis in underserved areas, where performance measures are challenging. Aims To describe the impact caused by adequate stroke care training, using realistic simulation, in a developing country telestroke network. Methods Retrospective observational study comparing the number of all stroke diagnoses, thrombolysis rate, door-to-needle time and symptomatic intracranial hemorrhage after intravenous thrombolysis, during one year providing just algorithms and orientation in stroke care to spoke facilities (phase 1), with the results achieved along one year after the beginning of ongoing live training sessions (phase 2)...
July 24, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Pietro Aricò, Gianluca Borghini, Gianluca Di Flumeri, Nicolina Sciaraffa, Fabio Babiloni
In the last decade, passive BCI algorithms and biosignals acquisition technologies experienced a significant growth that has allowed the real-time analysis of biosignals, with the aim to quantify relevant insights, like mental and emotional states, of the users. Several passive BCI-based applications have been tested in laboratory settings, and just few of them in real or, at least, simulated but high-realistic settings. Anyhow, works performed in laboratory settings are not able to take into account all those factors (artefacts, non-brain influences, other mental states) that could impair the usability of passive BCIs during real applications, naturally characterized by higher complexity...
July 24, 2018: Physiological Measurement
Maury Pinsk, Jolanta Karpinski, Euan Carlisle
Purpose of the review: The Royal College of Physicians and Surgeons of Canada, with its Competence by Design initiative, is adopting the principles of competency-based medical education for residency training and continuing professional development. This initiative is being undertaken to meet the new standards of medical education in Canada, which include social accountability to meet performance-based outcomes of training. Nephrology is poised to implement Competence by Design into residency training in July 2018 and initiate a continuous quality improvement cycle to periodically renew and update the training requirements to be socially accountable and relevant in the modern age of medicine...
2018: Canadian Journal of Kidney Health and Disease
J Th C M de Kruif, M B Scholtens, J van der Rijt, M R de Boer, M M G A van den Berg, Y C de Vries, R M Winkels, M Visser, E Kampman, M J Westerman
PURPOSE: Dutch Health care professionals (HCPs) provide little information concerning health risks associated with weight gain during chemotherapy for breast cancer. Women with breast cancer have specified the need for more information on nutrition and physical activity to deal with weight gain. The aims of this study were to assess the perceptions of Dutch HCPs on weight gain during chemotherapy and in addition evaluate whether and what kind of information on dietary intake and physical activity HCPs provide to prevent/treat weight gain during (neo)adjuvant chemotherapy...
July 19, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Janine H Stubbe, Angelo Richardson, Rogier M van Rijn
Aim: The amount of injuries, illnesses and mental health problems was calculated among circus arts students, using a method designed to capture more than just time-loss and/or medical injuries. Furthermore, injury incidence rate, injury incidence proportions, anatomical injury location and severity of injuries were assessed. Methods: A total of 44 first-year, second-year and third-year circus arts students were prospectively followed during one academic year. Every month, all students were asked to complete questionnaires by using the online Performing Artist and Athlete Health Monitor, which includes the Oslo Sports Trauma Research Centre Questionnaire on Health Problems...
2018: BMJ Open Sport & Exercise Medicine
Ian Couper, Sunanda Ray, Duane Blaauw, Gideon Ng'wena, Lucy Muchiri, Eren Oyungu, Akinyinka Omigbodun, Imran Morhason-Bello, Charles Ibingira, James Tumwine, Daphney Conco, Sharon Fonn
BACKGROUND: Africa's health systems rely on services provided by mid-level health workers (MLWs). Investment in their training is worthwhile since they are more likely to be retained in underserved areas, require shorter training courses and are less dependent on technology and investigations in their clinical practice than physicians. Their training programs and curricula need up-dating to be relevant to their practice and to reflect advances in health professional education. This study was conducted to review the training and curricula of MLWs in Kenya, Nigeria, South Africa and Uganda, to ascertain areas for improvement...
July 16, 2018: BMC Health Services Research
Shin Wakatsuki, Pedro Tanaka, Rafael Vinagre, Adrian Marty, Jakob Louis Demant L Thomsen, Alex Macario
Background Teaching during patient care is an important competency for faculty. Little is known about anesthesiology resident preferences for teaching by anesthesiology faculty in the operating room (OR). If the behaviors and characteristics of anesthesia teaching in the OR that are most valued by residents were identified, faculty could incorporate that best practice to teach residents during OR cases. The objective of this phenomenological study was to interview anesthesiology residents to determine what they perceive the best faculty teachers are doing in the OR to educate residents...
May 1, 2018: Curēus
Volkhard Fischer, Agnieszka Dudzinska, Ingo Just
Aim: The classical course structure for medicine in Germany is separated by three sections of the medical state examination. This structure is generally regarded as sensible and unchangeable. Because the special program structure at Hannover Medical School (MHH) has one integrated, rather than two separate study blocks, it is possible to examine the influence of structural modifications on the study success of different admission groups. Methods: The data was obtained from students admitted to the MHH between 2006 and 2008 in different admission quotas...
2018: GMS Journal for Medical Education
Abigail Naana Osei Agyemang, Kingsley Badu, Sandra Baffour-Awuah, Ellis Owusu-Dabo, Nana-Kwadwo Biritwum, Rolf Garms, Thomas Florian Kruppa
The African Programme for Onchocerciasis Control (APOC), which focused on annual mass treatment with ivermectin, was launched in 1995 and was replaced by the Expanded Special Project for Neglected Tropical Diseases (ESPEN) by the end of 2015. In Ghana, the Community Directed Treatment with Ivermectin (CDTI) was introduced in 1999. After a decade, biannual reinforcement was introduced during which the Ghana Health Service (GHS) recorded coverage rates through routine data collection. Transmission studies conducted in the Upper Denkyira East Municipal (UDEM) of the forest zone of Ghana in 2002 and 2006 had shown that annual treatments with ivermectin had hardly any effect on the transmission of Onchocerca volvulus by the vector Simulium sanctipauli...
June 19, 2018: Acta Tropica
Frank W J M Smeenk, Laurien A Schrijver, Hennie C J van Bavel, Eric F J van de Laar
In 2014, a group of physicians of the Catharina Hospital in Eindhoven (The Netherlands) started a project called "Talking about end-of-life care in a timely manner". Just like others in the country, the Eindhoven group noticed that regularly, very frail elderly people were admitted to hospital in acute situations without there ever having been conversations about their wishes concerning treatment options at the end of life. The project aimed to prevent unnecessary admissions and treatments for these frail patients by stimulating physicians, patients and informal caregivers to start conversations about end-of-life care together at an earlier stage...
December 2017: Breathe
R Lee Kirby, Amira Aggour, Audrey Chen, Cher Smith, Chris Theriault, Kara Matheson
PURPOSE: The tilt-rest skill consists of tipping the wheelchair back and allowing it to rest against a solid object with the wheel locks applied (e.g., for pressure redistribution, neck comfort or hands-free activities). The objective of this study was to determine the proportion of experienced manual wheelchair users who are aware of this skill and who can perform it. MATERIALS AND METHODS: We conducted a cross-sectional survey of 49 manual wheelchair users using a questionnaire developed for the purpose...
June 19, 2018: Disability and Rehabilitation. Assistive Technology
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