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Anne M Dubin, Neal W Jorgensen, Andrew E Radbill, David J Bradley, Jennifer N Silva, Sabrina Tsao, Ronald J Kanter, Ronn E Tanel, Bhavya Trivedi, Ming-Lon Young, Andreas Pflaumer, Jorge McCormack, Stephen P Seslar
BACKGROUND: Since the onset of pediatric catheter ablation, the pediatric electrophysiology community has reported outcomes via various registries (PAPCA and the Pediatric Catheter Ablation registry (PCAR)). Most recently, a modern era pediatric and congenital ablation registry (MAP-IT) was developed for eventual incorporation into the NCDR IMPACT registry. OBJECTIVE: We aimed to describe initial findings from the MAP-IT pilot registry, and compare these findings to earlier registries...
August 14, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Anne M Kolenic
Nursing clinical research is a growing field, and as more nurses become engaged in conducting clinical research, feasibility studies may be their first encounter. Understanding what they are, how to conduct them, and the importance of properly reporting their outcomes is vital to the continued advancement of nursing science.
September 1, 2018: Oncology Nursing Forum
Kathleen M Adelgais, J Matthew Sholl, Rachael Alter, Kristin Lauria Gurley, Camille Broadwater-Hollifield, Peter Taillac
BACKGROUND: Individual states, regions, and local emergency medical service (EMS) agencies are responsible for the development and implementation of prehospital patient care protocols. Many states lack model prehospital guidelines for managing common conditions. Recently developed national evidence-based guidelines (EBGs) may address this gap. Barriers to statewide dissemination and implementation of model guidelines have not been studied. The objective of this study was to examine barriers and enablers to dissemination and implementation of an evidence-based guideline for traumatic pain management across 5 states...
August 17, 2018: Prehospital Emergency Care
Rebecca Ward, John Paul Valenzuela, Weiguo Li, Guangkuo Dong, Susan C Fagan, Adviye Ergul
Diabetes increases the risk and severity of cognitive impairment, especially after ischemic stroke. Pathological remodeling of the cerebrovasculature has been postulated to contribute to poor neuronal repair and worsened cognitive deficits in diabetes. However, little is known about the effect of diabetes on the vascularization of hippocampus, a domain critical to memory and learning. Therefore we had two aims for this study: 1) to determine the impact of diabetes on hippocampal neurovascular remodeling and the resulting cognitive impairment after stroke using two models with varying disease severity, and 2) to compare the effects of ischemia on hippocampal neurovascular injury in diabetic males and females...
August 17, 2018: American Journal of Physiology. Heart and Circulatory Physiology
Victor E Staartjes, Marc L Schröder
No abstract text is available yet for this article.
August 17, 2018: Journal of Neurosurgery. Spine
Allen L Ho, Yagmur Muftuoglu, Arjun V Pendharkar, Eric S Sussman, Brenda E Porter, Casey H Halpern, Gerald A Grant
OBJECTIVE Stereoelectroencephalography (SEEG) has increased in popularity for localization of epileptogenic zones in drug-resistant epilepsy because safety, accuracy, and efficacy have been well established in both adult and pediatric populations. Development of robot-guidance technology has greatly enhanced the efficiency of this procedure, without sacrificing safety or precision. To date there have been very limited reports of the use of this new technology in children. The authors present their initial experience using the ROSA platform for robot-guided SEEG in a pediatric population...
August 17, 2018: Journal of Neurosurgery. Pediatrics
Mary A Johnson, Sanjeeva Kariyawasam, Krishna Epari, Mohammad Ballal
BACKGROUND: Minimally invasive oesophagectomy (MIO) has a steep learning curve. We report our outcomes of a standardized 25 mm circular-stapled anastomosis using a trans-orally placed anvil (Orvil™). The objective of this study is to report the initial experience of introducing two-stage MIO to an Australian tertiary health service. METHODS: We describe our consecutive case series of all MIOs performed from a prospectively maintained database. We assessed the morbidity and mortality of MIO at our institution...
August 17, 2018: ANZ Journal of Surgery
Terri Link
The perioperative environment is fast paced and complex. Competing responsibilities, noise and distractions, and reluctance of team members to speak up when they are aware of a potential patient safety issue are all barriers to effective communication in the perioperative setting. Communication breakdowns among health care providers can lead to medical errors and patient harm. Accurate and complete communication about the patient and the patient's care can contribute to improved efficiency, better patient outcomes, and fewer adverse events...
August 2018: AORN Journal
Martin S Lipsky, Catherine J Cone
Background: An educational method gaining acceptance in health profession's training is mastery learning. Mastery learning requires learners to demonstrate essential knowledge and skills measured against rigorously set standards without regard to time. The key elements of mastery learning include focus on a single subject, short curricular blocks, setting specific objectives, using frequent feedback, deliberative practice, and demonstrating mastery before moving onto the next subject...
January 2018: Education for Health: Change in Training & Practice
Judy Clegg, Rachael Black, Antoin Smith, Shelagh Brumfitt
PURPOSE: Intensive interaction is used to increase communication in people at a pre-verbal stage of communication development. The aim of the study was to evaluate a city-wide implementation of intensive interaction training to care staff by investigating how staff use intensive interaction with adults with profound and multiple learning disability, and their perceived impact of intensive interaction on these service users. METHOD: In phase 1, a survey investigated the outcomes of intensive interaction training on the work practices of staff supporting people with profound and multiple learning disability...
August 17, 2018: Disability and Rehabilitation
Tessie W October, Zoelle B Dizon, Melinda F Hamilton, Vanessa N Madrigal, Robert M Arnold
BACKGROUND: Inter-specialty clinicians often co-lead family conferences for hospitalised patients. Families frequently report receiving different messages from different clinicians. We developed a communication training workshop that crosses disciplines and co-trains clinicians in one setting to create a culture of delivering a unified message. METHODS: We developed a 2-day paediatric communication skills workshop to teach the skills necessary to conduct a family conference...
August 16, 2018: Clinical Teacher
Rishad Khan, Joanne Plahouras, Bradley C Johnston, Michael A Scaffidi, Samir C Grover, Catharine M Walsh
BACKGROUND: Endoscopy has traditionally been taught with novices practicing on real patients under the supervision of experienced endoscopists. Recently, the growing awareness of the need for patient safety has brought simulation training to the forefront. Simulation training can provide trainees with the chance to practice their skills in a learner-centred, risk-free environment. It is important to ensure that skills gained through simulation positively transfer to the clinical environment...
August 17, 2018: Cochrane Database of Systematic Reviews
Chandra L Ford, Lois M Takahashi, P Paul Chandanabhumma, Maria Elena Ruiz, William E Cunningham
Public Health Critical Race Praxis (PHCRP) contributes three functional elements to health equity studies: a race conscious orientation; an antiracism lexicon based on Critical Race Theory (CRT); and an integrated, reflexive approach. Few big data studies employ all three functional elements. Therefore, this article describes the application of PHCRP to the Human Immunodeficiency Virus Testing, Linkage and Retention in care (HIV TLR) study (N=3,476,741), which connects multiple large datasets to electronic medical records to examine contextual determinants of racial/ethnic disparities in HIV care continuum outcomes in southern California...
2018: Ethnicity & Disease
F Guerra, P Checcacci, A Vegni, M di Marino, M Annecchiarico, M Farsi, A Coratti
PURPOSE: Robotics has shown encouraging results for a number of technically demanding abdominal surgeries including pancreaticoduodenectomy, which has originally represented a relative contraindication to the application of the minimally-invasive technique. We aimed to investigate the perioperative, clinicopathologic, and oncological outcomes of robot-assisted pancreaticoduodenectomy by assessing a consecutive series of totally robotic procedures. METHODS: All consecutive patients who underwent robotic pancreaticoduodenectomy were included in the present analysis...
August 13, 2018: Journal of Visceral Surgery
Y Zhang, G-J Shan, Y-X Zhang, S-J Cao, S-N Zhu, H-J Li, D Ma, D-X Wang
BACKGROUND: The choice of general anaesthetics may affect postoperative cognitive outcomes. This study was designed to compare the potential impact of propofol-based vs sevoflurane-based general anaesthesia on the development of delayed neurocognitive recovery in older adults early after major cancer surgery. METHODS: Older adults (aged ≥65 and <90 yr) who were scheduled to undergo major cancer surgery (≥2 h) were randomised to receive either propofol- or sevoflurane-based general anaesthesia...
September 2018: British Journal of Anaesthesia
Mohsen Malekinejad, Hacsi Horvath, Harry Snyder, Claire D Brindis
BACKGROUND: There is often a discordance between health research evidence and public health policies implemented by the United States federal government. In the process of developing health policy, discordance can arise through subjective and objective factors that are unrelated to the value of the evidence itself, and can inhibit the use of research evidence. We explore two common types of discordance through four illustrative examples and then propose a potential means of addressing discordance...
August 16, 2018: Health Research Policy and Systems
Gurwinder Kaur Gill, Mary Jane McNally, Vin Berman
Demographics in Canada, and the workplace, are changing. These include population changes due to race, ethnicity, religion/faith, immigration status, gender, sexual identity and orientation, disability, income, educational background, socioeconomic status, and literacy. While this rich diversity can present challenges for patient experiences/outcomes and working environments, it can also present opportunities for positive transformation. For successful transformation to take place, strategies should focus on "Diversity, Equity, and Inclusion" (DEI) versus "diversity" alone and on creating inclusive team environments for positive staff experiences/engagement...
August 16, 2018: Healthcare Management Forum
Daniel P Russo, Kimberley M Zorn, Alex Michael Clark, Hao Zhu, Sean Ekins
Many chemicals that disrupt endocrine function have been linked to a variety of adverse biological outcomes. However, screening for endocrine disruption using in vitro or in vivo approaches is costly and time-consuming. Computational methods, e.g. Quantitative Structure-Activity Relationship models, have become more reliable due to bigger training sets, increased computing power, and advanced machine learning algorithms such as multi-layered Artificial Neural Networks. Machine learning models can be used to predict compounds for endocrine disrupting capabilities such as binding to the estrogen receptor (ER) and allow for prioritization and further testing...
August 16, 2018: Molecular Pharmaceutics
Lívia Clemente Motta-Teixeira, Aline Vilar Machado-Nils, Daniella Sabino Battagello, Giovanne Baroni Diniz, Jéssica Andrade-Silva, Sinésio Silva-Junior, Raphael Afonso Matos, Fernanda Gaspar do Amaral, Gilberto Fernando Xavier, Jackson Cioni Bittencourt, Russel J Reiter, Paul Jonh Lucassen, Aniko Korosi, José Cipolla-Neto
Maternal melatonin provides photoperiodic information to the fetus and thus influences the regulation and timing of the offspring's internal rhythms and preparation for extra-uterine development. There is clinical evidence that melatonin deprivation of both mother and fetus during pregnancy, and of the neonate during lactation, results in negative long-term health outcomes. As a consequence, we hypothesized that the absence of maternal pineal melatonin might determine abnormal brain programming in the offspring, which would lead to long-lasting implications for behavior and brain function...
August 13, 2018: Hormones and Behavior
Whitney E Muhlestein, Dallin S Akagi, Jason M Davies, Lola B Chambless
BACKGROUND: Current outcomes prediction tools are largely based on and limited by regression methods. Utilization of machine learning (ML) methods that can handle multiple diverse inputs could strengthen predictive abilities and improve patient outcomes. Inpatient length of stay (LOS) is one such outcome that serves as a surrogate for patient disease severity and resource utilization. OBJECTIVE: To develop a novel method to systematically rank, select, and combine ML algorithms to build a model that predicts LOS following craniotomy for brain tumor...
August 3, 2018: Neurosurgery
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