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Pediatric simulation

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https://www.readbyqxmd.com/read/29319897/application-of-a-physiologically-based-pharmacokinetic-model-for-the-prediction-of-bumetanide-plasma-and-brain-concentrations-in-the-neonate
#1
Maria D Donovan, Khaled Abduljalil, John F Cryan, Geraldine B Boylan, Brendan T Griffin
Bumetanide is a loop diuretic that is proposed to possess a beneficial effect on disorders of the central nervous system, including neonatal seizures. Therefore, prediction of unbound bumetanide concentrations in brain is relevant from a pharmacological prospective. A physiologically-based pharmacokinetic (PBPK) model was developed for the prediction of bumetanide disposition in plasma and brain in adult and pediatric populations. A compound file was built for bumetanide integrating physicochemical data and in vitro data...
January 10, 2018: Biopharmaceutics & Drug Disposition
https://www.readbyqxmd.com/read/29316801/economic-analysis-of-rapid-multiplex-polymerase-chain-reaction-testing-for-meningitis-encephalitis-in-pediatric-patients
#2
Steve Duff, Rodrigo Hasbun, Christine C Ginocchio, Joan-Miquel Balada-Llasat, Louise Zimmer, Samuel A Bozzette
AIM: We assessed the possible economic impact of a rapid test in pediatric patients with suspected community-acquired meningitis/encephalitis. MATERIALS & METHODS: Modeling simulated diagnosis, clinical decisions, resource use/costs of standard of care (SOC) and two cerebrospinal fluid testing strategies using FilmArray® (FA), a US FDA-cleared system that provides results in approximately 1 h. RESULTS: Pathogens detected by FA caused approximately 75% of cases, 97% of which would be accurately diagnosed with FA...
January 10, 2018: Future Microbiology
https://www.readbyqxmd.com/read/29300375/the-cost-and-diagnostic-yield-of-exome-sequencing-for-children-with-suspected-genetic-disorders-a-benchmarking-study
#3
Nick Dragojlovic, Alison M Elliott, Shelin Adam, Clara van Karnebeek, Anna Lehman, Jill C Mwenifumbo, Tanya N Nelson, Christèle du Souich, Jan M Friedman, Larry D Lynd
PurposeThis study aimed to generate benchmark estimates for the cost, diagnostic yield, and cost per positive diagnosis of diagnostic exome sequencing (ES) in heterogeneous pediatric patient populations and to illustrate how the design of an ES service can influence its cost and yield.MethodsA literature review and Monte Carlo simulations were used to generate benchmark estimates for singleton and trio ES. A cost model for the Clinical Assessment of the Utility of Sequencing and Evaluation as a Service (CAUSES) study, which is testing a proposed delivery model for diagnostic ES in British Columbia, is used to illustrate the potential effects of changing the service design...
January 4, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29298223/nurses-responses-and-reactions-to-an-emergent-pediatric-simulation-exercise
#4
Kenneth Hoffman, Victoria von Sadovszky
Pediatric nurses' responses and reactions in emergent simulations are understudied. Using authority gradient theory as a guide, the purpose of this study was to examine nurses' reactions during an emergency simulation exercise when directed to give an incorrect medication dose. Ten groups of noncritical care nurses were videotaped from the beginning of the simulation through debriefing. Although errors were made during the simulation event, all groups responded correctly during debriefing, indicating that authority gradient may play a role in clinical decision-making...
January 2018: Journal for Nurses in Professional Development
https://www.readbyqxmd.com/read/29287862/using-simulators-to-teach-pediatric-airway-procedures-in-an-international-setting
#5
Marissa A Schwartz, Katherine R Kavanagh, Steven J Frampton, Iain A Bruce, Tulio A Valdez
INTRODUCTION: There has been a growing shift towards endoscopic management of laryngeal procedures in pediatric otolaryngology. There still appears to be a shortage of pediatric otolaryngology programs and children's hospitals worldwide where physicians can learn and practice these skills. Laryngeal simulation models have the potential to be part of the educational training of physicians who lack exposure to relatively uncommon pediatric otolaryngologic pathology. OBJECTIVES: The objective of this study was to assess the utility of pediatric laryngeal models to teach laryngeal pathology to physicians at an international meeting...
January 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29281890/analysis-of-dose-accuracy-injection-force-and-usability-assessment-of-a-new-half-unit-prefilled-insulin-pen
#6
Mallika Bariya, Irina Nayberg
Half-unit insulin pens (HUPs) offer finer gradation of insulin dosing than their integer-unit counterparts, tackling the inaccuracies of dose rounding that make it difficult for insulin-sensitive populations to achieve tight glycemic control. This article analyzes the first prefilled HUP, the Humalog Junior KwikPen, in the context of other, similar devices and the developing landscape of smart insulin pens. The Junior KwikPen's suitability for pediatric patients is assessed in reference to a recent study surveying its accuracy and usability under varying conditions intended to simulate real-world use...
December 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29274818/population-pharmacokinetics-and-dosing-simulations-of-ceftazidime-in-chinese-neonates
#7
Honghong Wang, Xingang Li, Shusen Sun, Guifu Mao, Ping Xiao, Chan Fu, Zhuoxin Liang, Min Zheng, Yuling Huang, Haihong Tang, Renhao Ou, Ni Yang, Xi Ling, Zhigang Zhao
An accurate dosage determination is required in neonates when antibiotics are used. The adult data cannot be simply extrapolated to the pediatric population due to significant individual differences. We aimed to identify factors impacting ceftazidime exposure in neonates and to provide drug dosing guidance to clinicians. 43 neonates aged less than 60 days with proven or suspected infections were enrolled in this study. After intravenous administration, blood samples were collected, and plasma ceftazidime concentration was determined using a high-performance liquid chromatography method...
December 21, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29260766/-mathematical-cartographic-modeling-and-forecasting-of-caries-and-acute-apical-periodontitis-incidence-in-pediatric-population
#8
N M Agarkov, S N Gontarev, V D Lutsenko, A P Yakovlev, A V Ivanov
The paper presents the results of mathematical-cartographic simulation study of the incidence of caries and acute apical periodontitis in pediatric population of Belgorod region. The Borisov district was found to be the most unfavorable area of the region with the highest incidence of the diseases. The forecast indicates an increase in the incidence of caries in children by 181.1 cases and acute apical periodontitis by 15.00 cases per 1.000 children annually in the coming years. The incidence of acute apical periodontitis is influenced by the excess of maximum permissible concentration of phenol and soot in atmospheric air, forming a homogenous cluster...
2017: Stomatologii︠a︡
https://www.readbyqxmd.com/read/29247506/suboptimal-anti-tuberculosis-drug-concentrations-and-outcomes-in-small-and-hiv-coinfected-children-in-india-recommendations-for-dose-modifications
#9
Benjamin Guiastrennec, Geetha Ramachandran, Mats O Karlsson, A K Hemanth Kumar, Perumal Kannabiran Bhavani, N Poorana Gangadevi, Soumya Swaminathan, Amita Gupta, Kelly E Dooley, Radojka M Savic
This work aimed to evaluate the once-daily anti-tuberculosis treatment as recommended by the new Indian pediatric guidelines. Isoniazid, rifampin and pyrazinamide concentration-time profiles and treatment outcome were obtained from 161 Indian children with drug-sensitive tuberculosis undergoing thrice-weekly dosing as per previous Indian pediatric guidelines. The exposure-response relationships were established using a population pharmacokinetic-pharmacodynamic approach. Rifampin exposure was identified as the unique predictor of treatment outcome...
December 16, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29233428/training-student-pharmacists-to-administer-emergency-pediatric-influenza-vaccine-a-comparison-of-traditional-vs-just-in-time-training
#10
Colleen M Terriff, Kimberly McKeirnan
INTRODUCTION: This study compared traditional training (TT) and just-in-time training (JITT) of P3 student pharmacists regarding interest, confidence, and comfort pre- and post-training (primary objective); and assessment and administration competency (secondary objective) during a simulated influenza vaccination clinic. METHODS: Student pharmacists were randomized 1:1 to receive either TT or JITT, completed pre- and post-training surveys assessing interest, confidence and comfort; and evaluated on performance during a simulated emergency infant vaccination...
July 2017: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29232353/improving-pediatric-preparedness-in-critical-access-hospital-emergency-departments-impact-of-a-longitudinal-in-situ-simulation-program
#11
Jessica H Katznelson, Jiangxia Wang, Martha W Stevens, William A Mills
OBJECTIVES: Critical access hospitals (CAH) see few pediatric patients. Many of these hospitals do not have access to physicians with pediatric training. We sought to evaluate the impact of an in situ pediatric simulation program in the CAH emergency department setting on care team performance during resuscitation scenarios. METHODS: Five CAHs conducted 6 high-fidelity pediatric simulations over a 12-month period. Team performance was evaluated using a validated 35-item checklist representing commonly expected resuscitation team interventions...
January 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29231093/the-utility-of-simulation-in-the-management-of-patients-with-congenital-heart-disease-past-present-and-future
#12
Ali Subat, Andrew Goldberg, Samuel Demaria, Daniel Katz
Significant advancements have been made in the diagnosis and management of congenital heart disease (CHD). As a result, a higher percentage of these patients are surviving to adulthood. Despite this improvement in management, these patients remain at higher risk of morbidity and mortality, particularly in the perioperative setting. One new area of interest in these patients is the implementation of simulation-based medical education. Simulation has demonstrated various benefits across high-acuity scenarios encountered in the hospital...
December 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29223672/education-and-the-pediatric-surgeon
#13
REVIEW
Joe I Curry, Celeste Hollands
There have been many changes in the domain of clinical surgery over the last 2 decades, but probably none more so than in education. The British Association of Pediatric Surgeons recognizes the importance of this topic and has commissioned a special session on this subject jointly with the International Pediatric Endosurgery Group. Free papers presented on a number of educational subjects and specific topics of recruitment and simulation were covered in invited lectures. The session was completed with a keynote lecture from the renowned educationalist Professor Roger Kneebone...
November 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29206799/simulation-based-educational-module-improves-intern-and-medical-student-performance-of-closed-reduction-and-percutaneous-pinning-of-pediatric-supracondylar-humeral-fractures
#14
Bennet A Butler, Cort D Lawton, Jamie Burgess, Earvin S Balderama, Katherine A Barsness, John F Sarwark
BACKGROUND: Simulation-based education has been integrated into many orthopaedic residency programs to augment traditional teaching models. Here we describe the development and implementation of a combined didactic and simulation-based course for teaching medical students and interns how to properly perform a closed reduction and percutaneous pinning of a pediatric supracondylar humeral fracture. METHODS: Subjects included in the study were either orthopaedic surgery interns or subinterns at our institution...
December 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29206726/standardization-of-pediatric-interfacility-transport-handover-measuring-the-development-of-a-shared-mental-model
#15
Anthony A Sochet, Kelsey S Ryan, Jennifer L Bartlett, Thomas A Nakagawa, Ladonna Bingham
OBJECTIVES: To determine if standardization of pediatric interfacility transport handover is associated with the development of a prototypical shared mental model between healthcare providers. DESIGN: A single center, prepost, retrospective cohort study. SETTINGS: A 259-bed, tertiary care, pediatric referral center. PATIENTS: Children 0 to 18 years old transferred to our critical care units or emergency center from October 2016 to February 2017...
December 4, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29204851/fixed-versus-variable-practice-for-teaching-medical-students-the-management-of-pediatric-asthma-exacerbations-using-simulation
#16
David Drummond, Jennifer Truchot, Eleonora Fabbro, Pierre-François Ceccaldi, Patrick Plaisance, Antoine Tesnière, Alice Hadchouel
Simulation-based trainings represent an interesting approach to teach medical students the management of pediatric asthma exacerbations (PAEs). In this study, we compared two pedagogical approaches, training students once on three different scenarios of PAEs versus training students three times on the same scenario of PAE. Eighty-five third-year medical students, novice learners for the management of PAEs, were randomized and trained. Students were assessed twice, 1 week and 4 months after the training, on a scenario of PAE new to both groups and on scenarios used during the training...
December 4, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29203948/optimal-detection-of-weak-positive-latent-dependence-between-two-sequences-of-multiple-tests
#17
Sihai Dave Zhao, T Tony Cai, Hongzhe Li
It is frequently of interest to jointly analyze two paired sequences of multiple tests. This paper studies the problem of detecting whether there are more pairs of tests that are significant in both sequences than would be expected by chance. The asymptotic detection boundary is derived in terms of parameters such as the sparsity of non-null cases in each sequence, the effect sizes of the signals, and the magnitude of the dependence between the two sequences. A new test for detecting weak dependence is also proposed, shown to be asymptotically adaptively optimal, studied in simulations, and applied to study genetic pleiotropy in 10 pediatric autoimmune diseases...
August 2017: Journal of Multivariate Analysis
https://www.readbyqxmd.com/read/29202248/bag-valve-mask-ventilation-as-a-perceptual-cognitive-skill
#18
Joel M Mumma, Francis T Durso, Michelle Dyes, Rogelio Dela Cruz, Valerie P Fox, Mary Hoey
Objective This study used a high-fidelity infant mannequin to examine the relationship between the quality of bag valve mask ventilation (BVMV) and how providers of varying levels of experience use visual feedback (e.g., electronic vital signs) to guide their performance. Background BVMV is a common and critical procedure for managing pediatric respiratory emergencies. However, providers do not consistently deliver effective BVMV. Efforts to improve BVMV have ignored the question of how providers effectively use feedback often available during BVMV...
December 1, 2017: Human Factors
https://www.readbyqxmd.com/read/29194306/an-innovative-and-successful-simulation-day
#19
Ann M Bowling, Michelle Eismann
This article discusses the development of a creative and innovative plan to incorporate independent activities, including skill reviews and scenarios, into a single eight-hour day, using small student groups to enhance the learning process for pediatric nursing students. The simulation day consists of skills activities and pediatric simulation scenarios using the human patient simulator. Using small student groups in simulation captures the students' attention and enhances motivation to learn. The simulation day is a work in progress; appropriate changes are continually being made to improve the simulation experience for students...
March 2017: Nursing Education Perspectives
https://www.readbyqxmd.com/read/29189596/procedural-training-and-assessment-for-pediatric-emergency-medicine-physicians-within-the-united-states-and-canada-a-survey-study
#20
Rebekah A Burns, Neil G Uspal
OBJECTIVES: The aims of this study were to determine current practices in procedural training and skill assessment for attending physicians working in pediatric emergency departments within the United States and Canada and identify barriers to providing training and assessment. METHODS: This was a cross-sectional survey study. Members of the pediatric emergency medicine fellowship program directors and associate program directors Listserv were invited to participate in an anonymous survey about attending physician training and assessment practices for 9 specific procedures and barriers to training and assessment...
November 20, 2017: Pediatric Emergency Care
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