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Highly reliable team

Derek Wakeman, Max R Langham
The operating room (OR) is a special place wherein groups of highly skilled individuals must work in a coordinated and harmonious fashion to deliver optimal patient care. Team dynamics and human factors principles were initially studied by the aviation industry to better understand and prevent airline accidents. As a result, crew resource management (CRM) training was designed for all flight personnel to create a highly reliable industry with a commitment to a culture of safety. CRM has since been adapted to health care, resulting in care improvement and harm reduction across a wide variety of medical specialties...
April 2018: Seminars in Pediatric Surgery
Tyler Sheetz, Cheryl T Lee
PURPOSE OF REVIEW: As the population ages, urologic oncologists are caring for older and more vulnerable patients that must withstand complex surgical treatments. Our healthcare environment emphasizes surgical quality, reductions in length of hospital stay, reduced readmission rates, and high patient satisfaction. So those who manage urologic malignancies must be able to optimize their patients. Understanding the concept of frailty, how to diagnose it in a timely and reliable manner, appreciate its perioperative impact, and consider interventions to reduce its effects may improve surgical outcomes...
March 13, 2018: Current Opinion in Urology
Hyun Bae Yoon, Wan Beom Park, Sun-Jung Myung, Sang Hui Moon, Jun-Bean Park
PURPOSE: Team-based learning (TBL) is increasingly employed in medical education because of its potential to promote active group learning. In TBL, learners are usually asked to assess the contributions of peers within their group to ensure accountability. The purpose of this study is to assess the validity and reliability of a peer evaluation instrument that was used in TBL classes in a single medical school. METHODS: A total of 141 students were divided into 18 groups in 11 TBL classes...
March 2018: Korean Journal of Medical Education
Marco Barbanti, Simona Gulino, Giuliano Costa, Corrado Tamburino
Transcatheter aortic valve implantation (TAVI) is now a widely adopted therapy for the treatment of elderly patients with severe aortic stenosis. Improved pre-procedural screening, increased operators' experience and technology advancement have made this technique highly reliable and standardized. Areas covered: The purpose of this review article is to provide an overview of the strategies that can be adopted to optimize the TAVI procedure (pre-interventional work-up and procedural simplification and early discharge)...
March 9, 2018: Expert Review of Cardiovascular Therapy
Ana Barros, Luís Moreira, Helena Santos, Nuno Ribeiro, Filipe Santos-Silva
Cancer literacy is currently one of the most important dimensions of cancer continuum. Objective assessment of cancer knowledge in populations remains a challenging field to public health entities. Different evaluation tools are currently available; still, some groups remain disregarded due to the absence of validated instruments. Cancer literacy in adolescents and young adults has been clearly overlooked being a subject that requires new tools to be properly studied. To address this topic, we developed a new instrument and field tested it in a classroom environment for internal reliability, construct, and face validity...
March 5, 2018: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
Pascal Edouard, Astrid Junge, Marianna Kiss-Polauf, Christophe Ramirez, Monica Sousa, Toomas Timpka, Pedro Branco
OBJECTIVES: The quality of epidemiological injury data depends on the reliability of reporting to an injury surveillance system. Ascertaining whether all physicians/physiotherapists report the same information for the same injury case is of major interest to determine data validity. The aim of this study was therefore to analyse the data collection reliability through the analysis of the interrater reliability. DESIGN: Cross-sectional survey. METHODS: During the 2016 European Athletics Advanced Athletics Medicine Course in Amsterdam, all national medical teams were asked to complete seven virtual case reports on a standardised injury report form using the same definitions and classifications of injuries as the international athletics championships injury surveillance protocol...
March 1, 2018: Journal of Science and Medicine in Sport
Rozh Jalil, Tayana Soukup, Waseem Akhter, Nick Sevdalis, James S A Green
BACKGROUND: High-quality leadership and chairing skills are vital for good performance in multidisciplinary tumor boards (MTBs), but no instruments currently exist for assessing and improving these skills. OBJECTIVE: To construct and validate a robust instrument for assessment of MTB leading and chairing skills. DESIGN AND SETTING: We developed an observational MTB leadership assessment instrument (ATLAS). ATLAS includes 12 domains that assess the leadership and chairing skills of the MTB chairperson...
March 3, 2018: World Journal of Urology
Karen L Johnson, Lauri Speirs, Anne Mitchell, Heather Przybyl, Diane Anderson, Brenda Manos, Amy T Schaenzer, Keri Winchester
BACKGROUND: Patients who receive prolonged endotracheal intubation (> 48 hours) are at risk for dysphagia. Nurses should conduct swallowing assessments after extubation because of the high likelihood of aspiration pneumonia developing. No valid and reliable postextubation dysphagia screening tools are available. OBJECTIVES: To establish content validity, analyze interrater reliability, and determine sensitivity and specificity of an evidence-based postextubation dysphagia screening tool developed by a multidisciplinary team...
March 2018: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Andrea Fanelli, Rohan Jaishankar, Aristotelis Filippidis, James Holsapple, Thomas Heldt
OBJECTIVES:  Our objective was to develop, deploy, and test a data-acquisition system for the reliable and robust archiving of high-resolution physiological waveform data from a variety of bedside monitoring devices, including the GE Solar 8000i patient monitor, and for the logging of ancillary clinical and demographic information. MATERIALS AND METHODS:  The data-acquisition system consists of a computer-based archiving unit and a GE Tram Rac 4A that connects to the GE Solar 8000i monitor...
2018: Acta Neurochirurgica. Supplement
Richard J Pugh, Amy Ellison, Kate Pye, Christian P Subbe, Chris M Thorpe, Nazir I Lone, Andrew Clegg
BACKGROUND: For healthcare systems, an ageing population poses challenges in the delivery of equitable and effective care. Frailty assessment has the potential to improve care in the intensive care setting, but applying assessment tools in critical illness may be problematic. The aim of this systematic review was to evaluate evidence for the feasibility and reliability of frailty assessment in critical care. METHODS: Our primary search was conducted in Medline, Medline In-process, EMBASE, CINAHL, PsycINFO, AMED, Cochrane Database of Systematic Reviews, and Web of Science (January 2001 to October 2017)...
February 26, 2018: Critical Care: the Official Journal of the Critical Care Forum
Saraswathi Vedam, Kathrin Stoll, Marian MacDorman, Eugene Declercq, Renee Cramer, Melissa Cheyney, Timothy Fisher, Emma Butt, Y Tony Yang, Holly Powell Kennedy
METHODS: Our multidisciplinary team examined published regulatory data to inform a 50-state database describing the environment for midwifery practice and interprofessional collaboration. Items (110) detailed differences across jurisdictions in scope of practice, autonomy, governance, and prescriptive authority; as well as restrictions that can affect patient safety, quality, and access to maternity providers across birth settings. A nationwide survey of state regulatory experts (n = 92) verified the 'on the ground' relevance, importance, and realities of local interpretation of these state laws...
2018: PloS One
Benjamin M Jackson, Ted Polglaze, Brian Dawson, Trish King, Peter Peeling
PURPOSE: To compare data from conventional GPS and new GNSS-enabled tracking devices, and to examine the inter-unit reliability of GNSS devices. METHODS: Inter-device differences between 10 Hz GPS and GNSS devices were examined during laps (n=40) of a simulated game circuit (SGC) and during elite hockey matches (n=21); GNSS inter-unit reliability was also examined during the SGC laps. Differences in distance values and measures in three velocity categories (low <3 m...
February 21, 2018: International Journal of Sports Physiology and Performance
Julian D Egan-Shuttler, Rohan Edmonds, Stephen J Ives
(248 words)Heart rate (HR) variability (HRV) is a reliable indicator of cardiac parasympathetic activity and has been used in athletic populations to measure training adaptations. To date, there is limited research showing whether HRV is practical in youth female athletes and rowers during short periods of overload training. PURPOSE: The purpose of this study was to evaluate the practicality of HRV in documenting training responses during a period of overload training in youth female rowers...
February 15, 2018: Journal of Strength and Conditioning Research
Judy Blauwet, Mandy Bell
Technology for technology's sake is never a good idea. There must be a purpose behind it. It must help us do our jobs better. Technology allows healthcare to remain affordable and, as such, accessible. Technology must increase access to care, improve safety, make test results more reliable, and help teams communicate better for a seamless care experience.Avera Health, a health system based in Sioux Falls, South Dakota, comprises 330 facilities in 100 communities in five states. Sponsored by the Benedictine and Presentation Sisters, Avera is a healthcare ministry whose employees deliver high-quality care with compassion...
April 2018: Frontiers of Health Services Management
Xin-Ran Tang, Ying-Qin Li, Shao-Bo Liang, Wei Jiang, Fang Liu, Wen-Xiu Ge, Ling-Long Tang, Yan-Ping Mao, Qing-Mei He, Xiao-Jing Yang, Yuan Zhang, Xin Wen, Jian Zhang, Ya-Qin Wang, Pan-Pan Zhang, Ying Sun, Jing-Ping Yun, Jing Zeng, Li Li, Li-Zhi Liu, Na Liu, Jun Ma
BACKGROUND: Gene expression patterns can be used as prognostic biomarkers in various types of cancers. We aimed to identify a gene expression pattern for individual distant metastatic risk assessment in patients with locoregionally advanced nasopharyngeal carcinoma. METHODS: In this multicentre, retrospective, cohort analysis, we included 937 patients with locoregionally advanced nasopharyngeal carcinoma from three Chinese hospitals: the Sun Yat-sen University Cancer Center (Guangzhou, China), the Affiliated Hospital of Guilin Medical University (Guilin, China), and the First People's Hospital of Foshan (Foshan, China)...
February 7, 2018: Lancet Oncology
Jörg Matschullat, Clemens Reimann, Manfred Birke, Debora Dos Santos Carvalho
A reliable overview of measured concentrations of TC, TN and TS, TOC/TN ratios, and their regional distribution patterns in agricultural soil at the continental scale and based on measured data has been missing - despite much previous work on local and the European scales. Detection and mapping of natural (ambient) background element concentrations and variability in Europe was the focus of this work. While total C and S data had been presented in the GEMAS atlas already, this work delivers more precise (lower limit of determination) and fully quantitative data, and for the first time high-quality TN data...
February 5, 2018: Science of the Total Environment
Jennifer L Fang, Gladys B Asiedu, Ann M Harris, Katherine Carroll, Christopher E Colby
BACKGROUND: Teleneonatology may improve the quality of high-risk newborn resuscitations performed by general providers in community settings. Variables that affect teleneonatology utilization have not been identified. INTRODUCTION: The objective of our mixed-methods study was to understand the barriers and facilitators experienced by local care providers who receive teleneonatology services. MATERIALS AND METHODS: In October 2015, an electronic survey was sent to 349 teleneonatology participants at 6 community hospitals to assess user satisfaction, technology usability and acceptability, and impact on patient care...
February 8, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Vlatka Lajnert, Daniela Kovacevic Pavicic, Andrej Pavlic, Alessandra Pokrajac-Bulian, Stjepan Spalj
OBJECTIVE: To create and validate a brief questionnaire designed for the assessment of satisfaction with smile aesthetics and to test its efficiency as a patient-centred outcome measure of aesthetic interventions in dentistry. MATERIALS AND METHODS: A team of three specialists - two from prosthodontics and one psychologist - used a self-evaluation scale consisting of five elements in order to rate self-perceived smile aesthetics. A total of 671 subjects (63% female), 18-86 years of age, were included in the investigation...
February 7, 2018: International Dental Journal
Yuanbo Cui, Wei Wu, Pengju Lv, Jianying Zhang, Bingqing Bai, Wei Cao
Esophageal squamous cell carcinoma (ESCC) is one of the most lethal malignant cancers with high incidence and mortality. Current reliable effective diagnostic and prognostic biomarkers are very limited in clinic. Emerging evidence indicates that dysregulated expression of the long non-coding RNAs (lncRNAs) was examined in various types of cancer including ESCC. ESCC associated lncRNA _1 (ESCCAL_1) was first time identified to be increased expression in ESCC, and therefore named by our research team. However, its potential function in the progression of ESCC remains unclear...
January 2, 2018: Oncotarget
Li-Bing Zheng, Yong Mao, Jun Wang, Ruan-Ni Chen, Yong-Quan Su, Yue-Qun Hong, Yu-Jian Hong, Yu-Cong Hong
Larimichthys crocea, the special marine economy fish, owns the largest annual yield for a single species in China. One of the most significant factors affecting large yellow croaker culture is the diseases, especially the threat of marine white spot disease which caused by a protozoan Cryptocaryon irritans. Antimicrobial peptides (AMPs) have been demonstrated to be active against bacterium, fungi and parasites, showing their potential usefulness in aquaculture as substitutes for antibiotics. Many researches have been carried out about the AMPs concentrating on the activity resist on C...
February 1, 2018: Fish & Shellfish Immunology
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