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Healthcare simulation

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https://www.readbyqxmd.com/read/28302085/adaptation-of-non-technical-skills-behavioural-markers-for-delivery-room-simulation
#1
Fabrizio Bracco, Michele Masini, Gabriele De Tonetti, Francesca Brogioni, Arianna Amidani, Sara Monichino, Alessandra Maltoni, Andrea Dato, Claudia Grattarola, Massimo Cordone, Giancarlo Torre, Claudio Launo, Carlo Chiorri, Danilo Celleno
BACKGROUND: Simulation in healthcare has proved to be a useful method in improving skills and increasing the safety of clinical operations. The debriefing session, after the simulated scenario, is the core of the simulation, since it allows participants to integrate the experience with the theoretical frameworks and the procedural guidelines. There is consistent evidence for the relevance of non-technical skills (NTS) for the safe and efficient accomplishment of operations. However, the observation, assessment and feedback on these skills is particularly complex, because the process needs expert observers and the feedback is often provided in judgmental and ineffective ways...
March 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28299963/cost-effectiveness-analysis-on-the-use-of-fidaxomicin-and-vancomycin-to-treat-clostridium-difficile-infection-in-france
#2
Maureen Watt, Aurélien Dinh, Alban Le Monnier, Patrick Tilleul
BACKGROUND: Fidaxomicin is a macrocyclic antibiotic with proven efficacy against Clostridium difficile infection (CDI) in adults. It was licensed in France in 2012, but, due to higher acquisition costs compared with existing treatments, healthcare providers require information on its cost/benefit profile. OBJECTIVE: To compare healthcare costs and health outcomes of fidaxomicin and vancomycin, as reference treatment for CDI. METHODS: A Markov model was used to simulate the treatment pathway, over 1 year, of adult patients with CDI receiving fidaxomicin or vancomycin...
March 16, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28297325/an-evaluation-of-organ-dose-modulation-on-a-ge-optima-ct660-computed-tomography-scanner
#3
Matthew T Dixon, Robert J Loader, Gregory C Stevens, Nick P Rowles
Organ Dose Modulation or ODM (GE Healthcare, Milwaukee, WI) was evaluated to characterize changes in CTDIvol, image noise, effective dose, and organ dose saving to patients. Three separate investigations were completed: a tube current modulation phantom was scanned with and without ODM, a CTDIvol phantom was scanned with ODM, and Monte Carlo simulations were performed. ODM was found to reduce the CTDIvol by approximately 20% whilst increasing the noise by approximately 14%. This was reflected in the dose distribution, where the anterior peripheral dose was reduced by approximately 40% whilst the identical posterior dose remained largely unaffected...
May 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28297050/preoperative-computer-simulation-for-planning-of-vascular-access-surgery-in-hemodialysis-patients
#4
Niek Zonnebeld, Wouter Huberts, Magda M van Loon, Tammo Delhaas, Jan H M Tordoir
INTRODUCTION: The arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis patients. Unfortunately, 20-40% of all constructed AVFs fail to mature (FTM), and are therefore not usable for hemodialysis. AVF maturation importantly depends on postoperative blood volume flow. Predicting patient-specific immediate postoperative flow could therefore support surgical planning. A computational model predicting blood volume flow is available, but the effect of blood flow predictions on the clinical endpoint of maturation (at least 500 mL/min blood volume flow, diameter of the venous cannulation segment ≥4 mm) remains undetermined...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28296923/screening-gestational-diabetes-mellitus-the-role-of-maternal-age
#5
Chun-Heng Kuo, Szu-Chi Chen, Chi-Tai Fang, Feng-Jung Nien, En-Tzu Wu, Shin-Yu Lin, Lee-Ming Chuang, Chien-Nan Lee, Hung-Yuan Li
OBJECTIVE: Using a specific cutoff of fasting plasma glucose (FPG) to screen gestational diabetes mellitus (GDM) can reduce the use of oral glucose tolerance tests (OGTT). Since the prevalence of GDM increases with age, this screening method may not be appropriate in healthcare systems where women become pregnant at older ages. Therefore, we aimed to develop a screening algorithm for GDM that takes maternal age into consideration. METHODS: We included 945 pregnant women without history of GDM who received 75g OGTT to diagnose GDM in 2011...
2017: PloS One
https://www.readbyqxmd.com/read/28294392/cost-effectiveness-of-population-based-community-workplace-and-individual-policies-for-diabetes-prevention-in-the-uk
#6
P R Breeze, C Thomas, H Squires, A Brennan, C Greaves, P Diggle, E Brunner, A Tabak, L Preston, J Chilcott
AIM: To analyse the cost-effectiveness of different interventions for Type 2 diabetes prevention. within a common framework METHODS: A micro-simulation model was developed to evaluate the cost-effectiveness of a range of diabetes prevention interventions including: (1) soft drinks taxation; (2) retail policy in socially deprived areas; (3) workplace intervention; (4) community-based intervention; and (5) screening and intensive lifestyle intervention in individuals with high diabetes risk...
March 10, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28289919/patients-with-chronic-conditions-simulate-to-educate
#7
Thomas Lefèvre, Rémi Gagnayre, Maxime Gignon
Simulation in healthcare in an way to train professionals but it is not yet use commonly to train patient or their caregivers. Recently, it has been suggested to extend simulations to patients with chronic conditions. Simulations could help patients and caregivers to acquire psychosocial and self-management skills. This approach proved to be effective for the training of healthcare professionals, but its transferability to patients needs to be evaluated. Already, several questions arise. However, by considering simulations as pretexts for debriefing, they enable patients and professionals to assess a concrete situation, implying voluntary and reflexive learning processes...
March 13, 2017: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/28288018/cost-effectiveness-of-the-13-valent-pneumococcal-conjugate-vaccine-in-children-in-portugal
#8
Miguel Gouveia, Francesca Fiorentino, Gonçalo Jesus, João Costa, Margarida Borges
INTRODUCTION: Pneumococcal infections are the leading cause of vaccine-preventable death in children. In June 2015, the 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in the Portuguese Immunization Program. We evaluate the cost-effectiveness of children vaccination with PCV13 versus no vaccination for preventing pneumococcal diseases (PD). METHOD: A cohort simulation model for 2014 Portuguese newborns was used, considering a lifetime horizon and existence of herd effect on adults...
March 10, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28286295/impact-of-non-medical-vaccine-exemption-policies-on-the-health-and-economic-burden-of-measles
#9
Melanie D Whittington, Allison Kempe, Amanda Dempsey, Rachel Herlihy, Jonathan D Campbell
OBJECTIVE: Despite relatively high national vaccination coverage for measles, geographic vaccination variation exists resulting in clusters of susceptibility. A portion of this geographic variation can be explained by differences in state policies related to non-medical vaccine exemptions. The objective of this analysis was to determine the magnitude, likelihood, and cost of a measles outbreak under different non-medical vaccine exemption policies. METHODS: An agent-based transmission model simulated the likelihood and magnitude of a measles outbreak under different non-medical vaccine exemption policies, previously categorized as easy, medium, or difficult...
March 9, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28285549/methodology-of-the-access-to-care-and-timing-simulation-model-for-traumatic-spinal-cord-injury-care
#10
Argelio Santos, Nader Fallah, Rachel Lewis, Marcel F Dvorak, Michael G Fehlings, Anthony Scott Burns, Vanessa K Noonan, Christiana L Cheng, Elaine Chan, Anoushka Singh, Lise M Belanger, Derek Atkins
Despite the relatively low incidence, the management and care of persons with traumatic spinal cord injury (tSCI) can be resource intensive and complex, spanning multiple phases of care and disciplines. Using a simulation model built with a system level view of the healthcare system allows for prediction of the impact of interventions on patient and system outcomes from injury through to community reintegration after tSCI. The Access to Care and Timing (ACT) project developed a simulation model for tSCI care using techniques from operations research and its development has been described previously...
March 12, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28276844/an-acute-interprofessional-simulation-experience-for-occupational-and-physical-therapy-students-key-findings-from-a-survey-study
#11
Erin M Thomas, Melinda F Rybski, Tonya L Apke, Deb A Kegelmeyer, Anne D Kloos
Due to the fast pace and high complexity of managing patients in intensive and acute care units (ICUs), healthcare students often feel challenged and unprepared to practice in this environment. Simulations and standardised patients provide "hands-on" learning experiences that are realistic and help students to gain competence and confidence. This study examined the impact of an intensive case simulation laboratory using a patient simulator and standardised patients on students' perceptions of their confidence and preparedness to work in acute care settings...
February 28, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28275838/economic-evaluation-of-a-population-based-osteoporosis-intervention-for-outpatients-with-non-traumatic-non-hip-fractures-the-catch-a-break-1i-type-c-fls
#12
S R Majumdar, D A Lier, D A Hanley, A G Juby, L A Beaupre
Fracture liaison services (FLS) are advocated to improve osteoporosis treatment after fragility fracture, but there are few economic analyses of different models. A population-based 1i [=type C] FLS for non-hip fractures was implemented and it costs $44 per patient and it was very cost-effective ($9200 per QALY gained). Small operational changes would convert it from cost-effective to cost-saving. INTRODUCTION: After fragility fracture, <20% of patients receive osteoporosis treatment...
March 9, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28272350/a-risk-assessment-of-antibiotic-pan-drug-resistance-in-the-uk-bayesian-analysis-of-an-expert-elicitation-study
#13
Daniel Carter, André Charlett, Stefano Conti, Julie V Robotham, Alan P Johnson, David M Livermore, Tom Fowler, Mike Sharland, Susan Hopkins, Neil Woodford, Philip Burgess, Stephen Dobra
To inform the UK antimicrobial resistance strategy, a risk assessment was undertaken of the likelihood, over a five-year time-frame, of the emergence and widespread dissemination of pan-drug-resistant (PDR) Gram-negative bacteria that would pose a major public health threat by compromising effective healthcare delivery. Subsequent impact over five- and 20-year time-frames was assessed in terms of morbidity and mortality attributable to PDR Gram-negative bacteraemia. A Bayesian approach, combining available data with expert prior opinion, was used to determine the probability of the emergence, persistence and spread of PDR bacteria...
March 7, 2017: Antibiotics
https://www.readbyqxmd.com/read/28271262/patient-self-assessment-of-surgical-site-infection-is-inaccurate
#14
Vered Richter, Matan J Cohen, Shmuel Benenson, Gideon Almogy, Mayer Brezis
BACKGROUND: Availability of surgical site infection (SSI) surveillance rates challenges clinicians, healthcare administrators and leaders and the public. The purpose of this report is to demonstrate the consequences patient self-assessment strategies have on SSI reporting rates. METHODS: We performed SSI surveillance among patients undergoing general surgery procedures, including telephone follow-up 30 days after surgery. Additionally we undertook a separate validation study in which we compared patient self-assessments of SSI with surgeon assessment...
March 7, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28270258/the-impact-of-reducing-antibiotics-on-the-transmission-of-multidrug-resistant-organisms
#15
Sean L Barnes, Clare Rock, Anthony D Harris, Sara E Cosgrove, Daniel J Morgan, Kerri A Thom
OBJECTIVE Antibiotic resistance is a major threat to public health. Resistance is largely driven by antibiotic usage, which in many cases is unnecessary and can be improved. The impact of decreasing overall antibiotic usage on resistance is unknown and difficult to assess using standard study designs. The objective of this study was to explore the potential impact of reducing antibiotic usage on the transmission of multidrug-resistant organisms (MDROs). DESIGN We used agent-based modeling to simulate interactions between patients and healthcare workers (HCWs) using model inputs informed by the literature...
March 8, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28270207/cost-effectiveness-of-adding-novel-or-group-5-interventions-to-a-background-regimen-for-the-treatment-of-multidrug-resistant-tuberculosis-in-germany
#16
Daniel Wirth, Ramesh Dass, Robert Hettle
BACKGROUND: Treatment of multidrug-resistant tuberculosis (MDR-TB) is complex, lengthy, and involves a minimum of four drugs termed a background regimen (BR), that have not previously been prescribed or that have proven susceptible to patient sputum culture isolates. In recent years, promising new treatment options have emerged as add-on therapies to a BR. The aim of this study was to evaluate the long-term costs and effectiveness of adding the novel or group 5 interventions bedaquiline, delamanid, and linezolid to a background regimen (BR) of drugs for the treatment of adult patients with pulmonary multidrug-resistant tuberculosis (MDR-TB), within their marketing authorisations, from a German healthcare cost-effectiveness perspective...
March 8, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28269616/cluster-based-architecture-and-network-maintenance-protocol-for-medical-priority-aware-cognitive-radio-based-hospital
#17
Ishtiak Al Mamoon, A K M Muzahidul Islam, Sabariah Baharun, Ashir Ahmed, Shozo Komaki
Due to the rapid growth of wireless medical devices in near future, wireless healthcare services may face some inescapable issue such as medical spectrum scarcity, electromagnetic interference (EMI), bandwidth constraint, security and finally medical data communication model. To mitigate these issues, cognitive radio (CR) or opportunistic radio network enabled wireless technology is suitable for the upcoming wireless healthcare system. The up-to-date research on CR based healthcare has exposed some developments on EMI and spectrum problems...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28269615/a-comprehensive-reputation-mechanism-for-ubiquitous-healthcare-environment-exploiting-cloud-model
#18
Georgia Athanasiou, Dimitrios Lymberopoulos
Absence of trust foundations may outweigh benefits of ubiquitous and personalized mental healthcare supervision provided within a Ubiquitous Healthcare environment (UH). Trust is composed by patient's Personal Interaction Experience (PIE) and social entourage accumulated PIE, i.e. Reputation (R). In this paper, a cloud-based Reputation mechanism is proposed. Since PIE is the elementary trust information source, also an Updating mechanism of PIE, is introduced, in this paper. Cloud materialization of combined mechanisms provides adaptability to UH Providers' dynamic behavior, facilitates detection of milking behaviors and complex malicious attacks while meets the challenge of limited accuracy in case of data sparseness...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28268328/3d-printed-microfluidic-mixer-for-point-of-care-diagnosis-of-anemia
#19
Kimberly Plevniak, Matthew Campbell, Mei He
3D printing has been an emerging fabrication tool in prototyping and manufacturing. We demonstrated a 3D microfluidic simulation guided computer design and 3D printer prototyping for quick turnaround development of microfluidic 3D mixers, which allows fast self-mixing of reagents with blood through capillary force. Combined with smartphone, the point-of-care diagnosis of anemia from finger-prick blood has been successfully implemented and showed consistent results with clinical measurements. Capable of 3D fabrication flexibility and smartphone compatibility, this work presents a novel diagnostic strategy for advancing personalized medicine and mobile healthcare...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28264455/a-fast-channel-assignment-scheme-for-emergency-handling-in-wireless-body-area-networks
#20
Sabita Nepal, Amod Pudasani, Seokjoo Shin
Ubiquitous healthcare is a promising technology that has attracted significant attention in recent years; this has led to the realization of wireless body area networks (WBANs). For designing a robust WBAN system, the WBAN has to solve the drawbacks of wireless technology. Also, a WBAN has to support immediate, reliable data transmission for medical services during emergencies. Hence, this study proposes a new MAC superframe structure that can handle emergencies by delivering strongly correlated regular data to a caretaker, within a certain time threshold...
February 27, 2017: Sensors
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