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https://www.readbyqxmd.com/read/29334569/assessment-of-prehospital-hemorrhage-and-airway-care-using-a-simulation-model
#1
Mariya E Skube, Seth Witthuhn, Kristine Mulier, Bonnie Boucher, Elizabeth Lusczek, Greg J Beilman
BACKGROUND: The quality of prehospital care impacts patient outcomes. Military efforts have focused on training revision and the creation of high fidelity simulation models to address potentially survivable injuries. We sought to investigate the applicability of models emphasizing hemorrhage control and airway management to a civilian population. METHODS: Prehospital healthcare providers (PHPs) undergoing their annual training were enrolled. A trauma scenario was simulated with two modules: hemorrhage control and airway management...
January 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29331740/development-and-validation-of-a-new-population-based-simulation-model-of-osteoarthritis-in-new-zealand
#2
Ross Wilson, J Haxby Abbott
OBJECTIVE: To describe the construction and preliminary validation of a new population-based microsimulation model developed to analyse the health and economic burden and cost-effectiveness of treatments for knee osteoarthritis (OA) in New Zealand (NZ). METHOD: We developed the New Zealand Management of Osteoarthritis (NZ-MOA) model, a discrete-time state-transition microsimulation model of the natural history of radiographic knee OA. In this article, we report on the model structure, derivation of input data, validation of baseline model parameters against external data sources, and validation of model outputs by comparison of the predicted population health loss with previous estimates...
January 10, 2018: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/29330842/self-perceived-long-term-transfer-of-learning-after-postpartum-hemorrhage-simulation-training
#3
Brena C P Melo, Ana R Falbo, Jette Led Sorensen, Jeroen J G van Merriënboer, Cees van der Vleuten
OBJECTIVE: To explore long-term transfer (application of acquired knowledge and skills on the job) after postpartum hemorrhage simulation training based on either instructional design (ID) principles or conventional best practice. METHODS: In this qualitative study, semi-structured interviews with obstetrics and gynecology healthcare practitioners were conducted between August 7 and September 26, 2015, in Recife, Brazil. The participants were randomly selected from each of two postpartum hemorrhage simulations attended 2 years earlier (one ID and one conventional best practice)...
January 13, 2018: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29325871/use-of-uv-fluorescence-based-simulation-in-evaluation-of-personal-protective-equipment-worn-for-first-assessment-and-care-of-a-patient-with-suspected-high-consequence-infectious-disease
#4
Samantha Hall, Bozena Poller, Claire Bailey, Samantha Gregory, Richard Clark, Paul Roberts, Anne Tunbridge, Vin Poran, Cariad Evans, Brian Crook
BACKGROUND: Variations currently exist across the UK in the choice of personal protective equipment (PPE) used by healthcare workers when caring for patients with suspected high consequence infectious diseases (HCIDs). AIM: To test the protection afforded to healthcare workers by current PPE ensembles during assessment of a suspected HCID case and to provide an evidence base to justify proposal of a unified PPE ensemble for healthcare workers across the UK. METHODS: One 'basic level' (enhanced precautions) PPE ensemble and five 'suspected case' PPE ensembles were evaluated in volunteer trials using 'Violet'; a UV-fluorescence-based simulation exercise to visualise exposure/contamination events...
January 8, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29320790/-learning-in-protected-environment-implementation-in-continuing-medical-education
#5
Lion Sieg, Lars Friedrich, Hendrik Eismann
Actual concepts in continuing medical education in acute or emergency medicine contain skill training as well as simulation training. Methods and mechanisms to reduce crisis, like human factor training, shared mental models or closed-loop communication are incorporated. It is unknown which training method is optimal for individual departments in hospitals or for the individual level of education of the healthcare provider. A concept we provide is the so called "learning in protected environment": this environment protects the course participants and our patients from negative consequences of a conventional hands-on training...
January 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29317750/exhaled-air-dispersion-during-bag-mask-ventilation-and-sputum-suctioning-implications-for-infection-control
#6
Matthew T V Chan, Benny K Chow, Thomas Lo, Fanny W Ko, Susanna S Ng, Tony Gin, David S Hui
Mask ventilation and coughing during oro-tracheal suctioning produce aerosols that enhance nosocomial transmission of respiratory infections. We examined the extent of exhaled air dispersion from a human-patient-simulator during mask ventilation by different groups of healthcare workers and coughing bouts. The simulator was programmed to mimic varying severity of lung injury. Exhaled airflow was marked with tiny smoke particles, and highlighted by laser light-sheet. We determined the normalized exhaled air concentration in the leakage jet plume from the light scattered by smoke particles...
January 9, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29306382/diagnostic-radiographers-working-in-the-operating-theatre-an-action-research-project
#7
S Naylor, D Foulkes
INTRODUCTION: Failures in interprofessional communication are well-documented and are an established cause of medical error and negative health outcomes. Socio-historical issues like imbalances in power and status are particularly prevalent in the operating theatre environment, adding complications to interprofessional working. Simulation, used in healthcare education, may impact positively on interprofessional working. METHODS: The aim of this action research study was to develop, pilot and run a simulation experience for Diagnostic Radiography (DRAD) students...
February 2018: Radiography
https://www.readbyqxmd.com/read/29306100/nursing-students-perceptions-of-a-video-based-serious-game-s-educational-value-a-pilot-study
#8
Hege M Johnsen, Mariann Fossum, Pirashanthie Vivekananda-Schmidt, Ann Fruhling, Åshild Slettebø
BACKGROUND: Despite an increasing number of serious games (SGs) in nursing education, few evaluation studies specifically address their educational value in terms of face, content, and construct validity. OBJECTIVES: To assess nursing students' perceptions of a video-based SG in terms of face, content, and construct validity. In addition, the study assessed perceptions of usability, individual factors, and preferences regarding future use. DESIGN: A pilot study was conducted...
December 28, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/29300783/the-economic-benefits-of-reducing-cardiovascular-disease-mortality-in-quebec-canada
#9
David Boisclair, Yann Décarie, François Laliberté-Auger, Pierre-Carl Michaud, Carole Vincent
OBJECTIVES: We assess how different scenarios of cardiovascular disease (CVD) prevention, aimed at meeting targets set by the World Health Organization (WHO) for 2025), may impact healthcare spending in Quebec, Canada over the 2050 horizon. METHODS: We provide long-term forecasts of healthcare use and costs at the Quebec population level using a novel dynamic microsimulation model. Using both survey and administrative data, we simulate the evolution of the Quebec population's health status until death, through a series of dynamic transitions that accounts for social and demographic characteristics associated with CVD risk factors...
2018: PloS One
https://www.readbyqxmd.com/read/29298994/cost-effectiveness-of-hla-dqb1-hla-b-pharmacogenetic-guided-treatment-and-blood-monitoring-in-us-patients-taking-clozapine
#10
François R Girardin, Antoine Poncet, Arnaud Perrier, Nathalie Vernaz, Mark Pletscher, Caroline F Samer, Jeffrey A Lieberman, Jean Villard
Less than 1% of adult patients with schizophrenia taking clozapine develop agranulocytosis, and most of these cases occur within the first weeks of treatment. The human leukocyte antigen (HLA) region has been associated with genetic susceptibility to clozapine-induced agranulocytosis (single amino acid changes in HLA-DQB1 (126Q) and HLA-B (158T)). The current study aimed to evaluate the cost-effectiveness, from a healthcare provider's perspective, of an HLA genotype-guided approach in patients with treatment-resistant schizophrenia who were taking clozapine and to compare the results with the current absolute neutrophil count monitoring (ANCM) schemes used in the USA...
January 3, 2018: Pharmacogenomics Journal
https://www.readbyqxmd.com/read/29286511/cerebral-impact-of-prenatal-irradiation-by-131i-an-experimental-model-of-clinical-neuroradioembryological-effects
#11
V V Talko, K M Loganovsky, I P Drozd, Ye V Tukalenko, T K Loganovska, S Yu Nechayev, S V Masiuk, Ye M Prokhorova
Human brain in prenatal period is a most vulnerable to ionizing radiation body structure. Unlike atomic bombings or radiological interventions in healthcare leading at most to external irradiation the intensive internal exposure may occur upon nuclear reactor accidents followed by substantial release and fallout of radioactive 131I. The latter can lead to specific neuroradioembryological effects. OBJECTIVE: To create an experimental model of prenatal cerebral radiation effects of 131I in human and to determine the experimental and clinical neuroradioembryological effects...
December 2017: Problemy Radiat︠s︡iĭnoï Medyt︠s︡yny Ta Radiobiolohiï
https://www.readbyqxmd.com/read/29284358/storage-and-transport-of-reconstituted-omacetaxine-mepesuccinate-considerations-for-home-administration
#12
Alpa Parikh, Jennifer van de Rijn, Chris Melville, Marazban Sarkari, Sylvie Peltier, Robert McKean
Purpose Omacetaxine mepesuccinate ("omacetaxine") is approved by the US Food and Drug Administration for the treatment of adult patients with chronic- or accelerated-phase chronic myeloid leukemia with resistance and/or intolerance to two or more tyrosine kinase inhibitors. In May 2014, the US Food and Drug Administration approved revisions to the packaging information that included directions for home administration of reconstituted omacetaxine by patients or caregivers using syringes filled at a healthcare facility...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29284026/a-monte-carlo-simulation-approach-for-estimating-the-health-and-economic-impact-of-interventions-provided-at-a-student-run-clinic
#13
Daniel J Arenas, Lanair A Lett, Heather Klusaritz, Anne M Teitelman
BACKGROUND: Student Run Clinics (SRCs) are a common aspect of medical education, present at more than half of US medical schools, and noted for providing care to communities that might otherwise lack access, including the uninsured and underinsured. To date, few studies have rigorously quantified the health and economic benefits of SRCs, and the present study remedies that. METHODS AND FINDINGS: We used Monte Carlo simulations to estimate the health impact of common preventive health interventions applied to individuals in quality-adjusted life-years (QALYs)...
2017: PloS One
https://www.readbyqxmd.com/read/29283674/patient-narratives-as-a-teaching-tool-a-pilot-study-of-first-year-medical-students-and-patient-educators-affected-by-intellectual-developmental-disabilities
#14
Alon Coret, Kerry Boyd, Kevin Hobbs, Joyce Zazulak, Meghan McConnell
PROBLEM: People with intellectual and developmental disabilities (IDD) face complex biopsychosocial challenges and are medically underserved. This is in part due to insufficient resources and supports but can also be attributed to a lack of adequate physician training in addressing the unique needs of this population. INTERVENTION: This study aimed to introduce 1st-year medical students to the IDD population using a blended educational experience that included video narratives of and direct interactions with people affected by IDD...
December 28, 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/29282109/simulated-patient-encounters-to-improve-adolescent-retention-in-hiv-care-in-kenya-study-protocol-of-a-stepped-wedge-randomized-controlled-trial
#15
Kate S Wilson, Cyrus Mugo, David Bukusi, Irene Inwani, Anjuli D Wagner, Helen Moraa, Tamara Owens, Joseph B Babigumira, Barbra A Richardson, Grace C John-Stewart, Jennifer A Slyker, Dalton C Wamalwa, Pamela K Kohler
BACKGROUND: Adolescent-friendly policies aim to tailor HIV services for adolescents and young adults aged 10-24 years (AYA) to promote health outcomes and improve retention in HIV care and treatment. However, few interventions focus on improving healthcare worker (HCW) competencies and skills for provision of high-quality adolescent care. Standardized patients (SPs) are trained actors who work with HCWs in mock clinical encounters to improve clinical assessment, communication, and empathy skills...
December 28, 2017: Trials
https://www.readbyqxmd.com/read/29282043/a-one-day-surgical-skill-training-course-for-medical-students-improved-surgical-skills-and-increased-interest-in-surgery-as-a-career
#16
Ho Seok Seo, Yong Hwa Eom, Min Ki Kim, Young-Min Kim, Byung Joo Song, Kyo Young Song
BACKGROUND: Despite many high-quality programs in basic surgical-skill education, the surgical skill of junior doctors varies widely. This, together with the waning interest in surgery as a career among medical students, is a serious issue confronted by hospitals and healthcare systems worldwide. We, therefore, developed and implemented an intensive one-day surgical-skill training course for two purposes; it would improve surgical skills and increase interest in surgery among medical students...
December 28, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29276288/hazardous-drug-contamination-of-drug-preparation-devices-and-staff-a-contamination-study-simulating-the-use-of-chemotherapy-drugs-in-a-clinical-setting
#17
Evan Call, Brian Bill, Chad McLean, Nathan Call, Allyn Bernkopf, Craig Oberg
Background: Hazardous drug contamination (HD) in healthcare environments continues, placing healthcare staff at risk of significantly chronic health problems, despite the use of personal protective equipment (PPE) and closed system transfer device systems (CSTDs). Objective: This study's aim was to determine how HD might spread through touch after handling contaminated vials in simulated pharmacy and nursing environments. Methods: UV fluorescent powder Glo Germ (Glo Germ Co., Moab, UT), composed of melamine resin, was used to simulate HD...
September 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29275240/decomposition-of-moral-hazard
#18
John A Nyman, Cagatay Koc, Bryan E Dowd, Ellen McCreedy, Helen Markelova Trenz
This study seeks to simulate the portion of moral hazard that is due to the income transfer contained in the coinsurance price reduction. Healthcare spending of uninsured individuals from the MEPS with a priority health condition is compared with the predicted counterfactual spending of those same individuals if they were insured with either (1) a conventional policy that paid off with a coinsurance rate or (2) a contingent claims policy that paid off by a lump sum payment upon becoming ill. The lump sum payment is set to be equal to the insurer's predicted spending under the coinsurance policy...
December 11, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/29258908/linear-regression-and-the-normality-assumption
#19
A F Schmidt, Chris Finan
OBJECTIVE: Researchers often perform arbitrary outcome transformations to fulfil the normality assumption of a linear regression model. This manuscript explains and illustrates that in large data settings, such transformations are often unnecessary, and worse, may bias model estimates. DESIGN: Linear regression assumptions are illustrated using simulated data and an empirical example on the relation between time since type 2 diabetes diagnosis and glycated haemoglobin (HbA1c)...
December 16, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/29250812/a-multiple-model-generalisation-of-updating-clinical-prediction-models
#20
Glen P Martin, Mamas A Mamas, Niels Peek, Iain Buchan, Matthew Sperrin
There is growing interest in developing clinical prediction models (CPMs) to aid local healthcare decision-making. Frequently, these CPMs are developed in isolation across different populations, with repetitive de novo derivation a common modelling strategy. However, this fails to utilise all available information and does not respond to changes in health processes through time and space. Alternatively, model updating techniques have previously been proposed that adjust an existing CPM to suit the new population, but these techniques are restricted to a single model...
December 18, 2017: Statistics in Medicine
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