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Healthcare simulation

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https://www.readbyqxmd.com/read/27913159/assessing-functional-performance-using-computer-based-simulations-of-everyday-activities
#1
Sara J Czaja, David A Loewenstein, Chin Chin Lee, Shih Hua Fu, Philip D Harvey
Current functional capacity (FC) measures for patients with schizophrenia typically involve informant assessments or are in paper and pencil format, requiring in-person administration by a skilled assessor. This approach presents logistic problems and limits the possibilities for remote assessment, an important issue for these patients. This study evaluated the feasibility of using a computer-based assessment battery, including simulations of everyday activities. The battery was compared to in-person standard assessments of cognition and FC with respect to baseline convergence and sensitivity to group differences...
November 29, 2016: Schizophrenia Research
https://www.readbyqxmd.com/read/27909393/a-comparison-of-multiple-behavior-models-in-a-simulation-of-the-aftermath-of-an-improvised-nuclear-detonation
#2
Nidhi Parikh, Harshal G Hayatnagarkar, Richard J Beckman, Madhav V Marathe, Samarth Swarup
We describe a large-scale simulation of the aftermath of a hypothetical 10kT improvised nuclear detonation at ground level, near the White House in Washington DC. We take a synthetic information approach, where multiple data sets are combined to construct a synthesized representation of the population of the region with accurate demographics, as well as four infrastructures: transportation, healthcare, communication, and power. In this article, we focus on the model of agents and their behavior, which is represented using the options framework...
November 2016: Autonomous Agents and Multi-agent Systems
https://www.readbyqxmd.com/read/27902533/using-simulation-in-global-health-considerations-for-design-and-implementation
#3
Michael B Pitt, Walter J Eppich, Margaret L Shane, Sabrina M Butteris
Providers and educators increasingly participate in global health work during their careers. Simulation can play an important role in both preparing learners for work in resource-limited settings and training providers in these countries. However, little guidance exists for educators interested in creating and implementing scenarios for these settings. We discuss several key considerations unique to global health simulation ranging from addressing common cultural differences surrounding healthcare and varied regional approaches to disease identification and management to understanding precisely what resources exist in the setting and what strategies can be used to provide care when the expected resources are not available...
November 29, 2016: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/27894323/health-related-quality-of-life-and-a-cost-utility-simulation-of-adults-in-the-uk-with-osteogenesis-imperfecta-x-linked-hypophosphatemia-and-fibrous-dysplasia
#4
Lydia Forestier-Zhang, Laura Watts, Alison Turner, Harriet Teare, Jane Kaye, Joe Barrett, Cyrus Cooper, Richard Eastell, Paul Wordsworth, Muhammad K Javaid, Rafael Pinedo-Villanueva
BACKGROUND: Health-related quality of life of adults with osteogenesis imperfecta (OI), fibrous dysplasia (FD) and X-linked hypophosphatemia (XLH) remains poorly described. The aim of this study was to describe the HRQoL of adults with osteogenesis imperfecta, fibrous dysplasia and X-linked hypophophataemia and perform a cost-utility simulation to calculate the maximum cost that a health care system would be willing to pay for a hypothetical treatment of a rare bone disease. RESULTS: Participants completed the EQ-5D-5 L questionnaire between September 2014 and March 2016...
November 28, 2016: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/27893940/community-healthcare-professionals-overestimate-the-risk-of-fatal-anaphylaxis-for-food-allergic-children
#5
H J Hanna, J Emmanuel, S Naim, T Umasunthar, R J Boyle
BACKGROUND: Fatal food anaphylaxis is rare, but a major concern for people with food allergy and their carers. We evaluated whether community healthcare professionals accurately estimate risk of fatal anaphylaxis for food allergic children, and whether accurate risk estimation is related to competence in recognizing and managing anaphylaxis. METHODS: We enrolled 90 community healthcare professionals in a cross-sectional survey - 30 primary care nurses, 30 school first aiders, 30 community pharmacists...
December 2016: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27890158/improving-our-understanding-of-multi-tasking-in-healthcare-drawing-together-the-cognitive-psychology-and-healthcare-literature
#6
REVIEW
Heather E Douglas, Magdalena Z Raban, Scott R Walter, Johanna I Westbrook
Multi-tasking is an important skill for clinical work which has received limited research attention. Its impacts on clinical work are poorly understood. In contrast, there is substantial multi-tasking research in cognitive psychology, driver distraction, and human-computer interaction. This review synthesises evidence of the extent and impacts of multi-tasking on efficiency and task performance from health and non-healthcare literature, to compare and contrast approaches, identify implications for clinical work, and to develop an evidence-informed framework for guiding the measurement of multi-tasking in future healthcare studies...
March 2017: Applied Ergonomics
https://www.readbyqxmd.com/read/27882517/cost-effectiveness-of-apixaban-versus-warfarin-or-aspirin-for-stroke-prevention-in-patients-with-atrial-fibrillation-a-greek-perspective
#7
Kostas Athanasakis, Nadia Boubouchairopoulou, Eleftheria Karampli, Filippos Tarantilis, Paraskevi Savvari, Aikaterini Bilitou, John Kyriopoulos
BACKGROUND: Strokes attributed to atrial fibrillation (AF) represent a major cause of adult disability and a great burden to society and healthcare systems. OBJECTIVES: Our objective was to assess the cost effectiveness of apixaban, a direct acting oral anticoagulant (DOAC), versus warfarin or aspirin for patients with AF in the Greek healthcare setting. METHODS: We used a previously published Markov model to simulate clinical events for patients with AF treated with apixaban, the vitamin K antagonist (VKA) warfarin, or aspirin...
November 23, 2016: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/27874843/high-fidelity-simulation-experience-in-emergency-settings-doctors-and-nurses-satisfaction-levels
#8
Diletta Calamassi, Tiziana Nannelli, Andrea Guazzini, Laura Rasero, Stefano Bambi
BACKGROUND AND AIM OF THE WORK: Lots of studies describe High Fidelity Simulation (HFS) as an experience well-accepted by the learners. This study has explored doctors and nurses satisfaction levels during HFS sessions, searching the associations with the setting of simulation events (simulation center or on the field simulation). Moreover, we studied the correlation between HFS experience satisfaction levels and the socio-demographic features of the participants. METHODS: Mixed method study, using the Satisfaction of High-Fidelity Simulation Experience (SESAF) questionnaire through an online survey...
November 22, 2016: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/27874210/cost-effectiveness-of-using-cognitive-screening-tests-for-detecting-dementia-and-mild-cognitive-impairment-in-primary-care
#9
Thaison Tong, Praveen Thokala, Brian McMillan, Rob Ghosh, John Brazier
INTRODUCTION: We estimated the cost effectiveness of different cognitive screening tests for use by General Practitioners (GPs) to detect cognitive impairment in England. METHODS: A patient-level cost-effectiveness model was developed using a simulated cohort that represents the elderly population in England (65 years and older). Each patient was followed over a lifetime period. Data from published sources were used to populate the model. The costs include government funded health and social care, private social care and informal care...
November 22, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27861206/comparison-of-the-detection-rate-of-simulated-microcalcifications-in-full-field-digital-mammography-digital-breast-tomosynthesis-and-synthetically-reconstructed-2-dimensional-images-performed-with-2-different-digital-x-ray-mammography-systems
#10
Sabine Peters, Martin Hellmich, Alexander Stork, Jörn Kemper, Olga Grinstein, Michael Püsken, Leandra Stahlhut, Sonja Kinner, David Maintz, Kathrin Barbara Krug
OBJECTIVE: The aim of this study was to compare the microcalcification detectability in an anthropomorphic phantom model regarding number, size, and shape in full-field digital mammography (FFDM), synthetically reconstructed 2-dimensional (Synthetic-2D) images, and digital breast tomosynthesis (DBT) performed with 2 different x-ray mammography systems. MATERIALS AND METHODS: Simulated microcalcifications of different numbers (0 to >39), sizes (diameter, 100-800 μm), and shapes (round vs heterogeneous) were scattered by random distribution on 50 film phantoms each divided in 4 quadrants...
November 17, 2016: Investigative Radiology
https://www.readbyqxmd.com/read/27857515/the-ethics-of-the-relation-between-the-convicted-patient-and-the-physician
#11
Cristian Gherman, Ovidiu Chiroban, Dan Perju-Dumbrava
BACKGROUND AND AIM: Approaching the convicted patient is a topical issue in terms of alignment with EU provisions and recommendations, more so in the context of year by year increase in the number of convicts and consequently, prison patients. The prison patient exhibits increased vulnerability in regard to the rest of the convicts due to his/her medical status overlapping personality changes induced, while coping with a new environment. This represents a challenge for the physicians involved in the expertise process, which must act objectively within the limits and by the principles of professional ethics, while confronting a patient influenced by the prison environment...
2016: Clujul Medical (1957)
https://www.readbyqxmd.com/read/27855285/computational-drug-treatment-simulations-on-projections-of-dysregulated-protein-networks-derived-from-the-myelodysplastic-mutanome-match-clinical-response-in-patients
#12
Leylah Drusbosky, Cindy Medina, Regina Martuscello, Kimberly E Hawkins, Myron Chang, Jatinder K Lamba, Shireen Vali, Ansu Kumar, Neeraj Kumar Singh, Taher Abbasi, Mikkael A Sekeres, Mar Mallo, Francesc Sole, Rafael Bejar, Christopher R Cogle
Although the majority of MDS patients fail to achieve clinical improvement to approved therapies, some patients benefit from treatment. Predicting patient response prior to therapy would improve treatment effectiveness, avoid treatment-related adverse events and reduce healthcare costs. Three separate cohorts of MDS patients were used to simulate drug response to lenalidomide alone, hypomethylating agent (HMA) alone, or HMA plus lenalidomide. Utilizing a computational biology program, genomic abnormalities in each patient were used to create an intracellular pathway map that was then used to screen for drug response...
November 6, 2016: Leukemia Research
https://www.readbyqxmd.com/read/27853739/efficiency-of-endoscopy-units-can-be-improved-with-use-of-discrete-event-simulation-modeling
#13
Bryan G Sauer, Kanwar P Singh, Barry L Wagner, Matthew S Vanden Hoek, Katherine Twilley, Steven M Cohn, Vanessa M Shami, Andrew Y Wang
Background and study aims: The projected increased demand for health services obligates healthcare organizations to operate efficiently. Discrete event simulation (DES) is a modeling method that allows for optimization of systems through virtual testing of different configurations before implementation. The objective of this study was to identify strategies to improve the daily efficiencies of an endoscopy center with the use of DES. Methods: We built a DES model of a five procedure room endoscopy unit at a tertiary-care university medical center...
November 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27852293/a-simulation-based-curriculum-to-introduce-key-teamwork-principles-to-entering-medical-students
#14
Arna Banerjee, Jason M Slagle, Nathaniel D Mercaldo, Ray Booker, Anne Miller, Daniel J France, Lisa Rawn, Matthew B Weinger
BACKGROUND: Failures of teamwork and interpersonal communication have been cited as a major patient safety issue. Although healthcare is increasingly being provided in interdisciplinary teams, medical school curricula have traditionally not explicitly included the specific knowledge, skills, attitudes, and behaviors required to function effectively as part of such teams. METHODS: As part of a new "Foundations" core course for beginning medical students that provided a two-week introduction to the most important themes in modern healthcare, a multidisciplinary team, in collaboration with the Center for Experiential Learning and Assessment, was asked to create an experiential introduction to teamwork and interpersonal communication...
November 16, 2016: BMC Medical Education
https://www.readbyqxmd.com/read/27844177/a-method-to-simulate-incentives-for-cost-containment-under-various-cost-sharing-designs-an-application-to-a-first-euro-deductible-and-a-doughnut-hole
#15
D Cattel, R C van Kleef, R C J A van Vliet
Many health insurance schemes include deductibles to provide consumers with cost containment incentives (CCI) and to counteract moral hazard. Policymakers are faced with choices on the implementation of a specific cost sharing design. One of the guiding principles in this decision process could be which design leads to the strongest CCI. Despite the vast amount of literature on the effects of cost sharing, the relative effects of specific cost sharing designs-e.g., a traditional deductible versus a doughnut hole-will mostly be absent for a certain context...
November 14, 2016: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/27836368/the-cost-effectiveness-of-nonoperative-management-versus-laparoscopic-appendectomy-for-the-treatment-of-acute-uncomplicated-appendicitis-in-children
#16
James X Wu, Greg D Sacks, Aaron J Dawes, Daniel DeUgarte, Steven L Lee
BACKGROUND: Several studies have demonstrated the safety and short-term success of nonoperative management in children with acute, uncomplicated appendicitis. Nonoperative management spares the patients and their family the upfront cost and discomfort of surgery, but also risks recurrent appendicitis. METHODS: Using decision-tree software, we evaluated the cost-effectiveness of nonoperative management versus routine laparoscopic appendectomy. Model variables were abstracted from a review of the literature, Healthcare Cost and Utilization Project, and Medicare Physician Fee schedule...
October 20, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27832706/the-simulated-clinical-environment-cognitive-and-emotional-impact-among-undergraduates
#17
Marie-Laurence Tremblay, Alexandre Lafleur, Jimmie Leppink, Diana H J M Dolmans
CONTEXT: Simulated clinical immersion (SCI) is used in undergraduate healthcare programs to expose the learner to real-life situations in authentic simulated clinical environments. For novices, the environment in which the simulation occurs can be distracting and stressful, hence potentially compromising learning. OBJECTIVES: This study aims to determine whether SCI (with environment) imposes greater extraneous cognitive load and stress on undergraduate pharmacy students than simulated patients (SP) (without environment)...
November 10, 2016: Medical Teacher
https://www.readbyqxmd.com/read/27832503/estimating-the-accuracy-of-optic-nerve-sheath-diameter-measurement-using-a-pocket-sized-handheld-ultrasound-on-a-simulation-model
#18
Garrett G R J Johnson, Frederick A Zeiler, Bertram Unger, Gregory Hansen, Dimitrios Karakitsos, Lawrence M Gillman
BACKGROUND: Ultrasound measurement of optic nerve sheath diameter (ONSD) appears to be a promising, rapid, non-invasive bedside tool for identification of elevated intra-cranial pressure. With improvements in ultrasound technology, machines are becoming smaller; however, it is unclear if these ultra-portable handheld units have the resolution to make these measurements precisely. In this study, we estimate the accuracy of ONSD measurement in a pocket-sized ultrasound unit. METHODS: Utilizing a locally developed, previously validated model of the eye, ONSD was measured by two expert observers, three times with two machines and on five models with different optic nerve sheath sizes...
December 2016: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/27830241/the-rising-frequency-of-it-blackouts-indicates-the-increasing-relevance-of-it-emergency-concepts-to-ensure-patient-safety
#19
Ulrich Sax, M Lipprandt, R Röhrig
INTRODUCTION: As many medical workflows depend vastly on IT support, great demands are placed on the availability and accuracy of the applications involved. The cases of IT failure through ransomware at the beginning of 2016 are impressive examples of the dependence of clinical processes on IT. Although IT risk management attempts to reduce the risk of IT blackouts, the probability of partial/total data loss, or even worse, data falsification, is not zero. The objective of this paper is to present the state of the art with respect to strategies, processes, and governance to deal with the failure of IT systems...
November 10, 2016: Yearbook of Medical Informatics
https://www.readbyqxmd.com/read/27827383/emergence-of-ebola-virus-disease-in-a-french-acute-care-setting-a-simulation-study-based-on-documented-inter-individual-contacts
#20
Philippe Vanhems, Rosette Von Raesfeldt, René Ecochard, Nicolas Voirin
The potential spread of nosocomial Ebola virus disease (EVD) in non-outbreak areas is not known. The objective was to use detailed contact data on patients and healthcare workers (HCW) to estimate emergence probability and secondary incident cases (SIC) of EVD after hospitalization of an index case with undetected EVD. Contact data were collected through RFID devices used by patients and HCW during hospital care. A "susceptible-exposed-infected" model was used. Emergence probability, ranged from 7% to 84%. A plateau around 84% was observed...
November 9, 2016: Scientific Reports
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