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https://www.readbyqxmd.com/read/28814584/examining-self-reported-and-biological-stress-and-near-misses-among-emergency-medicine-residents-a-single-centre-cross-sectional-assessment-in-the-usa
#1
Bengt B Arnetz, Philip Lewalski, Judy Arnetz, Karen Breejen, Karin Przyklenk
OBJECTIVES: To examine the relationship between perceived and biological stress and near misses among Emergency Medicine residents. DESIGN: Self-rated stress and stress biomarkers were assessed in residents in Emergency Medicine before and after a day shift. The supervising physicians and residents reported numbers of near misses. SETTING: The study took place in the Emergency Department of a large trauma 1 centre, located in Detroit, USA...
August 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28810207/intermediate-care-to-intensive-care-triage-a-quality-improvement-project-to-reduce-mortality
#2
David N Hager, Pranav Chandrashekar, Robert W Bradsher, Ali M Abdel-Halim, Souvik Chatterjee, Melinda Sawyer, Roy G Brower, Dale M Needham
PURPOSE: Medical patients whose care needs exceed what is feasible on a general ward, but who do not clearly require critical care, may be admitted to an intermediate care unit (IMCU). Some IMCU patients deteriorate and require medical intensive care unit (MICU) admission. In 2012, staff in the Johns Hopkins IMCU expressed concern that patient acuity and the threshold for MICU admission were too high. Further, shared triage decision-making between residents and supervising physicians did not consistently occur...
August 3, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28808426/organisational-and-environmental-characteristics-of-residential-aged-care-units-providing-highly-person-centred-care-a-cross-sectional-study
#3
Karin Sjögren, Marie Lindkvist, Per-Olof Sandman, Karin Zingmark, David Edvardsson
BACKGROUND: Few studies have empirically investigated factors that define residential aged care units that are perceived as being highly person-centred. The purpose of this study was to explore factors characterising residential aged care units perceived as being highly person-centred, with a focus on organisational and environmental variables, as well as residents' and staff' characteristics. METHODS: A cross-sectional design was used. Residents (n = 1460) and staff (n = 1213) data from 151 residential care units were collected, as well as data relating to characteristics of the organisation and environment, and data measuring degree of person-centred care...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28767548/the-balance-between-surgical-resident-education-and-patient-safety-in-laparoscopic-colorectal-surgery-surgical-resident-s-performance-has-no-negative-impact
#4
Shigenori Homma, Futoshi Kawamata, Tadashi Yoshida, Yosuke Ohno, Nobuki Ichikawa, Susumu Shibasaki, Hideki Kawamura, Norihiko Takahashi, Akinobu Taketomi
OBJECTIVE: This study aimed to evaluate the feasibility and effectiveness of a comprehensive theoretical and hands-on training program in performing laparoscopic colonic resections under supervision of an expert surgeon. MATERIALS AND METHODS: Laparoscopic right colectomy was performed in 78 patients (10 with benign disease, 68 with carcinoma). Demographic, intraoperative, pathologic examination, and short-term outcome data were retrospectively compared between 25 patients operated by surgical residents (R group) and 53 patients operated by senior surgeons (S group)...
August 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28760802/this-much-water-a-qualitative-study-using-behavioural-theory-to-develop-a-community-service-video-to-prevent-child-drowning-in-western-australia
#5
Mel Denehy, Justine E Leavy, Jonine Jancey, Lauren Nimmo, Gemma Crawford
OBJECTIVES: Drowning in children under the age of 5 is a frequently occurring, yet preventable event. This research used behavioural theory to test the suitability and appropriateness of a drowning prevention message in a community service video. DESIGN: This qualitative study used content analysis of focus groups. Constructs from the Health Belief Model guided the data analysis. SETTING: Community organisations and playgrounds in Perth, Western Australia...
July 31, 2017: BMJ Open
https://www.readbyqxmd.com/read/28760467/resident-autonomy-in-the-operating-room-expectations-versus-reality
#6
Shari L Meyerson, Joel M Sternbach, Joseph B Zwischenberger, Edward M Bender
BACKGROUND: There is concern about graduating thoracic trainees' independent operative skills due to limited autonomy in training. This study compared faculty and trainee expected levels of autonomy with intraoperative measurements of autonomy for common cardiothoracic operations. METHODS: Participants underwent frame-of-reference training on the 4-point Zwisch scale of operative autonomy (show and tell → active help → passive help → supervision only) and evaluated autonomy in actual cases using the Zwisch Me!! mobile application...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28742711/readiness-of-us-general-surgery-residents-for-independent-practice
#7
Brian C George, Jordan D Bohnen, Reed G Williams, Shari L Meyerson, Mary C Schuller, Michael J Clark, Andreas H Meier, Laura Torbeck, Samuel P Mandell, John T Mullen, Douglas S Smink, Rebecca E Scully, Jeffrey G Chipman, Edward D Auyang, Kyla P Terhune, Paul E Wise, Jennifer N Choi, Eugene F Foley, Justin B Dimick, Michael A Choti, Nathaniel J Soper, Keith D Lillemoe, Joseph B Zwischenberger, Gary L Dunnington, Debra A DaRosa, Jonathan P Fryer
OBJECTIVE: This study evaluates the current state of the General Surgery (GS) residency training model by investigating resident operative performance and autonomy. BACKGROUND: The American Board of Surgery has designated 132 procedures as being "Core" to the practice of GS. GS residents are expected to be able to safely and independently perform those procedures by the time they graduate. There is growing concern that not all residents achieve that standard. Lack of operative autonomy may play a role...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742661/association-between-senior-obstetrician-supervision-of-resident-deliveries-and-mode-of-delivery
#8
Georgina Davis
No abstract text is available yet for this article.
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28741193/burr-hole-craniostomy-for-chronic-subdural-hematomas-by-general-surgeons-in-rural-kenya
#9
John K Kanyi, Timothy V Ogada, Mark J Oloo, Robert K Parker
INTRODUCTION: Chronic subdural hematoma (cSDH) is a common condition that causes significant morbidity and mortality. In rural sub-Saharan Africa, there are very few neurosurgeons. Yet, cSDH is treatable by relatively simple surgical intervention with potential for rapid clinical improvement. METHODS: We conducted a retrospective chart review of all patients with cSDH who underwent burr-hole trephination at Tenwek Hospital, Kenya, between July 2014 and July 2016...
July 24, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28737193/-vertebral-fractures-in-children-with-type-i-osteogenesis-imperfecta
#10
Andrea M Sepúlveda, Claudia V Terrazas, Josefina Sáez, María L Reyes
Osteogenesis imperfecta (OI) is an hereditary disease affecting conective tissue, mainly associated to growth retardation and pathological fractures. OI type I (OI type I), is the mildest, most often, and homogeneous in its fenotype. Vertebral fractures are the most significant complications, associated to skeletical and cardiopulmonary morbidity. OBJECTIVES: To characterize clinically a cohort of children with OI type I. PATIENTS AND METHODS: A cohort of OI type I children younger than 20 year old was evaluated...
June 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28733181/caring-for-a-person-with-dementia-on-the-margins-of-long-term-care-a-perspective-on-burden-from-8-european-countries
#11
Caroline Sutcliffe, Clarissa Giebel, Michel Bleijlevens, Connie Lethin, Minna Stolt, Kai Saks, Maria E Soto, Gabriele Meyer, Adelaida Zabalegui, Helen Chester, David Challis
OBJECTIVES: To explore associations between carer burden and characteristics of (1) the informal carer, (2) the person with dementia, and (3) the care support network in 8 European countries. DESIGN: Cross-sectional study. SETTING: People with dementia judged at risk of admission to long-term care (LTC) facilities in 8 European countries (Estonia, Finland, France, Germany, Netherlands, Spain, Sweden, United Kingdom). PARTICIPANTS: A total of 1223 people with dementia supported by community services at home or receiving day care or respite care and their informal carers...
July 18, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28727316/primary-inguinal-hernia-the-open-repair-today-pros-and-cons
#12
REVIEW
Giampiero Campanelli, Piero Giovanni Bruni, Andrea Morlacchi, Francesca Lombardo, Marta Cavalli
Open anterior repair for inguinal hernia offers several distinct advantages over endoscopic repair, especially when real-world effectiveness is taken into account. The learning curve for endoscopic techniques is long, whereas the Lichtenstein and other open tension-free techniques are easier to teach and replicate at all levels. The outcomes of Lichtenstein repairs for primary inguinal hernia as performed by non-experts and supervised residents are comparable to those of experts. Moreover, open tension-free repair does not require expensive instruments or dedicated equipment, other than the prosthetic mesh...
August 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28722624/knowledge-attitude-and-practice-of-mothers-caregivers-on-household-water-treatment-methods-in-northwest-ethiopia-a-community-based-cross-sectional-study
#13
Bikes Destaw Bitew, Yigzaw Kebede Gete, Gashaw Andargie Biks, Takele Tadesse Adafrie
In Ethiopia, ensuring safe drinking water remains a big challenge where waterborne diseases, including diarrhea cause a great harm in many rural communities. Limited knowledge, misinformation, negative attitude, and lack of experience toward best practices of alternative water treatment technologies were among the leading challenges. A community-based cross-sectional study was conducted from June 23 to 30, 2015, in Dabat District. The study participants were selected by using simple random sampling method. Questionnaire-based face-to-face interview technique of data collection was used by 20 data collectors under close supervision with six supervisors...
July 17, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28714800/differences-in-psychoactive-substance-abuse-between-youths-residing-in-and-outside-conflict-zones-as-a-function-of-level-of-religiosity-and-political-commitment
#14
Vered Ne'eman-Haviv, Yael Wilchek-Aviad
The aim of the present study was to examine the effect of the unique characteristics of residing in security and political conflict zones on the willingness to use and on the actual abuse of psychoactive substances. The study focuses on the differences between youths residing in and outside conflict zones in Israel. The present study examines the link between the adolescents' level of psychoactive substance abuse and town size as well as the youths' level of ideological commitment and religiosity. 1032 adolescents aged 14-18 participated in the study...
August 24, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28705161/entrustment-of-the-on-call-senior-medical-resident-role-implications-for-patient-safety-and-collective-care
#15
Noureen Huda, Lisa Faden, Mark Goldszmidt
BACKGROUND: The on-call responsibilities of a senior medicine resident (SMR) may include the admission transition of patient care on medical teaching teams (MTT), supervision of junior trainees, and ensuring patient safety. In many institutions, there is no standardised assessment of SMR competency prior to granting these on-call responsibilities in internal medicine. In order to fulfill competency based medical education requirements, training programs need to develop assessment approaches to make and defend such entrustment decisions...
July 14, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28697845/evaluation-of-veterans-affairs-primary-care-nurse-practitioner-residency-achievement-of-competencies
#16
Kathryn Wirtz Rugen, Mary A Dolansky, Maya Dulay, Samuel King, Nancy Harada
BACKGROUND: The Institute of Medicine has recommended the establishment of residency programs for advanced practice nursing graduates. Currently, the evidence about program effectiveness is limited. PURPOSE: To describe the nurse practitioner (NP) resident outcomes on seven competency domains established by the VA Centers of Excellence in Primary Care Education (VA CoEPCE). METHODS: We evaluated mean NP resident competency self-ratings and mean mentor ratings over the 12-month program across NP residency programs at five sites...
June 13, 2017: Nursing Outlook
https://www.readbyqxmd.com/read/28683990/how-safe-is-it-to-train-residents-to-perform-coronary-surgery-with-multiple-arterial-grafting-nineteen-years-of-training-at-a-single-institution
#17
Umberto Benedetto, Massimo Caputo, Mario Gaudino, Hunaid Vohra, Pierpaolo Chivasso, Alan Bryan, Gianni D Angelini
The learning curve of coronary artery bypass grafting (CABG) with multiple arterial grafting (MAG) is perceived to be associated with increased surgical morbidity and potentially poorer long-term outcomes. We compared short-term outcomes and long-term survival in patients who underwent CABG with MAG performed by attending surgeons or resident trainees at a single institution over a period of 19 years. Using our institutional database, we identified 3039 patients undergoing MAG from 1996-2015. Of those, 958 (32%) were operated on by residents and 2081 (68%) by attending surgeons...
April 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28682295/implementing-a-chronic-wound-care-curriculum-for-internal-medicine-residents
#18
Elizabeth Foy White-Chu, Tri Le, Renee Cordrey
OBJECTIVE: The objective of this study was to determine if participation in a practice-based learning session would change the residents' reported wound care practice. METHODS: A 90-minute didactic and skills workshop in chronic wound care was provided to 89 internal medicine (IM) residents divided into 4 groups, who were asked to complete an anonymous clinical vignette survey prior to the session and again 3 months after the practice-based learning session. RESULTS: Comparisons of the pretest and posttest scores (Mann-Whitney U Test) showed only ordering moisture-retentive dressing changed significantly...
June 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28669788/the-effect-of-gender-on-resident-autonomy-in-the-operating-room
#19
Shari L Meyerson, Joel M Sternbach, Joseph B Zwischenberger, Edward M Bender
OBJECTIVE: Discrimination against women training in medicine and surgery has been subjectively described for decades. This study objectively documents gender differences in the degree of autonomy given to thoracic surgery trainees in the operating room. DESIGN: Thoracic surgery residents and faculty underwent frame of reference training on the use of the 4-point Zwisch scale to measure operative autonomy. Residents and faculty then submitted evaluations of their perception of autonomy granted for individual operations as well as operative difficulty on a real-time basis using the "Zwisch Me!!" mobile application...
June 29, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28668549/design-and-implementation-of-a-robotic-surgery-training-experience-logging-system
#20
Kristin G Baldea, Ryan Thorwarth, Petar Bajic, Marcus L Quek, Gopal N Gupta
PURPOSE: Residents currently log robotic cases in the ACGME system as a "surgeon" if they performed any critical step of the procedure on the surgeon console. There is no standardization as to which steps or how much of the procedure should be performed by the resident. It was our objective to establish a tool for logging the true operative experience in robotic surgery to aid in assessing surgical competency as well as curriculum development. MATERIALS AND METHODS: We propose a tool to log surgical skill progression, experience, and feedback for robotic cases...
June 28, 2017: Journal of Surgical Education
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