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Medical Simulation

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https://www.readbyqxmd.com/read/28319990/a-decision-support-approach-for-provider-scheduling-in-a-patient-centered-medical-home
#1
Renata Konrad, Sarah Ficarra, Catherine Danko, Rachel Wallace, Cliona Archambeault
The patient-centered medical home (PCMH) has been proposed as a viable and medically effective model of primary care delivery. The fundamental principles of a PCMH address increased access and offer new ways to organize a practice. Creating provider schedules able to satisfy the operational and organizational constraints imposed by this type of delivery model is a challenging, complex, and time-consuming task.This article presents a two-step approach for scheduling providers and prospectively assessing the consequences of various schedules on patient throughput without experimenting on the real-world system...
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28319164/modeling-the-potential-impact-on-the-us-blood-supply-of-transfusing-critically-ill-patients-with-fresher-stored-red-blood-cells
#2
Arianna Simonetti, Hussein Ezzeldin, Mikhail Menis, Stephen McKean, Hector Izurieta, Steven A Anderson, Richard A Forshee
BACKGROUND: Although some studies have suggested that transfusion recipients may have better medical outcomes if transfused with red blood cell units stored for a short time, the overall body of evidence shows mixed results. It is important to understand how using fresher stored red blood cell units for certain patient groups may affect blood availability. METHODS: Based on the Stock-and-Flow simulation model of the US blood supply developed by Simonetti et al. 2014, we evaluated a newly implemented allocation method of preferentially transfusing fresher stored red blood cell units to a subset of high-risk group of critically ill patients and its potential impact on supply...
2017: PloS One
https://www.readbyqxmd.com/read/28318845/specifying-the-effects-of-physician-s-communication-on-patients-outcomes-a-randomised-controlled-trial
#3
Mara van Osch, Sandra van Dulmen, Liesbeth van Vliet, Jozien Bensing
OBJECTIVE: To experimentally test the effects of physician's affect-oriented communication and inducing expectations on outcomes in patients with menstrual pain. METHODS: Using a 2×2 RCT design, four videotaped simulated medical consultations were used, depicting a physician and a patient with menstrual pain. In the videos, two elements of physician's communication were manipulated: (1) affect-oriented communication (positive: warm, emphatic; versus negative: cold, formal), and (2) outcome expectation induction (positive versus uncertain)...
March 6, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28318742/a-mobile-based-surgical-simulation-application-a-comparative-analysis-of-efficacy-using-a-carpal-tunnel-release%C3%A2-module
#4
Kamil M Amer, Taha Mur, Kamal Amer, Asif M Ilyas
PURPOSE: The utilization of surgical simulation continues to grow in medical training. The TouchSurgery application (app) is a new interactive virtual reality smartphone- or tablet-based app that offers a step-by-step tutorial and simulation for the execution of various operations. The purpose of this study was to compare the efficacy of the app versus traditional teaching modalities utilizing the "Carpal Tunnel Surgery" module. We hypothesized that users of the app would score higher than those using the traditional education medium indicating higher understanding of the steps of surgery...
March 16, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28317922/optical-imaging-of-localized-chemical-events-using-programmable-diamond-quantum-nanosensors
#5
Torsten Rendler, Jitka Neburkova, Ondrej Zemek, Jan Kotek, Andrea Zappe, Zhiqin Chu, Petr Cigler, Jörg Wrachtrup
Development of multifunctional nanoscale sensors working under physiological conditions enables monitoring of intracellular processes that are important for various biological and medical applications. By attaching paramagnetic gadolinium complexes to nanodiamonds (NDs) with nitrogen-vacancy (NV) centres through surface engineering, we developed a hybrid nanoscale sensor that can be adjusted to directly monitor physiological species through a proposed sensing scheme based on NV spin relaxometry. We adopt a single-step method to measure spin relaxation rates enabling time-dependent measurements on changes in pH or redox potential at a submicrometre-length scale in a microfluidic channel that mimics cellular environments...
March 20, 2017: Nature Communications
https://www.readbyqxmd.com/read/28316887/comparison-of-methods-of-alert-acknowledgement-by-critical-care-clinicians-in-the-icu-setting
#6
Andrew M Harrison, Charat Thongprayoon, Christopher A Aakre, Jack Y Jeng, Mikhail A Dziadzko, Ognjen Gajic, Brian W Pickering, Vitaly Herasevich
BACKGROUND: Electronic Health Record (EHR)-based sepsis alert systems have failed to demonstrate improvements in clinically meaningful endpoints. However, the effect of implementation barriers on the success of new sepsis alert systems is rarely explored. OBJECTIVE: To test the hypothesis time to severe sepsis alert acknowledgement by critical care clinicians in the ICU setting would be reduced using an EHR-based alert acknowledgement system compared to a text paging-based system...
2017: PeerJ
https://www.readbyqxmd.com/read/28306682/training-future-anesthesiologists-in-obstetric-care
#7
Mauricio Vasco Ramírez
PURPOSE OF REVIEW: In order for the obstetric anesthesiologist to become a true perioperative / peripartum physician, a change in formative programs and certification process in anesthesia are needed. RECENT FINDINGS: Anesthesia training programs are migrating to competency based medical education (CBME) worldwide. The traditional model of attending lectures, grand rounds, reading textbooks and journal papers should be complemented by virtual modalities such as massive open online courses or online teaching tools...
March 16, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28304300/a-novel-method-for-direct-assessment-of-everyday-competence-among-older-adults
#8
Sara J Czaja, David A Loewenstein, Samir A Sabbag, Rosie E Curiel, Elizabeth Crocco, Philip D Harvey
BACKGROUND: Recent findings indicate that impairments in functional performance do occur among individuals diagnosed with mild cognitive impairment (MCI). Most assessment strategies for everyday competence are associated with challenges with reliability, are typically in paper and pencil format, or require in-person administration by a trained professional. OBJECTIVE: This paper reports on a novel technology-based assessment battery of everyday competence that includes ecologically valid simulations of daily activities important to independence...
March 10, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28302519/using-ontology-based-semantic-similarity-to-facilitate-the-article-screening-process-for-systematic-reviews
#9
Xiaonan Ji, Alan Ritter, Po-Yin Yen
OBJECTIVE: Systematic Reviews (SRs) are utilized to summarize evidence from high quality studies and are considered the preferred source of evidence-based practice (EBP). However, conducting SRs can be time and labor intensive due to the high cost of article screening. In previous studies, we demonstrated utilizing established (lexical) article relationships to facilitate the identification of relevant articles in an efficient and effective manner. Here we propose to enhance article relationships with background semantic knowledge derived from Unified Medical Language System (UMLS) concepts and ontologies...
March 13, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28302112/automation-bias-in-electronic-prescribing
#10
David Lyell, Farah Magrabi, Magdalena Z Raban, L G Pont, Melissa T Baysari, Richard O Day, Enrico Coiera
BACKGROUND: Clinical decision support (CDS) in e-prescribing can improve safety by alerting potential errors, but introduces new sources of risk. Automation bias (AB) occurs when users over-rely on CDS, reducing vigilance in information seeking and processing. Evidence of AB has been found in other clinical tasks, but has not yet been tested with e-prescribing. This study tests for the presence of AB in e-prescribing and the impact of task complexity and interruptions on AB. METHODS: One hundred and twenty students in the final two years of a medical degree prescribed medicines for nine clinical scenarios using a simulated e-prescribing system...
March 16, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28302096/mathematical-analysis-of-a-lymphatic-filariasis-model-with-quarantine-and-treatment
#11
Peter M Mwamtobe, Simphiwe M Simelane, Shirley Abelman, Jean M Tchuenche
BACKGROUND: Lymphatic filariasis is a globally neglected tropical parasitic disease which affects individuals of all ages and leads to an altered lymphatic system and abnormal enlargement of body parts. METHODS: A mathematical model of lymphatic filariaris with intervention strategies is developed and analyzed. Control of infections is analyzed within the model through medical treatment of infected-acute individuals and quarantine of infected-chronic individuals...
March 16, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28301484/health-facility-service-availability-and-readiness-for-intrapartum-and-immediate-postpartum-care-in-malawi-a-cross-sectional-survey
#12
Naoko Kozuki, Lolade Oseni, Angella Mtimuni, Reena Sethi, Tambudzai Rashidi, Fannie Kachale, Barbara Rawlins, Shivam Gupta
This analysis seeks to identify strengths and gaps in the existing facility capacity for intrapartum and immediate postpartum fetal and neonatal care, using data collected as a part of Malawi's Helping Babies Breath program evaluation. From August to September 2012, the Maternal and Child Health Integrated Program (MCHIP) conducted a cross-sectional survey in 84 Malawian health facilities to capture current health facility service availability and readiness and health worker capacity and practice pertaining to labor, delivery, and immediate postpartum care...
2017: PloS One
https://www.readbyqxmd.com/read/28301204/impact-of-an-interactive-diagnostic-case-simulator-on-a-medical-student-radiology-rotation
#13
Michael V Friedman, Jennifer L Demertzis, Travis J Hillen, Jeremiah R Long, David A Rubin
OBJECTIVE: The objective of our study was to assess the short-term impact of adding an interactive simulator to a medical student radiology clerkship. We hypothesized that transitioning students from passive observers to active participants in the reading room would create an appealing and effective learning experience for the current generation of students. MATERIALS AND METHODS: An interactive workstation that provided diagnostic simulations of 84 cases selected to maximize exposure to important diagnoses in musculoskeletal (MSK) radiology was created...
March 16, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28300878/surgical-model-pig-ex-vivo-for-venous-dissection-teaching-in-medical-schools
#14
Milton Ignacio Carvalho Tube, Fernando Antonio Campelo Spencer-Netto, Anderson Igor Pereira de Oliveira, Arthur Cesário de Holanda, Bruno Leão Dos Santos Barros, Caio Cezar Gomes Rezende, João Pedro Guerra Cavalcanti, Marília Apolinário Batista, Josemberg Marins Campos
PURPOSE: To investigate a method for development of surgical skills in medical students simulating venous dissection in surgical ex vivo pig model. METHODS: Prospective, analytical, experimental, controlled study with four stages: selection, theoretical teaching, training and assessment. Sample of 312 students was divided into two groups: Group A - 2nd semester students; Group B - students of 8th semester. The groups were divided into five groups of 12 students, trained two hours per week in the semester...
February 2017: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/28300387/real-time-ray-casting-based-scatter-dose-estimation-for-c-arm-x-ray-system
#15
Zaid Alnewaini, Eric Langer, Philipp Schaber, Matthias David, Dominik Kretz, Volker Steil, Jürgen Hesser
OBJECTIVES: Dosimetric control of staff exposure during interventional procedures under fluoroscopy is of high relevance. In this paper, a novel ray casting approximation of radiation transport is presented and the potential and limitation vs. a full Monte Carlo transport and dose measurements are discussed. METHOD: The x-ray source of a Siemens Axiom Artix C-arm is modeled by a virtual source model using single Gaussian-shaped source. A Geant4-based Monte Carlo simulation determines the radiation transport from the source to compute scatter from the patient, the table, the ceiling and the floor...
March 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28300340/trainees-at-a-resuscitation-a-dual-liability
#16
Nancy H Stewart, Audrey Tanksley, Dana P Edelson, Vineet M Arora
BACKGROUND: During basic life support (BLS) training, medical students receive little instruction on their role during a resuscitation attempt. Research is sparse regarding trainee perceptions of the resuscitation team. This study sought to describe trainee experiences and perceptions of resuscitation teams. METHODS: Clinical third-year medical students (MS3s) and incoming interns (PGY1s) reported on survey items addressing prior BLS education, knowledge of BLS, and the student's perceptions and experiences during a resuscitation attempt...
March 16, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28299529/modeling-and-simulation-in-dose-determination-for-biodefense-products-approved-under-the-fda-animal-rule
#17
Kimberly L Bergman, K Krudys, S K Seo, J Florian
Development of effective medical countermeasures for biodefense is vital to United States biopreparedness and response in the age of terrorism, both foreign and domestic. A traditional drug development pathway toward approval is not possible for most biodefense-related indications, creating the need for alternative development pathways such as the FDA's Animal Rule. Under this unique regulatory mechanism, FDA-approval is based on adequate and well-controlled animal studies when it is neither ethical nor feasible to conduct human efficacy studies...
March 15, 2017: Journal of Pharmacokinetics and Pharmacodynamics
https://www.readbyqxmd.com/read/28299158/a-study-on-strategic-planning-and-procurement-of-medicals-in-uganda-s-regional-referral-hospitals
#18
Ishak Kamaradi Masembe
This study was an analysis of the effect of strategic planning on procurement of medicals in Uganda's regional referral hospitals (RRH's). Medicals were defined as essential medicines, medical devices and medical equipment. The Ministry of Health (MOH) has been carrying out strategic planning for the last 15 years via the Health Sector Strategic Plans. Their assumption was that strategic planning would translate to strategic procurement and consequently, availability of medicals in the RRH's. However, despite the existence of these plans, there have been many complaints about expired drugs and shortages in RRH's...
December 31, 2016: Journal of Public Health in Africa
https://www.readbyqxmd.com/read/28298033/diffusion-tractography-imaging-guided-frameless-linear-accelerator-stereotactic-radiosurgical-thalamotomy-for-tremor-case-report
#19
Won Kim, Justin Sharim, Stephen Tenn, Tania Kaprealian, Yvette Bordelon, Nzhde Agazaryan, Nader Pouratian
Essential tremor and Parkinson's disease-associated tremor are extremely prevalent within the field of movement disorders. The ventral intermediate (VIM) nucleus of the thalamus has been commonly used as both a neuromodulatory and neuroablative target for the treatment of these forms of tremor. With both deep brain stimulation and Gamma Knife radiosurgery, there is an abundance of literature regarding the surgical planning, targeting, and outcomes of these methodologies. To date, there have been no reports of frameless, linear accelerator (LINAC)-based thalomotomies for tremor...
February 24, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28297991/solvent-free-molecular-level-modeling-of-self-assembling-amphiphiles-in-water
#20
Somajit Dey, Jayashree Saha
Aggregation mesophases of self-assembling amphiphiles in water are highly important in the context of biology (biomembranes), therapy (liposomes), industry (polymer surfactants), and condensed-matter physics (lyotropic liquid crystals). Besides helping to increase fundamental understanding of collective molecular behavior, simulations of these lyotropic phases are pivotal to technological and medical developments such as smart drug carriers for gene therapy. Implicit-solvent, coarse-grained, low resolution modeling with a simple pair potential is the key to realizing the larger length and time scales associated with such mesoscopic phenomena during a computer simulation...
February 2017: Physical Review. E
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