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https://www.readbyqxmd.com/read/28926391/medical-team-training-improves-team-performance-aoa-critical-issues
#1
James E Carpenter, James P Bagian, Rebecca G Snider, Kyle J Jeray
Effective teamwork and communication can decrease medical errors in environments where the culture of safety is enhanced. Health care can benefit from programs that are based on teamwork, as in other high-stress industries (e.g., aviation), with crew resource management programs, simulator use, and utilization of checklists. Medical team training (MTT) with a strong leadership commitment was used at our institution to focus specifically on creating open, yet structured, communication in operating rooms. Training included the 3 phases of the World Health Organization protocol to organize communication and briefings: preoperative verification, preincision briefing, and debriefing at or near the end of the surgical case...
September 20, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28926374/reducing-urban-violence-a-contrast-of-public-health-and-criminal-justice-approaches
#2
Magdalena Cerdá, Melissa Tracy, Katherine M Keyes
BACKGROUND: Cities are investing millions in Cure Violence, a public health approach to reduce urban violence by targeting at-risk youth and redirecting conflict to non-violent responses. The impact of such a program compared to criminal justice responses is unknown because experiments directly comparing criminal justice and public health approaches to violence prevention are infeasible with observational data. We simulated experiments to test the influence of two interventions on violence: a) Cure Violence; and b) directed police patrol in violence hot spots...
September 18, 2017: Epidemiology
https://www.readbyqxmd.com/read/28926204/acceptability-of-clinical-decision-support-interface-prototypes-for-a-nursing-electronic-health-record-to-facilitate-supportive-care-outcomes
#3
Janet Stifter, Vanessa E C Sousa, Alessandro Febretti, Karen Dunn Lopez, Andrew Johnson, Yingwei Yao, Gail M Keenan, Diana J Wilkie
PURPOSE: To determine the acceptability, usefulness, and ease of use for four nursing clinical decision support interface prototypes. METHODS: In a simulated hospital environment, 60 registered nurses (48 female; mean age = 33.7 ± 10.8; mean years of experience = 8.1 ± 9.7) participated in a randomized study with four study groups. Measures included acceptability, usefulness, and ease of use scales. FINDINGS: Mean scores were high for acceptability, usefulness, and the ease of use for all four groups...
September 19, 2017: International Journal of Nursing Knowledge
https://www.readbyqxmd.com/read/28925571/human-factors-and-simulation-in-emergency-medicine
#4
Emily M Hayden, Ambrose H Wong, Jeremy Ackerman, Margaret K Sande, Charles Lei, Leo Kobayashi, Michael Cassara, Dylan D Cooper, Kimberly Perry, William E Lewandowski, Mark W Scerbo
This consensus group from the 2017 Academic Emergency Medicine Consensus Conference "Catalyzing System Change through Health Care Simulation: Systems, Competency, and Outcomes" held in Orlando, Florida on May 16, 2017 focused on the use of human factors and simulation in the field of emergency medicine. The human factors discipline is often underutilized within emergency medicine but has significant potential in improving the interface between technologies and individuals in the field. The discussion explored the domain of human factors, its benefits in medicine, how simulation can be a catalyst for human factors work in emergency medicine, and how emergency medicine can collaborate with human factors professionals to affect change...
September 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28925064/improving-realism-in-clinical-trial-simulations-via-real-world-data
#5
EDITORIAL
Holly Kimko, Kwan Lee
Simulation validity depends on how well sampling distributions used reflect real-patient characteristics, such as drug adherence, disease progression, and pharmacologic handling in the body. We challenge the current use of growth charts from nondisease-specific pediatrics in simulations for drug development. Complementary use of data from clinical trials and the real-world is expected to achieve a more realistic representation of clinical outcomes for decisions in drug development, regulatory approval, and health technology assessment...
September 19, 2017: CPT: Pharmacometrics & Systems Pharmacology
https://www.readbyqxmd.com/read/28923711/identifying-the-arrival-of-extensional-and-flexural-wave-modes-using-wavelet-decomposition-of-ultrasonic-signals
#6
Arnab Gupta, John C Duke
In health monitoring applications of composite materials, the health state of specimens is often evaluated using naturally occurring and simulated Acoustic Emission stress waves. For such applications, identifying the arrival times of the extensional and flexural wave modes from acquired signals is a crucial step, and must be performed reliably and potentially on large sets of signals. This article proposes using the wavelet decomposition of a signal to develop a fast, algorithmic and automated approach to estimate the arrival times of the extensional and flexural wave modes...
September 9, 2017: Ultrasonics
https://www.readbyqxmd.com/read/28922132/design-of-secure-and-lightweight-authentication-protocol-for-wearable-devices-environment
#7
Ashok Kumar Das, Mohammad Wazid, Neeraj Kumar, Muhammad Khurram Khan, Kim-Kwang Raymond Choo, YoungHo Park
Wearable devices are used in various applications to collect information including step information, sleeping cycles, workout statistics, and health related information. Due to the nature and richness of the data collected by such devices, it is important to ensure the security of the collected data. This paper presents a new lightweight authentication scheme suitable for wearable device deployment. The scheme allows a user to mutually authenticate his/her wearable device(s) and the mobile terminal (e.g., Android and iOS device) and establish a session key among these devices (worn and carried by the same user) for secure communication between the wearable device and the mobile terminal...
September 18, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28919794/parenteral-nutrition-including-an-omega-3-fatty-acid-containing-lipid-emulsion-for-intensive-care-patients-in-china-a-pharmacoeconomic-analysis
#8
Yufei Feng, Chao Li, Tian Zhang, Lorenzo Pradelli
BACKGROUND/OBJECTIVES: Parenteral nutrition (PN) incorporating omega-3 fatty-acid-enriched lipid emulsions has been shown to be cost effective in Western populations. A pharmacoeconomic evaluation was performed within the Chinese intensive care unit (ICU) setting. This assessed whether the additional acquisition cost of PN with omega-3 fatty-acid-enriched lipid emulsion (SMOFlipid) vs standard PN was offset by improved clinical outcomes that can reduce subsequent costs. MATERIALS AND METHODS: A pharmacoeconomic discrete event simulation model was developed, based on an update to efficacy data from a previous international meta-analysis, with China-specific clinical and economic input parameters...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28919398/controlling-bovine-paratuberculosis-at-a-regional-scale-towards-a-decision-modelling-tool
#9
Gaël Beaunée, Elisabeta Vergu, Alain Joly, Pauline Ezanno
Johne's disease (paratuberculosis), a worldwide enzootic disease of cattle caused by Mycobacterium avium subsp. paratuberculosis (Map), mainly introduced into farms by purchasing infected animals, has a large economic impact for dairy producers. Since diagnostic tests used in routine are poorly sensitive, observing Map spread in the field is hardly possible, whereas there is a need for evaluating control strategies. Our objective was to provide a modelling framework to compare the efficacy of regional control strategies combining internal biosecurity measures and testing of traded animals, against Map spread in a metapopulation of dairy cattle herds...
September 14, 2017: Journal of Theoretical Biology
https://www.readbyqxmd.com/read/28918498/modeling-the-decision-of-mental-health-providers-to-implement-evidence-based-children-s-mental-health-services-a-discrete-choice-conjoint-experiment
#10
Charles E Cunningham, Melanie Barwick, Heather Rimas, Stephanie Mielko, Raluca Barac
Using an online, cross sectional discrete choice experiment, we modeled the influence of 14 implementation attributes on the intention of 563 providers to adopt hypothetical evidence-based children's mental health practices (EBPs). Latent class analysis identified two segments. Segment 1 (12%) would complete 100% of initial training online, devote more time to training, make greater changes to their practices, and introduce only minor modifications to EBPs. Segment 2 (88%) preferred fewer changes, more modifications, less training, but more follow-up...
September 16, 2017: Administration and Policy in Mental Health
https://www.readbyqxmd.com/read/28918407/burden-of-non-adherence-to-latent-tuberculosis-infection-drug-therapy-and-the-potential-cost-effectiveness-of-adherence-interventions-in-canada-a-simulation-study
#11
Anik R Patel, Jonathon R Campbell, Mohsen Sadatsafavi, Fawziah Marra, James C Johnston, Kirsten Smillie, Richard T Lester
OBJECTIVE: Pharmaceutical treatment of latent tuberculosis infection (LTBI) reduces the risk of progression to active tuberculosis (TB); however, poor adherence tempers the protective effect. We aimed to estimate the health burden of non-adherence, the maximum allowable cost of hypothetical new adherence interventions to be cost-effective and the potential value of existing adherence interventions for patients with low-risk LTBI in Canada. DESIGN: A microsimulation model of LTBI progression over 25 years...
September 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28917669/knowledge-driven-computational-modeling-in-alzheimer-s-research-current-state-and-future-trends
#12
Hugo Geerts, Martin Hofmann-Apitius, Thomas J Anastasio
Neurodegenerative diseases such as Alzheimer's disease (AD) follow a slowly progressing dysfunctional trajectory, with a large presymptomatic component and many comorbidities. Using preclinical models and large-scale omics studies ranging from genetics to imaging, a large number of processes that might be involved in AD pathology at different stages and levels have been identified. The sheer number of putative hypotheses makes it almost impossible to estimate their contribution to the clinical outcome and to develop a comprehensive view on the pathological processes driving the clinical phenotype...
September 14, 2017: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
https://www.readbyqxmd.com/read/28916284/stereotactic-body-radiotherapy-versus-low-dose-rate-brachytherapy-for-localised-prostate-cancer-a-cost-utility-analysis
#13
J Helou, S Torres, H B Musunuru, J Raphael, P Cheung, D Vesprini, H T Chung, L D'Alimonte, M Krahn, G Morton, A Loblaw
AIMS: To conduct a cost-utility analysis comparing stereotactic body radiotherapy (SBRT) with low dose rate brachytherapy (LDR-BT) for localised prostate cancer (PCa). MATERIALS AND METHODS: A decision-analytic Markov model was developed from the healthcare payer perspective to simulate the history of a 66-year-old man with low-risk PCa. The model followed patients yearly over their remaining lifetimes. Health states included 'recurrence-free', 'biochemical recurrence' (BR), 'metastatic' and 'death'...
September 12, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28915950/improving-team-performance-through-simulation-based-learning
#14
REVIEW
Mark S Volk
American health care is facing an epidemic of medical errors. A major cause of these errors is poor teamwork. Crisis resource management (CRM) is a set of teamwork principles derived from the airline industry. Medical simulation is an educational tool that affords health care providers a means of improving teamwork by learning and practicing CRM. This article (1) discusses the case for teaching team training, (2) reviews the principles of medical simulation as they pertain to team training, (3) provides practical guidelines for using medical simulation in otolaryngology education, (4) discusses current evidence for the efficacy of medical simulation...
October 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28915948/the-economics-of-surgical-simulation
#15
REVIEW
Noel Jabbour, Carl H Snyderman
There are massive hidden costs in the current paradigm of surgical training related to increased operative times for procedures with resident involvement and costs of medical errors. Shifting procedural training outside of the operating room through use of simulation has the potential to improve patient safety, minimize learning time to achieve competency, and increase operative efficiency. Investment in surgical simulation has the potential to reduce costs to health care systems through improved operating room efficiency and reduction of medical errors...
October 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28915046/factors-affecting-the-bioaccessibility-and-intestinal-transport-of-difenoconazole-hexaconazole-and-spirodiclofen-in-human-caco-2-cells-following-in-vitro-digestion
#16
Yanhong Shi, Jin-Jing Xiao, Rong-Peng Feng, Yu-Ying Liu, Min Liao, Xiangwei Wu, Ri-Mao Hua, Haiqun Cao
This study examined how gastrointestinal conditions affect pesticide bioaccessibility and intestinal transepithelial transport of pesticides (difenoconazole, hexaconazole, and spirodiclofen) in humans. We used an in vitro model combining human gastric and intestinal digestion, followed with Caco-2 cell model for human intestinal absorption. Bioaccessibility of three tested pesticides ranged from 25.2 to 76.3% and 10.6 to 79.63% in the gastric and intestinal phases, respectively. A marked trend similar to the normal distribution was observed between bioaccessibility and pH, with highest values observed at pH 2...
September 15, 2017: Journal of Agricultural and Food Chemistry
https://www.readbyqxmd.com/read/28914990/simulating-the-multi-disciplinary-care-team-approach-enhancing-student-understanding-of-anatomy-through-an-ultrasound-anchored-interprofessional-session
#17
Marianne T Luetmer, Beth A Cloud, James W Youdas, Wojciech Pawlina, Nirusha Lachman
Quality of healthcare delivery is dependent on collaboration between professional disciplines. Integrating opportunities for interprofessional learning in health science education programs prepares future clinicians to function as effective members of a multi-disciplinary care team. This study aimed to create a modified team-based learning (TBL) environment utilizing ultrasound technology during an interprofessional learning activity to enhance musculoskeletal anatomy knowledge of first year medical (MD) and physical therapy (PT) students...
September 15, 2017: Anatomical Sciences Education
https://www.readbyqxmd.com/read/28913756/spatial-analysis-and-health-risk-assessment-of-heavy-metals-concentration-in-drinking-water-resources
#18
Reza Ali Fallahzadeh, Mohammad Taghi Ghaneian, Mohammad Miri, Mohamad Mehdi Dashti
The heavy metals available in drinking water can be considered as a threat to human health. Oncogenic risk of such metals is proven in several studies. Present study aimed to investigate concentration of the heavy metals including As, Cd, Cr, Cu, Fe, Hg, Mn, Ni, Pb, and Zn in 39 water supply wells and 5 water reservoirs within the cities Ardakan, Meibod, Abarkouh, Bafgh, and Bahabad. The spatial distribution of the concentration was carried out by the software ArcGIS. Such simulations as non-carcinogenic hazard and lifetime cancer risk were conducted for lead and nickel using Monte Carlo technique...
September 15, 2017: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/28912590/the-importance-of-simulated-lung-fluid-slf-extractions-for-a-more-relevant-evaluation-of-the-oxidative-potential-of-particulate-matter
#19
Aude Calas, Gaëlle Uzu, Jean M F Martins, Didier Voisin, Lorenzo Spadini, Thomas Lacroix, Jean-Luc Jaffrezo
Particulate matter (PM) induces oxidative stress in vivo, leading to adverse health effects. Oxidative potential (OP) of PM is increasingly studied as a relevant metric for health impact (instead of PM mass concentration) as much of the ambient particle mass do not contribute to PM toxicity. Several assays have been developed to quantify PM oxidative potential and a widely used one is the acellular dithiothreitol (DTT) assay. However in such assays, particles are usually extracted with methanol or Milli-Q water which is unrepresentative of physiological conditions...
September 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28911848/detecting-weak-position-fluctuations-from-encoder-signal-using-singular-spectrum-analysis
#20
Xiaoqiang Xu, Ming Zhao, Jing Lin
Mechanical fault or defect will cause some weak fluctuations to the position signal. Detection of such fluctuations via encoders can help determine the health condition and performance of the machine, and offer a promising alternative to the vibration-based monitoring scheme. However, besides the interested fluctuations, encoder signal also contains a large trend and some measurement noise. In applications, the trend is normally several orders larger than the concerned fluctuations in magnitude, which makes it difficult to detect the weak fluctuations without signal distortion...
September 11, 2017: ISA Transactions
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