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Medical scenario simulation

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https://www.readbyqxmd.com/read/28079581/assessing-the-impact-of-the-anesthesia-medication-template-on-medication-errors-during-anesthesia-a-prospective-study
#1
Eliot B Grigg, Lizabeth D Martin, Faith J Ross, Axel Roesler, Sally E Rampersad, Charles Haberkern, Daniel K W Low, Kristen Carlin, Lynn D Martin
BACKGROUND: Medication errors continue to be a significant source of patient harm in the operating room with few concrete countermeasures. The organization and identification of medication syringes may have an impact on the commission of medication errors in anesthesia, so a team of physicians and designers at the University of Washington created the Anesthesia Medication Template (AMT) to define a formal way of organizing the anesthesia workspace. The purpose of this study is to assess the ability of the AMT to reduce perioperative medication errors by anesthesia providers...
January 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28074337/economic-burden-of-rheumatoid-arthritis-in-italy-possible-consequences-on-anti-citrullinated-protein-antibody-positive-patients
#2
Francesco Saverio Mennini, Andrea Marcellusi, Lara Gitto, Florenzo Iannone
BACKGROUND: Rheumatoid arthritis (RA) is an autoimmune disease with a substantial medical and economic burden. In Italy, it affects approximately 280,000 people, therefore representing the musculoskeletal disease with the highest economic impact in terms of costs for the National Health Service and the social security system. OBJECTIVE: The aim of this study was to estimate the annual economic burden of RA in Italy and determine the potential cost reduction considering the most effective biologic treatment for early rapidly progressing RA (ERPRA) patients...
January 10, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28073934/the-influence-of-customer-medicine-seller-transactional-dynamics-on-childhood-diarrhoea-management-a-qualitative-study-in-ghana
#3
Lauren Rosapep, Emily Sanders, Kathryn Banke
In 2004, the World Health Organization (WHO) and United Nations Children's Fund (UNICEF) jointly revised the recommended treatment for acute paediatric diarrhoea to specify supplementing reduced osmolarity oral rehydration salts (ORS) with zinc. In many countries, however, a significant knowledge-practice gap persists in appropriate diarrhoea management among private healthcare providers. For example, the United States Agency for International Development (USAID)-funded Strengthening Health Outcomes through the Private Sector (SHOPS) project recently demonstrated that over-the-counter medicine sellers (MS) in Ghana recommended inappropriate diarrhoea treatments, despite their demonstrated knowledge of appropriate treatment protocols...
January 10, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28062684/sale-of-antibiotics-without-a-prescription-at-community-pharmacies-in-urban-china-a-multicentre-cross-sectional-survey
#4
Jie Chang, Dan Ye, Bing Lv, Minghuan Jiang, Shan Zhu, Kangkang Yan, Yun Tian, Yu Fang
OBJECTIVES: To quantify sales of antibiotics without a medical prescription and to assess the quality of pharmacy services in relation to the antibiotics sold in community pharmacies in urban China. METHODS: A multicentre cross-sectional survey of community pharmacies was undertaken in 2015 using the simulated client method. Two clinical case scenarios (paediatric diarrhoea and adult acute upper respiratory infection) were presented at systematically sampled community pharmacies in Eastern (Nanjing), Central (Changsha) and Western China (Xi'an)...
January 6, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28060235/orif-or-arthroplasty-for-displaced-femoral-neck-fractures-in-patients-younger-than-65-years-old-an-economic-decision-analysis
#5
Eric Swart, Paulvalery Roulette, Daniel Leas, Kevin J Bozic, Madhav Karunakar
BACKGROUND: The decision between open reduction and internal fixation (ORIF) and arthroplasty for a displaced femoral neck fracture in a patient ≤65 years old can be challenging. Both options have potential drawbacks; if a fracture treated with ORIF fails to heal it may require a revision operation, whereas a relatively young patient who undergoes arthroplasty may need revision within his/her lifetime. The purpose of this study was to employ decision analysis modeling techniques to generate evidence-based treatment recommendations in this clinical scenario...
January 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28053558/high-fidelity-medical-simulation-training-improves-medical-students-knowledge-and-confidence-levels-in-septic-shock-resuscitation
#6
Veerapong Vattanavanit, Jarernporn Kawla-Ied, Rungsun Bhurayanontachai
BACKGROUND: Septic shock resuscitation bundles have poor compliance worldwide partly due to a lack of knowledge and clinical skills. High-fidelity simulation-based training is a new teaching technology in our faculty which may improve the performance of medical students in the resuscitation process. However, since the efficacy of this training method in our institute is limited, we organized an extra class for this evaluation. PURPOSE: The aim was to evaluate the effect on medical students' knowledge and confidence levels after the high-fidelity medical simulation training in septic shock management...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28052886/intestinal-rehabilitation-for-children-with-intestinal-failure-is-cost-effective-a-simulation-study
#7
Henk Groen, Esther G Neelis, Marten J Poley, Joanne F Olieman, René Scheenstra, Paul Fm Krabbe, Gerard Dijkstra, Edmond Hhm Rings
BACKGROUND: Children with intestinal failure (IF) depend on parenteral nutrition (PN). The goal in the treatment of IF is to wean children off PN through intestinal rehabilitation (IR). Although the healthcare burden of IF is enormous, to our knowledge there has been no previous cost-effectiveness analysis in pediatric IF including IR. OBJECTIVE: We sought to determine the cost-effectiveness of IR in terms of costs and life-years. DESIGN: We simulated the treatment of IF in children in a discrete-event model...
January 4, 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28048297/th-ef-bra-08-a-novel-technique-for-estimating-volumetric-cine-mri-vc-mri-from-multi-slice-sparsely-sampled-cine-images-using-motion-modeling-and-free-form-deformation
#8
W Harris, F Yin, C Wang, Z Chang, J Cai, Y Zhang, L Ren
PURPOSE: To develop a technique to estimate on-board VC-MRI using multi-slice sparsely-sampled cine images, patient prior 4D-MRI, motion-modeling and free-form deformation for real-time 3D target verification of lung radiotherapy. METHODS: A previous method has been developed to generate on-board VC-MRI by deforming prior MRI images based on a motion model(MM) extracted from prior 4D-MRI and a single-slice on-board 2D-cine image. In this study, free-form deformation(FD) was introduced to correct for errors in the MM when large anatomical changes exist...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048281/th-b-brc-00-how-to-identify-and-resolve-potential-clinical-errors-before-they-impact-patients-treatment-lessons-learned
#9
Indra Das
Radiation treatment consists of a chain of events influenced by the quality of machine operation, beam data commissioning, machine calibration, patient specific data, simulation, treatment planning, imaging and treatment delivery. There is always a chance that the clinical medical physicist may make or fail to detect an error in one of the events that may impact on the patient's treatment. In the clinical scenario, errors may be systematic and, without peer review, may have a low detectability because they are not part of routine QA procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048164/su-f-j-124-reduction-in-dosimetric-impact-of-motion-using-vmat-compared-to-imrt-in-hypofractionated-prostate-cancer-patients
#10
B Ravindranath, J Xiong, L Happersett, G Mageras, P Zhang, M Hunt
PURPOSE: To quantify and compare the dosimetric impact of motion management correction strategies during VMAT and IMRT for hypofractionated prostate treatment. METHODS: Two arc VMAT and 9 field IMRT plans were generated for two prostate cancer patients undergoing hypofractionated radiotherapy (7.5Gy × 5 and 8Gy × 5). 212 motion traces were retrospectively extracted from treatment records of prostate cancer patients with implanted Calypso beacons. Dose to the CTV and normal tissues was reconstructed for each trace and plan taking into account the actual treatment delivery time...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047931/su-f-t-249-application-of-human-factors-methods-usability-testing-in-the-radiation-oncology-environment
#11
H Warkentin, K Bubric, H Giovannetti, G Graham, C Clay
PURPOSE: As a quality improvement measure, we undertook this work to incorporate usability testing into the implementation procedures for new electronic documents and forms used by four affiliated radiation therapy centers. METHODS: A human factors specialist provided training in usability testing for a team of medical physicists, radiation therapists, and radiation oncologists from four radiotherapy centers. A usability testing plan was then developed that included controlled scenarios and standardized forms for qualitative and quantitative feedback from participants, including patients...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047817/tu-h-campus-jep3-05-adaptive-determination-of-needle-sequence-hdr-prostate-brachytherapy-with-divergent-needle-by-needle-delivery
#12
M Borot de Battisti, B Denis de Senneville, M Maenhout, G Hautvast, D Binnekamp, J J W Lagendijk, M Van Vulpen, M A Moerland
PURPOSE: To develop a new method which adaptively determines the optimal needle insertion sequence for HDR prostate brachytherapy involving divergent needle-by-needle dose delivery by e.g. a robotic device. A needle insertion sequence is calculated at the beginning of the intervention and updated after each needle insertion with feedback on needle positioning errors. METHODS: Needle positioning errors and anatomy changes may occur during HDR brachytherapy which can lead to errors in the delivered dose...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047816/su-g-jep3-04-estimating-4d-cbct-from-prior-information-and-extremely-limited-angle-projections-using-structural-pca-and-weighted-free-form-deformation
#13
W Harris, F Yin, Y Zhang, L Ren
PURPOSE: To investigate the feasibility of using structure-based principal component analysis (PCA) motion-modeling and weighted free-form deformation to estimate on-board 4D-CBCT using prior information and extremely limited angle projections for potential 4D target verification of lung radiotherapy. METHODS: A technique for lung 4D-CBCT reconstruction has been previously developed using a deformation field map (DFM)-based strategy. In the previous method, each phase of the 4D-CBCT was generated by deforming a prior CT volume...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047635/th-b-brc-01-how-to-identify-and-resolve-potential-clinical-errors
#14
I Das
Radiation treatment consists of a chain of events influenced by the quality of machine operation, beam data commissioning, machine calibration, patient specific data, simulation, treatment planning, imaging and treatment delivery. There is always a chance that the clinical medical physicist may make or fail to detect an error in one of the events that may impact on the patient's treatment. In the clinical scenario, errors may be systematic and, without peer review, may have a low detectability because they are not part of routine QA procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047327/su-f-t-279-impact-of-beam-energy-drifts-on-imrt-delivery-accuracy
#15
S Goddu, G Kamal, A Herman, S Edwards, S Yaddanapudi, S Oddiraju, B Cai, D Rangaraj, S Mutic
PURPOSE: According to TG-40 percent-depth-dose (PDD) tolerance is ±2% but TG-142 is ±1%. Now the question is, which one is relevant in IMRT era? The primary objective of this study is to evaluate dosimetric impact of beam-energy-drifts on IMRT-delivery. METHODS: Beam-energy drifts were simulated by adjusting Linac's bending-magnet-current (BMC) followed by tuning the pulse-forming network and adjusting gun-current. PDD change of -0.6% and +1.2% were tested. Planar-dosimetry measurements were performed using an ionization-chamber-array in solid-water phantoms...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046984/th-b-brc-02-troubleshooting-issues-with-linear-accelerator
#16
S Sutlief
Radiation treatment consists of a chain of events influenced by the quality of machine operation, beam data commissioning, machine calibration, patient specific data, simulation, treatment planning, imaging and treatment delivery. There is always a chance that the clinical medical physicist may make or fail to detect an error in one of the events that may impact on the patient's treatment. In the clinical scenario, errors may be systematic and, without peer review, may have a low detectability because they are not part of routine QA procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046324/th-b-brc-03-measurement-and-calibration-discrepancy-advanced-warning-guidance
#17
D Followill
Radiation treatment consists of a chain of events influenced by the quality of machine operation, beam data commissioning, machine calibration, patient specific data, simulation, treatment planning, imaging and treatment delivery. There is always a chance that the clinical medical physicist may make or fail to detect an error in one of the events that may impact on the patient's treatment. In the clinical scenario, errors may be systematic and, without peer review, may have a low detectability because they are not part of routine QA procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28042009/so-you-want-to-conduct-a-randomised-trial-learnings-from-a-failed-feasibility-study-of-a-crisis-resource-management-prompt-during-simulated-paediatric-resuscitation
#18
Rachel Teis, Jyai Allen, Nigel Lee, Sue Kildea
BACKGROUND: No study has tested a Crisis Resource Management prompt on resuscitation performance. METHODS: We conducted a feasibility, unblinded, parallel-group, randomised controlled trial at one Australian paediatric hospital (June-September 2014). Eligible participants were any doctor, nurse, or nurse manager who would normally be involved in a Medical Emergency Team simulation. The unit of block randomisation was one of six scenarios (3 control:3 intervention) with or without a verbal prompt...
December 29, 2016: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28009599/a-national-curriculum-of-fundamental-skills-for-plastic-surgery-residency-report-of-the-inaugural-acaps-boot-camp
#19
Edward H Davidson, Jenny C Barker, Francesco M Egro, Alexandra Krajewski, Jeffrey E Janis, Vu T Nguyen
BACKGROUND: The Inaugural American Council of Academic Plastic Surgeons Plastic Surgery Boot Camp program was developed in response to ongoing changes in graduate medical education. The Boot Camp is a hands-on, practicum-based, 3-day course to introduce core concepts in plastic surgery for new plastic surgery residents (in both integrated and independent tracks). METHODS: The course was held in Pittsburgh in July to August 2015. There were 43 attendees (35 integrated/8 independent) representing 22 residency programs across 15 states...
December 22, 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/27956530/predictive-analysis-of-mechanistic-triggers-and-mitigation-strategies-for-pathological-scarring-in-skin-wounds
#20
Sridevi Nagaraja, Lin Chen, Jian Zhou, Yan Zhao, David Fine, Luisa A DiPietro, Jaques Reifman, Alexander Y Mitrophanov
Wound fibrosis (i.e., excessive scar formation) is a medical problem of increasing prevalence, with poorly understood mechanistic triggers and limited therapeutic options. In this study, we employed an integrated approach that combines computational predictions with new experimental studies in mice to identify plausible mechanistic triggers of pathological scarring in skin wounds. We developed a computational model that predicts the time courses for six essential cell types, 18 essential molecular mediators, and collagen, which are involved in inflammation and proliferation during wound healing...
December 12, 2016: Journal of Immunology: Official Journal of the American Association of Immunologists
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