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Medical scenario simulation

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https://www.readbyqxmd.com/read/27914853/monitoring-the-fitness-of-antiviral-resistant-influenza-strains-during-an-epidemic-a-mathematical-modelling-study
#1
Kathy Leung, Marc Lipsitch, Kwok Yung Yuen, Joseph T Wu
BACKGROUND: Antivirals (eg, oseltamivir) are important for mitigating influenza epidemics. In 2007, an oseltamivir-resistant influenza seasonal A H1N1 strain emerged and spread to global fixation within 1 year. This event showed that antiviral-resistant (AVR) strains can be intrinsically more transmissible than their contemporaneous antiviral-sensitive (AVS) counterpart. Surveillance of AVR fitness is therefore essential. Our objective was to develop a simple method for estimating AVR fitness from surveillance data...
November 30, 2016: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/27902693/the-long-term-benefits-of-increased-aspirin-use-by-at-risk-americans-aged-50-and-older
#2
David B Agus, Étienne Gaudette, Dana P Goldman, Andrew Messali
BACKGROUND: The usefulness of aspirin to defend against cardiovascular disease in both primary and secondary settings is well recognized by the medical profession. Multiple studies also have found that daily aspirin significantly reduces cancer incidence and mortality. Despite these proven health benefits, aspirin use remains low among populations targeted by cardiovascular prevention guidelines. This article seeks to determine the long-term economic and population-health impact of broader use of aspirin by older Americans at higher risk for cardiovascular disease...
2016: PloS One
https://www.readbyqxmd.com/read/27896984/methods-for-clustering-time-series-data-acquired-from-mobile-health-apps
#3
Nicole Tignor, Pei Wang, Nicholas Genes, Linda Rogers, Steven G Hershman, Erick R Scott, Micol Zweig, Yu-Feng Yvonne Chan, Eric E Schadt
In our recent Asthma Mobile Health Study (AMHS), thousands of asthma patients across the country contributed medical data through the iPhone Asthma Health App on a daily basis for an extended period of time. The collected data included daily self-reported asthma symptoms, symptom triggers, and real time geographic location information. The AMHS is just one of many studies occurring in the context of now many thousands of mobile health apps aimed at improving wellness and better managing chronic disease conditions, leveraging the passive and active collection of data from mobile, handheld smart devices...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27884391/basic-airway-skills-acquisition-using-the-american-college-of-surgeons-association-for-surgical-education-medical-student-simulation-based-surgical-skills-curriculum-initial-results
#4
Sydne Muratore, Michael Kim, Jaisa Olasky, Andre Campbell, Robert Acton
BACKGROUND: The ACS/ASE Medical Student Simulation-Based Skills Curriculum was developed to standardize medical student training. This study aims to evaluate the feasibility and validity of implementing the basic airway curriculum. METHODS: This single-center, prospective study of medical students participating in the basic airway module from 12/2014-3/2016 consisted of didactics, small-group practice, and testing in a simulated clinical scenario. Proficiency was determined by a checklist of skills (1-15), global score (1-5), and letter grade (NR-needs review, PS-proficient in simulation scenario, CP-proficient in clinical scenario)...
November 4, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27882523/simulation-in-undergraduate-psychiatry-exploring-the-depth-of-learner-engagement
#5
REVIEW
Petal S Abdool, Latika Nirula, Sarah Bonato, Tarek K Rajji, Ivan L Silver
OBJECTIVES: Simulation-based methodologies are increasingly used in undergraduate medical education to expand students' exposure to complex clinical scenarios. Engagement of students in these simulation-based methodologies is a key determinant of their success in learning. Thus, the authors conducted a systematic review to (1) identify simulation methods in use within the undergraduate psychiatry curriculum and (2) assess learner engagement using these methods. METHODS: Following a PRISMA methodology, the authors searched MEDLINE, ERIC, and PsychINFO databases from 1977 to 2015...
November 23, 2016: Academic Psychiatry
https://www.readbyqxmd.com/read/27873333/simulating-survival-data-with-predefined-censoring-rates-for-proportional-hazards-models
#6
Fei Wan
The proportional hazard model is one of the most important statistical models used in medical research involving time-to-event data. Simulation studies are routinely used to evaluate the performance and properties of the model and other alternative statistical models for time-to-event outcomes under a variety of situations. Complex simulations that examine multiple situations with different censoring rates demand approaches that can accommodate this variety. In this paper, we propose a general framework for simulating right-censored survival data for proportional hazards models by simultaneously incorporating a baseline hazard function from a known survival distribution, a known censoring time distribution, and a set of baseline covariates...
November 21, 2016: Statistics in Medicine
https://www.readbyqxmd.com/read/27871594/obstetric-team-simulation-program-challenges
#7
A S Bullough, S Wagner, T Boland, T P Waters, K Kim, W Adams
OBJECTIVE: To describe the challenges associated with the development and assessment of an obstetric emergency team simulation program. DESIGN: The goal was to develop a hybrid, in-situ and high fidelity obstetric emergency team simulation program that incorporated weekly simulation sessions on the labor and delivery unit, and quarterly, education protected sessions in the simulation center. All simulation sessions were video-recorded and reviewed. SETTING: Labor and delivery unit and simulation center...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27858851/a-comparison-of-a-traditional-endotracheal-tube-versus-etview-sl-in-endotracheal-intubation-during-different-emergency-conditions-a-randomized-crossover-cadaver-trial
#8
Zenon Truszewski, Paweł Krajewski, Marcin Fudalej, Jacek Smereka, Michael Frass, Oliver Robak, Bianka Nguyen, Kurt Ruetzler, Lukasz Szarpak
BACKGROUND: Airway management is a crucial skill essential to paramedics and personnel working in Emergency Medical Services and Emergency Departments: Lack of practice, a difficult airway, or a trauma situation may limit the ability of paramedics to perform direct laryngoscopy during cardiopulmonary resuscitation. Videoscope devices are alternatives for airway management in these situations. The ETView VivaSight SL (ETView; ETView Ltd., Misgav, Israel) is a new, single-lumen airway tube with an integrated high-resolution imaging camera...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27858502/prehospital-providers-perceptions-on-providing-patient-and-family-centered-care
#9
Emily M Ayub, Esther M Sampayo, Manish I Shah, Cara B Doughty
BACKGROUND: A gap exists in understanding a provider's approach to delivering care that is mutually beneficial to patients, families, and other providers in the prehospital setting. The purpose of this study was to identify attitudes, beliefs, and perceived barriers to providing patient and family centered care (PFCC) in the prehospital setting and to describe potential solutions for improving PFCC during critical pediatric events. METHODS: We conducted a qualitative, cross-sectional study of a purposive sample of Emergency Medical Technicians (EMTs) and paramedics from an urban, municipal, fire-based EMS system, who participated in the Pediatric Simulation Training for Emergency Prehospital Providers (PediSTEPPS) course...
November 18, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27832693/distance-learning-can-be-as-effective-as-traditional-learning-for-medical-students-in-the-initial-assessment-of-trauma-patients
#10
Shervin Farahmand, Ebrahim Jalili, Mona Arbab, Mojtaba Sedaghat, Mandana Shirazi, Fatemeh Keshmiri, Arsalan Azizpour, Somayeh Valadkhani, Shahram Bagheri-Hariri
Distance learning is expanding and replacing the traditional academic medical settings. Managing trauma patients seems to be a prerequisite skill for medical students. This study has been done to evaluate the efficiency of distance learning on performing the initial assessment and management in trauma patients, compared with the traditional learning among senior medical students. One hundred and twenty senior medical students enrolled in this single-blind quasi-experimental study and were equally divided into the experimental (distance learning) and control group (traditional learning)...
September 2016: Acta Medica Iranica
https://www.readbyqxmd.com/read/27830241/the-rising-frequency-of-it-blackouts-indicates-the-increasing-relevance-of-it-emergency-concepts-to-ensure-patient-safety
#11
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/27825662/talk-the-talk-implementing-a-communication-curriculum-for-surgical-residents
#12
Anna B Newcomb, Amber W Trickey, Melissa Porrey, Jeffrey Wright, Franco Piscitani, Paula Graling, Jonathan Dort
OBJECTIVES: The Accreditation Council for Graduate Medical Education milestones provide a framework of specific interpersonal and communication skills that surgical trainees should aim to master. However, training and assessment of resident nontechnical skills remains challenging. We aimed to develop and implement a curriculum incorporating interactive learning principles such as group discussion and simulation-based scenarios to formalize instruction in patient-centered communication skills, and to identify best practices when building such a program...
November 4, 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27816802/parallel-deformation-of-heterogeneous-chainmail-models-application-to-interactive-deformation-of-large-medical-volumes
#13
Alejandro Rodríguez, Alejandro León, Germán Arroyo
In this work we present a new solution for correctly handling heterogeneous materials in ChainMail models, which are widely used in medical applications. Our core method relies on two main components: (1) a novel timestamp-based propagation scheme that tracks the propagation speed of a deformation through the model and allows to correct ambiguous configurations, and (2) a novel relaxation stage that performs an energy minimization process taking into account the heterogeneity of the model. In addition, our approach extends the SP-ChainMail algorithm by supporting interactive topology changes and handling multiple concurrent deformations, increasing its range of applicability...
October 17, 2016: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/27811195/injury-representation-against-ballistic-threats-using-three-novel-numerical-models
#14
Johno Breeze, R Fryer, D Pope, J Clasper
Injury modelling of ballistic threats is a valuable tool for informing policy on personal protective equipment and other injury mitigation methods. Currently, the Ministry of Defence (MoD) and Centre for Protection of National Infrastructure (CPNI) are focusing on the development of three interlinking numerical models, each of a different fidelity, to answer specific questions on current threats. High-fidelity models simulate the physical events most realistically, and will be used in the future to test the medical effectiveness of personal armour systems...
November 3, 2016: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27810116/simulation-training-for-primary-caregivers-in-the-neonatal-intensive-care-unit
#15
REVIEW
Jennifer Arnold, Maria Carmen G Diaz
Simulation is a hands-on educational modality that creates a safe, confidential learning environment that is closely aligned with the principles of patient- and family-centered care. This makes it an ideal training tool for families and caregivers of medically complex infants as they prepare for their care at home. Multidisciplinary collaboration and participation is vital to the success of these simulations and encourages the development of needs assessments and learning objectives that are congruent with the family's goals, beliefs, and culture...
October 31, 2016: Seminars in Perinatology
https://www.readbyqxmd.com/read/27809338/cost-effectiveness-of-histamine2-receptor-antagonists-versus-proton-pump-inhibitors-for-stress-ulcer-prophylaxis-in-critically-ill-patients
#16
Drayton A Hammond, Niranjan Kathe, Anuj Shah, Bradley C Martin
STUDY OBJECTIVE: To determine the cost-effectiveness of stress ulcer prophylaxis with histamine2 receptor antagonists (H2RA) versus proton pump inhibitors (PPI) in critically ill and mechanically ventilated adults. DESIGN: A decision analytic model estimating the costs and effectiveness of stress ulcer prophylaxis (with H2RAs and PPIs) from a health care institutional perspective. PATIENTS: Adult, mixed intensive care unit (ICU) population who received an H2RA or PPI for up to 9 days...
November 3, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27780740/comparative-performance-assessment-of-commercially-available-automatic-external-defibrillators-a-simulation-and-real-life-measurement-study-of-hands-off-time
#17
Simone Savastano, Vincenzo Vanni, Roman Burkart, Maurizio Raimondi, Fabrizio Canevari, Simone Molinari, Enrico Baldi, Aurora I Danza, Maria Luce Caputo, Romano Mauri, Francois Regoli, Giulio Conte, Claudio Benvenuti, Angelo Auricchio
PURPOSE: Early and good quality cardiopulmonary resuscitation (CPR) and the use of automated external defibrillators (AEDs) improve cardiac arrest patients' survival. However, AED peri- and post-shock/analysis pauses may reduce CPR effectiveness. METHODS: The time performance of 12 different commercially available AEDs was tested in a manikin based scenario; then the AEDs recordings from the same tested models following the clinical use both in Pavia and Ticino were analyzed to evaluate the post-shock and post-analysis time...
October 22, 2016: Resuscitation
https://www.readbyqxmd.com/read/27769177/application-of-a-nonrandomized-stepped-wedge-design-to-evaluate-an-evidence-based-quality-improvement-intervention-a-proof-of-concept-using-simulated-data-on-patient-centered-medical-homes
#18
Alexis K Huynh, Martin L Lee, Melissa M Farmer, Lisa V Rubenstein
BACKGROUND: Stepped wedge designs have gained recognition as a method for rigorously assessing implementation of evidence-based quality improvement interventions (QIIs) across multiple healthcare sites. In theory, this design uses random assignment of sites to successive QII implementation start dates based on a timeline determined by evaluators. However, in practice, QII timing is often controlled more by site readiness. We propose an alternate version of the stepped wedge design that does not assume the randomized timing of implementation while retaining the method's analytic advantages and applying to a broader set of evaluations...
October 21, 2016: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/27753711/an-international-interprofessional-study-of-mental-models-and-factors-delaying-neuroimaging-of-critically-head-injured-children-presenting-to-emergency-departments
#19
Marc Auerbach, Joanne Cole, Pina Violano, Linda Roney, Catherine Doherty, Michael Shepherd, Ralph MacKinnon
OBJECTIVES: Thousands of head-injured children are cared for by interprofessional teams in emergency departments every day. Teams must balance performing time-consuming interventions with safe transport for neuroimaging. This study aims to describe and compare providers' perspectives on the transfer of head-injured children to neuroimaging and factors contributing to delays. METHODS: Participants were interprofessional health care providers involved in the care of head-injured children at sites in the United Kingdom, the United States, and New Zealand...
October 8, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27741071/improved-team-performance-during-pediatric-resuscitations-after-rapid-cycle-deliberate-practice-compared-with-traditional-debriefing-a-pilot-study
#20
Daniel S Lemke, Elaine K Fielder, Deborah C Hsu, Cara B Doughty
INTRODUCTION: Simulation-based medical education (SBME) improves medical knowledge compared with no intervention. In traditional SBME, more time is spent debriefing than practicing skills. Rapid cycle deliberate practice (RCDP) simulation allows learners to practice skills repetitively, receive brief interspersed feedback, and has been shown to improve individual performance of resuscitation skills in simulation; it has not been compared with traditional simulation methods. OBJECTIVE: The aim of the study was to compare traditional and RCDP SBME...
October 6, 2016: Pediatric Emergency Care
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