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https://www.readbyqxmd.com/read/28338948/comparing-measured-and-calculated-doses-in-interventional-cardiology-procedures
#1
M W Oliveira da Silva, L V Canevaro, J Hunt, B B D Rodrigues
Interventional cardiology requires complex procedures and can result in high doses and dose rates to the patient and medical staff. The many variables that influence the dose to the patient and staff include the beam position and angle, beam size, kVp, filtration, kerma-area product and focus-skin distance. A number of studies using the Monte Carlo method have been undertaken to obtain prospective dose assessments. In this paper, detailed irradiation scenarios were simulated mathematically and the resulting dose estimates were compared with real measurements made previously under very similar irradiation conditions and geometries...
March 16, 2017: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/28328394/proposing-telecardiology-services-on-cloud-for-different-medical-institutions-a-model-of-reference
#2
Isabel De la Torre-Díez, Begoña Garcia-Zapirain, Miguel López-Coronado, Joel J P C Rodrigues
INTRODUCTION: For a cloud-based telecardiology solution to be established in any scenario, it is necessary to ensure optimum levels of security, as patient's data will not be in the same place from where access is gained. The main objective of this article is to present a secure, cloud-based solution for a telecardiology service in different scenarios: a hospital, a health center in a city, and a group of health centers in a rural area. METHODS: iCanCloud software is used to simulate the scenarios...
March 1, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28323084/integration-of-in-hospital-cardiac-arrest-contextual-curriculum-into-a-basic-life-support-course-a-randomized-controlled-simulation-study
#3
Elizabeth A Hunt, Jordan M Duval-Arnould, Nnenna O Chime, Kareen Jones, Michael Rosen, Merona Hollingsworth, Deborah Aksamit, Marida Twilley, Cheryl Camacho, Daniel P Nogee, Julianna Jung, Kristen Nelson-McMillan, Nicole Shilkofski, Julianne S Perretta
OBJECTIVE: To compare resuscitation performance on simulated in-hospital cardiac arrests after traditional American Heart Association (AHA) Healthcare Provider Basic Life Support course (TradBLS) versus revised course including in-hospital skills (HospBLS). DESIGN: Prospective, randomized, controlled curriculum evaluation. SETTING: Johns Hopkins Medicine Simulation Center. SUBJECTS: One hundred twenty-two first year medical students divided into fifty-nine teams...
March 18, 2017: Resuscitation
https://www.readbyqxmd.com/read/28322631/priming-patient-safety-through-nursing-handoff-communication
#4
Patricia S Groves, Jacinda L Bunch, Ellen Cram, Amany Farag, Kirstin Manges, Yelena Perkhounkova, Jill Scott-Cawiezell
Understanding how safety culture mechanisms affect nursing safety-oriented behavior and thus patient outcomes is critical to developing hospital safety programs. Safety priming refers to communicating safety values intended to activate patient safety goals. Safety priming through nursing handoff communication was tested as a means by which cultural safety values may affect nursing practice. The mixed-methods pilot study setting was an academic medical center's high-fidelity simulation lab. Twenty nurses were randomized into intervention and control groups...
October 1, 2016: Western Journal of Nursing Research
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
#5
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/28302112/automation-bias-in-electronic-prescribing
#6
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/28301484/health-facility-service-availability-and-readiness-for-intrapartum-and-immediate-postpartum-care-in-malawi-a-cross-sectional-survey
#7
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/28290956/multidisciplinary-in-situ-simulation-based-training-as-a-postpartum-hemorrhage-quality-improvement-project
#8
Monica A Lutgendorf, Carmen Spalding, Elizabeth Drake, Dennis Spence, Jason O Heaton, Kristina V Morocco
BACKGROUND: Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28289915/numerical-modeling-of-hemodynamics-scenarios-of-patient-specific-coronary-artery-bypass-grafts
#9
Francesco Ballarin, Elena Faggiano, Andrea Manzoni, Alfio Quarteroni, Gianluigi Rozza, Sonia Ippolito, Carlo Antona, Roberto Scrofani
A fast computational framework is devised to the study of several configurations of patient-specific coronary artery bypass grafts. This is especially useful to perform a sensitivity analysis of the hemodynamics for different flow conditions occurring in native coronary arteries and bypass grafts, the investigation of the progression of the coronary artery disease and the choice of the most appropriate surgical procedure. A complete pipeline, from the acquisition of patient-specific medical images to fast parameterized computational simulations, is proposed...
March 13, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/28288579/the-cost-effectiveness-of-using-chronic-kidney-disease-risk-scores-to-screen-for-early-stage-chronic-kidney-disease
#10
Benjamin O Yarnoff, Thomas J Hoerger, Siobhan K Simpson, Alyssa Leib, Nilka R Burrows, Sundar S Shrestha, Meda E Pavkov
BACKGROUND: Better treatment during early stages of chronic kidney disease (CKD) may slow progression to end-stage renal disease and decrease associated complications and medical costs. Achieving early treatment of CKD is challenging, however, because a large fraction of persons with CKD are unaware of having this disease. Screening for CKD is one important method for increasing awareness. We examined the cost-effectiveness of identifying persons for early-stage CKD screening (i.e., screening for moderate albuminuria) using published CKD risk scores...
March 13, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28286528/evaluation-of-a-pilot-project-to-introduce-simulation-based-team-training-to-pediatric-surgery-trauma-room-care
#11
Markus Lehner, Ellen Heimberg, Florian Hoffmann, Oliver Heinzel, Hans-Joachim Kirschner, Martina Heinrich
Introduction. Several studies in pediatric trauma care have demonstrated substantial deficits in both prehospital and emergency department management. Methods. In February 2015 the PAEDSIM collaborative conducted a one and a half day interdisciplinary, simulation based team-training course in a simulated pediatric emergency department. 14 physicians from the medical fields of pediatric surgery, pediatric intensive care and emergency medicine, and anesthesia participated, as well as four pediatric nurses. After a theoretical introduction and familiarization with the simulator, course attendees alternately participated in six simulation scenarios and debriefings...
2017: International Journal of Pediatrics
https://www.readbyqxmd.com/read/28283305/non-prescription-supply-of-combination-analgesics-containing-codeine-in-community-pharmacy-a-simulated-patient-study
#12
Georgia A Byrne, Penelope J Wood, M Joy Spark
BACKGROUND: The inappropriate use of non-prescription combination analgesics containing codeine (NP-CACC) has become a significant health issue in Australia. OBJECTIVE: To investigate the current management of NP-CACC direct product requests in community pharmacies located in Victoria, Australia. METHODS: A covert simulated patient (SP) method was used to observe the responses of pharmacy staff during an NP-CACC request. Four SPs were trained to complete 1 of 2 scenarios...
March 2, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28281931/incorporation-of-stochastic-engineering-models-as-prior-information-in-bayesian-medical-device-trials
#13
Tarek Haddad, Adam Himes, Laura Thompson, Telba Irony, Rajesh Nair
Evaluation of medical devices via clinical trial is often a necessary step in the process of bringing a new product to market. In recent years, device manufacturers are increasingly using stochastic engineering models during the product development process. These models have the capability to simulate virtual patient outcomes. This article presents a novel method based on the power prior for augmenting a clinical trial using virtual patient data. To properly inform clinical evaluation, the virtual patient model must simulate the clinical outcome of interest, incorporating patient variability, as well as the uncertainty in the engineering model and in its input parameters...
March 10, 2017: Journal of Biopharmaceutical Statistics
https://www.readbyqxmd.com/read/28274986/use-of-simulation-training-to-prepare-pharmacy-residents-for-medical-emergencies
#14
Melissa L Thompson Bastin, Aaron M Cook, Alexander H Flannery
PURPOSE: The use of high-fidelity simulation training for preparing pharmacy residents for various high-stress and high-impact medical emergencies and the impact of this training on pharmacy residents' perception of preparedness are described. SUMMARY: During the 2015-16 residency year at the University of Kentucky Medical Center, simulation training, in addition to lecture-based orientation training, was chosen as a method to reinforce skills and knowledge learned throughout the orientation, before residents began working on-call shifts...
March 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28253848/improved-recognition-of-ineffective-chest-compressions-after-a-brief-crew-resource-management-crm-training-a-prospective-randomised-simulation-study
#15
Leopold Haffner, Moritz Mahling, Alexander Muench, Christoph Castan, Paul Schubert, Aline Naumann, Silke Reddersen, Anne Herrmann-Werner, Jörg Reutershan, Reimer Riessen, Nora Celebi
BACKGROUND: Chest compressions are a core element of cardio-pulmonary resuscitation. Despite periodic training, real-life chest compressions have been reported to be overly shallow and/or fast, very likely affecting patient outcomes. We investigated the effect of a brief Crew Resource Management (CRM) training program on the correction rate of improperly executed chest compressions in a simulated cardiac arrest scenario. METHODS: Final-year medical students (n = 57) were randomised to receive a 10-min computer-based CRM or a control training on ethics...
March 3, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28251618/a-randomised-crossover-simulation-study-comparing-the-impact-of-chemical-biological-radiological-or-nuclear-substance-personal-protection-equipment-on-the-performance-of-advanced-life-support-interventions
#16
J Schumacher, J Arlidge, F Garnham, I Ahmad
Recent incidents involving chemical, biological, radiological and nuclear substances have stressed the importance of sufficient personal protection equipment for medical first-responders. Modern lightweight, battery-independent, suit ensembles may prove superior to the current protective suit used in the UK. This study compared the powered respiratory protective suit (PRPS ensemble) with a lightweight suit consisting of a SARATOGA(®) Multipurpose CBRN Protective Coverall Polyprotect 12 in conjunction with the Avon C50 Respirator/Avon CBRNF12CE filter canister and butyl rubber protective gloves (Polyprotect 12 ensemble)...
March 2, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28246338/decreasing-prescribing-errors-during-pediatric-emergencies-a-randomized-simulation-trial
#17
Guylaine Larose, Arielle Levy, Benoit Bailey, Barbara Cummins-McManus, Denis Lebel, Jocelyn Gravel
OBJECTIVE: To evaluate whether a clinical aid providing precalculated medication doses decreases prescribing errors among residents during pediatric simulated cardiopulmonary arrest and anaphylaxis. METHODS: A crossover randomized trial was conducted in a tertiary care hospital simulation center with residents rotating in the pediatric emergency department. The intervention was a reference book providing weight-based precalculated doses. The control group used a card providing milligram-per-kilogram doses...
March 2017: Pediatrics
https://www.readbyqxmd.com/read/28230170/modeling-continuous-admixture-using-admixture-induced-linkage-disequilibrium
#18
Ying Zhou, Hongxiang Qiu, Shuhua Xu
Recent migrations and inter-ethnic mating of long isolated populations have resulted in genetically admixed populations. To understand the complex population admixture process, which is critical to both evolutionary and medical studies, here we used admixture induced linkage disequilibrium (LD) to infer continuous admixture events, which is common for most existing admixed populations. Unlike previous studies, we expanded the typical continuous admixture model to a more general scenario with isolation after a certain duration of continuous gene flow...
February 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28220187/-emergency-medical-training-through-simulation-always-the-same-for-everyone
#19
REVIEW
A Schaumberg, T Schröder, M Sander
Simulation assumes a growing importance in the field of emergency medical education. Many rescue service schools work with simulators or even have their own simulation center. Classic resuscitation training in the classroom is increasingly being replaced by realistic case scenarios. But simulators themselves do not train! Using a simulator in emergency medical training does not necessarily mean achieving sustained learning success among the participants. Depending on the skills, abilities or competences being taught, there seems to be different requirements for simulation...
March 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28211003/an-easy-to-build-low-budget-point-of-care-ultrasound-simulator-from-linux-to-a-web-based-solution
#20
Domagoj Damjanovic, Ulrich Goebel, Benedikt Fischer, Martin Huth, Hartmut Breger, Hartmut Buerkle, Axel Schmutz
BACKGROUND: Hands-on training in point-of-care ultrasound (POC-US) should ideally comprise bedside teaching, as well as simulated clinical scenarios. High-fidelity phantoms and portable ultrasound simulation systems are commercially available, however, at considerable costs. This limits their suitability for medical schools. A Linux-based software for Emergency Department Ultrasound Simulation (edus2TM) was developed by Kulyk and Olszynski in 2011. Its feasibility for POC-US education has been well-documented, and shows good acceptance...
December 2017: Critical Ultrasound Journal
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