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https://www.readbyqxmd.com/read/28437749/epilepsy-awareness-and-emergency-rescue-training-ignorance-is-bliss
#1
Rohit Shankar, Caryn Jory, Brendan McLean, Phil Tittensor, Matthew Walker
Status epilepticus (SE) has a high mortality rate and is associated with complications such as neurological deficit and cognitive decline. Buccal midazolam is the recommended emergency rescue medication in the UK to reduce the duration of a seizure and SE. It should be administered by an appropriately trained person. There are agreed guidelines on training standards for its administration in the UK produced by the Joint Epilepsy Council of the United Kingdom and Ireland. Training should provide an overview of epilepsy to facilitate safe, person-centered care and appropriate administration of rescue medication to people with epilepsy (PWE)...
April 19, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28437224/structure-process-and-culture-of-intensive-care-units-treating-patients-with-severe-traumatic-brain-injury-survey-of-centers-participating-in-the-american-college-of-surgeons-trauma-quality-improvement-program
#2
Aziz S Alali, Victroia McCredie, Todd G Mainprize, David Gomez, Avery B Nathens
Outcome after severe traumatic brain injury (TBI) differs substantially between hospitals. Explaining this variation begins with understanding the differences in structures and processes of care, particularly at intensive care units (ICUs) where acute TBI care takes place. We invited trauma medical directors (TMDs) from 187 centers participating in the American College of Surgeons Trauma Quality Improvement Program to complete a survey. The survey domains included ICU model, type, availability of specialized units, staff, training programs, standard protocols and order sets, approach to withdrawal of life support, and perceived level of neurosurgeons' engagement in the ICU management of TBI...
February 15, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28437212/the-impact-of-communication-skills-training-on-cardiology-fellows-and-attending-physicians-perceived-comfort-with-difficult-conversations
#3
Kathryn Berlacher, Robert M Arnold, Eva Reitschuler-Cross, Jeffrey Teuteberg, Winifred Teuteberg
BACKGROUND: Cardiologists need to decide which treatments are appropriate for seriously ill patients and whether they align with patient goals. Reconciling medical options with patients' wishes requires skilled communication. Although there is evidence that communication is teachable, few cardiologists receive formal training. OBJECTIVE: To demonstrate that providing communication skills training to cardiologists is feasible and improves their perceived preparedness (PP) for leading difficult conversations...
March 1, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28437091/speeding-up-early-drug-discovery-in-antiviral-research-a-fragment-based-in-silico-approach-for-the-design-of-virtual-anti-hepatitis-c-leads
#4
Alejandro Speck-Planche, M Natalia Dias Soeiro Cordeiro
Hepatitis C constitutes an unresolved global health problem. This infectious disease is caused by the hepatotropic hepatitis C virus (HCV), and it can lead to the occurrence of life-threatening medical conditions such as cirrhosis and liver cancer. Nowadays, major clinical concerns have arisen due to the appearance of multidrug resistance (MDR), and the side effects especially associated with long-term treatments. In this work, we report the first multitasking model for quantitative structure-biological effect relationships (mtk-QSBER), focused on the simultaneous exploration of anti-HCV activity and in vitro safety profiles related to the absorption, distribution, metabolism, elimination, and toxicity (ADMET)...
April 24, 2017: ACS Combinatorial Science
https://www.readbyqxmd.com/read/28436853/automatic-skin-lesion-segmentation-using-deep-fully-convolutional-networks-with-jaccard-distance
#5
Yading Yuan, Ming Chao, Yeh-Chi Lo
Automatic skin lesion segmentation in dermoscopic images is a challenging task due to the low contrast between lesion and the surrounding skin, the irregular and fuzzy lesion borders, the existence of various artifacts, and various imaging acquisition conditions. In this article, we present a fully automatic method for skin lesion segmentation by leveraging a 19-layer deep convolutional neural networks (CNNs) that is trained end-to- end and does not rely on prior knowledge of the data. We propose a set of strategies to ensure effective and efficient learning with limited training data...
April 18, 2017: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/28436742/training-pediatric-fellows-in-palliative-care-a-pilot-comparison-of-simulation-training-and-didactic-education
#6
Katharine E Brock, Harvey J Cohen, Barbara M Sourkes, Julie J Good, Louis P Halamek
BACKGROUND: Pediatric fellows receive little palliative care (PC) education and have few opportunities to practice communication skills. OBJECTIVE: In this pilot study, we assessed (1) the relative effectiveness of simulation-based versus didactic education, (2) communication skill retention, and (3) effect on PC consultation rates. DESIGN: Thirty-five pediatric fellows in cardiology, critical care, hematology/oncology, and neonatology at two institutions enrolled: 17 in the intervention (simulation-based) group (single institution) and 18 in the control (didactic education) group (second institution)...
April 24, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28436344/inattention-tests-for-delirium
#7
Paul Regal
Voyer and colleagues (2016) report an interesting and important comparison of ten attention/concentration tests for DSM-5 delirium. I have a number of questions and comments as follows: (1) What training did the research assistants have? DSM-5 diagnosis is generally regarded as a decision by medical specialists. When the person has prior dementia, identifying delirium is a high-level medical skill. Behavioral and psychological symptoms of dementia can closely mimic delirium unless the examiner focuses on behavioral triggers and the speed of cognitive decline...
April 24, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28436206/clinical-practice-guidelines-on-iron-therapy-a-critical-evaluation
#8
Lucia Del Vecchio, Francesco Locatelli
Anemia is common among patients with chronic kidney disease (CKD) and it is managed primarily with erythropoiesis-stimulating agents (ESA) and iron therapy. Following concerns around ESA therapy and economic constraints, IV iron is more and more administered worldwide. Several guidelines or position papers, which give indications on iron therapy in CKD patients, have been issued in Nephrology. Unfortunately, the field is characterized by a lack of evidence. As a result, the recommendations/suggestions are not uniform...
April 24, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28436158/collaborating-on-medication-errors-in-nursing
#9
Marketa Marvanova, Paul J Henkel
BACKGROUND: Nurse educators are faced with changing roles and expanding responsibilities for medication administration and monitoring in pursuit of improved patient safety. The aims of this study were to develop, implement and evaluate clinical simulation experiences that included, along with nursing faculty members, a pharmacist educator for the teaching of preventable medication errors in undergraduate nursing education. METHODS: Four clinical simulation scenarios using high-fidelity patient simulators were developed focusing on select medication problems in nursing practice...
April 24, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28435756/identifying-barriers-in-the-use-of-electronic-health-records-in-hawai-i
#10
Faith D Hamamura, Kelley Withy, Kira Hughes
Hawai'i faces unique challenges to Electronic Health Record (EHR) adoption due to physician shortages, a widespread distribution of Medically Underserved Areas and Populations (MUA/P), and a higher percentage of small independent practices. However, research on EHR adoption in Hawai'i is limited. To address this gap, this article examines the current state of EHR in Hawai'i, the barriers to adoption, and the future of Health Information Technology (HIT) initiatives to improve the health of Hawai'i's people...
March 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28435563/ultrasound-guided-percutaneous-lavage-in-the-treatment-of-calcific-tendinopathy-of-elbow-extensor-tendons-a-case-report
#11
M Abate, V Salini, C Schiavone
We report the efficacy of the ultrasound-guided percutaneous treatment in the management of elbow extensor tendons calcific tendinopathy. The ultrasound-guided percutaneous treatment is broadly used with positive results in patients suffering from rotator cuff calcific tendinopathy. However, this interventional method has been reported only in one patient in the medical literature. A 34 years-old female who complained pain, swelling and severe functional limitation of the right elbow was referred to our unit...
July 2016: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28435498/security-violent-events-and-anticipated-surge-capabilities-of-emergency-departments-in-washington-state
#12
Jonathan S Weyand, Emily Junck, Christopher S Kang, Jason D Heiner
INTRODUCTION: Over the past 15 years, violent threats and acts against hospital patients, staff, and providers have increased and escalated. The leading area for violence is the emergency department (ED) given its 24/7 operations, role in patient care, admissions gateway, and center for influxes during acute surge events. This investigation had three objectives: to assess the current security of Washington State EDs; to estimate the prevalence of and response to threats and violence in Washington State EDs; and to appraise the Washington State ED security capability to respond to acute influxes of patients, bystanders, and media during acute surge events...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435344/development-of-performance-and-error-metrics-for-ultrasound-guided-axillary-brachial-plexus-block
#13
Osman M Ahmed, Brian D O'Donnell, Anthony G Gallagher, George D Shorten
PURPOSE: Change in the landscape of medical education coupled with a paradigm shift toward outcome-based training mandates the trainee to demonstrate specific predefined performance benchmarks in order to progress through training. A valid and reliable assessment tool is a prerequisite for this process. The objective of this study was to characterize ultrasound-guided axillary brachial plexus block to develop performance and error metrics and to verify face and content validity using a modified Delphi method...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28435015/using-classification-models-for-the-generation-of-disease-specific-medications-from-biomedical-literature-and-clinical-data-repository
#14
Liqin Wang, Peter J Haug, Guilherme Del Fiol
OBJECTIVE: Mining disease-specific associations from existing knowledge resources can be useful for building disease-specific ontologies and supporting knowledge-based applications. Many association mining techniques have been exploited. However, the challenge remains when those extracted associations contained much noise. It is unreliable to determine the relevance of the association by simply setting up arbitrary cut-off points on multiple scores of relevance; and it would be expensive to ask human experts to manually review a large number of associations...
April 20, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28434911/does-quantity-ensure-quality-standardized-osce-stations-for-outcome-oriented-evaluation-of-practical-skills-at-different-medical-faculties
#15
Iris Schleicher, Karsten Leitner, Jana Juenger, Andreas Moeltner, Miriam Ruesseler, Bernd Bender, Jasmina Sterz, Tina Stibane, Sarah Koenig, Susanne Frankenhauser, Joachim Gerhard Kreuder
BACKGROUND: Practical skills are often assessed using Objective Structured Clinical Skill Exams (OSCE). Nevertheless, in Germany, interchange and agreement between different medical faculties or a general agreement on the minimum standard for passing is lacking. METHODS: We developed standardized OSCE-stations for assessing structured clinical examination of knee and shoulder joint with identical checklists and evaluation standards. These were implemented into the OSCE-course at five different medical faculties...
April 20, 2017: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
https://www.readbyqxmd.com/read/28434885/early-performance-on-an-eye-surgery-simulator-predicts-subsequent-resident-surgical-performance
#16
Ramak Roohipoor, Mehdi Yaseri, Amir Teymourpour, Carolyn Kloek, John B Miller, John I Loewenstein
OBJECTIVE: To examine early performance on an eye surgery simulator and its relationship to subsequent live surgical performance in a single large residency program. DESIGN: Retrospective study. SETTING: Massachusetts Eye and Ear, Harvard Medical School, Department of Ophthalmology. METHODS: In a retrospective study, we compared performance of 30 first-year ophthalmology residents on an eye surgery simulator to their surgical skills as third-year residents...
April 20, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28434847/mri-before-radiography-for-patients-with-new-shoulder-conditions
#17
Kirstin M Small, Frank J Rybicki, Lindsay R Miller, Stephen D Daniels, Laurence D Higgins
PURPOSE: To assess the patterns of Appropriate Criteria application among orthopedic specialists and other fields of medicine for use of MRI and radiography and the subsequent necessity for surgical intervention. METHODS: The hospital electronic medical record was used to identify all shoulder MRI studies at a single large urban teaching hospital between January 2, 2011, and June 30, 2011. For each study, variables collected included ordering department, patient age, patient gender, patient's self-reported race/ethnicity, whether the patient obtained surgery for an issue related to the MRI diagnosis, the type of MRI ordered, the date of pain onset, the date of x-ray (if any), and the date of the MRI...
April 20, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28434473/the-effect-of-applying-pressure-to-the-liv3-and-li4-on-the-symptoms-of-premenstrual-syndrome-a-randomized-clinical-trial
#18
Fatemeh Bazarganipour, Seyed-Abdolvahab Taghavi, Helen Allan, Fatemeh Beheshti, Asma Khalili, Fahimeh Miri, Marziyeh Rezaei, Mahbobeh Mojgori, Fatemeh Imaninasab, Fahimeh Irani, Shohreh Salari
OBJECTIVE: To evaluate the effect of simple acupressure protocol in LIV3, LI4 and placebo points on the quality of life (QOL) in women with premenstrual syndrome (PMS). METHOD: This paper reports a randomized, single blinded clinical trial. 97 participants (students in of Hormozgan University of Medical Sciences, Iran) with PMS were allocated to three groups to receive 20min acupressure on different acupoints for 14days before menstruation for three consecutive menstrual cycles (training and then two cycles self applied acupressure)...
April 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28434131/knowing-how-and-knowing-why-testing-the-effect-of-instruction-designed-for-cognitive-integration-on-procedural-skills-transfer
#19
Jeffrey J H Cheung, Kulamakan M Kulasegaram, Nicole N Woods, Carol-Anne Moulton, Charlotte V Ringsted, Ryan Brydges
Transfer is a desired outcome of simulation-based training, yet evidence for how instructional design features promote transfer is lacking. In clinical reasoning, transfer is improved when trainees experience instruction integrating basic science explanations with clinical signs and symptoms. To test whether integrated instruction has similar effects in procedural skills (i.e., psychomotor skills) training, we studied the impact of instruction that integrates conceptual (why) and procedural (how) knowledge on the retention and transfer of simulation-based lumbar puncture (LP) skill...
April 22, 2017: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/28434119/cost-analysis-for-the-implementation-of-a-medication-review-with-follow-up-service-in-spain
#20
Aranzazu Noain, Victoria Garcia-Cardenas, Miguel Angel Gastelurrutia, Amaia Malet-Larrea, Fernando Martinez-Martinez, Daniel Sabater-Hernandez, Shalom I Benrimoj
Background Medication review with follow-up (MRF) is a professional pharmacy service proven to be cost-effective. Its broader implementation is limited, mainly due to the lack of evidence-based implementation programs that include economic and financial analysis. Objective To analyse the costs and estimate the price of providing and implementing MRF. Setting Community pharmacy in Spain. Method Elderly patients using poly-pharmacy received a community pharmacist-led MRF for 6 months. The cost analysis was based on the time-driven activity based costing model and included the provider costs, initial investment costs and maintenance expenses...
April 22, 2017: International Journal of Clinical Pharmacy
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