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https://www.readbyqxmd.com/read/29151000/implementing-clinical-practice-changes-in-critical-care-lessons-learned-in-a-national-collaborative-of-over-60-icu-teams
#1
Ruth Kleinpell, Jerry J Zimmerman
Improving care in the intensive care unit (ICU) is a global area of focus for clinicians worldwide. The complexity of the ICU environment, compounded by multiple patient comorbidities and high acuity levels, makes the ICU a unique and challenging area of clinical practice. The essence of quality improvement - designing and implementing strategies to enhance care - fit well with the ICU setting. However, implementing clinical change is challenging, regardless of the clinical setting. A national collaborative targeting ICU settings was initiated which provided a number of lessons learned regarding implementing quality of care initiatives in critical care...
November 18, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29150237/-maternal-deaths-due-to-amniotic-fluid-embolism-results-from-the-french-confidential-enquiry-into-maternal-deaths-2010-2012
#2
E Morau, A Proust, J-C Ducloy
Amniotic fluid embolism (AFE) is an unpredictable, dreadful complication of pregnancy or childbirth. EA typically includes in the same lapse of time respiratory, haemodynamic, neurological and hemorrhagic symptoms (from early and severe coagulopathy). Immediate supportive treatment by a multidisciplinary team is the cornerstone of the management. Between 2010 an 2012 in France, 24 deaths were related to AFE giving a maternal mortality ratio of 1/100,000 live births (CI 95% 0.6-1.4). AFE ranks as the second leading cause of direct maternal death...
November 14, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29146665/the-relative-effect-of-team-based-learning-on-motivation-and-learning-a-self-determination-theory-perspective
#3
Lucas M Jeno, Arild Raaheim, Sara Madeleine Kristensen, Kjell Daniel Kristensen, Torstein Nielsen Hole, Mildrid J Haugland, Silje Mæland
We investigate the effects of team-based learning (TBL) on motivation and learning in a quasi-experimental study. The study employs a self-determination theory perspective to investigate the motivational effects of implementing TBL in a physiotherapy course in higher education. We adopted a one-group pretest-posttest design. The results show that the students' intrinsic motivation, identified regulation, perceived competence, and perceived autonomy support significantly increased going from lectures to TBL...
2017: CBE Life Sciences Education
https://www.readbyqxmd.com/read/29143698/using-the-integrate-hta-guidance-experience-from-cadth
#4
Ken Bond, Laura Weeks
OBJECTIVES: The aim of this study was to describe an initial exploration by CADTH, Canada's pan-Canadian health technology assessment (HTA) agency, in using the INTEGRATE-HTA guidance in the production of an HTA that examined the use of both in-center and in-home dialysis modalities for the treatment of end-stage kidney disease in adults in Canada. METHODS AND RESULTS: We outline CADTH's standard HTA production process and context and then describe the experience of the assessment team in using the INTEGRATE-HTA guidance, specifically to help structure and guide the use of a logic model, the identification of implementation issues, and the identification and examination of ethical issues...
November 16, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/29140919/collaboration-and-teamwork-in-the-health-professions-rethinking-the-role-of-conflict
#5
Quentin Eichbaum
Whereas the business professions have long recognized that conflict can be a source of learning and innovation, the health professions still tend to view conflict negatively as being disruptive, inefficient, and unprofessional. As a consequence, the health professions tend to avoid conflict or resolve it quickly. This neglect to appreciate conflict's positive attributes appears to be driven in part by (1) individuals' fears about being negatively perceived and the potential negative consequences in an organization of being implicated in conflict, (2) constrained views and approaches to professionalism and to evaluation and assessment, and (3) lingering autocracies and hierarchies of power that view conflict as a disruptive threat...
November 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29140769/addressing-maternal-health-during-cdc-s-ebola-response-in-the-united-states
#6
Sascha Ellington, Mirna Perez, Diane Morof, Marianne E Zotti, William Callaghan, Dana Meaney-Delman, Maleeka Glover, Quynh-Chau Ha, Denise J Jamieson
Previous outbreaks suggest that pregnant women with Ebola virus disease (EVD) are at increased risk for severe disease and death. Healthcare workers who treat pregnant women with EVD are at increased risk of body fluid exposure. Despite the absence of pregnant women with EVD in the United States, CDC activated the Maternal Health Team (MHT), a functional unit dedicated to emergency preparedness and response issues, on October 18, 2014. We describe major activities of the MHT. A high-priority MHT activity was to publish guiding principles early in the response...
November 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/29138217/effectiveness-of-interprofessional-education-in-renal-physiology-curricula-for-health-sciences-graduate-students
#7
Lisa M Harrison-Bernard, Mihran V Naljayan, Jane M Eason, Donald E Mercante, Tina P Gunaldo
The primary purpose of conducting an interprofessional education (IPE) experience during the renal physiology block of a graduate-level course was to provide basic science, physical therapy, and physician assistant graduate students with an opportunity to work as a team in the diagnosis, treatment, and collaborative care of a patient with acute kidney injury. The secondary purpose was to enhance the understanding of basic renal physiology principles with a patient case presentation of renal pathophysiology...
December 1, 2017: Advances in Physiology Education
https://www.readbyqxmd.com/read/29138172/framework-for-building-primary-care-capacity-to-address-the-social-determinants-of-health
#8
Andrew D Pinto, Gary Bloch
PROBLEM ADDRESSED: Family physicians have long understood that social factors influence the health of individuals and communities; however, most primary care organizations have yet to develop the capacity to specifically address these social determinants of health (SDOH). OBJECTIVE OF PROGRAM: To support SDOH interventions and foster an organizational culture in which addressing SDOH is considered part of high-quality primary care. PROGRAM DESCRIPTION: An academic family health team in Toronto, Ont, established a committee comprising a diverse group of health professionals focused on the SDOH...
November 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29138126/promoting-secondary-analysis-of-electronic-medical-records-in-china-summary-of-the-plagh-mit-critical-data-conference-and-health-datathon
#9
Peiyao Li, Chen Xie, Tom Pollard, Alistair Edward William Johnson, Desen Cao, Hongjun Kang, Hong Liang, Yuezhou Zhang, Xiaoli Liu, Yong Fan, Yuan Zhang, Wanguo Xue, Lixin Xie, Leo Anthony Celi, Zhengbo Zhang
Electronic health records (EHRs) have been widely adopted among modern hospitals to collect and track clinical data. Secondary analysis of EHRs could complement the traditional randomized control trial (RCT) research model. However, most researchers in China lack either the technical expertise or the resources needed to utilize EHRs as a resource. In addition, a climate of cross-disciplinary collaboration to gain insights from EHRs, a crucial component of a learning healthcare system, is not prevalent. To address these issues, members from the Massachusetts Institute of Technology (MIT) and the People's Liberation Army General Hospital (PLAGH) organized the first clinical data conference and health datathon in China, which provided a platform for clinicians, statisticians, and data scientists to team up and address information gaps in the intensive care unit (ICU)...
November 14, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/29137723/the-promise-and-problems-of-non-physician-practitioners-in-general-surgery-education-results-of-a-multi-center-mixed-methods-study-of-faculty
#10
James E Coverdill, Jeff Scott Shelton, Adnan Alseidi, David C Borgstrom, Daniel L Dent, Russell Dumire, Jonathan Fryer, Thomas H Hartranft, Steven B Holsten, M Timothy Nelson, Mohsen M Shabahang, Stanley R Sherman, Paula M Termuhlen, Randy J Woods, John D Mellinger
BACKGROUND: Nurse Practitioners and Physician Assistants - called non-physician practitioners or NPPs - are common, but little is known about their educational promise and problems. METHODS: General surgery faculty in 13 residency programs were surveyed (N = 279 with a 71% response rate) and interviewed (N = 43) about experiences with NPPs. The survey documents overall patterns and differences by program type and primary service; interviews point to deeper rationales and concerns...
November 5, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29137508/health-professional-education-and-universal-health-coverage-a-summary-of-challenges-and-selected-case-studies
#11
Arthika Sripathy, Joachim Marti, Hannah Patel, Javaid I Sheikh, Ara W Darzi
Low- and middle-income countries are experiencing serious shortages in meeting health workforce requirements for universal health coverage. We examine how national-level policies can address these deficiencies and support the development of an appropriately skilled health workforce in line with population needs. We discuss three innovative, government-led solutions that are designed to align health workforce training with the demands of universal health coverage. Specifically, we discuss two initiatives to train and retain doctors in rural areas of Thailand, the large-scale training of community health workers within multidisciplinary primary health care teams in Brazil, and the introduction of a postgraduate diploma program in primary care for nurses in India...
November 2017: Health Affairs
https://www.readbyqxmd.com/read/29133335/barriers-and-facilitators-to-learn-and-improve-through-morbidity-and-mortality-conferences-a-qualitative-study
#12
Marit S de Vos, Jaap F Hamming, Perla J Marang-van de Mheen
OBJECTIVES: To explore barriers and facilitators to successful morbidity and mortality conferences (M&M), driving learning and improvement. DESIGN: This is a qualitative study with semistructured interviews. Inductive, thematic content analysis was used to identify barriers and facilitators, which were structured across a pre-existing framework for change in healthcare. SETTING: Dutch academic surgical department with a long tradition of M&M...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29131704/impact-of-team-composition-on-student-perceptions-of-interprofessional-teamwork-a-6-year-cohort-study
#13
Chad Lairamore, Duston Morris, Rachel Schichtl, Lorrie George-Paschal, Heather Martens, Alexandros Maragakis, Mary Garnica, Barbara Jones, Myra Grantham, Adam Bruenger
Interprofessional education (IPE) provides students with opportunities to learn about the roles and responsibilities of other professions and develop communication and teamwork skills. As different health professions have recognised the importance of IPE, the number of disciplines participating in IPE events is increasing. Consequently, it is important to examine the effect group structure has on the learning environment and student knowledge acquisition during IPE events. The purpose of this study was to determine the effect of group composition on student perceptions of interprofessional teamwork and collaboration when participating in a case-based IPE forum...
November 13, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/29130555/ethmoidal-adenocarcinoma-treated-by-exclusive-endoscopic-approach-focus-on-learning-curve-and-modification-of-management
#14
Natalie Oker, Benjamin Verillaud, Michel Wassef, Sébastien Froelich, Damien Bresson, Romain Kania, Philippe Herman
BACKGROUND: The purpose of this study was to investigate the outcome and recurrences for ethmoidal adenocarcinomas treated by exclusive endoscopic surgery in curative intent and investigate the role of the learning curve. METHODS: We conducted a single-center retrospective study, including 60 patients separated in 2 groups (2002-2011 n = 28 and 2012-2015 n = 32). RESULTS: The global survival rate at 5 years was 72.6%, and the global and local recurrence rates were 21...
November 11, 2017: Head & Neck
https://www.readbyqxmd.com/read/29128989/infant-mortality-lessons-learned-from-a-fetal-and-infant-mortality-review-program
#15
Haywood L Brown, Mark Smith, Yvonne Beasley, Teri Conard, Anne Lise Musselman, Virginia A Caine
Objective To review fetal and infant deaths from women enrolled in Indianapolis Healthy Start using the National Fetal and Infant Mortality Review (FIMR) methods to provide strategies for prevention. METHODS: Marion County Public Health Department (MCPHD) FIMR staff identified and reviewed 22 fetal and infant deaths to Indianapolis Healthy Start program participants between 2005 and 2012. Trained FIMR nurses completed 13 of 20 maternal interviews and compiled case summaries of all deaths from the MCPHD FIMR database...
November 11, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/29128437/participatory-action-research-opens-doors-mentoring-indigenous-researchers-to-improve-midwifery-in-urban-australia
#16
Sophie D Hickey, Sarah-Jade Maidment, Kayla M Heinemann, Yvette L Roe, Sue V Kildea
PROBLEM: There is increasing demand for capacity building among the Aboriginal and Torres Strait Islander (Indigenous) maternal and infant health workforce to improve health outcomes for mothers and babies; yet few studies describe the steps taken to mentor novice Indigenous researchers to contribute to creating a quality evidence-base in this space. BACKGROUND: The Indigenous Birthing in an Urban Setting study is a partnership project aimed at improving maternity services for Indigenous families in South East Queensland...
November 8, 2017: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/29127582/lessons-learned-from-participating-in-d3r-2016-grand-challenge-2-compounds-targeting-the-farnesoid-x-receptor
#17
Rui Duan, Xianjin Xu, Xiaoqin Zou
D3R 2016 Grand Challenge 2 focused on predictions of binding modes and affinities for 102 compounds against the farnesoid X receptor (FXR). In this challenge, two distinct methods, a docking-based method and a template-based method, were employed by our team for the binding mode prediction. For the new template-based method, 3D ligand similarities were calculated for each query compound against the ligands in the co-crystal structures of FXR available in Protein Data Bank. The binding mode was predicted based on the co-crystal protein structure containing the ligand with the best ligand similarity score against the query compound...
November 10, 2017: Journal of Computer-aided Molecular Design
https://www.readbyqxmd.com/read/29126602/the-potential-of-blended-learning-in-education-and-training-for-advanced-civilian-and-military-trauma-care
#18
Linda Sonesson, Kenneth Boffard, Lars Lundberg, Martin Rydmark, Klas Karlgren
INTRODUCTION: In the field of advanced care of the complex trauma patient, there is an emerging need for focused education and training. However, several hospitals do not support further education and training in this field, and the challenge of releasing time for physicians and nurses is well-known. Educational strategies using blended learning, which combines traditional classroom methods with modern computer-assisted methods and media, have not yet been widely used. This study analysed the educational challenges and areas for improvement, according to senior physicians and nurses, and investigated the potential use of blended learning...
November 6, 2017: Injury
https://www.readbyqxmd.com/read/29125507/self-management-and-health-care-transition-trials-tribulations-and-triumphs
#19
Cecily L Betz
PURPOSE: The purpose of this article is to provide perspectives pertaining to the importance of fostering comprehensive self-management competencies of AEA-SHCN, with attention directed to AEA with spina bifida based upon the Health Care Transition Research Consortium Health Care Transition model. This article is based upon the plenary presentation given at the Spina Bifida 3rd World Congress, entitled, Self-Management and Health Care Transition: Trials, Tribulations and Triumphs. METHOD: A historical perspective of healthcare transition initiatives and best practice guidelines is provided that have influenced the field of research and practice...
October 20, 2017: Journal of Pediatric Rehabilitation Medicine
https://www.readbyqxmd.com/read/29125007/the-importance-of-design-thinking-in-medical-education
#20
Basil Badwan, Roshit Bothara, Mieke Latijnhouwers, Alisdair Smithies, John Sandars
Design thinking provides a creative and innovate approach to solve a complex problem. The discover, define, develop and delivery phases of design thinking lead to the most effective solution and this approach can be widely applied in medical education, from technology intervention projects to curriculum development. Participants in design thinking acquire essential transferable life-long learning skills in dealing with uncertainty and collaborative team working.
November 10, 2017: Medical Teacher
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