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Prescribing errors

Lynn V Monrouxe, Lisa Grundy, Mala Mann, Zoe John, Eleni Panagoulas, Alison Bullock, Karen Mattick
OBJECTIVE: To understand how prepared UK medical graduates are for practice and the effectiveness of workplace transition interventions. DESIGN: A rapid review of the literature (registration #CRD42013005305). DATA SOURCES: Nine major databases (and key websites) were searched in two timeframes (July-September 2013; updated May-June 2014): CINAHL, Embase, Educational Resources Information Centre, Health Management Information Consortium, MEDLINE, MEDLINE in Process, PsycINFO, Scopus and Web of Knowledge...
January 13, 2017: BMJ Open
Tomasz Dabrowski, Kieran Lyons, Glenn Nolan, Alan Berry, Caroline Cusack, Joe Silke
A 3D primitive equation coastal ocean model for southwest Ireland, called the Bantry Bay model, was developed and implemented operationally. Validated model outputs have multiple uses. One of the incentives to develop the model was to explore the possible transport pathways that carry harmful algae blooms (HAB) into Bantry Bay. The model is nested offline in a regional North East Atlantic operational model. Surface forcing is taken from the half-degree Global Forecasting System, available at three-hourly intervals...
March 2016: Harmful Algae
G B Downey, J M McDonald, R G Downey
This study was designed to investigate levels of stress, anxiety or depression and to identify factors compounding or relieving stress in anaesthesia trainees within the Australian and New Zealand College of Anaesthetists (ANZCA) training scheme. An electronic survey was sent to 999 randomly selected trainees and 428 responses were received. In addition to demographics, psychological wellbeing was assessed using the Kessler Psychological Distress Scale (K10) and questions were asked about depression and anxiety, exacerbating factors, personal healthcare and strategies used to manage stress...
January 2017: Anaesthesia and Intensive Care
Christian F Clarenbach, Laurent P Nicod, Malcolm Kohler
BACKGROUND: The aim of the Asthma Survey was to generate insights about the daily practice of physicians with regard to inhaler devices used for treating asthma under real-world conditions in Switzerland. METHODS: A questionnaire was administered to 605 participating hospital- and practice-based Swiss physicians. Areas of interest were practical aspects of patient education, typical difficulties encountered when prescribing pressurized metered-dose inhalers (pMDI) and dry-powder inhalers (DPI), and reasons for physician preferences...
November 2016: Journal of Thoracic Disease
Justin Keasberry, Ian A Scott, Clair Sullivan, Andrew Staib, Richard Ashby
Objective The aim of the present study was to determine the effects of hospital-based eHealth technologies on quality, safety and efficiency of care and clinical outcomes.Methods Systematic reviews and reviews of systematic reviews of eHealth technologies published in PubMed/Medline/Cochrane Library between January 2010 and October 2015 were evaluated. Reviews of implementation issues, non-hospital settings or remote care or patient-focused technologies were excluded from analysis. Methodological quality was assessed using a validated appraisal tool...
January 9, 2017: Australian Health Review: a Publication of the Australian Hospital Association
Manisha Gupta, Sudhir Kumar Rana, Sanjiv Kumar Mittal, R N P Sinha
INTRODUCTION: Amblyopia is one of the common causes of childhood visual impairment. The prevalence of amblyopia usually varies according to the age group of the studied population and the factors prevailing in that region. The upper limit of the critical time when amblyopia can develop is around eight years of age and it can be permanent if corrective measures are not taken in time. AIM: The purpose of study was to know the profile and pattern of amblyopia in children aged 5-15 years with refractive error in Uttarakhand and to compare it with national and regional (South Asian) studies...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
Jinish Jose, Denny Devassykutty
INTRODUCTION: Paediatric prescription analysis was done by vari-ous studies in tertiary care centers but not much published data, at primary care level. The Medical Council of India introduced new prescription format and also antibiotic stewardship program was launched by Government of Kerala in the year 2015. So in these contexts this study was conducted. AIM: To analyse the patterns of prescriptions and drug dis-pensing in pediatric patients using WHO core drug use indicators and parameters in the prescription format prescribed by Medical Council of India...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
E Mosher, M Choi, E Jones, C Lee
PURPOSE: To assess individual variation in heart volume and location in order to develop a prediction model of the heart. This heart prediction model will be used to calculate individualized heart doses for radiotherapy patients in epidemiological studies. METHODS: Chest CT images for 30 adult male and 30 adult female patients were obtained from NIH Clinical Center. Image-analysis computer programs were used to segment the whole heart and 8 sub-regions and to measure the volume of each sub- region and the dimension of the whole heart...
June 2016: Medical Physics
D Piriyasang, P Pattaranutaporn, K Manokhoon
PURPOSE: Cylindrical applicators are often used for postoperative HDRbrachytherapy in endometrial carcinoma. It has been considered that dosimetric variation between fractions for this treatment is minimal and might not be necessary to perform treatment planning for every fractions. At our institute, it is traditional to perform treatment planning with CT simulation on the first fraction and uses this plan for the rest of treatment. This study was aim to evaluate the errors of critical structure doses between the fractions when simulation and planning were done for first fraction only...
June 2016: Medical Physics
D Thomas, A Kishan, A Santhanam, Y Min, D O'Connell, J Lamb, M Cao, N Agazaryan, Y Yang, P Lee, D Low
PURPOSE: To evaluate the effect of inter- and intra-fractional tumor motion on the error in four-dimensional computed tomography (4DCT) maximal intensity projection (MIP)-based lung tumor internal target volumes (ITV), using deformable image registration of real-time 2D-sagital cine-mode MRI acquired during lung SBRT treatments. METHODS: Five lung tumor patients underwent free breathing SBRT treatment on the ViewRay, with dose prescribed to PTV (4DCT MIP-based ITV+3-6mm margin)...
June 2016: Medical Physics
M Lee, J Jung, S Lee, S Kim, Y Cho, I Lee, T Suh
PURPOSE: This study investigates the effects of different kinds and designs of commercialized breast implants on the dose distributions in breast cancer radiotherapy under a variety of conditions. METHODS: The dose for the clinical conventional tangential irradiation, Intensity Modulated Radiation Therapy (IMRT), volumetric modulated arc therapy (VMAT) breast plans was measured using radiochromic films and stimulated luminescence dosimeter (OSLD). The radiochromic film was used as an integrating dosimeter, while the OSLDs were used for real-time dosimetry to isolate the contribution of dose from individual segment...
June 2016: Medical Physics
J Zhang, D Nguyen, K Woods, A Tran, X Li, X Ding, P Kabolizadeh, T Guerrero, K Sheng
PURPOSE: We performed a retrospective dosimetric comparison study between the robustness optimized Intensity Modulated Proton Therapy (RO-IMPT), volumetric-modulated arc therapy (VMAT), and the non-coplanar 4? intensity modulated radiation therapy (IMRT). These methods represent the most advanced radiation treatment methods clinically available. We compare their dosimetric performance for head and neck cancer treatments with special focus on the OAR sparing near the tumor volumes. METHODS: A total of 11 head and neck cases, which include 10 recurrent cases and one bilateral case, were selected for the study...
June 2016: Medical Physics
S Wegener, B Herzog, O Sauer
PURPOSE: The conventional plan verification strategy is delivering a plan to a QA-phantom before the first treatment. Monitoring each fraction of the patient treatment in real-time would improve patient safety. We evaluated how well a new detector, the IQM (iRT Systems, Germany), is capable of detecting errors we induced into IMRT plans of three different treatment regions. Results were compared to an established phantom. METHODS: Clinical plans of a brain, prostate and head-and-neck patient were modified in the Pinnacle planning system, such that they resulted in either several percent lower prescribed doses to the target volume or several percent higher doses to relevant organs at risk...
June 2016: Medical Physics
C Geady, B Keller, M Ruschin, E Hahn, N Makhani, S Bosnic, D Vesprini, H Soliman, J Lee, C McCann
PURPOSE: To determine the Planning Target Volume (PTV) margin for Hypofractionated Partial Breast Irradiation (HPBI) using the van Herk formalism (M=2.5∑+0.7σ). HPBI is a novel technique intended to provide local control in breast cancer patients not eligible for surgical resection, using 40 Gy in 5 fractions prescribed to the gross disease. METHODS: Setup uncertainties were quantified through retrospective analysis of cone-beam computed tomography (CBCT) data sets, collected prior to (prefraction) and after (postfraction) treatment delivery...
June 2016: Medical Physics
J Yu, E Nichols, D Strauss, H Chung, U Langner, K Langen
PURPOSE: To measure the skin dose and compare it with the calculated dose from a treatment planning system (TPS) for breast cancer treatment using scanning proton beam therapy (SPBT). METHODS: A single en-face-beam SPBT plan was generated by a commercial TPS for two breast cancer patients. The treatment volumes were the entire breasts (218 cc and 1500 cc) prescribed to 50.4 Gy (RBE) in 28 fractions. A range shifter of 5 cm water equivalent thickness was used. The organ at risk (skin) was defined to be 5 mm thick from the surface...
June 2016: Medical Physics
S Moon, M Yoon, W Chung, M Chung, D Kim
PURPOSE: Confirming the dose delivered to a patient is important to make sure the treatment quality and safety of the radiotherapy. Measuring a transit dose of the patient during the radiotherapy could be an interesting way to confirm the patient dose. In this study, we evaluated the feasibility of the transit dosimetry with a glass dosimeter in brachytherapy. METHODS: We made a phantom that inserted the glass dosimeters and placed under patient lying on a couch for cervix cancer brachytherapy...
June 2016: Medical Physics
A Barragan Montero, K Souris, J Lee, E Sterpin
PURPOSE: To develop an efficient method to implement random set-up errors and organ motion in robust optimization for proton therapy treatment planning. METHODS: The plans were created with an in-house robust optimizer, coupled with a super-fast Monte Carlo (MC) engine (less than 1 minute for final dose). MC simulates random errors by shifting randomly the starting point of each particle, according to their probability distribution. Such strategy assumes a sufficient number of treatment fractions...
June 2016: Medical Physics
O Gopan, A Kalet, W Smith, K Hendrickson, M Kim, L Young, M Nyflot, A Chvetsov, M Phillips, E Ford
PURPOSE: A standard tool for ensuring the quality of radiation therapy treatments is the initial physics plan review. However, little is known about its performance in practice. The goal of this study is to measure the effectiveness of physics plan review by introducing simulated errors into "mock" treatment plans and measuring the performance of plan review by physicists. METHODS: We generated six mock treatment plans containing multiple errors. These errors were based on incident learning system data both within the department and internationally (SAFRON)...
June 2016: Medical Physics
J Pearse, J Chow
PURPOSE: We created two applications, one for use on Android and one for use on Windows, to carry out monitor unit (MU) calculations. These applications carried out these long calculations quickly, while avoiding the potential for human error. METHODS: A general formula for calculating MU for an orthovoltage x-ray machine was used and implemented in two programs created for Android and Windows. The formula relies on the prescribed dose and fractionation. Other values the formula relies upon are relative exposure factor (REF) and backscatter factor (BSF)...
June 2016: Medical Physics
K Chapagain, B D Paranjape, G Lama
INTRODUCTION: To ensure safe, effective and rational prescribing by tomorrow's doctors it is important to assess the prescribing skills of today's medical students. The aim of this study was to assess the prescribing skills of MBBS preclinical students of a Teaching Hospital. METHODS: First and second year medical students were given different sets of common clinical scenarios and asked to write a prescription for these. The physician and drug related components were analyzed following the WHO guidelines...
October 2016: JNMA; Journal of the Nepal Medical Association
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