WorldWideScience

Sample records for event review team

  1. Learning Team Review 2016-0002 Parking Lot Event 2016

    Energy Technology Data Exchange (ETDEWEB)

    Wilburn, Dianne Williams [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Bitteker, Leo John [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Brooks, Melynda Louise [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Romero-Trujillo, Natalie [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Currie, Scott Allister [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Martin, Joanne Skrivan [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Sondheim, Walter E. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Tovesson, Fredrik [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Young, Jennifer S. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Crespin, Thomas Joe [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-09-02

    The purpose of a Learning Team is to transfer and communicate the information into operational feedback and improvement. We want to pay attention to the small things that go wrong because they are often early warning signals and may provide insight into the health of the whole system. The incident involved the collision of a van with a forklift having raised tines in rainy, overcast weather.

  2. Team Modelling: Literature Review

    Science.gov (United States)

    2006-08-01

    cognitive and/or reasoning ability (g), spatial orientation, and verbal comprehension. In terms of personality, Jordan (2001) has argued that research on...broadminded ( Jordan , 2001). Most of the team research pertaining to the Big Five factors has focused on the conscientiousness and agreeableness factors...transformational leadership on team performance, the findings have generally been positive. Dvir, Eden, Avolio, & Shamir (2002; cited in Lim & Ployhart

  3. Training Team Problem Solving Skills: An Event-Based Approach.

    Science.gov (United States)

    Oser, R. L.; Gualtieri, J. W.; Cannon-Bowers, J. A.; Salas, E.

    1999-01-01

    Discusses how to train teams in problem-solving skills. Topics include team training, the use of technology, instructional strategies, simulations and training, theoretical framework, and an event-based approach for training teams to perform in naturalistic environments. Contains 68 references. (Author/LRW)

  4. Individual and team performance in team-handball: a review.

    Science.gov (United States)

    Wagner, Herbert; Finkenzeller, Thomas; Würth, Sabine; von Duvillard, Serge P

    2014-12-01

    Team handball is a complex sport game that is determined by the individual performance of each player as well as tactical components and interaction of the team. The aim of this review was to specify the elements of team-handball performance based on scientific studies and practical experience, and to convey perspectives for practical implication. Scientific studies were identified via data bases of PubMed, Web of Knowledge, SPORT Discus, Google Scholar, and Hercules. A total of 56 articles met the inclusion criteria. In addition, we supplemented the review with 13 additional articles, proceedings and book sections. It was found that the specific characteristics of team-handball with frequent intensity changes, team-handball techniques, hard body confrontations, mental skills and social factors specify the determinants of coordination, endurance, strength and cognition. Although we found comprehensive studies examining individual performance in team-handball players of different experience level, sex or age, there is a lack of studies, particularly for team-handball specific training, as well as cognition and social factors. Key PointsThe specific characteristics of team-handball with frequent intensity changes, specific skills, hard body confrontations, mental skills and social factors define the determinants of coordination, endurance, strength and cognition.To increase individual and team performance in team-handball specific training based on these determinants have been suggested.Although there are comprehensive studies examining individual performance in team-handball players of different experience level, sex, or age are published, there is a lack of training studies, particularly for team-handball specific techniques and endurance, as well as cognition and social factors.

  5. Solar Decathlon 2005: The Event in Review

    Energy Technology Data Exchange (ETDEWEB)

    Moon, S.; Nahan, R.; Warner, C.; Wassmer, M.

    2006-06-01

    Solar Decathlon 2005: The Event in Review is a technical report describing the 2005 Solar Decathlon, an event sponsored by the U.S. Department of Energy wherein 18 collegiate teams competed in 10 contests to design, build, and operate an attractive, efficient, entirely solar-powered home. The report gives an overview of the competition, including final results, team strategies, and detailed descriptions the 18 homes.

  6. Entrepreneurial team cognition: A review

    NARCIS (Netherlands)

    de Mol, E.; Khapova, S.N.; Elfring, T.

    2015-01-01

    Entrepreneurial team scholars highlight the importance of studying entrepreneurial team cognition in gaining a better understanding of why some entrepreneurial teams are capable of developing teamwork leading to successful entrepreneurial outcomes while others are not. However, in the absence of a

  7. Managing Virtual Product Development team: A Review

    OpenAIRE

    Amir Mohammad Colabi; Behrouz Zarei

    2014-01-01

    Although there are many potential benefits associated with the use of virtual product development teams, exploiting these benefits requires an appropriate management. Managing virtual product development team is a critical issue as many of these teams fail to accomplish their goals. Review of previous literature shows that body of knowledge in managing virtual product development teams is fragmented and inconsistent. The main objective of this paper is to categorize the previous research on t...

  8. Review of child development teams.

    OpenAIRE

    Zahir, M; Bennett, S

    1994-01-01

    Since the Court report was published in 1976 there has been a consensus that the needs of children with disabilities are best met by child development teams. This study explored the structure, facilities, and organisational elements of child development teams operating in the South East Thames region by means of a structured interview with senior professionals involved with organising services for children with disabilities in 14 of 15 health districts in the region. Although all districts ha...

  9. Review of child development teams.

    Science.gov (United States)

    Zahir, M; Bennett, S

    1994-03-01

    Since the Court report was published in 1976 there has been a consensus that the needs of children with disabilities are best met by child development teams. This study explored the structure, facilities, and organisational elements of child development teams operating in the South East Thames region by means of a structured interview with senior professionals involved with organising services for children with disabilities in 14 of 15 health districts in the region. Although all districts had a designated child development team, not all core professionals were adequately represented and four of 14 districts had no child development centre. The quality of buildings and facilities was variable. Teams that did not have a physical base in the form of a centre had fewer staff in the service and poorer facilities. There is a need for further consensus work about broad guidelines on the requirements of child development teams. These will help to inform purchasing authorities about the needs of children with disabilities living in their districts.

  10. Managing Virtual Product Development team: A Review

    Directory of Open Access Journals (Sweden)

    Amir Mohammad Colabi

    2014-05-01

    Full Text Available Although there are many potential benefits associated with the use of virtual product development teams, exploiting these benefits requires an appropriate management. Managing virtual product development team is a critical issue as many of these teams fail to accomplish their goals. Review of previous literature shows that body of knowledge in managing virtual product development teams is fragmented and inconsistent. The main objective of this paper is to categorize the previous research on the subject of virtual product development team management in order to integrate the research into a thematic model and to enable recommendations for future research. So, this study reviews and summarizes empirical research in the field, also conceptual and qualitative papers, experiences, reports and explorative case studies. Results show that there are three fields of research in this area, including: Virtual production and Virtual team in Product Development, Managing virtual team in R&D[1] and product development, Managing global virtual product development teams. In order to organize previous studies in this area, a thematic map is proposed which shows the structure and sequence of research. Finally, a comprehensive discussion on the future directions in this field is proposed.

  11. High-Intensity Events in International Women's Team Handball Matches.

    Science.gov (United States)

    Luteberget, Live S; Spencer, Matt

    2017-01-01

    International women's team handball is a physically demanding sport and is intermittent in nature. The aim of the study was to profile high-intensity events (HIEs) in international women's team handball matches with regard to playing positions. Twenty female national-team handball players were equipped with inertial movement units (OptimEye S5, Catapult Sports, Australia) in 9 official international matches. Players were categorized in 4 different playing positions: backs, wings, pivots, and goalkeepers (GKs). PlayerLoad™, accelerations (Acc), changes of direction (CoD), decelerations (Dec), and the sum of the latter 3, HIEs, were extracted from raw-data files using the manufacturer's software. All Acc, Dec, CoD, and HIEs >2.5 m/s were included. Data were log-transformed and differences were standardized for interpretation of magnitudes and reported with effect-size statistics. Mean numbers of events were 0.7 ± 0.4 Acc/min, 2.3 ± 0.9 Dec/min, and 1.0 ± 0.4 CoD/min. Substantial differences between playing positions, ranging from small to very large, were found in the 3 parameters. Backs showed a most likely greater frequency for HIE/min (5.0 ± 1.1 HIE/min) than all other playing positions. Differences between playing positions were also apparent in PlayerLoad/min. HIEs in international women's team handball are position specific, and the overall intensity depends on the positional role within a team. Specific HIE and intensity profiles from match play provide useful information for a better understanding of the overall game demands and for each playing position.

  12. Enhancing Team Projects Using an Event-Triggered Knowledge Network

    Directory of Open Access Journals (Sweden)

    Xuelian Xiao

    2011-06-01

    Full Text Available Across the disciplines and levels of education, team projects are becoming an increasingly important tool for assessment. However, it is often difficult to make sure that work is fairly distributed, that a reasonable schedule is formed which does not leave everything for the last minute, and that individual students are fairly rewarded/penalized for their respective contributions. To solve these problems, we can model a project using events, rules, and workflows. Depending on the nature of an event, an appropriate rule can be triggered, which can subsequently initiate a workflow that will assign specific tasks to specific roles within the team. Events that occur over the course of the project, fired from a variety of sources, can lead to the derivation of new knowledge, and potentially alter the flow of the team’s activities. An integration of mobile devices into the system can insure that students are always aware of the current state of the system and their roles within it. At the conclusion and at all prior points in the project lifecycle, a comprehensive log of each student’s activities will be available and will greatly simplify the task of assigning fair and accurate grades. The result will be a more educational, more equitable, and far more engaging learning experience.

  13. Outcomes of classroom-based team training interventions for multiprofessional hospital staff. A systematic review

    DEFF Research Database (Denmark)

    Rabøl, Louise Isager; Østergaard, Doris; Mogensen, Torben

    2010-01-01

    Several studies show that communication errors in healthcare teams are frequent and can lead to adverse events. Team training has been suggested as a way to safer communication and has been implemented in healthcare as classroom-based or simulation-based team training or a combination of both....... The objective of this paper is to systematically review studies evaluating the outcomes of classroom-based multiprofessional team training for hospital staff....

  14. Strategies Used In Capture The Flag Events Contributing To Team Performance

    Science.gov (United States)

    2016-03-01

    unlimited STRATEGIES USED IN CAPTURE-THE-FLAG EVENTS CONTRIBUTING TO TEAM PERFORMANCE Wye Kede Jerel Yam Civilian, Ministry Of Defence, Singapore Applied...infrastructure against opposing teams, while also attempting to attack their opponents’ infrastructures. The popularity of CTF events has grown beyond educational ...services, teams also attempt to compromise their opponents’ vulnerable services to access a specific file on the target system (which is akin to capturing

  15. "Yes, we can!" review on team confidence in sports.

    Science.gov (United States)

    Fransen, Katrien; Mertens, Niels; Feltz, Deborah; Boen, Filip

    2017-08-01

    During the last decade, team confidence has received more and more attention in the sport psychology literature. Research has demonstrated that athletes who are more confident in their team's abilities exert more effort, set more challenging goals, are more resilient when facing adversities, and ultimately perform better. This article reviews the existing literature in order to provide more clarity in terms of the conceptualization and the operationalization of team confidence. We thereby distinguish between collective efficacy (i.e., process-oriented team confidence) and team outcome confidence (i.e., outcome-oriented team confidence). In addition, both the sources as well as the outcomes of team confidence will be discussed. Furthermore, we will go deeper into the dispersion of team confidence and we will evaluate the current guidelines on how to measure both types of team confidence. Building upon this base, the article then highlights interesting avenues for future research in order to further improve both our theoretical knowledge on team confidence and its application to the field. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Team Training: Literature Review and Annotated Bibliography

    Science.gov (United States)

    1981-05-01

    on tht. proe.r.s of sdaptatioo by the I’inut to eiutPrteltt ,hisrattrrstie. of til ativironluelt. 4.nipha•sitrig cognitiv as•ap.tts of trarniig...and contributed only to changes tn morale . It was recommended that team communications be r ’-iimized except when required informiation could bu secured...b) comnposition of group and * assignn;ent of memnibers, (c) briefing and preparation of personnel. (d) interest and morale , (e) safety precautions

  17. Multidisciplinary in-hospital teams improve patient outcomes: A review

    OpenAIRE

    Epstein, Nancy E.

    2014-01-01

    Background: The use of multidisciplinary in-hospital teams limits adverse events (AE), improves outcomes, and adds to patient and employee satisfaction. Methods: Acting like "well-oiled machines," multidisciplinary in-hospital teams include "staff" from different levels of the treatment pyramid (e.g. staff including nurses′ aids, surgical technicians, nurses, anesthesiologists, attending physicians, and others). Their enhanced teamwork counters the "silo effect" by enhancing communication...

  18. Operating Room Team Training with Simulation: A Systematic Review.

    Science.gov (United States)

    Robertson, Jamie M; Dias, Roger D; Yule, Steven; Smink, Douglas S

    2017-05-01

    Nontechnical skills (NTS) such as teamwork and communication play an important role in preventing adverse outcomes in the operating room (OR). Simulation-based OR team training focused on these skills provides an environment where team members can learn with and from one another. We sought to conduct a systematic review to identify simulation-based approaches to NTS training for surgical teams. We conducted a systematic search of PubMed, ERIC, and the Cochrane Database using keywords and MeSH terms for studies describing simulation-based training for OR teams, including members from surgery, anesthesia, and nursing in September 2016. Information on the simulations, participants, and NTS assessments were abstracted from the articles meeting our search criteria. We identified 10 published articles describing simulation-based OR team-training programs focused on NTS. The primary focus of these programs was on communication, teamwork, leadership, and situation awareness. Only four of the programs used a validated instrument to assess the NTS of the individuals or teams participating in the simulations. Simulation-based OR team-training programs provide opportunities for NTS development and reflection by participants. Future programs could benefit from involving the full range of disciplines and professions that compose an OR team, as well as increased use of validated assessment instruments.

  19. Solar Decathlon 2002: The Event in Review

    Energy Technology Data Exchange (ETDEWEB)

    Eastment, M.; Hayter, S.; Nahan, R.; Stafford, B.; Warner, C.; Hancock, E.; Howard, R.

    2004-06-01

    This book describes the first Solar Decathlon, a competition for college and university students, which took place on the National Mall in fall 2002. Student teams competed to design, build, and operate the most attractive, energy-efficient house that used only solar energy. In addition to the competition, the Solar Decathlon was also a public event. The book describes the events on the Mall, including technical details about the ten contests that comprised the competition and descriptions of the public's and the media's responses to the event. The book also provides information about the student teams' activities in the year and a half before they arrived to compete on the Mall.

  20. TEAM.

    Science.gov (United States)

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This document presents materials covering the television campaign against drunk driving called "TEAM" (Techniques for Effective Alcohol Management). It is noted that TEAM's purpose is to promote effective alcohol management in public facilities and other establishments that serve alcoholic beverages. TEAM sponsors are listed, including…

  1. Cross-functional Sourcing Teams – A Purchasing and Supply Management Literature Review

    DEFF Research Database (Denmark)

    Hansen, Anders Peder Lysholm

    2014-01-01

    This paper presents a systematic literature review of scientific papers on cross-functional sourcing teams in top journals within Purchasing and Supply Management. The review identifies four common research topics within the field; Determining factors of sourcing team success, Performance...... management/goals of sourcing teams, Behavior and decisions in sourcing teams and Involvement of purchasing in sourcing teams. Further research on Performance Management and how to create a holistic, teams based perspective in cross-functional sourcing teams is suggested....

  2. The external leadership of self-managing teams: intervening in the context of novel and disruptive events.

    Science.gov (United States)

    Morgeson, Frederick P

    2005-05-01

    Relatively little empirical research has been conducted on external leaders of self-managing teams. The integration of functional leadership theory with research on team routines suggests that leaders can intervene in teams in several different ways, and the effectiveness of this intervention depends on the nature of the events the team encounters. External team leaders from 3 organizations first described a series of events (N=117), and leaders and team members then completed surveys to quantitatively describe the events. Results indicated that leader preparation and supportive coaching were positively related to team perceptions of leader effectiveness, with preparation becoming more strongly related to effectiveness as event novelty increased. More active leader intervention activities (active coaching and sense making) were negatively related to satisfaction with leadership yet were positively related to effectiveness as events became more disruptive.

  3. Nursing team stress in the perioperative period: an integrative review

    Directory of Open Access Journals (Sweden)

    Dafne Eva Corrêa Brandão

    2013-09-01

    Full Text Available This integrative review aimed at analyzing evidences available in literature regarding stress levels in nursing teams during the perioperative period. Primary studies were searched in the following databases: PubMed, CINAHL and LILACS. Included studies were grouped into the following thematic categories: stress level in the workplace and stress factors (n=8 and stress coping strategies used by the nursing staff (n=6. Evidence suggests that stress in the workplace worsens the health of the nursing team, provoking undesirable effects both in the professional and personal lives of these professionals. The assessment of working conditions to identify the main stressing factors and the implementation of individual and organizational measures to reduce nursing teams stress may increase productivity and workers’ satisfaction, improving the assistance quality offered to surgical patients.

  4. Report of the Space Shuttle Management Independent Review Team

    Science.gov (United States)

    1995-01-01

    At the request of the NASA Administrator a team was formed to review the Space Shuttle Program and propose a new management system that could significantly reduce operating costs. Composed of a group of people with broad and extensive experience in spaceflight and related areas, the team received briefings from the NASA organizations and most of the supporting contractors involved in the Shuttle Program. In addition, a number of chief executives from the supporting contractors provided advice and suggestions. The team found that the present management system has functioned reasonably well despite its diffuse structure. The team also determined that the shuttle has become a mature and reliable system, and--in terms of a manned rocket-propelled space launch system--is about as safe as today's technology will provide. In addition, NASA has reduced shuttle operating costs by about 25 percent over the past 3 years. The program, however, remains in a quasi-development mode and yearly costs remain higher than required. Given the current NASA-contractor structure and incentives, it is difficult to establish cost reduction as a primary goal and implement changes to achieve efficiencies. As a result, the team sought to create a management structure and associated environment that enables and motivates the Program to further reduce operational costs. Accordingly, the review team concluded that the NASA Space Shuttle Program should (1) establish a clear set of program goals, placing a greater emphasis on cost-efficient operations and user-friendly payload integration; (2) redefine the management structure, separating development and operations and disengaging NASA from the daily operation of the space shuttle; and (3) provide the necessary environment and conditions within the program to pursue these goals.

  5. Leadership training in health care action teams: a systematic review.

    Science.gov (United States)

    Rosenman, Elizabeth D; Shandro, Jamie R; Ilgen, Jonathan S; Harper, Amy L; Fernandez, Rosemarie

    2014-09-01

    To identify and describe the design, implementation, and evidence of effectiveness of leadership training interventions for health care action (HCA) teams, defined as interdisciplinary teams whose members coordinate their actions in time-pressured, unstable situations. The authors conducted a systematic search of the PubMed/MEDLINE, CINAHL, ERIC, EMBASE, PsycINFO, and Web of Science databases, key journals, and review articles published through March 2012. They identified peer-reviewed English-language articles describing leadership training interventions targeting HCA teams, at all levels of training and across all health care professions. Reviewers, working in duplicate, abstracted training characteristics and outcome data. Methodological quality was evaluated using the Medical Education Research Study Quality Instrument (MERSQI). Of the 52 included studies, 5 (10%) focused primarily on leadership training, whereas the remainder included leadership training as part of a larger teamwork curriculum. Few studies reported using a team leadership model (2; 4%) or a theoretical framework (9; 17%) to support their curricular design. Only 15 studies (29%) specified the leadership behaviors targeted by training. Forty-five studies (87%) reported an assessment component; of those, 31 (69%) provided objective outcome measures including assessment of knowledge or skills (21; 47%), behavior change (8; 18%), and patient- or system-level metrics (8; 18%). The mean MERSQI score was 11.4 (SD 2.9). Leadership training targeting HCA teams has become more prevalent. Determining best practices in leadership training is confounded by variability in leadership definitions, absence of supporting frameworks, and a paucity of robust assessments.

  6. 7 CFR 4290.360 - Initial review of Applicant's management team's qualifications.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Initial review of Applicant's management team's...'s management team's qualifications. The Secretary will review the information submitted by the Applicant concerning the qualifications of the Applicant's management team to determine in his or her sole...

  7. Reliability of team-based self-monitoring in critical events: a pilot study.

    Science.gov (United States)

    Stocker, Martin; Menadue, Lynda; Kakat, Suzan; De Costa, Kumi; Combes, Julie; Banya, Winston; Lane, Mary; Desai, Ajay; Burmester, Margarita

    2013-12-01

    Teamwork is a critical component during critical events. Assessment is mandatory for remediation and to target training programmes for observed performance gaps. The primary purpose was to test the feasibility of team-based self-monitoring of crisis resource management with a validated teamwork assessment tool. A secondary purpose was to assess item-specific reliability and content validity in order to develop a modified context-optimised assessment tool.We conducted a prospective, single-centre study to assess team-based self-monitoring of teamwork after in-situ inter-professional simulated critical events by comparison with an assessment by observers. The Mayo High Performance Teamwork Scale (MHPTS) was used as the assessment tool with evaluation of internal consistency, item-specific consensus estimates for agreement between participating teams and observers, and content validity. 105 participants and 58 observers completed the MHPTS after a total of 16 simulated critical events over 8 months. Summative internal consistency of the MHPTS calculated as Cronbach's alpha was acceptable with 0.712 for observers and 0.710 for participants. Overall consensus estimates for dichotomous data (agreement/non-agreement) was 0.62 (Cohen's kappa; IQ-range 0.31-0.87). 6/16 items had excellent (kappa > 0.8) and 3/16 good reliability (kappa > 0.6). Short questions concerning easy to observe behaviours were more likely to be reliable. The MHPTS was modified using a threshold for good reliability of kappa > 0.6. The result is a 9 item self-assessment tool (TeamMonitor) with a calculated median kappa of 0.86 (IQ-range: 0.67-1.0) and good content validity. Team-based self-monitoring with the MHPTS to assess team performance during simulated critical events is feasible. A context-based modification of the tool is achievable with good internal consistency and content validity. Further studies are needed to investigate if team-based self-monitoring may be used as part of a

  8. What is the impact of multidisciplinary team simulation training on team performance and efficiency of patient care? An integrative review.

    Science.gov (United States)

    Murphy, Margaret; Curtis, Kate; McCloughen, Andrea

    2016-02-01

    In hospital emergencies require a structured team approach to facilitate simultaneous input into immediate resuscitation, stabilisation and prioritisation of care. Efforts to improve teamwork in the health care context include multidisciplinary simulation-based resuscitation team training, yet there is limited evidence demonstrating the value of these programmes.(1) We aimed to determine the current state of knowledge about the key components and impacts of multidisciplinary simulation-based resuscitation team training by conducting an integrative review of the literature. A systematic search using electronic (three databases) and hand searching methods for primary research published between 1980 and 2014 was undertaken; followed by a rigorous screening and quality appraisal process. The included articles were assessed for similarities and differences; the content was grouped and synthesised to form three main categories of findings. Eleven primary research articles representing a variety of simulation-based resuscitation team training were included. Five studies involved trauma teams; two described resuscitation teams in the context of intensive care and operating theatres and one focused on the anaesthetic team. Simulation is an effective method to train resuscitation teams in the management of crisis scenarios and has the potential to improve team performance in the areas of communication, teamwork and leadership. Team training improves the performance of the resuscitation team in simulated emergency scenarios. However, the transferability of educational outcomes to the clinical setting needs to be more clearly demonstrated. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  9. Creating Value through Virtual Teams: A Current Literature Review

    Directory of Open Access Journals (Sweden)

    Akemi Takeoka Chatfield

    2014-11-01

    Full Text Available Globally, virtual teams (VT as ICT-enabled emergent network organisation forms have gained international validity by innovative organisations, with a corresponding surge of interest in understanding how organisations can leverage VT to create business value. Despite growing deliberations in VT literature on managing VT, tasks and outcomes, however, creating business value through VT remains an unresolved theoretical and pragmatic conundrum. A review of prior relevant literature is essential to advancing knowledge. The paucity of published review articles seems to have impeded the field’s accumulation of VT knowledge. This research, therefore, reviews the current literature on case studies of VT to address the question: What are organisational challenges in creating business value through VT in the organisation? The key challenges found in the literature are effective communication, knowledge sharing, trust, and interpersonal skills in the new virtual boundary-less environment. Drawing on the IT business value model, we also discuss their resource-based implications.

  10. Multidisciplinary team simulation for the operating theatre: a review of the literature.

    Science.gov (United States)

    Tan, Shaw Boon; Pena, Guilherme; Altree, Meryl; Maddern, Guy J

    2014-01-01

    Analyses of adverse events inside the operating theatre has demonstrated that many errors are caused by failure in non-technical skills and teamwork. While simulation has been used successfully for teaching and improving technical skills, more recently, multidisciplinary simulation has been used for training team skills. We hypothesized that this type of training is feasible and improves team skills in the operating theatre. A systematic search of the literature for studies describing true multidisciplinary operating theatre team simulation was conducted in November and December 2012. We looked at the characteristics and outcomes of the team simulation programmes. 1636 articles were initially retrieved. Utilizing a stepwise evaluation process, 26 articles were included in the review. The studies reveal that multidisciplinary operating theatre simulation has been used to provide training in technical and non-technical skills, to help implement new techniques and technologies, and to identify latent weaknesses within a health system. Most of the studies included are descriptions of training programmes with a low level of evidence. No randomized control trial was identified. Participants' reactions to the training programme were positive in all studies; however, none of them could objectively demonstrate that skills acquired from simulation are transferred to the operating theatre or show a demonstrable benefit in patient outcomes. Multidisciplinary operating room team simulation is feasible and widely accepted by participants. More studies are required to assess the impact of this type of training on operative performance and patient safety. © 2013 Royal Australasian College of Surgeons.

  11. Impact of crisis resource management simulation-based training for interprofessional and interdisciplinary teams: A systematic review.

    Science.gov (United States)

    Fung, Lillia; Boet, Sylvain; Bould, M Dylan; Qosa, Haytham; Perrier, Laure; Tricco, Andrea; Tavares, Walter; Reeves, Scott

    2015-01-01

    Crisis resource management (CRM) abilities are important for different healthcare providers to effectively manage critical clinical events. This study aims to review the effectiveness of simulation-based CRM training for interprofessional and interdisciplinary teams compared to other instructional methods (e.g., didactics). Interprofessional teams are composed of several professions (e.g., nurse, physician, midwife) while interdisciplinary teams are composed of several disciplines from the same profession (e.g., cardiologist, anaesthesiologist, orthopaedist). Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC were searched using terms related to CRM, crisis management, crew resource management, teamwork, and simulation. Trials comparing simulation-based CRM team training versus any other methods of education were included. The educational interventions involved interprofessional or interdisciplinary healthcare teams. The initial search identified 7456 publications; 12 studies were included. Simulation-based CRM team training was associated with significant improvements in CRM skill acquisition in all but two studies when compared to didactic case-based CRM training or simulation without CRM training. Of the 12 included studies, one showed significant improvements in team behaviours in the workplace, while two studies demonstrated sustained reductions in adverse patient outcomes after a single simulation-based CRM team intervention. In conclusion, CRM simulation-based training for interprofessional and interdisciplinary teams show promise in teaching CRM in the simulator when compared to didactic case-based CRM education or simulation without CRM teaching. More research, however, is required to demonstrate transfer of learning to workplaces and potential impact on patient outcomes.

  12. Selected Success Factors of Virtual Teams: Literature Review and Suggestions for Future Research

    Directory of Open Access Journals (Sweden)

    Szewc Justyna

    2014-10-01

    Full Text Available The aim of this paper is to extend the knowledge about virtual teams and above all to stress the differences between face-to-face and virtual teams as well as to define its chosen success factors. This paper is based on an extended literature review of virtual teams. The author describes virtual teams, reasons for their implementation and four factors that are prerequisites for team success.

  13. Outcomes of classroom-based team training interventions for multiprofessional hospital staff. A systematic review

    DEFF Research Database (Denmark)

    Rabøl, Louise Isager; Østergaard, Doris; Mogensen, Torben

    2010-01-01

    Several studies show that communication errors in healthcare teams are frequent and can lead to adverse events. Team training has been suggested as a way to safer communication and has been implemented in healthcare as classroom-based or simulation-based team training or a combination of both...

  14. Embracing the Devil: An Analysis of the Formal Adoption of Red Teaming in the Security Planning for Major Events

    Science.gov (United States)

    2017-03-01

    Inaugural Ceremonies JFCOM Joint Forces Command MC Millennium Challenge MERT Major Event Red Team NFL National Football League NORAD North...political conventions, State of the Union events, world leader summits, such as the annual United Nations General Assembly, and the National Football ...and explosives successfully past Transportation Security Administration screeners in 67 out 70 separate attempts.60 Similarly, in the cyber-world

  15. Organization of the French emergency teams in the event of a radiological accident

    Energy Technology Data Exchange (ETDEWEB)

    Dumon, F. [Faculte de Pharmacie, 13 - Marseille (France); Pizzocaro, Y. [CSP, Risques Technologiques, 83 - Toulon (France)

    2001-07-01

    Nowadays, the intervention in ionizing environment is increasingly probable. It is still rare, but with the development of the nuclear programme of electricity production which was held in the french past and the significant rise in the use of the radioelements, as well in the medical field as industrial, the radioactive risk cannot be neglected. Technical and human resources, brought by mobile emergency teams called CMIR, were thus implemented to ensure either the safety of only hard-working exposed to the ionizing radiations, but also that of the population. In France, the organization of the public authorities in the event of nuclear accident, fixed by Directives of the Prime Minister which relate to nuclear safety, protection against radiation, the law and order and the civil safety, is described in Particular Plan for Intervention (PPI). (author)

  16. Adverse Events of Acupuncture: A Systematic Review of Case Reports

    Science.gov (United States)

    Xu, Shifen; Wang, Lizhen; Cooper, Emily; Zhang, Ming; Manheimer, Eric; Berman, Brian; Shen, Xueyong; Lao, Lixing

    2013-01-01

    Acupuncture, moxibustion, and cupping, important in traditional Eastern medicine, are increasingly used in the West. Their widening acceptance demands continual safety assessment. This review, a sequel to one our team published 10 years ago, is an evaluation of the frequency and severity of adverse events (AEs) reported for acupuncture, moxibustion, and cupping between 2000 and 2011. Relevant English-language reports in six databases were identified and assessed by two reviewers. During this 12-year period, 117 reports of 308 AEs from 25 countries and regions were associated with acupuncture (294 cases), moxibustion (4 cases), or cupping (10 cases). Country of occurrence, patient's sex and age, and outcome were extracted. Infections, mycobacterial, staphylococcal, and others, were the main complication of acupuncture. In the previous review, we found the main source of infection to be hepatitis, caused by reusable needles. In this review, we found the majority of infections to be bacterial, caused by skin contact at acupoint sites; we found no cases of hepatitis. Although the route of infection had changed, infections were still the major complication of acupuncture. Clearly, guidelines such as Clean Needle Technique must be followed in order to minimize acupuncture AEs. PMID:23573135

  17. Team-Based Care with Pharmacists to Improve Blood Pressure: a Review of Recent Literature.

    Science.gov (United States)

    Kennelty, Korey A; Polgreen, Linnea A; Carter, Barry L

    2018-01-18

    We review studies published since 2014 that examined team-based care strategies and involved pharmacists to improve blood pressure (BP). We then discuss opportunities and challenges to sustainment of team-based care models in primary care clinics. Multiple studies presented in this review have demonstrated that team-based care including pharmacists can improve BP management. Studies highlighted the cost-effectiveness of a team-based pharmacy intervention for BP control in primary care clinics. Little information was found on factors influencing sustainability of team-based care interventions to improve BP control. Future work is needed to determine the best populations to target with team-based BP programs and how to implement team-based approaches utilizing pharmacists in diverse clinical settings. Future studies need to not only identify unmet clinical needs but also address reimbursement issues and stakeholder engagement that may impact sustainment of team-based care interventions.

  18. US pharmacists' effect as team members on patient care: systematic review and meta-analyses.

    Science.gov (United States)

    Chisholm-Burns, Marie A; Kim Lee, Jeannie; Spivey, Christina A; Slack, Marion; Herrier, Richard N; Hall-Lipsy, Elizabeth; Graff Zivin, Joshua; Abraham, Ivo; Palmer, John; Martin, Jennifer R; Kramer, Sandra S; Wunz, Timothy

    2010-10-01

    One approach postulated to improve the provision of health care is effective utilization of team-based care including pharmacists. The objective of this study was to conduct a comprehensive systematic review with focused meta-analyses to examine the effects of pharmacist-provided direct patient care on therapeutic, safety, and humanistic outcomes. The following databases were searched from inception to January 2009: NLM PubMed; Ovid/MEDLINE; ABI/INFORM; Health Business Fulltext Elite; Academic Search Complete; International Pharmaceutical Abstracts; PsycINFO; Cochrane Database of Systematic Reviews; National Guideline Clearinghouse; Database of Abstracts of Reviews of Effects; ClinicalTrials.gov; LexisNexis Academic Universe; and Google Scholar. Studies selected included those reporting pharmacist-provided care, comparison groups, and patient-related outcomes. Of these, 56,573 citations were considered. Data were extracted by multidisciplinary study review teams. Variables examined included study characteristics, pharmacists' interventions/services, patient characteristics, and study outcomes. Data for meta-analyses were extracted from randomized controlled trials meeting meta-analysis criteria. A total of 298 studies were included. Favorable results were found in therapeutic and safety outcomes, and meta-analyses conducted for hemoglobin A1c, LDL cholesterol, blood pressure, and adverse drug events were significant (P < 0.05), favoring pharmacists' direct patient care over comparative services. Results for humanistic outcomes were favorable with variability. Medication adherence, patient knowledge, and quality of life-general health meta-analyses were significant (P < 0.05), favoring pharmacists' direct patient care. Pharmacist-provided direct patient care has favorable effects across various patient outcomes, health care settings, and disease states. Incorporating pharmacists as health care team members in direct patient care is a viable solution to help improve

  19. External Peer Review Report on the Defense Contract Management Agency Office of Independent Assessment Internal Review Team

    Science.gov (United States)

    2015-11-02

    External Peer Review Report on the Defense Contract Management Agency Office of Independent Assessment Internal Review Team N O V E M B E R 2 , 2 0 1 5...MANAGEMENT AGENCY SUBJECT: External Peer Review Report on the Defense Contract Management Agency Office of Independent Assessment Internal Review Team...Report No. DODIG-2016-007) Attached is the External Peer Review Report on the Defense Contract Management Agency Office of Independent Assessment

  20. Evaluative research on palliative support teams: a literature review.

    NARCIS (Netherlands)

    Francke, A.L.

    2000-01-01

    Sixteen studies on the effectiveness of palliative support teams were analyzed. It was established that in most cases uncontrolled designs with repeated measurements were used. The assessment methods varied strongly. However, the Support Team Assessment Schedule was the most frequently used

  1. Team science as interprofessional collaborative research practice: a systematic review of the science of team science literature

    Science.gov (United States)

    Little, Meg M; St Hill, Catherine A; Ware, Kenric B; Swanoski, Michael T; Chapman, Scott A; Lutfiyya, M Nawal; Cerra, Frank B

    2017-01-01

    The National Institute of Health's concept of team science is a means of addressing complex clinical problems by applying conceptual and methodological approaches from multiple disciplines and health professions. The ultimate goal is the improved quality of care of patients with an emphasis on better population health outcomes. Collaborative research practice occurs when researchers from >1 health-related profession engage in scientific inquiry to jointly create and disseminate new knowledge to clinical and research health professionals in order to provide the highest quality of patient care to improve population health outcomes. Training of clinicians and researchers is necessary to produce clinically relevant evidence upon which to base patient care for disease management and empirically guided team-based patient care. In this study, we hypothesized that team science is an example of effective and impactful interprofessional collaborative research practice. To assess this hypothesis, we examined the contemporary literature on the science of team science (SciTS) produced in the past 10 years (2005–2015) and related the SciTS to the overall field of interprofessional collaborative practice, of which collaborative research practice is a subset. A modified preferred reporting items for systematic reviews and meta-analyses (PRISMA) approach was employed to analyze the SciTS literature in light of the general question: Is team science an example of interprofessional collaborative research practice? After completing a systematic review of the SciTS literature, the posed hypothesis was accepted, concluding that team science is a dimension of interprofessional collaborative practice. PMID:27619555

  2. Transport-related Adverse Events in Critically-ill Children: The Role of a Dedicated Transport Team.

    Science.gov (United States)

    Prabhudesai, Sumant; Kasala, Mohanbabu; Manwani, Nitin; Krupanandan, Ravikumar; Ramachandran, Bala

    2017-11-15

    To compare the frequency of transport-related adverse events in children during specialized, non-specialized or unassisted transports. Patients were grouped based on transport team involved - specialized (Group-1); non-specialized (Group-2); unassisted transport (Group-3). Demographics, events during transport and condition on arrival were recorded. Group-1 children had a lower incidence of adverse events compared to Group-2 and Group-3 (4.3%, 82.6% and 85.4% respectively; P<0.001). At arrival, children in Group-1 had a lower incidence of respiratory distress and airway compromise (P< 0.001). Transport of critically ill children by a specialized transport team is associated with fewer transport-related adverse events.

  3. Strengths and weaknesses of working with the Global Trigger Tool method for retrospective record review: focus group interviews with team members.

    Science.gov (United States)

    Schildmeijer, Kristina; Nilsson, Lena; Perk, Joep; Arestedt, Kristofer; Nilsson, Gunilla

    2013-09-24

    The aim was to describe the strengths and weaknesses, from team member perspectives, of working with the Global Trigger Tool (GTT) method of retrospective record review to identify adverse events causing patient harm. A qualitative, descriptive approach with focus group interviews using content analysis. 5 Swedish hospitals in 2011. 5 GTT teams, with 5 physicians and 11 registered nurses. 5 focus group interviews were carried out with the five teams. Interviews were taped and transcribed verbatim. 8 categories emerged relating to the strengths and weaknesses of the GTT method. The categories found were: Usefulness of the GTT, Application of the GTT, Triggers, Preventability of harm, Team composition, Team tasks, Team members' knowledge development and Documentation. Gradually, changes in the methodology were made by the teams, for example, the teams reported how the registered nurses divided up the charts into two sets, each being read respectively. The teams described the method as important and well functioning. Not only the most important, but also the most difficult, was the task of bringing the results back to the clinic. The teams found it easier to discuss findings at their own clinics. The GTT method functions well for identifying adverse events and is strengthened by its adaptability to different specialties. However, small, gradual methodological changes together with continuingly developed expertise and adaption to looking at harm from a patient's perspective may contribute to large differences in assessment over time.

  4. Identifying characteristics and practices of multidisciplinary team reviews for patients with severe mental illness: a systematic review.

    Science.gov (United States)

    Woody, Charlotte A; Baxter, Amanda J; Harris, Meredith G; Siskind, Dan J; Whiteford, Harvey A

    2018-02-01

    Multidisciplinary teams in mental health receive limited guidance, leading to inconsistent practices. We undertook a systematic review of the characteristics and practices of multidisciplinary team reviews for patients with severe mental illness or in relevant mental health service settings. Sources published since 2000 were located via academic database and web searches. Results were synthesised narratively. A total of 14 sources were analysed. Important characteristics and practices identified included routine monitoring and evaluation, good communication, equality between team members, and clear documentation practices. Success factors included defined leadership and clear team goals. Four sources described considerations for patients with complex clinical needs, including allocating sufficient time for discussion, maintaining connections with community providers, and ensuring culturally sensitive practices. No single best practice model was found, due to variations in team caseload, casemix, and resourcing levels. However, key ingredients for success were proposed. Sources were mostly descriptive; there remains a lack of evidence-based guidance regarding multidisciplinary team review characteristics and practices.

  5. Team-Based Professional Development Interventions in Higher Education: A Systematic Review.

    Science.gov (United States)

    Gast, Inken; Schildkamp, Kim; van der Veen, Jan T

    2017-08-01

    Most professional development activities focus on individual teachers, such as mentoring or the use of portfolios. However, new developments in higher education require teachers to work together in teams more often. Due to these changes, there is a growing need for professional development activities focusing on teams. Therefore, this review study was conducted to provide an overview of what is known about professional development in teams in the context of higher education. A total of 18 articles were reviewed that describe the effects of professional development in teams on teacher attitudes and teacher learning. Furthermore, several factors that can either hinder or support professional development in teams are identified at the individual teacher level, at the team level, and also at the organizational level.

  6. Six years' experience with interdisciplinary review teams in health technology assessment in Norway.

    Science.gov (United States)

    Håheim, Lise Lund; Mørland, Berit; Wisløff, Torbjørn Fosen; Lyngstadaas, Anita

    2005-01-01

    The aim of this study was to evaluate the use of interdisciplinary review teams that have been the main and central work form in making health technology assessments at the Norwegian Centre for Health Technology Assessment. Evaluation questionnaires were sent to all 112 participants in the 17 review teams for the period of January 1998 to June 2003 after completion of the literature assessment. Questions were on the theme/mandate of the assessments, composition of the review team, organization of the work, the working method, and update of the report. The teams ranged from 4 to 14 persons regarded as opinion leaders in their field. The project periods lasted from 4 to 33 months. In all, fifty-five participants gave fifty-eight responses (51.8 percent) to the questionnaires. A total of 83 percent thought the theme was well argued, and 62 percent thought the mandate for the assessments was sufficiently clear. Approximately 80 percent were positive to the composition of the review team. In all, 22 percent expressed that the work method was too extensive and 43 percent wanted more tuition. General comments were that the working method gave competence in assessing medical literature, relevant professional training, and tuition in a working method that ensured the legitimacy of their work. The review team participants were satisfied with most aspects of the work. The Norwegian Centre for Health Technology Assessment will continue using interdisciplinary review teams in making health technology assessments.

  7. Microdynamics in diverse teams : A review and integration of the diversity and stereotyping literatures

    NARCIS (Netherlands)

    van Dijk, J.; Meyer, B.; van Engen, M.L.; Loyd, D.L.

    2017-01-01

    Research on the consequences of diversity in teams continues to produce inconsistent results. We review the recent developments in diversity research and identify two shortcomings. First, an understanding of the microdynamics affecting processes and outcomes in diverse teams is lacking. Second,

  8. Team-Based Professional Development Interventions in Higher Education: A Systematic Review

    Science.gov (United States)

    Gast, Inken; Schildkamp, Kim; van der Veen, Jan T.

    2017-01-01

    Most professional development activities focus on individual teachers, such as mentoring or the use of portfolios. However, new developments in higher education require teachers to work together in teams more often. Due to these changes, there is a growing need for professional development activities focusing on teams. Therefore, this review study…

  9. Team Modelling: Review of Experimental Scenarios and Computational Models

    Science.gov (United States)

    2006-09-01

    designed to be) Yes Yes No Yes (Model individuals, or sub-teams - groups of individuals.) 19 C3TRACE* (Command, Control, and Communicatio ...radar sensors, satellites, c2 structures, jammers, communicatio ns networks and devices, and fire support) Depends (EADSIM normally models at

  10. Can team-based care improve patient satisfaction? A systematic review of randomized controlled trials

    National Research Council Canada - National Science Library

    Wen, Jin; Schulman, Kevin A

    2014-01-01

    .... The effectiveness of these approaches on patient outcomes has not been well documented. This paper reports a systematic review of the relationship between team-based care and patient satisfaction...

  11. Interprofessional Team Training at the Prelicensure Level: A Review of the Literature.

    Science.gov (United States)

    Nelson, Sioban; White, Catriona F; Hodges, Brian D; Tassone, Maria

    2017-05-01

    The authors undertook a descriptive analysis review to gain a better understanding of the various approaches to and outcomes of team training initiatives in prelicensure curricula since 2000. In July and August 2014, the authors searched the MEDLINE, PsycINFO, Embase, Business Source Premier, and CINAHL databases to identify evaluative studies of team training programs' effects on the team knowledge, communication, and skills of prelicensure students published from 2000 to August 2014. The authors identified 2,568 articles, with 17 studies meeting the selection criteria for full text review. The most common study designs were single-group, pre/posttest studies (n = 7), followed by randomized controlled or comparison trials (n = 6). The Situation, Background, Assessment, Recommendation communication tool (n = 5); crisis resource management principles (n = 6); and high-fidelity simulation (n = 4) were the most common curriculum bases used. Over half of the studies (n = 9) performed training with students from more than one health professions program. All but three used team performance assessments, with most (n = 8) using observed behavior checklists created for that specific study. The majority of studies (n = 16) found improvements in team knowledge, communication, and skills. Team training appears effective in improving team knowledge, communication, and skills in prelicensure learners. Continued exploration of the best method of team training is necessary to determine the most effective way to move forward in prelicensure interprofessional team education.

  12. Team Composition Issues for Future Space Exploration: A Review and Directions for Future Research.

    Science.gov (United States)

    Bell, Suzanne T; Brown, Shanique G; Abben, Daniel R; Outland, Neal B

    2015-06-01

    Future space exploration, such as a mission to Mars, will require space crews to live and work in extreme environments unlike those of previous space missions. Extreme conditions such as prolonged confinement, isolation, and expected communication time delays will require that crews have a higher level of interpersonal compatibility and be able to work autonomously, adapting to unforeseen challenges in order to ensure mission success. Team composition, or the configuration of member attributes, is an important consideration for maximizing crewmember well-being and team performance. We conducted an extensive search to find articles about team composition in long-distance space exploration (LDSE)-analogue environments, including a search of databases, specific relevant journals, and by contacting authors who publish in the area. We review the team composition research conducted in analogue environments in terms of two paths through which team composition is likely to be related to LDSE mission success, namely by 1) affecting social integration, and 2) the team processes and emergent states related to team task completion. Suggestions for future research are summarized as: 1) the need to identify ways to foster unit-level social integration within diverse crews; 2) the missed opportunity to use team composition variables as a way to improve team processes, emergent states, and task completion; and 3) the importance of disentangling the effect of specific team composition variables to determine the traits (e.g., personality, values) that are associated with particular risks (e.g., subgrouping) to performance.

  13. SOLIDS PRECIPITATION EVENT IN MCU CAUSAL ANALYSIS AND RECOMMENDATIONS FROM SOLIDS RECOVERY TEAM

    Energy Technology Data Exchange (ETDEWEB)

    Garrison, A.; Aponte, C.

    2014-08-15

    A process upset occurred in the Modular Caustic-Side Solvent Extraction Unit (MCU) facility on April 6th, 2014. During recovery efforts, a significant amount of solids were found in the Salt Solution Feed Tank (SSFT), Salt Solution Receipt Tanks (SSRTs), two extraction contactors, and scrub contactors. The solids were identified by Savannah River National Laboratory (SRNL) as primarily sodium oxalate and sodium alumina silicate (NAS) with the presence of some aluminum hydroxide. NAS solids have been present in the SSFT since simulant runs during cold chemical startup of MCU in 2007, and have not hindered operations since that time. During the process upset in April 2014, the oxalate solids partially blocked the aqueous outlet of the extraction contactors, causing salt solution to exit through the contactor organic outlet to the scrub contactors with the organic phase. This salt solution overwhelmed the scrub contactors and passed with the organic phase to the strip section of MCU. The partially reversed flow of salt solution resulted in a Strip Effluent (SE) stream that was high in Isopar™ L, pH and sodium. The primary cause of the excessive solids accumulation in the SSRTs and SSFT at MCU is attributed to an increase in the frequency of oxalic acid cleaning of the 512-S primary filter. Agitation in the SSRTs at MCU in response to cold weather likely provided the primary mechanism to transfer the solids to the contactors. Sources of the sodium oxalate solids are attributed to the oxalic acid cleaning solution used to clean the primary filter at the Actinide Removal Process (ARP) filtration at 512-S, as well as precipitation from the salt batch feed, which is at or near oxalate saturation. The Solids Recovery Team was formed to determine the cause of the solids formation and develop recommendations to prevent or mitigate this event in the future. A total of 53 recommendations were generated. These recommendations were organized into 4 focus areas: • Improve

  14. A systematic review of team formulation in clinical psychology practice: Definition, implementation, and outcomes.

    Science.gov (United States)

    Geach, Nicole; Moghaddam, Nima G; De Boos, Danielle

    2017-10-03

    Team formulation is promoted by professional practice guidelines for clinical psychologists. However, it is unclear whether team formulation is understood/implemented in consistent ways - or whether there is outcome evidence to support the promotion of this practice. This systematic review aimed to (1) synthesize how team formulation practice is defined and implemented by practitioner psychologists and (2) analyse the range of team formulation outcomes in the peer-reviewed literature. Seven electronic bibliographic databases were searched in June 2016. Eleven articles met inclusion criteria and were quality assessed. Extracted data were synthesized using content analysis. Descriptions of team formulation revealed three main forms of instantiation: (1) a structured, consultation approach; (2) semi-structured, reflective practice meetings; and (3) unstructured/informal sharing of ideas through routine interactions. Outcome evidence linked team formulation to a range of outcomes for staff teams and service users, including some negative outcomes. Quality appraisal identified significant issues with evaluation methods; such that, overall, outcomes were not well-supported. There is weak evidence to support the claimed beneficial outcomes of team formulation in practice. There is a need for greater specification and standardization of 'team formulation' practices, to enable a clearer understanding of any relationships with outcomes and implications for best-practice implementations. Under the umbrella term of 'team formulation', three types of practice are reported: (1) highly structured consultation; (2) reflective practice meetings; and (3) informal sharing of ideas. Outcomes linked to team formulation, including some negative outcomes, were not well evidenced. Research using robust study designs is required to investigate the process and outcomes of team formulation practice. © 2017 The British Psychological Society.

  15. Performance factors in women's team handball: physical and physiological aspects--a review.

    Science.gov (United States)

    Manchado, Carmen; Tortosa-Martínez, Juan; Vila, Helena; Ferragut, Carmen; Platen, Petra

    2013-06-01

    Team handball is an Olympic sport played professionally in many European countries. Nevertheless, a scientific knowledge regarding women's elite team handball demands is limited. Thus, the purpose of this article was to review a series of studies (n = 33) on physical characteristics, physiological attributes, physical attributes, throwing velocity, and on-court performances of women's team handball players. Such empirical and practical information is essential to design and implement successful short-term and long-term training programs for women's team handball players. Our review revealed that (a) players that have a higher skill level are taller and have a higher fat-free mass; (b) players who are more aerobically resistant are at an advantage in international level women team handball; (c) strength and power exercises should be emphasized in conditioning programs, because they are associated with both sprint performance and throwing velocity; (d) speed drills should also be implemented in conditioning programs but after a decrease in physical training volume; (e) a time-motion analysis is an effective method of quantifying the demands of team handball and provides a conceptual framework for the specific physical preparation of players. According to our results, there are only few studies on on-court performance and time-motion analysis for women's team handball players, especially concerning acceleration profiles. More studies are needed to examine the effectiveness of different training programs of women's team handball players' physiological and physical attributes.

  16. a model for quantity estimation for multi-coded team events

    African Journals Online (AJOL)

    Complete preparation requires the choice of medications in sufficient quantity to cater .... difficult. 1. The team physicians have to be prepared to manage any .... Aspirin. 300 mg. 500. 26. 5. 0.16. Docdol tabs. Paracetamol, codeine. 500 mg; 10 mg. 30. 18. 60. 0.1. 1. Myprodol caps. Paracetamol, ibuprofen, codeine. 250 mg ...

  17. Optimising the Efficacy of Hybrid Academic Teams: Lessons from a Systematic Review Process

    Science.gov (United States)

    Lake, Warren; Wallin, Margie; Boyd, Bill; Woolcott, Geoff; Markopoulos, Christos; Boyd, Wendy; Foster, Alan

    2018-01-01

    Undertaking a systematic review can have many benefits, beyond any theoretical or conceptual discoveries pertaining to the underlying research question. This paper explores the value of utilising a hybrid academic team when undertaking the systematic review process, and shares a range of practical strategies. The paper also comments on how such a…

  18. Is there a role for pharmacists in multidisciplinary health-care teams at community outreach events for the homeless?

    Science.gov (United States)

    Chan, Vincent; Patounas, Marea; Dornbusch, Debbie; Tran, Hung; Watson, Patricia

    2015-01-01

    Homelessness is a significant public health problem. It is well-documented that people experiencing homelessness exhibit more serious illnesses and have poorer health than the general population. The provision of services and interventions by health-care professionals, including pharmacists, may make a simple yet important contribution to improved health outcomes in those experiencing homelessness, but evidence of roles and interventions is limited and variable. In Australia, the Queensland University of Technology Health Clinic connects with the homeless community by taking part in community outreach events. This paper provides details of one such event, as well as the roles, interventions and experiences of pharmacists. Participation and inclusion of pharmacists in a multidisciplinary health-care team approach at homeless outreach events should be supported and encouraged.

  19. Multidisciplinary team, working with elderly persons living in the community: a systematic literature review.

    Science.gov (United States)

    Johansson, Gudrun; Eklund, Kajsa; Gosman-Hedström, Gunilla

    2010-01-01

    As the number of elderly persons with complex health needs is increasing, teams for their care have been recommended as a means of meeting these needs, particularly in the case of elderly persons with multi-diseases. Occupational therapists, in their role as team members, exert significant influence in guiding team recommendations. However, it has been emphasized that there is a lack of sound research to show the impact of teamwork from the perspective of elderly persons. The aim of this paper was to explore literature concerning multidisciplinary teams that work with elderly persons living in the community. The research method was a systematic literature review and a total of 37 articles was analysed. The result describes team organisation, team intervention and outcome, and factors that influence teamwork. Working in a team is multifaceted and complex. It is important to enhance awareness about factors that influence teamwork. The team process itself is also of great importance. Clinical implications for developing effective and efficient teamwork are also presented and discussed.

  20. Alain Badiou's Being and Event (Book Review

    Directory of Open Access Journals (Sweden)

    Jon Roffe

    2006-01-01

    Full Text Available Much like the parade of claimants for the hand of Penelope in Homer’s Odyssey, the theoretical humanities have been presented with a string of would-be maîtres à pensers, each bringing with them claims of radical originality, and the promise of hope for the disciplines in question. Not only is the philosophy of Alain Badiou among the very few who have serious justifications to the claim of originality, the rigour, scope and goals of his philosophy reveal him as the first thinker in a long time to have the resources necessary to engage with the ailments of theoretical discourse in the contemporary environment of global capitalism, and the steady dismantling of the traditional infrastructure of the human sciences and philosophy. This article provides an outline of the key positions espoused in Badiou's key work Being and Event, and an assessment of its contemporary import.

  1. A scoping review of crisis teams managing dementia in older people.

    Science.gov (United States)

    Streater, Amy; Coleston-Shields, Donna Maria; Yates, Jennifer; Stanyon, Miriam; Orrell, Martin

    2017-01-01

    Research on crisis teams for older adults with dementia is limited. This scoping review aimed to 1) conduct a systematic literature review reporting on the effectiveness of crisis interventions for older people with dementia and 2) conduct a scoping survey with dementia crisis teams mapping services across England to understand operational procedures and identify what is currently occurring in practice. For the systematic literature review, included studies were graded using the Critical Appraisal Skills Programme checklist. For the scoping survey, Trusts across England were contacted and relevant services were identified that work with people with dementia experiencing a mental health crisis. The systematic literature review demonstrated limited evidence in support of crisis teams reducing the rate of hospital admissions, and despite the increase in number of studies, methodological limitations remain. For the scoping review, only half (51.8%) of the teams had a care pathway to manage crises and the primary need for referral was behavioral or psychological factors. Evidence in the literature for the effectiveness of crisis teams for older adults with dementia remains limited. Being mainly cohort designs can make it difficult to evaluate the effectiveness of the intervention. In practice, it appears that the pathway for care managing crisis for people with dementia varies widely across services in England. There was a wide range of names given to the provision of teams managing crisis for people with dementia, which may reflect the differences in the setup and procedures of the service. To provide evidence on crisis intervention teams, a comprehensive protocol is required to deliver a standardized care pathway and measurable intervention as part of a large-scale evaluation of effectiveness.

  2. Interprofessional Teamwork and Collaboration Between Community Health Workers and Healthcare Teams: An Integrative Review.

    Science.gov (United States)

    Franklin, Catherine M; Bernhardt, Jean M; Lopez, Ruth Palan; Long-Middleton, Ellen R; Davis, Sheila

    2015-01-01

    Community Health Workers (CHWs) serve as a means of improving outcomes for underserved populations. However, their relationship within health care teams is not well studied. The purpose of this integrative review was to examine published research reports that demonstrated positive health outcomes as a result of CHW intervention to identify interprofessional teamwork and collaboration between CHWs and health care teams. A total of 47 studies spanning 33 years were reviewed using an integrative literature review methodology for evidence to support the following assumptions of effective interprofessional teamwork between CHWs and health care teams: (1) shared understanding of roles, norms, values, and goals of the team; (2) egalitarianism; (3) cooperation; (4) interdependence; and(5) synergy. Of the 47 studies, 12 reported at least one assumption of effective interprofessional teamwork. Four studies demonstrated all 5 assumptions of interprofessional teamwork. Four studies identified in this integrative review serve as exemplars for effective interprofessional teamwork between CHWs and health care teams. Further study is needed to describe the nature of interprofessional teamwork and collaboration in relation to patient health outcomes.

  3. Primary care teams in Ireland: a qualitative mapping review of Irish grey and published literature.

    Science.gov (United States)

    O'Sullivan, M; Cullen, W; MacFarlane, A

    2015-03-01

    The Irish government published its primary care strategy, Primary Care: A New Direction in 2001. Progress with the implementation of Primary care teams is modest. The aim of this paper is to map the Irish grey literature and peer-reviewed publications to determine what research has been carried out in relation to primary care teams, the reform process and interdisciplinary working in primary care in Ireland. This scoping review employed three methods: a review of Web of Science, Medline and Embase databases, an email survey of researchers across academic institutions, the HSE and independent researchers and a review of Lenus and the Health Well repository. N = 123 outputs were identified. N = 14 were selected for inclusion. A thematic analysis was undertaken. Common themes identified were resources, GP participation, leadership, clarity regarding roles in primary care teams, skills and knowledge for primary care team working, communication and community. There is evidence of significant problems that disrupt team formation and functioning that warrants more comprehensive research.

  4. Rapid response team composition effects on outcomes for adult hospitalised patients: A systematic review.

    Science.gov (United States)

    Daniele, Rose Mary; Bova, Ann Marie; LeGar, Michelle; Smith, Pauline J; Shortridge-Baggett, Lillie M

    2011-01-01

    Utilisation of a rapid response team (RRT) in a hospital setting has been documented in the literature. RRTs were formed to intervene quickly when the hospitalised patient first shows signs of deterioration. The purpose was to prevent failure to rescue, leading to intensive care unit transfers, cardiac arrest and mortality. To date, however, there is a lack of evidence to support the effectiveness of this intervention. The focused question, subsequent systematic review and data analysis are presented. To synthesise the best available research evidence on the impact of rapid response team composition on cardiopulmonary arrest outside the intensive care unit (ICU), unplanned transfers to ICU, in-hospital mortality, length of hospital stay in hospitalised non-ICU adult medical-surgical patients and staff satisfaction. Published and unpublished literature were searched. The databases searched for studies from 1989 to 2010 were CINAHL, EMBASE, Google Scholar, Mednar, New York Academy of Medicine, Proquest and PubMed. Reference lists of included studies were hand searched. Initial keywords searched were rapid response team, rapid response system, medical emergency team, medical emergency system and team composition. The studies included in the systematic review were randomized controlled trials (RCTs). In absence of sufficient RCTs, quasi-experimental studies, cohort studies, observational and control trials without randomization were included. Types of participants were adults (18 years and older) hospitalised in an acute care setting, not requiring the specialized care and management of an ICU. Hospitalised paediatric patients, ICU patients, hospice or palliative care patients were excluded. JBI MAStARI Critical Appraisal Tools were used for the methodological assessment of identified studies. Data were collected specifically related to RRT intervention, study methods and design, randomization, length of intervention, data collection points and inclusion criteria

  5. Multiple mortality events in bats: a global review

    Science.gov (United States)

    O'Shea, Thomas J.; Cryan, Paul; Hayman, David TH; Plowright, Raina K.; Streicker, Daniel G.

    2016-01-01

    Despite conservation concerns for many species of bats, factors causing mortality in bats have not been reviewed since 1970. Here, we review and qualitatively describe trends in the occurrence and apparent causes of multiple mortality events (MMEs) in bats around the world.

  6. Clinical review criteria and medical emergency teams: evaluating a two-tier rapid response system.

    Science.gov (United States)

    Bingham, Gordon; Fossum, Mariann; Barratt, Macey; Bucknall, Tracey

    2015-09-01

    To assess the prevalence of patients fulfilling clinical review criteria (CRC), to determine activation rates for CRC assessments, to compare baseline characteristics and outcomes of patients who fulfilled CRC with patients who did not, and to identify the documented nursing actions in response to CRC values. A cross-sectional study using a retrospective medical record audit, in a universityaffiliated, tertiary referral hospital with a two-tier rapid response system in Melbourne, Australia. We used a convenience sample of hospital inpatients on general medical, surgical and specialist service wards admitted during a 24-hour period in 2013. Medical emergency team (MET) or code blue activation, unplanned intensive care unit admissions, hospital length of stay and inhospital mortality. For patients who fulfilled CRC or MET criteria during the 24- hour period, the specific criteria fulfilled, escalation treatments and outcomes were collected. Of the sample (N = 422), 81 patients (19%) fulfilled CRC on 109 occasions. From 109 CRC events, 66 patients (81%) had at least one observation fulfilling CRC, and 15 patients (18%) met CRC on multiple occasions. The documented escalation rate was 58 of 109 events (53%). The number of patients who fulfilled CRC and subsequent MET call activation criteria within 24 hours was significantly greater than the number who did not meet CRC (P CRC during the study period; these patients were about four times more likely to also fulfil MET call criteria. Contrary to hospital policy, escalation was not documented for about half the patients meeting CRC values. Despite the clarity of escalation procedures on the graphic observation chart, escalation remains an ongoing problem. Further research is needed on the impact on patient outcomes over time and to understand factors influencing staff response.

  7. Incidence and preventability of adverse events requiring intensive care admission: a systematic review.

    Science.gov (United States)

    Vlayen, Annemie; Verelst, Sandra; Bekkering, Geertruida E; Schrooten, Ward; Hellings, Johan; Claes, Neree

    2012-04-01

    Adverse events are unintended patient injuries or complications that arise from health care management resulting in death, disability or prolonged hospital stay. Adverse events that require critical care are a considerable financial burden to the health care system, but also their global impact on patients and society is probably underestimated. The objectives of this systematic review were to synthesize the best available evidence regarding the estimates of the incidence and preventability of adverse events that necessitate intensive care admission, to determine the type and consequences [mortality, length of intensive care unit (ICU) stay and costs] of these adverse events. MEDLINE (from 1966 to present), EMBASE (from 1974 to present) and CENTRAL (version 1-2010) were searched for studies reporting on unplanned admissions on ICUs. Several other sources were searched for additional studies. Only quantitative studies that used chart review for the detection of adverse events requiring intensive care admission were considered for eligibility. For the purposes of this systematic review, ICUs were defined as specialized hospital facilities which provide continuous monitoring and intensive care for acutely ill patients. Studies that were published in the English, Dutch, German, French or Spanish language were eligible for inclusion. Two reviewers independently extracted data and assessed the methodological quality of the included studies. A total of 27 studies were reviewed. Meta-analysis of the data was not appropriate because of methodological and statistical heterogeneity between studies; therefore, results are presented in a descriptive way. The percentage of surgical and medical adverse events that required ICU admission ranged from 1.1% to 37.2%. ICU readmissions varied from 0% to 18.3%. Preventability of the adverse events varied from 17% to 76.5%. Preventable adverse events are further synthesized by type of event. Consequences of the adverse events included a

  8. River Protection Project (RPP) Readiness to Proceed 2 Internal Independent Review Team Final Report

    Energy Technology Data Exchange (ETDEWEB)

    SCHAUS, P.S.

    2000-03-29

    This report describes the results of an independent review team brought in to assess CH2M Hill Hanford Group's readiness and ability to support the RPP's move into its next major phase - retrieval and delivery of tank waste to the Privatization Contractor

  9. River Protection Project (RPP) Readiness to Proceed 2 Internal Independent Review Team Final Report

    Energy Technology Data Exchange (ETDEWEB)

    SCHAUS, P.S.

    2000-03-15

    This report describes the results of an independent review team brought in to assess CH2M HILL Hanford's readiness and ability to support the RPP's move into its next major phase - retrieval and delivery of tank waste to the Privatization Contractor.

  10. A review of Perindopril in the reduction of cardiovascular events

    Directory of Open Access Journals (Sweden)

    Duncan J Campbell

    2006-06-01

    Full Text Available Duncan J CampbellSt. Vincent’s Institute of Medical Research and the Department of Medicine, University of Melbourne, St. Vincent’s Hospital, Fitzroy, Victoria, AustraliaBackground: Angiotensin-converting enzyme inhibitors (ACEI have a well-established role in the prevention of cardiovascular events in hypertension, left ventricular dysfunction, and heart failure. More recently, ACEI have been shown to prevent cardiovascular events in individuals with increased cardiovascular risk, where hypertension, left ventricular dysfunction, or heart failure was not the primary indication for ACEI therapy.Objective: To review studies of the effects of the ACEI perindopril on cardiovascular events.Method: The EUROPA (European Trial on Reduction of Cardiac Events with Perindopril in Patients with Stable Coronary Artery Disease Study, PROGRESS (Perindopril Protection Against Recurrent Stroke Study, and ASCOT-BPLA (Anglo-Scandinavian Cardiac Outcomes Trial – Blood Pressure Lowering Arm trials are reviewed.Results: Perindopril alone reduced cardiovascular events in subjects with stable coronary heart disease. Perindopril in combination with indapamide reduced cardiovascular events in subjects with cerebrovascular disease. Perindopril in combination with amlodipine reduced cardiovascular events in subjects with hypertension.Conclusion: Perindopril reduced cardiovascular events. The reduction of cardiovascular events by perindopril was in large part associated with reduction of blood pressure, and greater reduction in cardiovascular events was associated with greater reduction of blood pressure. Perindopril may need to be combined with other antihypertensive agents to maximize reduction of cardiovascular events.Keywords: Angiotensin-converting enzyme inhibitor, hypertension, coronary heart disease, stroke, myocardial infarction, heart failure

  11. Teaching nurses teamwork: Integrative review of competency-based team training in nursing education.

    Science.gov (United States)

    Barton, Glenn; Bruce, Anne; Schreiber, Rita

    2017-12-20

    Widespread demands for high reliability healthcare teamwork have given rise to many educational initiatives aimed at building team competence. Most effort has focused on interprofessional team training however; Registered Nursing teams comprise the largest human resource delivering direct patient care in hospitals. Nurses also influence many other health team outcomes, yet little is known about the team training curricula they receive, and furthermore what specific factors help translate teamwork competency to nursing practice. The aim of this review is to critically analyse empirical published work reporting on teamwork education interventions in nursing, and identify key educational considerations enabling teamwork competency in this group. CINAHL, Web of Science, Academic Search Complete, and ERIC databases were searched and detailed inclusion-exclusion criteria applied. Studies (n = 19) were selected and evaluated using established qualitative-quantitative appraisal tools and a systematic constant comparative approach. Nursing teamwork knowledge is rooted in High Reliability Teams theory and Crew or Crisis Resource Management sources. Constructivist pedagogy is used to teach, practice, and refine teamwork competency. Nursing teamwork assessment is complex; involving integrated yet individualized determinations of knowledge, skills, and attitudes. Future initiatives need consider frontline leadership, supportive followership and skilled communication emphasis. Collective stakeholder support is required to translate teamwork competency into nursing practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Life events in schizoaffective disorder: A systematic review.

    Science.gov (United States)

    Vardaxi, Chrysoula Ch; Gonda, Xenia; Fountoulakis, Konstantinos N

    2018-02-01

    Life events play a central role in the development of psychiatric disorders and impact course and outcome. We present a systematic review of the literature on the relationship of life events with the onset and long-term course of schizoaffective disorder. MEDLINE was searched with the combination of the key words: 'life events' plus 'schizoaffective'. The PRISMA method was followed in the review process. From the identified 66 papers only 12 were considered to be of relevance to the current study and 6 more papers were identified by inspecting the reference lists of the identified papers. There are very few studies focusing on the role of life events in schizoaffective disorder indicating insufficient data concerning the relationship of life events with onset and long-term course of schizoaffective disorder. Reported effects are not generic but concern specific events like the loss of mother, and females seem to be more vulnerable. Patients with schizoaffective disorder manifest high rates of PTSD. The literature on life events with the development and course of schizoaffective disorder is limited and precludes solid conclusions. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. A scoping review of crisis teams managing dementia in older people

    Directory of Open Access Journals (Sweden)

    Streater A

    2017-10-01

    Full Text Available Amy Streater,1,2 Donna Maria Coleston-Shields,2 Jennifer Yates,2 Miriam Stanyon,2 Martin Orrell2 1Research and Development, North East London NHS Foundation Trust, Ilford, 2Institute of Mental Health, University of Nottingham, Nottingham, UK Background: Research on crisis teams for older adults with dementia is limited. This scoping review aimed to 1 conduct a systematic literature review reporting on the effectiveness of crisis interventions for older people with dementia and 2 conduct a scoping survey with dementia crisis teams mapping services across England to understand operational procedures and identify what is currently occurring in practice.Methods: For the systematic literature review, included studies were graded using the Critical Appraisal Skills Programme checklist. For the scoping survey, Trusts across England were contacted and relevant services were identified that work with people with dementia experiencing a mental health crisis.Results: The systematic literature review demonstrated limited evidence in support of crisis teams reducing the rate of hospital admissions, and despite the increase in number of studies, methodological limitations remain. For the scoping review, only half (51.8% of the teams had a care pathway to manage crises and the primary need for referral was behavioral or psychological factors.Conclusion: Evidence in the literature for the effectiveness of crisis teams for older adults with dementia remains limited. Being mainly cohort designs can make it difficult to evaluate the effectiveness of the intervention. In practice, it appears that the pathway for care managing crisis for people with dementia varies widely across services in England. There was a wide range of names given to the provision of teams managing crisis for people with dementia, which may reflect the differences in the setup and procedures of the service. To provide evidence on crisis intervention teams, a comprehensive protocol is required

  14. Evaluation of stress response using psychological, biological, and electrophysiological markers during immersive simulation of life threatening events in multidisciplinary teams.

    Science.gov (United States)

    Ghazali, D A; Darmian-Rafei, I; Nadolny, J; Sosner, P; Ragot, S; Oriot, D

    2017-07-27

    Stress might impair clinical performance in real life and in simulation-based education (SBE). Subjective or objective measures can be used to assess stress during SBE. This monocentric study aimed to evaluate the effects of simulation of life-threatening events on measurements of various stress parameters (psychological, biological, and electrophysiological parameters) in multidisciplinary teams (MDTs) during SBE. The effect of gender and status of participants on stress response was also investigated. Twelve emergency MDTs of 4 individuals were recruited for an immersive simulation session. Stress was assessed by: (1) self-reported stress; (2) Holter analysis, including heart rate and heart rate variability in the temporal and spectral domain (autonomic nervous system); (3) salivary cortisol (hypothalamic pituitary adrenal axis). Forty-eight participants (54.2% men, psychological, biological and electrophysiological parameters. Copyright © 2017 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

  15. Team climate and quality of care in primary health care: a review of studies using the Team Climate Inventory in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Goh Teik T

    2009-10-01

    Full Text Available Abstract Background Attributes of teams could affect the quality of care delivered in primary care. The aim of this study was to systematically review studies conducted within the UK NHS primary care that have measured team climate using the Team Climate Inventory (TCI, and to describe, if reported, the relationship between the TCI and measures of quality of care. Findings The databases MEDLINE, EMBASE, and CINAHL were searched. The reference lists of included article were checked and one relevant journal was hand-searched. Eight papers were included. Three studies used a random sample; the remaining five used convenience or purposive samples. Six studies were cross sectional surveys, whilst two were before and after studies. Four studies examined the relationship between team climate and quality of care. Only one study found a positive association between team climate and higher quality care in patients with diabetes, positive patient satisfaction and self-reported effectiveness. Conclusion While the TCI has been used to measure team attributes in primary care settings in the UK it is difficult to generalise from these data. A small number of studies reported higher TCI scores being associated with only certain aspects of quality of care; reasons for the pattern of association are unclear. There are a number of methodological challenges to conducting such studies in routine service settings. Further research is needed in order to understand how to measure team functioning in relation to quality of care.

  16. The Validity and Reliability of Global Positioning Systems in Team Sport: A Brief Review.

    Science.gov (United States)

    Scott, Macfarlane T U; Scott, Tannath J; Kelly, Vincent G

    2016-05-01

    The use of global positioning systems (GPS) has increased dramatically over the last decade. Using signals from orbiting satellites, the GPS receiver calculates the exact position of the device and the speed at which the device is moving. Within team sports GPS devices are used to quantify the external load experienced by an athlete, allowing coaches to better manage trainings loads and potentially identify athletes who are overreaching or overtraining. This review aims to collate all studies that have tested either (or both) the validity or reliability of GPS devices in a team sport setting, with a particular focus on (a) measurements of distance, speed, velocities, and accelerations across all sampling rates and (b) accelerometers, player/body load and impacts in accelerometer-integrated GPS devices. A comprehensive search of the online libraries identified 22 articles that fit search criteria. The literature suggests that all GPS units, regardless of sampling rate, are capable of tracking athlete's distance during team sport movements with adequate intraunit reliability. One Hertz and 5Hz GPS units have limitations in their reporting of distance during high-intensity running, velocity measures, and short linear running (particularly those involving changes of direction), although these limitations seem to be overcome during measures recorded during team sport movements. Ten Hertz GPS devices seem the most valid and reliable to date across linear and team sport simulated running, overcoming many limitations of earlier models, whereas the increase to 15Hz GPS devices have had no additional benefit.

  17. What benefits does team sport hold for the workplace? A systematic review.

    Science.gov (United States)

    Brinkley, Andrew; McDermott, Hilary; Munir, Fehmidah

    2017-01-01

    Physical inactivity is proven to be a risk factor for non-communicable diseases and all-cost mortality. Public health policy recommends community settings worldwide such as the workplace to promote physical activity. Despite the growing prevalence of workplace team sports, studies have not synthesised their benefits within the workplace. A systematic review was carried out to identify articles related to workplace team sports, including intervention, observational and qualitative studies. Eighteen studies met the inclusion criteria. The findings suggest team sport holds benefits not only for individual health but also for group cohesion and performance and organisational benefits such as the increased work performance. However, it is unclear how sport is most associated with these benefits as most of the studies included poorly described samples and unclear sports activities. Our review highlights the need to explore and empirically understand the benefits of workplace team sport for individual, group and organisational health outcomes. Researches carried out in this field must provide details regarding their respective samples, the sports profile and utilise objective measures (e.g., sickness absence register data, accelerometer data).

  18. An update of preliminary perspectives gained from Individual Plant Examination of External Events (IPEEE) submittal reviews

    Energy Technology Data Exchange (ETDEWEB)

    Rubin, A.M.; Chen, J.T.; Chokshi, N. [Nuclear Regulatory Commission, Washington, DC (United States); Nowlen, S.P.; Bohn, M.P. [Sandia National Labs., Albuquerque, NM (United States); Sewell, R.; Kazarians, M.; Lambright, J. [Energy Research, Inc., Rockville, MD (United States)

    1998-03-01

    As a result of the US Nuclear Regulatory Commission (USNRC) initiated Individual Plant Examination of External Events (IPEEE) program, virtually every operating commercial nuclear power reactor in the US has performed an assessment of severe accident risk due to external events. To date, the USNRC staff has received 63 IPEEE submittals and will receive an additional 11 by mid 1998. Currently, 49 IPEEE submittals are under various stages ore view. This paper is based on the information available for those 41 plants for which at least preliminary Technical Evaluation Reports have been prepared by the review teams. The goal of the review is to ascertain whether the licensee`s IPEEE process is capable of identifying external events-induced severe accident vulnerabilities and cost-effective safety improvements to either eliminate or reduce the impact of these vulnerabilities. The review does not, however, attempt to validate or verify the results of the licensee`s IPEEE. The primary objective of this paper is to provide an update on the preliminary perspectives and insights gained from the IPEEE process.

  19. Estimating Weight and Moments for Ship Control Design Technical Assessment Team Reviews

    Science.gov (United States)

    2016-07-26

    other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a...estimations for the Ship Change Document (SCD) Technical Assessment Team (TAT) review process. 15. SUBJECT TERMS Weight and Moment, Weight Calculations 16...service life allowances early in life, will be put into a critical status if the rate of consumption is too high. If a class has managed to reduce

  20. Serenoa repens (saw palmetto): a systematic review of adverse events.

    Science.gov (United States)

    Agbabiaka, Taofikat B; Pittler, Max H; Wider, Barbara; Ernst, Edzard

    2009-01-01

    Serenoa repens (W. Bartram) Small, also known as saw palmetto, is one of the most widely used herbal preparations for the treatment of lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). Although a number of randomized controlled trials (RCTs) and systematic reviews of the efficacy of S. repens for the treatment of LUTS and BPH have been published, no systematic review on its drug interactions or adverse events currently exists. This review assesses all available human safety data of S. repens monopreparations. Systematic literature searches were conducted from date of inception to February 2008 in five electronic databases; reference lists and our departmental files were checked for further relevant publications. Information was requested from spontaneous reporting schemes of the WHO and national safety bodies. Twenty-four manufacturers/distributors of S. repens preparations and four herbalist organizations were contacted for additional information. No language restrictions were imposed. Only reports of adverse events in humans from monopreparations of S. repens were included. Data from all articles, regardless of study design, reporting adverse events or interactions were independently extracted by the first author and validated by the second. Forty articles (26 randomized controlled trials, 4 non-randomized controlled trials, 6 uncontrolled trials and 4 case reports/series) were included. They suggest that adverse events associated with the use of S. repens are mild and similar to those with placebo. The most frequently reported adverse events are abdominal pain, diarrhoea, nausea, fatigue, headache, decreased libido and rhinitis. More serious adverse events such as death and cerebral haemorrhage are reported in isolated case reports and data from spontaneous reporting schemes, but causality is questionable. No drug interactions were reported. Currently available data suggest that S. repens is well tolerated by most users and is not

  1. Evidence-based interventions to reduce adverse events in hospitals: a systematic review of systematic reviews

    NARCIS (Netherlands)

    Zegers, H.W.; Hesselink, G.; Geense, W.; Vincent, C.; Wollersheim, H.

    2016-01-01

    OBJECTIVE: To provide an overview of effective interventions aimed at reducing rates of adverse events in hospitals. DESIGN: Systematic review of systematic reviews. DATA SOURCES: PubMed, CINAHL, PsycINFO, the Cochrane Library and EMBASE were searched for systematic reviews published until October

  2. Effects of team coordination during cardiopulmonary resuscitation: a systematic review of the literature.

    Science.gov (United States)

    Fernandez Castelao, Ezequiel; Russo, Sebastian G; Riethmüller, Martin; Boos, Margarete

    2013-08-01

    The purpose of this study is to identify and evaluate to what extent the literature on team coordination during cardiopulmonary resuscitation (CPR) empirically confirms its positive effect on clinically relevant medical outcome. A systematic literature search in PubMed, MEDLINE, PsycINFO and CENTRAL databases was performed for articles published in the last 30 years. A total of 63 articles were included in the review. Planning, leadership, and communication as the three main interlinked coordination mechanisms were found to have effect on several CPR performance markers. A psychological theory-based integrative model was expanded upon to explain linkages between the three coordination mechanisms. Planning is an essential element of leadership behavior and is primarily accomplished by a designated team leader. Communication affects medical performance, serving as the vehicle for the transmission of information and directions between team members. Our findings also suggest teams providing CPR must continuously verbalize their coordination plan in order to effectively structure allocation of subtasks and optimize success. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Global positioning systems (GPS) and microtechnology sensors in team sports: a systematic review.

    Science.gov (United States)

    Cummins, Cloe; Orr, Rhonda; O'Connor, Helen; West, Cameron

    2013-10-01

    Use of Global positioning system (GPS) technology in team sport permits measurement of player position, velocity, and movement patterns. GPS provides scope for better understanding of the specific and positional physiological demands of team sport and can be used to design training programs that adequately prepare athletes for competition with the aim of optimizing on-field performance. The objective of this study was to conduct a systematic review of the depth and scope of reported GPS and microtechnology measures used within individual sports in order to present the contemporary and emerging themes of GPS application within team sports. A systematic review of the application of GPS technology in team sports was conducted. We systematically searched electronic databases from earliest record to June 2012. Permutations of key words included GPS; male and female; age 12-50 years; able-bodied; and recreational to elite competitive team sports. The 35 manuscripts meeting the eligibility criteria included 1,276 participants (age 11.2-31.5 years; 95 % males; 53.8 % elite adult athletes). The majority of manuscripts reported on GPS use in various football codes: Australian football league (AFL; n = 8), soccer (n = 7), rugby union (n = 6), and rugby league (n = 6), with limited representation in other team sports: cricket (n = 3), hockey (n = 3), lacrosse (n = 1), and netball (n = 1). Of the included manuscripts, 34 (97 %) detailed work rate patterns such as distance, relative distance, speed, and accelerations, with only five (14.3 %) reporting on impact variables. Activity profiles characterizing positional play and competitive levels were also described. Work rate patterns were typically categorized into six speed zones, ranging from 0 to 36.0 km·h⁻¹, with descriptors ranging from walking to sprinting used to identify the type of activity mainly performed in each zone. With the exception of cricket, no standardized speed zones or definitions were observed within or

  4. A Review and Annotated Bibliography of the Literature Pertaining to Team and Small Group Performance (1989 to 1999)

    National Research Council Canada - National Science Library

    LaJoie, Andrew

    1999-01-01

    .... Training and military doctrine has been evolving to reflect this emphasis on teamwork. The purpose of this annotated bibliography is to review literature published over the last ten years concerning team and small group performance...

  5. A-Base review reference package for OPF team: planning element no. 3 : Pacific & Freshwater Fisheries Management

    National Research Council Canada - National Science Library

    1985-01-01

    The purpose of the attached package is to assemble selected background material from A-Base Review Reports to assist OPF teams to develop and revise results and linkage statements, define performance...

  6. Team Teaching.

    Science.gov (United States)

    Bunyan, L. W.

    The purpose of this study was to review current developments in team teaching and to assess its potential in the Calgary, Alberta, schools. An investigation into team teaching situations in schools in the eastern half of the United States and Canada revealed characteristics common to successful programs (e.g., charismatic leadership and innovative…

  7. Team science as interprofessional collaborative research practice: a systematic review of the science of team science literature

    OpenAIRE

    Little, Meg M; St. Hill, Catherine A.; Ware, Kenric B; Swanoski, Michael T; Chapman, Scott A; Lutfiyya, M Nawal; Cerra, Frank B

    2016-01-01

    The National Institute of Health's concept of team science is a means of addressing complex clinical problems by applying conceptual and methodological approaches from multiple disciplines and health professions. The ultimate goal is the improved quality of care of patients with an emphasis on better population health outcomes. Collaborative research practice occurs when researchers from >1 health-related profession engage in scientific inquiry to jointly create and disseminate new knowledge ...

  8. Discussion of Comments from a Peer Review of A Technique for Human Event Anlysis (ATHEANA)

    Energy Technology Data Exchange (ETDEWEB)

    Bley, D.C.; Cooper, S.E.; Forester, J.A.; Kolaczkowski, A.M.; Ramey-Smith, A,; Wreathall J.

    1999-01-28

    In May of 1998, a technical basis and implementation guidelines document for A Technique for Human Event Analysis (ATHEANA) was issued as a draft report for public comment (NUREG-1624). In conjunction with the release of draft NUREG- 1624, a peer review of the new human reliability analysis method its documentation and the results of an initial test of the method was held over a two-day period in June 1998 in Seattle, Washington. Four internationally known and respected experts in HK4 or probabilistic risk assessment were selected to serve as the peer reviewers. In addition, approximately 20 other individuals with an interest in HRA and ATHEANA also attended the peer and were invited to provide comments. The peer review team was asked to comment on any aspect of the method or the report in which improvements could be made and to discuss its strengths and weaknesses. They were asked to focus on two major aspects: Are the basic premises of ATHEANA on solid ground and is the conceptual basis adequate? Is the ATHEANA implementation process adequate given the description of the intended users in the documentation? The four peer reviewers asked questions and provided oral comments during the peer review meeting and provided written comments approximately two weeks after the completion of the meeting. This paper discusses their major comments.

  9. A systematic review examining the effectiveness of blending technology with team-based learning.

    Science.gov (United States)

    River, Jo; Currie, Jane; Crawford, Tonia; Betihavas, Vasiliki; Randall, Sue

    2016-10-01

    Technological advancements are rapidly changing nursing education in higher education settings. Nursing academics are enthusiastically blending technology with active learning approaches such as Team Based Learning (TBL). While the educational outcomes of TBL are well documented, the value of blending technology with TBL (blended-TBL) remains unclear. This paper presents a systematic review examining the effectiveness of blended-TBL in higher education health disciplines. This paper aimed to identify how technology has been incorporated into TBL in higher education health disciplines. It also sought to evaluate the educational outcomes of blended-TBL in terms of student learning and preference. A review of TBL research in Medline, CINAHL, ERIC and Embase databases was undertaken including the search terms, team based learning, nursing, health science, medical, pharmaceutical, allied health education and allied health education. Papers were appraised using the Critical Appraisal Skills Program (CASP). The final review included 9 papers involving 2094 student participants. A variety of technologies were blended with TBL including interactive eLearning and social media. There is limited evidence that blended-TBL improved student learning outcomes or student preference. Enthusiasm to blend technology with TBL may not be as well founded as initially thought. However, few studies explicitly examined the value of incorporating technology into TBL. There is a clear need for research that can discern the impact of technology into TBL on student preference and learning outcomes, with a particular focus on barriers to student participation with online learning components. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Effects of Plyometric Training on Physical Fitness in Team Sport Athletes: A Systematic Review.

    Science.gov (United States)

    Slimani, Maamer; Chamari, Karim; Miarka, Bianca; Del Vecchio, Fabricio B; Chéour, Foued

    2016-12-01

    Plyometric training (PT) is a very popular form of physical conditioning of healthy individuals that has been extensively studied over the last decades. In this article, we critically review the available literature related to PT and its effects on physical fitness in team sport athletes. We also considered studies that combined PT with other popular training modalities (e.g. strength/sprint training). Generally, short-term PT (i.e. 2-3 sessions a week for 4-16 weeks) improves jump height, sprint and agility performances in team sport players. Literature shows that short PT (training appears to be too short to improve physical performance in elite male players. Available evidence suggests that short-term PT on non-rigid surfaces (i.e. aquatic, grass or sand-based PT) could elicit similar increases in jumping, sprinting and agility performances as traditional PT. Furthermore, the combination of various plyometric exercises and the bilateral and unilateral jumps could improve these performances more than the use of single plyometric drills or traditional PT. Thus, the present review shows a greater effect of PT alone on jump and sprint (30 m sprint performance only) performances than the combination of PT with sprint/strength training. Although many issues related to PT remain to be resolved, the results presented in this review allow recommending the use of well-designed and sport-specific PT as a safe and effective training modality for improving jumping and sprint performance as well as agility in team sport athletes.

  11. The impact of sleep deprivation in military surgical teams: a systematic review.

    Science.gov (United States)

    Parker, Rachael Sv; Parker, P

    2017-06-01

    Fatigue in military operations leads to safety and operational problems due to a decrease in alertness and performance. The primary method of counteracting the effects of sleep deprivation is to increase nightly sleep time, which in operational situations is not always feasible. History has taught us that surgeons and surgical teams are finite resources that cannot operate on patients indefinitely. A systematic review was conducted using the search terms 'sleep' and 'deprivation' examining the impact of sleep deprivation on cognitive performance in military surgical teams. Studies examining outcomes on intensive care patients and subjects with comorbidities were not addressed in this review. Sleep deprivation in any 'out-of-hours' surgery has a significant impact on overall morbidity and mortality. Sleep deprivation in surgeons and surgical trainees negatively impacts cognitive performance and puts their own and patients' health at risk. All published research lacks consensus when defining 'sleep deprivation' and 'rested' states. It is recognised that it would be unethical to conduct a well-designed randomised controlled trial, to determine the effects of fatigue on performance in surgery; however, there is a paucity between surrogate markers and applying simulated results to actual clinical performance. This requires further research. Recommended methods of combating fatigue include: prophylactically 'sleep-banking' prior to known periods of sleep deprivation, napping, use of stimulant or alerting substances such as modafinil, coordinated work schedules to reduce circadian desynchronisation and regular breaks with enforced rest periods. A forward surgical team will become combat-ineffective after 48 hours of continuous operations. This systematic review recommends implementing on-call periods of no more than 12 hours in duration, with adequate rest periods every 24 hours. Drug therapies and sleep banking may, in the short term, prevent negative effects of

  12. Effects of Plyometric Training on Physical Fitness in Team Sport Athletes: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Slimani Maamer

    2016-12-01

    Full Text Available Plyometric training (PT is a very popular form of physical conditioning of healthy individuals that has been extensively studied over the last decades. In this article, we critically review the available literature related to PT and its effects on physical fitness in team sport athletes. We also considered studies that combined PT with other popular training modalities (e.g. strength/sprint training. Generally, short-term PT (i.e. 2-3 sessions a week for 4-16 weeks improves jump height, sprint and agility performances in team sport players. Literature shows that short PT (<8 weeks has the potential to enhance a wide range of athletic performance (i.e. jumping, sprinting and agility in children and young adult amateur players. Nevertheless, 6 to 7 weeks training appears to be too short to improve physical performance in elite male players. Available evidence suggests that short-term PT on non-rigid surfaces (i.e. aquatic, grass or sand-based PT could elicit similar increases in jumping, sprinting and agility performances as traditional PT. Furthermore, the combination of various plyometric exercises and the bilateral and unilateral jumps could improve these performances more than the use of single plyometric drills or traditional PT. Thus, the present review shows a greater effect of PT alone on jump and sprint (30 m sprint performance only performances than the combination of PT with sprint/strength training. Although many issues related to PT remain to be resolved, the results presented in this review allow recommending the use of well-designed and sport-specific PT as a safe and effective training modality for improving jumping and sprint performance as well as agility in team sport athletes.

  13. Effects of Plyometric Training on Physical Fitness in Team Sport Athletes: A Systematic Review

    Science.gov (United States)

    Chamari, Karim; Miarka, Bianca; Del Vecchio, Fabricio B.; Chéour, Foued

    2016-01-01

    Abstract Plyometric training (PT) is a very popular form of physical conditioning of healthy individuals that has been extensively studied over the last decades. In this article, we critically review the available literature related to PT and its effects on physical fitness in team sport athletes. We also considered studies that combined PT with other popular training modalities (e.g. strength/sprint training). Generally, short-term PT (i.e. 2-3 sessions a week for 4-16 weeks) improves jump height, sprint and agility performances in team sport players. Literature shows that short PT (performance (i.e. jumping, sprinting and agility) in children and young adult amateur players. Nevertheless, 6 to 7 weeks training appears to be too short to improve physical performance in elite male players. Available evidence suggests that short-term PT on non-rigid surfaces (i.e. aquatic, grass or sand-based PT) could elicit similar increases in jumping, sprinting and agility performances as traditional PT. Furthermore, the combination of various plyometric exercises and the bilateral and unilateral jumps could improve these performances more than the use of single plyometric drills or traditional PT. Thus, the present review shows a greater effect of PT alone on jump and sprint (30 m sprint performance only) performances than the combination of PT with sprint/strength training. Although many issues related to PT remain to be resolved, the results presented in this review allow recommending the use of well-designed and sport-specific PT as a safe and effective training modality for improving jumping and sprint performance as well as agility in team sport athletes. PMID:28149427

  14. Diabetic foot infections: a team-oriented review of medical and surgical management

    Directory of Open Access Journals (Sweden)

    Claire M Capobianco

    2010-09-01

    Full Text Available As the domestic and international incidence of diabetes and metabolic syndrome continues to rise, health care providers need to continue improving management of the long-term complications of the disease. Emergency department visits and hospital admissions for diabetic foot infections are increasingly commonplace, and a like-minded multidisciplinary team approach is needed to optimize patient care. Early recognition of severe infections, medical stabilization, appropriate antibiotic selection, early surgical intervention, and strategic plans for delayed reconstruction are crucial components of managing diabetic foot infections. The authors review initial medical and surgical management and staged surgical reconstruction of diabetic foot infections in the inpatient setting.

  15. Adverse events related to emergency department care: a systematic review.

    Directory of Open Access Journals (Sweden)

    Antonia S Stang

    Full Text Available To systematically review the literature regarding the prevalence, preventability, severity and types of adverse events (AE in the Emergency Department (ED.We systematically searched major bibliographic databases, relevant journals and conference proceedings, and completed reference reviews of primary articles. Observational studies (cohort and case-control, quasi-experimental (e.g. before/after studies and randomized controlled trials, were considered for inclusion if they examined a broad demographic group reflecting a significant proportion of ED patients and described the proportion of AE. Studies conducted outside of the ED setting, those examining only a subpopulation of patients (e.g. a specific entrance complaint or receiving a specific intervention, or examining only adverse drug events, were excluded. Two independent reviewers assessed study eligibility, completed data extraction, and assessed study quality with the Newcastle Ottawa Scale.Our search identified 11,624 citations. Ten articles, representing eight observational studies, were included. Methodological quality was low to moderate with weaknesses in study group comparability, follow-up, and outcome ascertainment and reporting. There was substantial variation in the proportion of patients with AE related to ED care, ranging from 0.16% (n = 9308 to 6.0% (n = 399. Similarly, the reported preventability of AE ranged from 36% (n = 250 to 71% (n = 24. The most common types of events were related to management (3 studies, diagnosis (2 studies and medication (2 studies.The variability in findings and lack of high quality studies on AE in the high risk ED setting highlights the need for research in this area. Further studies with rigorous, standardized outcome assessment and reporting are required.

  16. External Peer Review Team Report Underground Testing Area Subproject for Frenchman Flat, Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Sam Marutzky

    2010-09-01

    An external peer review was conducted to review the groundwater models used in the corrective action investigation stage of the Underground Test Area (UGTA) subproject to forecast zones of potential contamination in 1,000 years for the Frenchman Flat area. The goal of the external peer review was to provide technical evaluation of the studies and to assist in assessing the readiness of the UGTA subproject to progress to monitoring activities for further model evaluation. The external peer review team consisted of six independent technical experts with expertise in geology, hydrogeology,'''groundwater modeling, and radiochemistry. The peer review team was tasked with addressing the following questions: 1. Are the modeling approaches, assumptions, and model results for Frenchman Flat consistent with the use of modeling studies as a decision tool for resolution of environmental and regulatory requirements? 2. Do the modeling results adequately account for uncertainty in models of flow and transport in the Frenchman Flat hydrological setting? a. Are the models of sufficient scale/resolution to adequately predict contaminant transport in the Frenchman Flat setting? b. Have all key processes been included in the model? c. Are the methods used to forecast contaminant boundaries from the transport modeling studies reasonable and appropriate? d. Are the assessments of uncertainty technically sound and consistent with state-of-the-art approaches currently used in the hydrological sciences? 3. Are the datasets and modeling results adequate for a transition to Corrective Action Unit monitoring studies—the next stage in the UGTA strategy for Frenchman Flat? The peer review team is of the opinion that, with some limitations, the modeling approaches, assumptions, and model results are consistent with the use of modeling studies for resolution of environmental and regulatory requirements. The peer review team further finds that the modeling studies have accounted

  17. A systematic review of core implementation components in team ball sport injury prevention trials.

    Science.gov (United States)

    O'Brien, James; Finch, Caroline F

    2014-10-01

    Recently, the use of specific exercise programmes to prevent musculoskeletal injuries in team ball sports has gained considerable attention, and the results of large-scale, randomised controlled trials have supported their efficacy. To enhance the translation of these interventions into widespread use, research trials must be reported in a way that allows the players, staff and policymakers associated with sports teams to implement these interventions effectively. In particular, information is needed on core implementation components, which represent the essential and indispensable aspects of successful implementation. To assess the extent to which team ball sport injury prevention trial reports have reported the core implementation components of the intervention, the intervention target and the use of any delivery agents (ie, staff or other personnel delivering the intervention). To summarise which specific types of intervention, intervention target and delivery agents are reported. To develop consensus between reviewers on the reporting of these components. Six electronic databases were systematically searched for English-language, peer-reviewed papers on injury prevention exercise programme (IPEP) trials in team ball sports. The reporting of all eligible trials was assessed by two independent reviewers. The reporting of the three core implementation components were coded as 'yes', 'no' or 'unclear'. For cases coded as 'yes', the specific types of interventions, intervention targets and delivery agents were extracted and summarised. The search strategy identified 52 eligible trials. The intervention and the intervention target were reported in all 52 trials. The reporting of 25 trials (48%) specified the use of delivery agents, the reporting of three trials (6%) specified not using delivery agents, and in the reporting of the remaining 24 trials (46%) the use of delivery agents was unclear. The reported intervention type was an IPEP alone in 43 trials (83

  18. Quality of reporting in systematic reviews of adverse events: systematic review

    Science.gov (United States)

    Zorzela, Liliane; Golder, Su; Liu, Yali; Pilkington, Karen; Hartling, Lisa; Joffe, Ari; Loke, Yoon

    2014-01-01

    Objectives To examine the quality of reporting of harms in systematic reviews, and to determine the need for a reporting guideline specific for reviews of harms. Design Systematic review. Data sources Cochrane Database of Systematic Reviews (CDSR) and Database of Abstracts of Reviews of Effects (DARE). Review methods Databases were searched for systematic reviews having an adverse event as the main outcome, published from January 2008 to April 2011. Adverse events included an adverse reaction, harms, or complications associated with any healthcare intervention. Articles with a primary aim to investigate the complete safety profile of an intervention were also included. We developed a list of 37 items to measure the quality of reporting on harms in each review; data were collected as dichotomous outcomes (“yes” or “no” for each item). Results Of 4644 reviews identified, 309 were systematic reviews or meta-analyses primarily assessing harms (13 from CDSR; 296 from DARE). Despite a short time interval, the comparison between the years of 2008 and 2010-11 showed no difference on the quality of reporting over time (P=0.079). Titles in fewer than half the reviews (proportion of reviews 0.46 (95% confidence interval 0.40 to 0.52)) did not mention any harm related terms. Almost one third of DARE reviews (0.26 (0.22 to 0.31)) did not clearly define the adverse events reviewed, nor did they specify the study designs selected for inclusion in their methods section. Almost half of reviews (n=170) did not consider patient risk factors or length of follow-up when reviewing harms of an intervention. Of 67 reviews of complications related to surgery or other procedures, only four (0.05 (0.01 to 0.14)) reported professional qualifications of the individuals involved. The overall, unweighted, proportion of reviews with good reporting was 0.56 (0.55 to 0.57); corresponding proportions were 0.55 (0.53 to 0.57) in 2008, 0.55 (0.54 to 0.57) in 2009, and 0.57 (0.55 to 0.58) in

  19. A review of simulation-enhanced, team-based cardiopulmonary resuscitation training for undergraduate students.

    Science.gov (United States)

    Onan, Arif; Simsek, Nurettin; Elcin, Melih; Turan, Sevgi; Erbil, Bülent; Deniz, Kaan Zülfikar

    2017-11-01

    Cardiopulmonary resuscitation training is an essential element of clinical skill development for healthcare providers. The International Liaison Committee on Resuscitation has described issues related to cardiopulmonary resuscitation and emergency cardiovascular care education. Educational interventions have been initiated to try to address these issues using a team-based approach and simulation technologies that offer a controlled, safe learning environment. The aim of the study is to review and synthesize published studies that address the primary question "What are the features and effectiveness of educational interventions related to simulation-enhanced, team-based cardiopulmonary resuscitation training?" We conducted a systematic review focused on educational interventions pertaining to cardiac arrest and emergencies that addressed this main question. The findings are presented together with a discussion of the effectiveness of various educational interventions. In conclusion, student attitudes toward interprofessional learning and simulation experiences were more positive. Research reports emphasized the importance of adherence to established guidelines, adopting a holistic approach to training, and that preliminary training, briefing, deliberate practices, and debriefing should help to overcome deficiencies in cardiopulmonary resuscitation training. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. A literature review: factors that impact on nurses' effective use of the Medical Emergency Team (MET).

    Science.gov (United States)

    Jones, Lisa; King, Lindy; Wilson, Christine

    2009-12-01

    The aim of this literature review is to identify factors, both positive and negative, that impact on nurses' effective use of the Medical Emergency Team (MET) in acute care settings. Outcomes for patients are often dependent on nurses' ability to identify and respond to signs of increasing illness and initiate medical intervention. In an attempt to improve patient outcomes, many acute hospitals have implemented a rapid response system known as the Medical Emergency Team (MET) which has improved management of critically ill ward patients. Subsequent research has indicated that the MET system continues to be underused by nurses. A comprehensive thematic literature review. The review was undertaken using key words and the electronic databases of Cumulative Index to Nursing and Allied Health Literature (CINAHL), OVID/MEDLINE, Blackwell Synergy, Science Direct and Informit. Fifteen primary research reports were relevant and included in the review. Five major themes emerged from the analysis of the literature as the major factors effecting nurses' use of the MET system. They were: education on the MET, expertise, support by medical and nursing staff, nurses' familiarity with and advocacy for the patient and nurses' workload. Ongoing education on all aspects of the MET system is recommended for nursing, medical and MET staff. Bringing MET education into undergraduate programs to prepare new graduates entering the workforce to care for acutely ill patients is also strongly recommended. Further research is also needed to determine other influences on MET activation. Relevance to clinical practice. Strategies that will assist nurses to use the MET system more effectively include recruitment and retention of adequate numbers of permanent skilled staff thereby increasing familiarity with and advocacy for the patient. Junior doctors and nurses should be encouraged to attend ward MET calls to gain skills in management of acutely ill patients.

  1. A review of significant events analysed in general practice: implications for the quality and safety of patient care

    Directory of Open Access Journals (Sweden)

    Bradley Nick

    2009-09-01

    Full Text Available Abstract Background Significant event analysis (SEA is promoted as a team-based approach to enhancing patient safety through reflective learning. Evidence of SEA participation is required for appraisal and contractual purposes in UK general practice. A voluntary educational model in the west of Scotland enables general practitioners (GPs and doctors-in-training to submit SEA reports for feedback from trained peers. We reviewed reports to identify the range of safety issues analysed, learning needs raised and actions taken by GP teams. Method Content analysis of SEA reports submitted in an 18 month period between 2005 and 2007. Results 191 SEA reports were reviewed. 48 described patient harm (25.1%. A further 109 reports (57.1% outlined circumstances that had the potential to cause patient harm. Individual 'error' was cited as the most common reason for event occurrence (32.5%. Learning opportunities were identified in 182 reports (95.3% but were often non-specific professional issues not shared with the wider practice team. 154 SEA reports (80.1% described actions taken to improve practice systems or professional behaviour. However, non-medical staff were less likely to be involved in the changes resulting from event analyses describing patient harm (p Conclusion The study provides some evidence of the potential of SEA to improve healthcare quality and safety. If applied rigorously, GP teams and doctors in training can use the technique to investigate and learn from a wide variety of quality issues including those resulting in patient harm. This leads to reported change but it is unclear if such improvement is sustained.

  2. Interdisciplinary Skills Review Program to Improve Team Responses During Postpartum Hemorrhage.

    Science.gov (United States)

    Bittle, Marianne; O'Rourke, Kathleen; Srinivas, Sindhu K

    2017-12-06

    To develop an interdisciplinary, interactive, skills review program to improve team responses during a postpartum hemorrhage (PPH). Online didactic modules in combination with an interdisciplinary skills program consisting of seven hemorrhage-related stations. The project was conducted in the Women's Health Department in a quaternary-care Magnet- and Baby Friendly-designated academic medical center in Philadelphia, Pennsylvania. Women cared for at this center have comorbidities that place them at greater risk for PPH. A need was identified to implement a multidisciplinary and comprehensive program to assess hemorrhage risk and appropriately recognize and intervene with all PPHs in this setting. The 276 participants, including registered nurses, obstetric and family medicine attending physicians and residents, advanced practice nurses, and ancillary staff in the hospital's Women's Health Department, completed the initial obstetric hemorrhage program. The program included online didactic modules, seven interdisciplinary skills stations led by trained nurses and providers, and an in situ simulation. Successful completion of the online modules was a prerequisite for participation in the skills stations. All participants completed a written program evaluation at the conclusion of the program. Results of the postassessment survey indicated that participants rated the program 3.94 of 4.00 for overall effectiveness to improve interdisciplinary team responses to PPH. Comments were overwhelmingly positive, and participants expressed increased confidence and knowledge related to PPH after completion of the program. An interdisciplinary program that included online didactic modules, interactive skills stations, and simulation improved team confidence and responses to PPH. Copyright © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  3. Infantile Apparent Life-Threatening Events, an Educational Review

    Directory of Open Access Journals (Sweden)

    Hamed Aminiahidashti

    2015-01-01

    Full Text Available Many physicians have received a frantic call from anxious parents stating that their child had stopped breathing, become limp, or turned blue but then had recovered quickly. An apparent life-threatening event (ALTE is defined as “an episode that is frightening to the observer, and is characterized by some combination of apnea, color change, marked change in muscle tone, choking, gagging, or coughing”. The incidence of ALTE is reported to be 0.05% to 6%. The knowledge about the most common causes and factors associated with higher risk of ALTE could be resulted in a more purposeful approach, improving the decision making process, and benefiting both children and parents. The aim of this review article was to report the epidemiology, etiology, evaluation, management, and disposition of ALTE. Infants with an ALTE might present no signs of acute illness and are commonly managed in the emergency settings that often require significant medical attention; hence, the emergency medicine personnel should be aware of the its clinical importance. There is no specific treatment for ALTE; therefore, the clinical evaluations should be focused on the detection of the underlying causes, which will define the outcomes and prognosis. ALTE is a confusing entity, representing a constellation of descriptive symptoms and signs; in other words, it is not a diagnosis. There are multiple possible etiologies and difficulties in evaluating and managing infants with these events, which are challenges to primary care physicians, emergency medicine specialists, and subspecialty pediatricians. The evaluation of these events in infants includes a detailed history, appropriate physical examination, diagnostic tests guided by obtained clues from the history and physical examination, and observation in the emergency department.

  4. The Chornobyl accident revisited, part III: Chornobyl source team release dynamics and reconstruction of events during the active phase

    Energy Technology Data Exchange (ETDEWEB)

    Sich, A.R.

    1995-07-01

    Chernobyl radioisotope release data presented by the Soviets at Vienna in August 1986 are reviewed and compared with newly available data for the period of the active phase (t=0{sup +} up to 10 days). An analysis of these data indicates that radioisotopes were released under roughly isothermal conditions. Moreover, the releases of 17 isotopes analyzed are surprisingly close in magnitude, both with respect to their normalized mass releases and with respect to their release efficacies relative to Zr-95. On the basis of the information presented in this and the previous two articles of this series, a sequence of events is postulated as to what may have occurred to the Unit 4 core during the active phase. This scenario strongly contradicts accounts based on information presented by the Soviets in August 1986. The release of eight volatile isotopes is estimated to be 92 MCi. This in substantially more than the 50 MCi claimed by the Soviets and confirms western suspicions that more was released.

  5. Bayesian analysis for extreme climatic events: A review

    Science.gov (United States)

    Chu, Pao-Shin; Zhao, Xin

    2011-11-01

    This article reviews Bayesian analysis methods applied to extreme climatic data. We particularly focus on applications to three different problems related to extreme climatic events including detection of abrupt regime shifts, clustering tropical cyclone tracks, and statistical forecasting for seasonal tropical cyclone activity. For identifying potential change points in an extreme event count series, a hierarchical Bayesian framework involving three layers - data, parameter, and hypothesis - is formulated to demonstrate the posterior probability of the shifts throughout the time. For the data layer, a Poisson process with a gamma distributed rate is presumed. For the hypothesis layer, multiple candidate hypotheses with different change-points are considered. To calculate the posterior probability for each hypothesis and its associated parameters we developed an exact analytical formula, a Markov Chain Monte Carlo (MCMC) algorithm, and a more sophisticated reversible jump Markov Chain Monte Carlo (RJMCMC) algorithm. The algorithms are applied to several rare event series: the annual tropical cyclone or typhoon counts over the central, eastern, and western North Pacific; the annual extremely heavy rainfall event counts at Manoa, Hawaii; and the annual heat wave frequency in France. Using an Expectation-Maximization (EM) algorithm, a Bayesian clustering method built on a mixture Gaussian model is applied to objectively classify historical, spaghetti-like tropical cyclone tracks (1945-2007) over the western North Pacific and the South China Sea into eight distinct track types. A regression based approach to forecasting seasonal tropical cyclone frequency in a region is developed. Specifically, by adopting large-scale environmental conditions prior to the tropical cyclone season, a Poisson regression model is built for predicting seasonal tropical cyclone counts, and a probit regression model is alternatively developed toward a binary classification problem. With a non

  6. Critical care clinician perceptions of factors leading to Medical Emergency Team review.

    Science.gov (United States)

    Currey, Judy; Allen, Josh; Jones, Daryl

    2017-05-05

    The introduction of rapid response systems has reduced the incidence of in-hospital cardiac arrest; however, many instances of clinical deterioration are unrecognised. Afferent limb failure is common and may be associated with unplanned intensive care admissions, heightened mortality and prolonged length of stay. Patients reviewed by a Medical Emergency Team are inherently vulnerable with a high in-hospital mortality. To explore perceptions of intensive care unit (ICU) staff who attend deteriorating acute care ward patients regarding current problems, barriers and potential solutions to recognising and responding to clinical deterioration that culminates in a Medical Emergency Team review. A descriptive exploratory design was used. Registered intensive care nurses and medical staff (N=207) were recruited during a professional conference using purposive sampling for experience in attending deteriorating patients. Written response surveys were used to address the study aim. Data were analysed using content analysis. Four major themes were identified: Governance, Teamwork, Clinical Care Delivery and End of Life Care. Participants perceived there was a lack of sufficient and senior staff with the required theoretical knowledge; and inadequate assessment and critical thinking skills for anticipating, recognising and responding to clinical deterioration. Senior doctors were perceived to inappropriately manage End of Life Care issues and displayed Teamwork behaviours rendering ward clinicians feeling fearful and intimidated. A lack of System and Clinical Governance hindered identification of clinical deterioration. To improve patient safety related to recognising and responding to clinical deterioration, suboptimal care due to professionals' knowledge, skills and behaviours need addressing, along with End of Life Care and Governance. Copyright © 2017 Australian College of Critical Care Nurses Ltd. All rights reserved.

  7. The impact of the multidisciplinary team in the management of individuals with diabetic foot ulcers: a systematic review.

    Science.gov (United States)

    Buggy, A; Moore, Z

    2017-06-02

    To assess the impact of the multidisciplinary team in the management of the diabetic foot compared with those who did not receive multidisciplinary care. A systematic review of the literature was conducted using the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Embase and Cochrane Library. The following search terms were used: diabetic foot, multidisciplinary team, patient care team, multidisciplinary care team. Data were extracted using a bespoke data extraction tool and quality appraisal of the studies was undertaken using the EBL Critical Appraisal checklist. Data analysis was undertaken using RevMan with results presented as odds ratio for dichotomous data, or mean difference for continuous data, all with the associated 95% confidence intervals. The search identified 19 eligible studies. Severity of amputation, death rates and length of hospital stay of clients receiving multidisciplinary team care were improved when compared with those who did not receive multidisciplinary team care. Ulcer healing and quality of life showed an improvement but not all studies explored these outcomes. Only 7 of the 19 articles appraised were found to be of acceptable quality, questioning the generalisability of the results. From the currently available evidence a positive impact of the multidisciplinary team on diabetic foot outcomes can be seen, but due to the lack of high-quality evidence and substantial heterogeneity in the studies, these results should be interpreted with caution.

  8. A Systematic Review of Developing Team Competencies in Information Systems Education

    Science.gov (United States)

    Figl, Kathrin

    2010-01-01

    The ability to work effectively in teams has been a key competence for information systems engineers for a long time. Gradually, more attention is being paid to developing this generic competence as part of academic curricula, resulting in two questions: how to best promote team competencies and how to implement team projects successfully. These…

  9. Systematic Review: Adverse Events of Fecal Microbiota Transplantation.

    Directory of Open Access Journals (Sweden)

    Sinan Wang

    Full Text Available Fecal microbiota transplantation (FMT is a microbiota-based therapy that shows therapeutic potential in recurrent or refractory Clostridium difficile infections and other intestinal or extra-intestinal disorders. Nonetheless, adverse events (AEs remain a major challenge in the application of FMT.To review the AEs of FMT and to address the concerns of safety during the procedure.Publications were retrieved in the databases of Medline, Embase and Cochrane Library. AEs were classified according to their causality with FMT or their severity.A total of 7562 original articles about FMT were identified in this study, 50 of them fulfilled the inclusion criteria. Totally 78 kinds of AEs were revealed enrolled in these 50 selected publications. The total incidence rate of AEs was 28.5%. Among the 42 publications, 5 kinds were definitely and 38 kinds were probably related to FMT. The commonest FMT-attributable AE was abdominal discomfort, which was reported in 19 publications. For upper gastrointestinal routes of FMT, 43.6% (89/204 patients were compromised by FMT-attributable AE, while the incidence dropped to 17.7% (76/430 for lower gastrointestinal routes. In contrast, the incidences of serious adverse events (SAEs were 2.0% (4/196 and 6.1% (40/659 for upper and lower gastrointestinal routes, respectively. A total of 44 kinds of SAEs occurred in 9.2% patients, including death (3.5%, 38/1089, infection (2.5%, 27/1089, relapse of inflammatory bowel diseases (0.6%, 7/1089 and Clostridium difficile infection (0.9%, 10/1089.Consequently, both AEs and SAEs are not rare and should be carefully monitored throughout FMT. However, high quality randomized controlled trials are still needed for the more definite incidence of AEs of FMT.

  10. Assessing the facilitators and barriers of interdisciplinary team working in primary care using normalisation process theory: An integrative review.

    Science.gov (United States)

    O'Reilly, Pauline; Lee, Siew Hwa; O'Sullivan, Madeleine; Cullen, Walter; Kennedy, Catriona; MacFarlane, Anne

    2017-01-01

    Interdisciplinary team working is of paramount importance in the reform of primary care in order to provide cost-effective and comprehensive care. However, international research shows that it is not routine practice in many healthcare jurisdictions. It is imperative to understand levers and barriers to the implementation process. This review examines interdisciplinary team working in practice, in primary care, from the perspective of service providers and analyses 1 barriers and facilitators to implementation of interdisciplinary teams in primary care and 2 the main research gaps. An integrative review following the PRISMA guidelines was conducted. Following a search of 10 international databases, 8,827 titles were screened for relevance and 49 met the criteria. Quality of evidence was appraised using predetermined criteria. Data were analysed following the principles of framework analysis using Normalisation Process Theory (NPT), which has four constructs: sense making, enrolment, enactment, and appraisal. The literature is dominated by a focus on interdisciplinary working between physicians and nurses. There is a dearth of evidence about all NPT constructs apart from enactment. Physicians play a key role in encouraging the enrolment of others in primary care team working and in enabling effective divisions of labour in the team. The experience of interdisciplinary working emerged as a lever for its implementation, particularly where communication and respect were strong between professionals. A key lever for interdisciplinary team working in primary care is to get professionals working together and to learn from each other in practice. However, the evidence base is limited as it does not reflect the experiences of all primary care professionals and it is primarily about the enactment of team working. We need to know much more about the experiences of the full network of primary care professionals regarding all aspects of implementation work. International

  11. Adverse drug event reporting systems: a systematic review.

    Science.gov (United States)

    Bailey, Chantelle; Peddie, David; Wickham, Maeve E; Badke, Katherin; Small, Serena S; Doyle-Waters, Mary M; Balka, Ellen; Hohl, Corinne M

    2016-07-01

    Adverse drug events (ADEs) are harmful and unintended consequences of medications. Their reporting is essential for drug safety monitoring and research, but it has not been standardized internationally. Our aim was to synthesize information about the type and variety of data collected within ADE reporting systems. We developed a systematic search strategy, applied it to four electronic databases, and completed an electronic grey literature search. Two authors reviewed titles and abstracts, and all eligible full-texts. We extracted data using a standardized form, and discussed disagreements until reaching consensus. We synthesized data by collapsing data elements, eliminating duplicate fields and identifying relationships between reporting concepts and data fields using visual analysis software. We identified 108 ADE reporting systems containing 1782 unique data fields. We mapped them to 33 reporting concepts describing patient information, the ADE, concomitant and suspect drugs, and the reporter. While reporting concepts were fairly consistent, we found variability in data fields and corresponding response options. Few systems clarified the terminology used, and many used multiple drug and disease dictionaries such as the Medical Dictionary for Regulatory Activities (MedDRA). We found substantial variability in the data fields used to report ADEs, limiting the comparability of ADE data collected using different reporting systems, and undermining efforts to aggregate data across cohorts. The development of a common standardized data set that can be evaluated with regard to data quality, comparability and reporting rates is likely to optimize ADE data and drug safety surveillance. © 2016 The British Pharmacological Society.

  12. The Research of Self-Management Team and Superior-Direction Team in Team Learning Influential Factors

    OpenAIRE

    Zhang Wei

    2013-01-01

    Team learning is a cure for bureaucracy; it facilitates team innovation and team performance. But team learning occurs only when necessary conditions were met. This research focused on differences of team learning influential factors between self-management team and superior-direction team. Four variables were chosen as predictors of team learning though literature review and pilot interview. The 4 variables are team motivation, team trust, team conflict and team leadership. Selected 54 self ...

  13. The affective bases of team performance during nonroutine events: The case of nuclear power plant control room crews

    Science.gov (United States)

    Kaplan, Seth A.

    By conceiving of teams' nonroutine performance as a series of coping responses, this paper examines how crewmembers' positive and negative affectivity (PA, NA) impact individual behaviors and team processes. A theoretical model is developed in which trait affect's influence is predicted to vary depending on the nature of the task, the level of analysis, and the timing of behaviors. The model is empirically tested using coded behaviors of 75 nuclear power plant control room operators, composing 17 crews, who engage in a high-fidelity training simulation. Results using random coefficient modeling were mixed, but generally failed to support the study hypotheses. Discussion focuses on the potential benefits of NA in organizations and on the limitations of the current study context.

  14. Adverse events in patients in home healthcare: a retrospective record review using trigger tool methodology.

    Science.gov (United States)

    Schildmeijer, Kristina Görel Ingegerd; Unbeck, Maria; Ekstedt, Mirjam; Lindblad, Marléne; Nilsson, Lena

    2018-01-03

    Home healthcare is an increasingly common part of healthcare. The patients are often aged, frail and have multiple diseases, and multiple caregivers are involved in their treatment. This study explores the origin, incidence, types and preventability of adverse events (AEs) that occur in patients receiving home healthcare. A study using retrospective record review and trigger tool methodology. Ten teams with experience of home healthcare from nine regions across Sweden reviewed home healthcare records in a two-stage procedure using 38 predefined triggers in four modules. A random sample of records from 600 patients (aged 18 years or older) receiving home healthcare during 2015 were reviewed. The cumulative incidence of AEs found in patients receiving home healthcare; secondary measures were origin, types, severity of harm and preventability of the AEs. The patients were aged 20-79 years, 280 men and 320 women. The review teams identified 356 AEs in 226 (37.7%; 95% CI 33.0 to 42.8) of the home healthcare records. Of these, 255 (71.6%; 95% CI 63.2 to 80.8) were assessed as being preventable, and most (246, 69.1%; 95% CI 60.9 to 78.2) required extra healthcare visits or led to a prolonged period of healthcare. Most of the AEs (271, 76.1%; 95% CI 67.5 to 85.6) originated in home healthcare; the rest were detected during home healthcare but were related to care outside home healthcare. The most common AEs were healthcare-associated infections, falls and pressure ulcers. AEs in patients receiving home healthcare are common, mostly preventable and often cause temporary harm requiring extra healthcare resources. The most frequent types of AEs must be addressed and reduced through improvements in interprofessional collaboration. This is an important area for future studies. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Impact on diabetes management of General Practice Management Plans, Team Care Arrangements and reviews.

    Science.gov (United States)

    Wickramasinghe, Leelani K; Schattner, Peter; Hibbert, Marienne E; Enticott, Joanne C; Georgeff, Michael P; Russell, Grant M

    2013-08-19

    To investigate whether General Practice Management Plans (GPMPs), Team Care Arrangements (TCAs) and reviews of these improve the management and outcomes of patients with diabetes when supported by cdmNet, a web-based chronic disease management system; and to investigate adherence to the annual cycle of care (ACOC), as recommended in diabetes guidelines. A before-and-after study to analyse prospectively collected data on 577 patients with type 1 or 2 diabetes mellitus who were managed with a GPMP created using cdmNet between June 2008 and November 2012. Completion of the clinical tests in the ACOC (process outcome) and values of six of these clinical measurements (clinical outcomes). Significant improvements were seen after creation of a GPMP in the proportion of ACOC clinical tests completed (57.9% v 74.8%, P < 0.001), total cholesterol level (P < 0.01), low-density lipoprotein (LDL) cholesterol level (P < 0.001) and body mass index (BMI) (P < 0.01). Patients using GPMPs and TCAs also improved their glycated haemoglobin (HbA1c) level (P < 0.05). Patients followed up with irregular reviews had significant improvements in the proportion of ACOC clinical tests completed (59.2% v 77.6%, P < 0.001), total cholesterol level (P < 0.05), and BMI (P < 0.01), but patients with regular reviews had greater improvements in the proportion of ACOC clinical tests completed (58.9% v 85.0%, P < 0.001), HbA(1c) level (57.7 v 53.0 mmol/mol, P < 0.05), total cholesterol level (4.8 v 4.5 mmol/L, P < 0.05), LDL cholesterol level (2.8 v 2.4 mmol/L, P < 0.01) and diastolic blood pressure (76.0 v 74.0 mmHg, P < 0.05). There were significant improvements in process and clinical outcomes for patients on a GPMP or a GPMP and TCA, particularly when these were followed up by regular reviews. Patients using cdmNet were four times more likely to have their GPMP or TCA followed up through regular reviews than the national average.

  16. Integrating natural language processing expertise with patient safety event review committees to improve the analysis of medication events.

    Science.gov (United States)

    Fong, Allan; Harriott, Nicole; Walters, Donna M; Foley, Hanan; Morrissey, Richard; Ratwani, Raj R

    2017-08-01

    Many healthcare providers have implemented patient safety event reporting systems to better understand and improve patient safety. Reviewing and analyzing these reports is often time consuming and resource intensive because of both the quantity of reports and length of free-text descriptions in the reports. Natural language processing (NLP) experts collaborated with clinical experts on a patient safety committee to assist in the identification and analysis of medication related patient safety events. Different NLP algorithmic approaches were developed to identify four types of medication related patient safety events and the models were compared. Well performing NLP models were generated to categorize medication related events into pharmacy delivery delays, dispensing errors, Pyxis discrepancies, and prescriber errors with receiver operating characteristic areas under the curve of 0.96, 0.87, 0.96, and 0.81 respectively. We also found that modeling the brief without the resolution text generally improved model performance. These models were integrated into a dashboard visualization to support the patient safety committee review process. We demonstrate the capabilities of various NLP models and the use of two text inclusion strategies at categorizing medication related patient safety events. The NLP models and visualization could be used to improve the efficiency of patient safety event data review and analysis. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Implementation of the Crisis Resolution Team model in adult mental health settings: a systematic review

    National Research Council Canada - National Science Library

    Wheeler, Claire; Lloyd-Evans, Brynmor; Churchard, Alasdair; Fitzgerald, Caroline; Fullarton, Kate; Mosse, Liberty; Paterson, Bethan; Zugaro, Clementina Galli; Johnson, Sonia

    2015-01-01

    Crisis Resolution Teams (CRTs) aim to offer an alternative to hospital admission during mental health crises, providing rapid assessment, home treatment, and facilitation of early discharge from hospital...

  18. Measuring team factors thought to influence the success of quality improvement in primary care: a systematic review of instruments.

    Science.gov (United States)

    Brennan, Sue E; Bosch, Marije; Buchan, Heather; Green, Sally E

    2013-02-14

    Measuring team factors in evaluations of Continuous Quality Improvement (CQI) may provide important information for enhancing CQI processes and outcomes; however, the large number of potentially relevant factors and associated measurement instruments makes inclusion of such measures challenging. This review aims to provide guidance on the selection of instruments for measuring team-level factors by systematically collating, categorizing, and reviewing quantitative self-report instruments. We searched MEDLINE, PsycINFO, and Health and Psychosocial Instruments; reference lists of systematic reviews; and citations and references of the main report of instruments. To determine the scope of the review, we developed and used a conceptual framework designed to capture factors relevant to evaluating CQI in primary care (the InQuIRe framework). We included papers reporting development or use of an instrument measuring factors relevant to teamwork. Data extracted included instrument purpose; theoretical basis, constructs measured and definitions; development methods and assessment of measurement properties. Analysis and synthesis: We used qualitative analysis of instrument content and our initial framework to develop a taxonomy for summarizing and comparing instruments. Instrument content was categorized using the taxonomy, illustrating coverage of the InQuIRe framework. Methods of development and evidence of measurement properties were reviewed for instruments with potential for use in primary care. We identified 192 potentially relevant instruments, 170 of which were analyzed to develop the taxonomy. Eighty-one instruments measured constructs relevant to CQI teams in primary care, with content covering teamwork context (45 instruments measured enabling conditions or attitudes to teamwork), team process (57 instruments measured teamwork behaviors), and team outcomes (59 instruments measured perceptions of the team or its effectiveness). Forty instruments were included for

  19. Continuity across inpatient and outpatient mental health care or specialisation of teams? A systematic review.

    Science.gov (United States)

    Omer, S; Priebe, S; Giacco, D

    2015-02-01

    A central question for the organisation of mental health care is whether the same clinicians should be responsible for a patient's care across inpatient and outpatient settings (continuity of care) or if there should be separate teams (specialisation). Current reforms in Europe are inconsistent on which to favour, and are based on little research evidence. This review is the first systematic appraisal of the existing evidence comparing continuity of care and specialisation across inpatient and outpatient mental health care. A systematic search for studies of any design comparing mental health care systems based on continuity or specialisation of care was performed. Differences in clinical, social and cost-effective outcomes, and the views and experiences of patients and staff were assessed using narrative synthesis. Seventeen studies met the inclusion criteria. All studies had methodological shortcomings, but findings point towards reduced length and number of hospitalisations, and faster or more flexible transitions between services in continuity systems. Survey and qualitative findings suggest advantages of both systems, whilst patients and staff appear to prefer a continuity system. The evidence base suggests better outcomes and stakeholder preferences for continuity of care systems, but the quality of existing studies is insufficient to draw definitive conclusions. Higher quality comparative studies across various settings and population groups are urgently needed. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  20. Learning Team Review 2016-0001: Installing Outlets for Programmatic Equipment

    Energy Technology Data Exchange (ETDEWEB)

    Dunwoody, John Tyler [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Obrey, Kimberly Ann [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Bridgewater, Jon S. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Griego, Frank X. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Brenner, Andrew Karl [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Lopez, Ted T. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Henderson, Kevin C. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Gordon, Lloyd Baumgardner [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Blumberg, Paul A. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Wilburn, Dianne Williams [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-09-08

    The purpose of a Learning Team is to transfer and communicate the information into operational feedback and improvement. We want to pay attention to the small things that go wrong because they are often early warning signals and may provide insight into the health of the whole system. An ESR was placed in the October of 2015 to move/install a number of 120V and 208V outlets in 455-104B to support programmatic furnace needs. Electrical design review was completed for ESR 22217 on February 22, 2016 and a Design Change Form completed describing the modification needed as: demolish 1 existing receptacle and circuit leaving conduit and jbox for use to install new receptacle and 5 new receptacles/circuits are required and one existing receptacle is to be relocated, listed under FSR 149229. The FSR scope of work was written:: Please have the Electricians come out to perform demolition (1ea.), installation (6ea.)& relocation (1ea.) of receptacles / circuits. ESR 22217 & DCF-16-35-0455-1281 is in place for this work. Coordinate final receptacle locations with Laboratory Resident. Contact John Dunwoody or O-MC for this information. WO# 545580-01 was signed on April 20, 2016.: Electricians to perform demolition, installation, & relocation of receptacles / circuits PER attached DCF-16-0455-1281-SK-1.

  1. Review of the tactical evaluation tools for youth players, assessing the tactics in team sports: football.

    Science.gov (United States)

    González-Víllora, Sixto; Serra-Olivares, Jaime; Pastor-Vicedo, Juan Carlos; da Costa, Israel Teoldo

    2015-01-01

    For sports assessment to be comprehensive, it must address all variables of sports development, such as psychological, social-emotional, physical and physiological, technical and tactical. Tactical assessment has been a neglected variable until the 1980s or 1990s. In the last two decades (1995-2015), the evolution of tactical assessment has grown considerably, given its importance in game performance. The aim of this paper is to compile and analyze different tactical measuring tools in team sports, particularly in soccer, through a bibliographical review. Six tools have been selected on five different criteria: (1) Instruments which assess tactics, (2) The studies have an evolution approach related to the tactical principles, (3) With a valid and reliable method, (4) The existence of publications mentioning the tool in the method, v. Applicable in different sports contexts. All six tools are structured around seven headings: introduction, objective(s), tactical principles, materials, procedures, instructions/rules of the game and published studies. In conclusion, the teaching-learning processes more tactical oriented have useful tactical assessment instrument in the literature. The selection of one or another depends some context information, like age and level of expertise of the players.

  2. Observation of interprofessional collaborative practice in primary care teams: An integrative literature review.

    Science.gov (United States)

    Morgan, Sonya; Pullon, Susan; McKinlay, Eileen

    2015-07-01

    Interprofessional collaboration improves patient care, especially for those patients with complex and/or chronic conditions. Many studies examining collaborative practice in primary care settings have been undertaken, yet identification of essential elements of effective interprofessional collaboration in primary care settings remains obscure. To examine the nature of interprofessional collaboration (including interprofessional collaborative practice) and the key influences that lead to successful models of interprofessional practice in primary care teams, as reported in studies using direct observation methods. Integrative review using Whittemore and Knafl's (2005) five stage framework: problem identification, literature search, data evaluation, data analysis and presentation. Data sources and review method: Primary research studies meeting the search criteria were accessed from MEDLINE, PsycINFO, Scopus, King's Fund and Informit Health Collection databases, and by hand-searching reference lists. From 2005 to 2013, 105 studies closely examining elements of interprofessional collaboration were identified. Of these, 11 studies were identified which incorporated a range of 'real time' direct observation methods where the collaborative practice of health professionals was closely observed. Constant opportunity for effective, frequent, informal shared communication emerged as the overarching theme and most critical factor in achieving and sustaining effective interprofessional collaboration and interprofessional collaborative practice in this review. Multiple channels for repeated (often brief) informal shared communication were necessary for shared knowledge creation, development of shared goals, and shared clinical decision making. Favourable physical space configuration and 'having frequent brief time in common' were key facilitators. This review highlights the need to look critically at the body of research purported to investigate interprofessional collaboration

  3. Team based learning in nursing and midwifery higher education; a systematic review of the evidence for change.

    Science.gov (United States)

    Dearnley, Chris; Rhodes, Christine; Roberts, Peter; Williams, Pam; Prenton, Sarah

    2018-01-01

    The aim of this study is to review the evidence in relation to the experiences and outcomes of students on nursing and/or midwifery higher education programmes, who experience team based learning. To examine the relationship between team based learning and attainment for nursing and midwifery students in professional higher education. To examine the relationship between team based learning and student satisfaction for nurses and midwifery students in higher education. To identify and report examples of good practice in the implementation of team based learning in Nursing and Midwifery higher education. A systematic Review of the literature was undertaken. The population were nurses and midwives studying on higher education pre and post registration professional programmes. The intervention was learning and teaching activities based on a team-based learning approach. Data sources included CINAHL and MEDLINE. ERIC and Index to Theses were also searched. International research papers published in English between 2011 and 2017 that met the inclusion criteria were included in the study. Papers that met the criteria were subjected to quality appraisal and agreement amongst authors for inclusion in the review. A total of sixteen papers were reviewed and four themes emerged for discussion. These were Student Engagement, Student Satisfaction, Attainment and Practice Development and Transformational Teaching and Learning. There is a tentative, though growing body of evidence to support TBL as a strategy that can impact on student engagement, student satisfaction, attainment, practice development and transformative teaching and learning. The literature indicates that implementing TBL within the curriculum is not without challenge and requires a sustained and structured approach. Staff and students need to understand the processes involved, and why they should be adhered to, in the pursuit of enhanced student experiences and outcomes for nurses and midwives in Higher Education

  4. Events

    Directory of Open Access Journals (Sweden)

    Marina Tkacheva

    2010-12-01

    Full Text Available Baikal Economic ForumInternational Scientific and Practical Conference"Culture of Wood - Wood in Culture"Summer Ateliers of UrbanistsMemorandum of Understanding between UIA and Active House AllianceKorean Team Wins the First Prize in the VELUX AwardUIA Professional Practice Commission"Zodchestvo 2010" International FestivalRainbow of "Zodchestvo 2010" in ManezhThree Opinions on One Book about Gogol's Two"Soviet Modernism" BookV Plenum of the Board of the Union of Architects of RussiaXXX Meeting of Chief ArchitectsCompetition of Graduation ProjectsInternational Day of Architecture

  5. Who should lead a trauma team: Surgeon or non-surgeon? A systematic review and meta-analysis

    Science.gov (United States)

    Hajibandeh, Shahab; Hajibandeh, Shahin

    2017-01-01

    Abstract: Background: Presence of a trauma team leader (TTL) in the trauma team is associated with positive patient outcomes in major trauma. The TTL is traditionally a surgeon who coordinates the resuscitation and ensures adherence to Advanced Trauma Life Support (ATLS) guidelines. The necessity of routine surgical leadership in the resuscitative component of trauma care has been questioned by some authors. Therefore, it remains controversial who should lead the trauma team. We aimed to evaluate outcomes associated with surgeon versus non-surgeon TTLs in management of trauma patients. Methods: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement standards, we performed a systematic review. Electronic databases MEDLINE, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched to identify randomized and non-randomized studies investigating outcomes associated with surgeon versus non-surgeon TTL in management of trauma patients. The Newcastle-Ottawa scale was used to assess the methodological quality and risk of bias of the selected studies. Fixed-effect model was applied to calculate pooled outcome data. Results: Three retrospective cohort studies, enrolling 2,519 adult major trauma patients, were included. Our analysis showed that there was no difference in survival [odds ratio (OR): 0.82, 95% confidence interval (CI) 0.61-1.10, P=0.19] and length of stay when trauma team was led by surgeon or non-surgeon TTLs; however, fewer injuries were missed when the trauma team was led by a surgeon (OR: 0.48, 95% CI 0.25-0.92, P=0.03). Conclusions: Despite constant debate, the comparative evidence about outcomes associated with surgeon and non-surgeon trauma team leader is insufficient. The best available evidence suggests that there is no significant difference in outcomes of surgeon or non-surgeon trauma team leaders. High quality randomized controlled trials are required to compare the

  6. Who should lead a trauma team: Surgeon or non-surgeon? A systematic review and meta-analysis.

    Science.gov (United States)

    Hajibandeh, Shahab; Hajibandeh, Shahin

    2017-07-01

    Presence of a trauma team leader (TTL) in the trauma team is associated with positive patient outcomes in major trauma. The TTL is traditionally a surgeon who coordinates the resuscitation and ensures adherence to Advanced Trauma Life Support (ATLS) guidelines. The necessity of routine surgical leadership in the resuscitative component of trauma care has been questioned by some authors. Therefore, it remains controversial who should lead the trauma team. We aimed to evaluate outcomes associated with surgeon versus non-surgeon TTLs in management of trauma patients. In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement standards, we performed a systematic review. Electronic databases MEDLINE, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched to identify randomized and non-randomized studies investigating outcomes associated with surgeon versus non-surgeon TTL in management of trauma patients. The Newcastle-Ottawa scale was used to assess the methodological quality and risk of bias of the selected studies. Fixed-effect model was applied to calculate pooled outcome data. Three retrospective cohort studies, enrolling 2,519 adult major trauma patients were included. Our analysis showed that there was no difference in survival [odds ratio (OR): 0.82, 95% confidence interval (CI) 0.61-1.10, P=0.19] and length of stay when trauma team was led by surgeon or non-surgeon TTLs; however, fewer injuries were missed when the trauma team was led by a surgeon (OR: 0.48, 95% CI 0.25-0.92, P=0.03). Despite constant debate, the comparative evidence about outcomes associated with surgeon and non-surgeon trauma team leader is insufficient. The best available evidence suggests that there is no significant difference in outcomes of surgeon or non-surgeon trauma team leaders. High quality randomized controlled trials are required to compare the effectiveness of surgeon and non-surgeon trauma team

  7. When Is a Sprint a Sprint? A Review of the Analysis of Team-Sport Athlete Activity Profile.

    Science.gov (United States)

    Sweeting, Alice J; Cormack, Stuart J; Morgan, Stuart; Aughey, Robert J

    2017-01-01

    The external load of a team-sport athlete can be measured by tracking technologies, including global positioning systems (GPS), local positioning systems (LPS), and vision-based systems. These technologies allow for the calculation of displacement, velocity and acceleration during a match or training session. The accurate quantification of these variables is critical so that meaningful changes in team-sport athlete external load can be detected. High-velocity running, including sprinting, may be important for specific team-sport match activities, including evading an opponent or creating a shot on goal. Maximal accelerations are energetically demanding and frequently occur from a low velocity during team-sport matches. Despite extensive research, conjecture exists regarding the thresholds by which to classify the high velocity and acceleration activity of a team-sport athlete. There is currently no consensus on the definition of a sprint or acceleration effort, even within a single sport. The aim of this narrative review was to examine the varying velocity and acceleration thresholds reported in athlete activity profiling. The purposes of this review were therefore to (1) identify the various thresholds used to classify high-velocity or -intensity running plus accelerations; (2) examine the impact of individualized thresholds on reported team-sport activity profile; (3) evaluate the use of thresholds for court-based team-sports and; (4) discuss potential areas for future research. The presentation of velocity thresholds as a single value, with equivocal qualitative descriptors, is confusing when data lies between two thresholds. In Australian football, sprint efforts have been defined as activity >4.00 or >4.17 m·s-1. Acceleration thresholds differ across the literature, with >1.11, 2.78, 3.00, and 4.00 m·s-2 utilized across a number of sports. It is difficult to compare literature on field-based sports due to inconsistencies in velocity and acceleration

  8. When Is a Sprint a Sprint? A Review of the Analysis of Team-Sport Athlete Activity Profile

    Science.gov (United States)

    Sweeting, Alice J.; Cormack, Stuart J.; Morgan, Stuart; Aughey, Robert J.

    2017-01-01

    The external load of a team-sport athlete can be measured by tracking technologies, including global positioning systems (GPS), local positioning systems (LPS), and vision-based systems. These technologies allow for the calculation of displacement, velocity and acceleration during a match or training session. The accurate quantification of these variables is critical so that meaningful changes in team-sport athlete external load can be detected. High-velocity running, including sprinting, may be important for specific team-sport match activities, including evading an opponent or creating a shot on goal. Maximal accelerations are energetically demanding and frequently occur from a low velocity during team-sport matches. Despite extensive research, conjecture exists regarding the thresholds by which to classify the high velocity and acceleration activity of a team-sport athlete. There is currently no consensus on the definition of a sprint or acceleration effort, even within a single sport. The aim of this narrative review was to examine the varying velocity and acceleration thresholds reported in athlete activity profiling. The purposes of this review were therefore to (1) identify the various thresholds used to classify high-velocity or -intensity running plus accelerations; (2) examine the impact of individualized thresholds on reported team-sport activity profile; (3) evaluate the use of thresholds for court-based team-sports and; (4) discuss potential areas for future research. The presentation of velocity thresholds as a single value, with equivocal qualitative descriptors, is confusing when data lies between two thresholds. In Australian football, sprint efforts have been defined as activity >4.00 or >4.17 m·s−1. Acceleration thresholds differ across the literature, with >1.11, 2.78, 3.00, and 4.00 m·s−2 utilized across a number of sports. It is difficult to compare literature on field-based sports due to inconsistencies in velocity and acceleration

  9. When Is a Sprint a Sprint? A Review of the Analysis of Team-Sport Athlete Activity Profile

    Directory of Open Access Journals (Sweden)

    Alice J. Sweeting

    2017-06-01

    Full Text Available The external load of a team-sport athlete can be measured by tracking technologies, including global positioning systems (GPS, local positioning systems (LPS, and vision-based systems. These technologies allow for the calculation of displacement, velocity and acceleration during a match or training session. The accurate quantification of these variables is critical so that meaningful changes in team-sport athlete external load can be detected. High-velocity running, including sprinting, may be important for specific team-sport match activities, including evading an opponent or creating a shot on goal. Maximal accelerations are energetically demanding and frequently occur from a low velocity during team-sport matches. Despite extensive research, conjecture exists regarding the thresholds by which to classify the high velocity and acceleration activity of a team-sport athlete. There is currently no consensus on the definition of a sprint or acceleration effort, even within a single sport. The aim of this narrative review was to examine the varying velocity and acceleration thresholds reported in athlete activity profiling. The purposes of this review were therefore to (1 identify the various thresholds used to classify high-velocity or -intensity running plus accelerations; (2 examine the impact of individualized thresholds on reported team-sport activity profile; (3 evaluate the use of thresholds for court-based team-sports and; (4 discuss potential areas for future research. The presentation of velocity thresholds as a single value, with equivocal qualitative descriptors, is confusing when data lies between two thresholds. In Australian football, sprint efforts have been defined as activity >4.00 or >4.17 m·s−1. Acceleration thresholds differ across the literature, with >1.11, 2.78, 3.00, and 4.00 m·s−2 utilized across a number of sports. It is difficult to compare literature on field-based sports due to inconsistencies in velocity and

  10. Team Leader Structuring for Team Effectiveness and Team Learning in Command-and-Control Teams.

    Science.gov (United States)

    van der Haar, Selma; Koeslag-Kreunen, Mieke; Euwe, Eline; Segers, Mien

    2017-04-01

    Due to their crucial and highly consequential task, it is of utmost importance to understand the levers leading to effectiveness of multidisciplinary emergency management command-and-control (EMCC) teams. We argue that the formal EMCC team leader needs to initiate structure in the team meetings to support organizing the work as well as facilitate team learning, especially the team learning process of constructive conflict. In a sample of 17 EMCC teams performing a realistic EMCC exercise, including one or two team meetings (28 in sum), we coded the team leader's verbal structuring behaviors (1,704 events), rated constructive conflict by external experts, and rated team effectiveness by field experts. Results show that leaders of effective teams use structuring behaviors more often (except asking procedural questions) but decreasingly over time. They support constructive conflict by clarifying and by making summaries that conclude in a command or decision in a decreasing frequency over time.

  11. Can Team Triage Improve Patient Flow in the Emergency Department? A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Ming, Thomas; Lai, Aaron; Lau, Pui-Man

    2016-01-01

    This systematic review was performed as a feasibility study for revamping the triage service of an emergency department (ED) in a district hospital. In view of the overcrowding problem that plagues EDs worldwide, we reviewed evidence from randomized controlled trials (RCTs) to determine whether ED team triage improves patient flow in comparison with single-nurse triage. We measured improvement in patient flow in terms of the reduction in length of stay (LOS) or wait time (WT) for all ED patients. Adopting the Cochrane methodology, we searched and evaluated data sources for RCTs comparing patients assessed by an ED triage team, with patients receiving single-nurse triage at the same site. The data extracted were independently reviewed by 2 authors for inclusion and quality assessment. As for risk of bias across studies, there was an overall assessment of every outcome across the included studies according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria for RCTs. In total, 2,164 studies were identified and 2,106 were excluded on the basis of title/abstract, leaving 58 articles for full assessment. Four trials (all cluster RCTs) involving 14,772 patients (165 clusters) met the inclusion criteria. On the basis of our analysis, there was no statistically significant or clinically relevant reduction of LOS and WT for all patients in these studies. One study reported death as an outcome: Relative risk was 0.34 (95% CI [0.01, 8.24]), which suggested that team triage might reduce mortality. Overall, although we have found no conclusive evidence from RCTs to support the use of team triage for improving patient flow in the ED, the results need not deter nursing managers intending to introduce team triage for improving the morale of the triage nurse. However, they may need to consider economic and organizational factors, such as resource reallocation and staff receptiveness, in implementing the new practice.

  12. Description of a Heart Team approach to coronary revascularization and its beneficial long-term effect on clinical events after PCI.

    Science.gov (United States)

    Bonzel, Tassilo; Schächinger, Volker; Dörge, Hilmar

    2016-05-01

    We present a first description of a Heart Team (HT)-guided approach to coronary revascularization and its long-term effect on clinical events after percutaneous coronary intervention (PCI). The HT approach is a structured process to decide for coronary bypass grafting (CABG), PCI or conservative therapy in ad hoc situations as well as in HT conferences. As a hypothesis, during the long-term course after a PCI performed according to HT rules, a low number of late revascularizations, especially CABGs, are expected (F-PCI study). In this monocentric study, the HT approach to an all-comer population was first analyzed and described in general with the help of a database. Next the use of a HT approach was described for a more homogeneous subgroup with newly detected CAD (1.CAD). Those patients in whom the HT decision was PCI (which was a 1.PCI) were then studied with the help of questionnaires for clinical events during a very long-term follow-up. Events were CABG, PCI, diagnostic catheterization (DCath) and death. A significant number of patients were presented to HT conferences: 22 % out of all 11,174 catheterizations, 24 % out of all 7867 CAD cases and 35 % out of 3408 1.CAD cases. Most of these patients had multi-vessel disease (MVD). Conference decisions were isolated CABG in 46-66 %, PCI in 10-14 %, valvular surgery in 9-16 %, HTx in 10-21 % (Endstage heart failure candidates for surgery) and conservative therapy (Medical or no therapy, additional diagnostic procedures or no adherence to recommended therapy) in 2-3 %. However, most PCIs, ad hoc and elective, were performed under Heart Team rules, but without conference. During follow-up of 1.PCI patients (Kaplan-Meier analysis), CABG occurred in only 15 % of patients, PCI in 37 % and DCath in 65 %; mortality of any course was 51 %. Mortalities were similar in one-vessel disease and in a population of the same year, matched for age and sex (p approach is an effective tool for ad hoc and conference

  13. Extreme weather and climate events with ecological relevance: a review.

    Science.gov (United States)

    Ummenhofer, Caroline C; Meehl, Gerald A

    2017-06-19

    Robust evidence exists that certain extreme weather and climate events, especially daily temperature and precipitation extremes, have changed in regard to intensity and frequency over recent decades. These changes have been linked to human-induced climate change, while the degree to which climate change impacts an individual extreme climate event (ECE) is more difficult to quantify. Rapid progress in event attribution has recently been made through improved understanding of observed and simulated climate variability, methods for event attribution and advances in numerical modelling. Attribution for extreme temperature events is stronger compared with other event types, notably those related to the hydrological cycle. Recent advances in the understanding of ECEs, both in observations and their representation in state-of-the-art climate models, open new opportunities for assessing their effect on human and natural systems. Improved spatial resolution in global climate models and advances in statistical and dynamical downscaling now provide climatic information at appropriate spatial and temporal scales. Together with the continued development of Earth System Models that simulate biogeochemical cycles and interactions with the biosphere at increasing complexity, these make it possible to develop a mechanistic understanding of how ECEs affect biological processes, ecosystem functioning and adaptation capabilities. Limitations in the observational network, both for physical climate system parameters and even more so for long-term ecological monitoring, have hampered progress in understanding bio-physical interactions across a range of scales. New opportunities for assessing how ECEs modulate ecosystem structure and functioning arise from better scientific understanding of ECEs coupled with technological advances in observing systems and instrumentation.This article is part of the themed issue 'Behavioural, ecological and evolutionary responses to extreme climatic events

  14. Tools for Assessment of Communication Skills of Hospital Action Teams: A Systematic Review.

    Science.gov (United States)

    Rehim, Shady A; DeMoor, Stephanie; Olmsted, Richard; Dent, Daniel L; Parker-Raley, Jessica

    Hospital action teams comprise interdisciplinary health care providers working simultaneously to treat critically ill patients. Assessments designed to evaluate communication effectiveness or "nontechnical" performance of these teams are essential to minimize medical errors and improve team productivity. Although multiple communication tools are available, the characteristics and psychometric validity of these instruments have yet to be systematically compared. To identify assessments used to evaluate the communication or "nontechnical" performance of hospital action teams and summarize evidence to develop and validate these instruments. A literature search was conducted using MEDLINE/PubMed database to identify original articles related to assessment of communication skills in teams working in acute care medicine not exclusive to emergency room, operating room, prehospital air and ground transport, or code blue/rapid response resuscitations. Ten communication assessment tools were identified. Six tools (60%) were designed to measure communication performance of the whole team, whereas 4 tools (40%) were created to assess individual team member's communication skills. Regardless of the type of analysis, the most commonly assessed behavior domains were Leadership, Teamwork, Communication, and Situation awareness. Only 1 of 16 articles describing a particular communication assessment tool reported all the validation criteria, other authors underreported efforts to validate their instruments. A number of tools designed to measure the communication or "nontechnical" performance of hospital action teams are available. Unfortunately, limited reported validity evidence may hamper the utility of these tools in actual clinical practice until further validation studies are performed. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  15. Design of a medical record review study on the incidence and preventability of adverse events requiring a higher level of care in Belgian hospitals

    Directory of Open Access Journals (Sweden)

    Vlayen Annemie

    2012-08-01

    Full Text Available Abstract Background Adverse events are unintended patient injuries that arise from healthcare management resulting in disability, prolonged hospital stay or death. Adverse events that require intensive care admission imply a considerable financial burden to the healthcare system. The epidemiology of adverse events in Belgian hospitals has never been assessed systematically. Findings A multistage retrospective review study of patients requiring a transfer to a higher level of care will be conducted in six hospitals in the province of Limburg. Patient records are reviewed starting from January 2012 by a clinical team consisting of a research nurse, a physician and a clinical pharmacist. Besides the incidence and the level of causation and preventability, also the type of adverse events and their consequences (patient harm, mortality and length of stay will be assessed. Moreover, the adequacy of the patient records and quality/usefulness of the method of medical record review will be evaluated. Discussion This paper describes the rationale for a retrospective review study of adverse events that necessitate a higher level of care. More specifically, we are particularly interested in increasing our understanding in the preventability and root causes of these events in order to implement improvement strategies. Attention is paid to the strengths and limitations of the study design.

  16. Evidences for incipient hydrothermal event(s) in the Central Indian Basin: A review

    Digital Repository Service at National Institute of Oceanography (India)

    Iyer, S.D.

    -719 (1 degree S/81 degrees E) hydrothermal precipitates of inorganic calcite and eposition of sulphide minerals (approx. 7.5 to 9 Ma and 0.5 Ma) occur as a result of the on-going intraplate deformation. This paper reviews the above evidences...

  17. Events

    Directory of Open Access Journals (Sweden)

    Igor V. Karyakin

    2016-02-01

    Full Text Available The 9th ARRCN Symposium 2015 was held during 21st–25th October 2015 at the Novotel Hotel, Chumphon, Thailand, one of the most favored travel destinations in Asia. The 10th ARRCN Symposium 2017 will be held during October 2017 in the Davao, Philippines. International Symposium on the Montagu's Harrier (Circus pygargus «The Montagu's Harrier in Europe. Status. Threats. Protection», organized by the environmental organization «Landesbund für Vogelschutz in Bayern e.V.» (LBV was held on November 20-22, 2015 in Germany. The location of this event was the city of Wurzburg in Bavaria.

  18. ChaLearn Looking at People: A Review of Events and Resources

    OpenAIRE

    Escalera, Sergio; Baró, Xavier; Escalante, Hugo Jair; Guyon, Isabelle

    2017-01-01

    This paper reviews the historic of ChaLearn Looking at People (LAP) events. We started in 2011 (with the release of the first Kinect device) to run challenges related to human action/activity and gesture recognition. Since then we have regularly organized events in a series of competitions covering all aspects of visual analysis of humans. So far we have organized more than 10 international challenges and events in this field. This paper reviews associated events, and introduces the ChaLearn ...

  19. Report of the Event Tag Review and Recommendation Group

    Energy Technology Data Exchange (ETDEWEB)

    ATLAS Group; Assamagan, K.A.; Barberis, D.; Bentvelsen, S.; Brooijmans, G.; Cranmer, K.; Cranshaw, J.; Dell' Acqua, A.; Farbin, A.; Froidevaux, D.; Gianotti, F.; Hinchliffe, I.; LeCompte, T.; Maeno, T.; Malon, D.; Paige, F.; Polesello, G.; Quarrie, D.; Rousseau, D.; Schaffer, R.D.; Smizanska, M.; Unal, G.; Voss, K.; Wielers, M.

    2006-04-12

    In order to facilitate access to the large volumes of data (multiple petabytes per year) which will be produced during data taking and Monte Carlo production at ATLAS, work has proceeded on building a system of event-level metadata to allow selections of a subset of events to use as input to an analysis. This was included in the ATLAS Computing Model and was first studied and implemented by the Physics Analysis Tools group based on the decisions of the ESD/AOD Task Force. They used tools developed and supported by the CERN IT group and the ATLAS Database group. During 2005 this structure was put through various tests and evaluations. Also, work by physicists on reconstruction and analysis led to an improved understanding of the requirements on the TAG. This report addresses the effect of these new inputs on the previous work with regard to content and the infrastructure needed to support it.

  20. A review of critical in-flight events research methodology

    Science.gov (United States)

    Giffin, W. C.; Rockwell, T. H.; Smith, P. E.

    1985-01-01

    Pilot's cognitive responses to critical in-flight events (CIFE's) were investigated, using pilots, who had on the average about 2540 flight hours each, in four experiments: (1) full-mission simulation in a general aviation trainer, (2) paper and pencil CIFE tests, (3) interactive computer-aided scenario testing, and (4) verbal protocols in fault diagnosis tasks. The results of both computer and paper and pencil tests showed only 50 percent efficiency in correct diagnosis of critical events. The efficiency in arriving at a diagnosis was also low: over 20 inquiries were made for 21 percent of the scenarios diagnosed. The information-seeking pattern was random, with frequent retracing over old inquiries. The measures for developing improved cognitive skills for CIFE's are discussed.

  1. Association between antipsychotics and cardiovascular adverse events: A systematic review

    Directory of Open Access Journals (Sweden)

    Ana Amancio Santos Da Silva

    Full Text Available Summary Objective: Determine whether there is an association between the risk of cardiovascular adverse events and the use of antipsychotic agents. Method: Analysis of original articles retrieved from the following databases: LILACS, PubMed, Cochrane Controlled Trials Clinical Data Bank (CENTRAL and PsycINFO, without language restriction, dated until November 2015. After screening of 2,812 studies, three cohort original articles were selected for quality analysis. Results: 403,083 patients with schizophrenia and 119,015 participants in the control group data were analyzed. The occurrence of cardiovascular events observed in the articles was: 63.5% (article 1, 13.1% (article 2 and 24.95% (article 3 in the group of treated schizophrenic patients, and 46.2%, 86.9% and 24.9%, respectively, in the control groups. Conclusion: Clinical heterogeneity among the studies led to a provisional response and made it impossible to perform the meta-analysis, although the articles demonstrate an association between cardiovascular adverse events and the use of antipsychotics. More quality clinical trials are needed to support this evidence.

  2. Review of Wind Energy Forecasting Methods for Modeling Ramping Events

    Energy Technology Data Exchange (ETDEWEB)

    Wharton, S; Lundquist, J K; Marjanovic, N; Williams, J L; Rhodes, M; Chow, T K; Maxwell, R

    2011-03-28

    Tall onshore wind turbines, with hub heights between 80 m and 100 m, can extract large amounts of energy from the atmosphere since they generally encounter higher wind speeds, but they face challenges given the complexity of boundary layer flows. This complexity of the lowest layers of the atmosphere, where wind turbines reside, has made conventional modeling efforts less than ideal. To meet the nation's goal of increasing wind power into the U.S. electrical grid, the accuracy of wind power forecasts must be improved. In this report, the Lawrence Livermore National Laboratory, in collaboration with the University of Colorado at Boulder, University of California at Berkeley, and Colorado School of Mines, evaluates innovative approaches to forecasting sudden changes in wind speed or 'ramping events' at an onshore, multimegawatt wind farm. The forecast simulations are compared to observations of wind speed and direction from tall meteorological towers and a remote-sensing Sound Detection and Ranging (SODAR) instrument. Ramping events, i.e., sudden increases or decreases in wind speed and hence, power generated by a turbine, are especially problematic for wind farm operators. Sudden changes in wind speed or direction can lead to large power generation differences across a wind farm and are very difficult to predict with current forecasting tools. Here, we quantify the ability of three models, mesoscale WRF, WRF-LES, and PF.WRF, which vary in sophistication and required user expertise, to predict three ramping events at a North American wind farm.

  3. Efficacy of simulation-based trauma team training of non-technical skills. A systematic review.

    Science.gov (United States)

    Gjeraa, K; Møller, T P; Østergaard, D

    2014-08-01

    Trauma resuscitation is a complex situation, and most organisations have multi-professional trauma teams. Non-technical skills are challenged during trauma resuscitation, and they play an important role in the prevention of critical incidents. Simulation-based training of these is recommended. Our research question was: Does simulation-based trauma team training of non-technical skills have effect on reaction, learning, behaviour or patient outcome? The authors searched PubMed, EMBASE and the Cochrane Library and found 13 studies eligible for analysis. We described and compared the educational interventions and the evaluations of effect according to the four Kirkpatrick levels: reaction, learning (knowledge, skills, attitudes), behaviour (in a clinical setting) and patient outcome. No studies were randomised, controlled and blinded, resulting in a moderate to high risk of bias. The multi-professional trauma teams had positive reactions to simulation-based training of non-technical skills. Knowledge and skills improved in all studies evaluating the effect on learning. Three studies found improvements in team performance (behaviour) in the clinical setting. One of these found difficulties in maintaining these skills. Two studies evaluated on patient outcome, of which none showed improvements in mortality, complication rate or duration of hospitalisation. A significant effect on learning was found after simulation-based training of the multi-professional trauma team in non-technical skills. Three studies demonstrated significantly increased clinical team performance. No effect on patient outcome was found. All studies had a moderate to high risk of bias. More comprehensive randomised studies are needed to evaluate the effect on patient outcome. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  4. Multidisciplinary team interventions to optimise health outcomes for older people in acute care settings: A systematic review.

    Science.gov (United States)

    Hickman, Louise D; Phillips, Jane L; Newton, Phillip J; Halcomb, Elizabeth J; Al Abed, Naser; Davidson, Patricia M

    2015-01-01

    A major challenge facing our health care systems internationally is managing the needs of increasing numbers of older people in hospital with chronic and complex conditions. A multidisciplinary approach is considered central to tailoring and targeting approaches to gerontological care, although this is often not realised in reality. Comprehensive geriatric assessment (CGA) is seen as gold standard, though they are not readily available in many acute settings, compounded by the requirement for time, coordination of multidisciplinary specialties, and reimbursement issues. This systematic review aimed to identify multidisciplinary team interventions to optimise health outcomes for older people in acute care settings. Systematic review of randomised controlled trials reporting acute care multidisciplinary team based interventions, to improve care outcomes for hospitalised older people. Electronic databases (MEDLINE, CINAHL (EBSCO), Cochrane and PsycINFO) were searched from 1 January 2000 to 1 July 2014 in the English language. Data was extracted by two reviewers and checked by a third reviewer to resolve any conflicts. Seven articles reporting RCTs met the systematic review inclusion criteria. The heterogeneity of study populations, multidisciplinary team interventions and outcome measures necessitated the use of narrative analysis. Three common elements of these studies included: (i) tailored treatment by clinicians with geriatric expertise (ii) a focus on transitional care interventions that enhance discharge planning; and (iii) communication an essential ingredient to improving care. The tailoring of treatment, underpinned with clear communication strategies can reduce emergency department re-admission rates, mortality and functional decline of older people. Refining health professionals roles and responsibilities within transition models is an essential component that can improve health outcomes for older people in acute care settings. Crown Copyright © 2015

  5. Infantile Apparent Life-Threatening Events, an Educational Review

    OpenAIRE

    Hamed Aminiahidashti

    2015-01-01

    Many physicians have received a frantic call from anxious parents stating that their child had stopped breathing, become limp, or turned blue but then had recovered quickly. An apparent life-threatening event (ALTE) is defined as ?an episode that is frightening to the observer, and is characterized by some combination of apnea, color change, marked change in muscle tone, choking, gagging, or coughing?. The incidence of ALTE is reported to be 0.05% to 6%. The knowledge about the most common ca...

  6. Which screening tools can predict injury to the lower extremities in team sports? : A systematic review

    NARCIS (Netherlands)

    Anne Benjaminse; Koen A.P.M. Lemmink; J.M. Dallinga

    2012-01-01

    Abstract BACKGROUND: Injuries to lower extremities are common in team sports such as soccer, basketball, volleyball, football and field hockey. Considering personal grief, disabling consequences and high costs caused by injuries to lower extremities, the importance for the prevention of these

  7. Team-Based Professional Development Interventions in Higher Education : A Systematic Review

    NARCIS (Netherlands)

    Gast, Inken; Schildkamp, Kim; van der Veen, Jan T.

    Most professional development activities focus on individual teachers, such as mentoring or the use of portfolios. However, new developments in higher education require teachers to work together in teams more often. Due to these changes, there is a growing need for professional development

  8. Evaluating School-Based Management: A Tool for Team Self-Review

    Science.gov (United States)

    Turnbull, Barbara

    2005-01-01

    Educational research has contributed a great deal to current understanding of effective school-based management (i.e. Wholstetter and Mohrman 1996, Leithwood and Menzies 1998). Through this research, practitioners have been given guidance on what constitutes effective teams. However, educational research has yet to provide comparable guidance in…

  9. Manifestation Determination Reviews and School Team Decision-Making with Students with Emotional/Behavioral Disabilities

    Science.gov (United States)

    Walker, Jennifer D.

    2013-01-01

    Manifestation determination teams are required by law to determine the relationship between a student's disability and behaviors that lead to disciplinary action when a student with a disability is either excluded from school for more than 10 days, is put in an interim alternative placement, or is under consideration for a change in placement.…

  10. Which Screening Tools Can Predict Injury to the Lower Extremities in Team Sports? A Systematic Review

    NARCIS (Netherlands)

    Dallinga, Joan M.; Benjaminse, Anne; Lemmink, Koen A. P. M.

    2012-01-01

    Background: Injuries to lower extremities are common in team sports such as soccer, basketball, volleyball, football and field hockey. Considering personal grief, disabling consequences and high costs caused by injuries to lower extremities, the importance for the prevention of these injuries is

  11. Definition of hemodynamic stability in blunt trauma patients: a systematic review and assessment amongst Dutch trauma team members.

    Science.gov (United States)

    Loggers, S A I; Koedam, T W A; Giannakopoulos, G F; Vandewalle, E; Erwteman, M; Zuidema, W P

    2017-12-01

    Trauma is a great contributor to mortality worldwide. One of the challenges in trauma care is early identification and management of bleeding. The circulatory status of blunt trauma patients in the emergency room is evaluated using hemodynamic (HD) parameters. However, there is no consensus on which parameters to use. In this study, we evaluate the used terms and definitions in the literature for HD stability and compare those to the opinion of Dutch trauma team members. A systematic review was performed to collect the definitions used for HD stability. Studies describing the assessment and/or treatment of blunt trauma patients in the emergency room were included. In addition, an online survey was conducted amongst Dutch trauma team members. Out of a total of 222, 67 articles were found to be eligible for inclusion. HD stability was defined in 70% of these articles. The most used parameters were systolic blood pressure and heart rate. Besides the variety of parameters, a broad range of corresponding cut-off points is noted. Despite some common ground, high inter- and intra-variability is seen for the physicians that are part of the Dutch trauma teams. All authors acknowledge HD stability as the most important factor in the assessment and management of blunt trauma patients. There is, however, no consensus in the literature as well as none-to-fair consensus amongst Dutch trauma team members in the definition of HD stability. A trauma team ready to co-operate with consensus-based opinions together with a valid scoring system is in our opinion the best method to assess and treat seriously injured trauma patients.

  12. Use of integrated technology in team sports: a review of opportunities, challenges, and future directions for athletes.

    Science.gov (United States)

    Dellaserra, Carla L; Gao, Yong; Ransdell, Lynda

    2014-02-01

    Integrated technology (IT), which includes accelerometers, global positioning systems (GPSs), and heart rate monitors, has been used frequently in public health. More recently, IT data have been used in sports settings to assess training and performance demands. However, the impact of IT in sports settings is yet to be evaluated, particularly in field-based team sports. This narrative-qualitative review provides an overview of the emerging impact of IT in sports settings. Twenty electronic databases (e.g., Medline, SPORTdiscus, and ScienceDirect), print publications (e.g., Signal Processing Magazine and Catapult Innovations news releases), and internet resources were searched using different combinations of keywords as follows: accelerometers, heart rate monitors, GPS, sport training, and field-based sports for relevant articles published from 1990 to the present. A total of 114 publications were identified, and 39 that examined a field-based team sport using a form of IT were analyzed. The articles chosen for analysis examined a field-based team sport using a form of IT. The uses of IT can be divided into 4 categories: (a) quantifying movement patterns (n = 22), (b) assessing the differences between demands of training and competition (n = 12), (c) measuring physiological and metabolic responses (n = 16), and (d) determining a valid definition for velocity and a sprint effort (n = 8). Most studies used elite adult male athletes as participants and analyzed the sports of Australian Rules football, field hockey, cricket, and soccer, with sample sizes between 5 and 20 participants. The limitations of IT in a sports setting include scalability issues, cost, and the inability to receive signals within indoor environments. Integrated technology can contribute to significant improvements in the preparation, training, and recovery aspects of field-based team sports. Future research should focus on using IT with female athlete populations and developing resources to use IT

  13. Single‐event multilevel surgery for children with cerebral palsy: a systematic review

    National Research Council Canada - National Science Library

    MCGINLEY, JENNIFER L; DOBSON, FIONA; GANESHALINGAM, REKHA; SHORE, BENJAMIN J; RUTZ, ERICH; GRAHAM, H KERR

    2012-01-01

    Aim  To conduct a systematic review of single‐event multilevel surgery (SEMLS) for children with cerebral palsy, with the aim of evaluating the quality of the evidence and developing recommendations for future research. Method...

  14. EPA Region 7 and Four States Water Quality Standards Review Process Kaizen Event

    Science.gov (United States)

    The submittal, review and approval process of the EPA–State process for developing and revising Water Quality Standards (WQS) was the focus of a Lean business process improvement kaizen event in June 2007.

  15. Resistance to aspirin: prevalence, mechanisms of action and association with thromboembolic events. A narrative review

    National Research Council Canada - National Science Library

    Cañivano Petreñas, L; García Yubero, C

    2010-01-01

    The purpose of this study is to review the prevalence of aspirin resistance in patients with a high risk of cardiovascular events, and secondly, to investigate its epidemiology and mechanism of action...

  16. Research on Common-Mode and Dependent (CMD) outage events in power systems : a review.

    OpenAIRE

    Papic, Milorad; Agarwal, Sudhir; Allan, Ron N.; Billinton, Roy; Dent, Chris; Ekisheva, Svetlana; Van Gent, Daniel; Jiang, Kai; Li, Wenyuan; Mitra, Joydeep; Pitto, Andrea; Schneider, Alexander; Singh, Chanan; Vadlamudi, Vijay Venu; Varghese, Matthew

    2016-01-01

    The purpose of this paper is to present a review of some fundamental concepts and practical applications in the area of common-mode and dependent (CMD) outage events in power systems. The paper is a result of ongoing activity carried out by the Probability Applications for Common and dependent Mode Events (PACME) Working Group (WG) of the Reliability, Risk and Probability Applications Subcommittee. The PACME WG was formed in 2010 to review, advance, and present the research and practical appl...

  17. The health and socioeconomic impacts of major multi-sport events: systematic review (1978-2008)

    OpenAIRE

    McCartney, G.; Thomas, S.; Thomson, H; Scott, J; Hamilton, V.; Hanlon, P.; Morrison, D.S.; Bond, L.

    2010-01-01

    Objective To assess the effects of major multi-sport events on health and socioeconomic determinants of health in the population of the city hosting the event.\\ud \\ud Design Systematic review.\\ud \\ud Data sources We searched the following sources without language restrictions for papers published between 1978 and 2008: Applied Social Science Index and Abstracts (ASSIA), British Humanities Index (BHI), Cochrane database of systematic reviews, Econlit database, Embase, Education Resources Infor...

  18. The incidence and nature of in-hospital adverse events: a systematic review

    NARCIS (Netherlands)

    de Vries, E. N.; Ramrattan, M. A.; Smorenburg, S. M.; Gouma, D. J.; Boermeester, M. A.

    2008-01-01

    INTRODUCTION: Adverse events in hospitals constitute a serious problem with grave consequences. Many studies have been conducted to gain an insight into this problem, but a general overview of the data is lacking. We performed a systematic review of the literature on in-hospital adverse events.

  19. Preliminary perspectives gaines from individual plant examination of external events (IPEEE) seismic and fire submittal review

    Energy Technology Data Exchange (ETDEWEB)

    Chen, J.T.; Connell, E.; Chokshi, N. [NRC, Washington, DC (United States)] [and others

    1997-02-01

    As a result of the U.S. Nuclear Regulatory Commission (USNRC) initiated Individual plant Examination of External Events (IPEEE) program, every operating nuclear power reactor in the United States has performed an assessment of severe accident due to external events. This paper provides a summary of the preliminary insights gained through the review of 24 IPEEE submittals.

  20. Report of the South Texas Project Allegations Review Team. Docket Nos. 50-498 and 50-499, Houston Lighting and Power Company et al.

    Energy Technology Data Exchange (ETDEWEB)

    Kokajko, L.; Skay, D.; Wang, H.; Murphy, D. [Nuclear Regulatory Commission, Washington, DC (United States)

    1995-03-01

    This report provides the results of the South Texas Project Allegations Review Team of the US Nuclear Regulatory Commission. This team was formed to obtain and review allegations from individuals represented by three attorneys who had contacted Congressional staff members. The allegers were employed in various capacities at South Texas Project Electric Generating Station, licensed by Houston Lighting and Power Company, et al.; therefore, the allegations are confined to this site. The South Texas Project Allegations Review Team reviewed, referred, and dispositioned concerns related to discriminatory issues (harassment and intimidation), falsification of records and omission of information, and various technical issues. The team was able to substantiate certain technical issues of minor safety significance or regulatory concern at the South Texas Project facility, but it did not find widespread discriminatory practices such as harassment and intimidation.

  1. MANAGING MULTICULTURAL PROJECT TEAMS

    Directory of Open Access Journals (Sweden)

    Cezar SCARLAT

    2014-06-01

    Full Text Available The article is based on literature review and authors’ own recent experience in managing multicultural project teams, in international environment. This comparative study considers two groups of projects: technical assistance (TA projects versus information technology (IT projects. The aim is to explore the size and structure of the project teams – according to the team formation and its lifecycle, and to identify some distinctive attributes of the project teams – both similarities and differences between the above mentioned types of projects. Distinct focus of the research is on the multiculturalism of the project teams: how the cultural background of the team members influences the team performance and team management. Besides the results of the study are the managerial implications: how the team managers could soften the cultural clash, and avoid inter-cultural misunderstandings and even conflicts – in order to get a better performance. Some practical examples are provided as well.

  2. Bench-to-bedside review: The MET syndrome – the challenges of researching and adopting medical emergency teams

    Science.gov (United States)

    Tee, Augustine; Calzavacca, Paolo; Licari, Elisa; Goldsmith, Donna; Bellomo, Rinaldo

    2008-01-01

    Studies of hospital performance highlight the problem of 'failure to rescue' in acutely ill patients. This is a deficiency strongly associated with serious adverse events, cardiac arrest, or death. Rapid response systems (RRSs) and their efferent arm, the medical emergency team (MET), provide early specialist critical care to patients affected by the 'MET syndrome': unequivocal physiological instability or significant hospital staff concern for patients in a non-critical care environment. This intervention aims to prevent serious adverse events, cardiac arrests, and unexpected deaths. Though clinically logical and relatively simple, its adoption poses major challenges. Furthermore, research about the effectiveness of RRS is difficult to conduct. Sceptics argue that inadequate evidence exists to support its widespread application. Indeed, supportive evidence is based on before-and-after studies, observational investigations, and inductive reasoning. However, implementing a complex intervention like RRS poses enormous logistic, political, cultural, and financial challenges. In addition, double-blinded randomised controlled trials of RRS are simply not possible. Instead, as in the case of cardiac arrest and trauma teams, change in practice may be slow and progressive, even in the absence of level I evidence. It appears likely that the accumulation of evidence from different settings and situations, though methodologically imperfect, will increase the rationale and logic of RRS. A conclusive randomised controlled trial is unlikely to occur. All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident. Arthur Schopenhauer (1788–1860), German philosopher PMID:18254927

  3. Using Dashboard Technology and Clinical Decision Support Systems to Improve Heart Team Efficiency and Accuracy: Review of the Literature.

    Science.gov (United States)

    Clarke, Sarah; Wilson, Marisa L; Terhaar, Mary

    2016-01-01

    This review aimed to provide a comprehensive overview of the current state of evidence for the use of clinical dashboards and clinical decision support systems (CDSS) in multidisciplinary teams. A literature search was performed for the dates 2004-2014 on CINAHL, Medline, Embase, and Cochrane Library. A citation search and a hand search of relevant papers were also conducted. (One hundred and twelve full text papers were retrieved of which 22 were included in the review.) There was considerable heterogeneity in setting, users, and indicators utilized. Information on usability and human-computer interaction was thoroughly reviewed. There was evidence that dashboards were associated with improved care processes when end-user input was incorporated and information was concurrent, pertinent and intuitive. There is some evidence that implementing clinical dashboards and/or CDSS that provide immediate access to current patient information for clinicians can improve processes and patient outcomes.

  4. Diabetic foot infections: a team-oriented review of medical and surgical management

    OpenAIRE

    Capobianco, Claire M; John J. Stapleton

    2010-01-01

    As the domestic and international incidence of diabetes and metabolic syndrome continues to rise, health care providers need to continue improving management of the long-term complications of the disease. Emergency department visits and hospital admissions for diabetic foot infections are increasingly commonplace, and a like-minded multidisciplinary team approach is needed to optimize patient care. Early recognition of severe infections, medical stabilization, appropriate antibiotic selection...

  5. [Developing team reflexivity as a learning and working tool for medical teams].

    Science.gov (United States)

    Riskin, Arieh; Bamberger, Peter

    2014-01-01

    Team reflexivity is a collective activity in which team members review their previous work, and develop ideas on how to modify their work behavior in order to achieve better future results. It is an important learning tool and a key factor in explaining the varying effectiveness of teams. Team reflexivity encompasses both self-awareness and agency, and includes three main activities: reflection, planning, and adaptation. The model of briefing-debriefing cycles promotes team reflexivity. Its key elements include: Pre-action briefing--setting objectives, roles, and strategies the mission, as well as proposing adaptations based on what was previously learnt from similar procedures; Post-action debriefing--reflecting on the procedure performed and reviewing the extent to which objectives were met, and what can be learnt for future tasks. Given the widespread attention to team-based work systems and organizational learning, efforts should be made toward ntroducing team reflexivity in health administration systems. Implementation could be difficult because most teams in hospitals are short-lived action teams formed for a particular event, with limited time and opportunity to consciously reflect upon their actions. But it is precisely in these contexts that reflexive processes have the most to offer instead of the natural impulsive collective logics. Team reflexivity suggests a potential solution to the major problems of iatorgenesis--avoidable medical errors, as it forces all team members to participate in a reflexive process together. Briefing-debriefing technology was studied mainly in surgical teams and was shown to enhance team-based learning and to improve quality-related outcomes and safety.

  6. Effects of Cold Water Immersion and Contrast Water Therapy for Recovery From Team Sport: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Higgins, Trevor R; Greene, David A; Baker, Michael K

    2017-05-01

    Higgins, TR, Greene, DA, Baker, MK. Effects of cold water immersion and contrast water therapy for recovery from team sport: a systematic review and meta-analysis. J Strength Cond Res 31(5): 1443-1460, 2017-To enhance recovery from sport, cold water immersion (CWI) and contrast water therapy (CWT) have become common practice within high level team sport. Initially, athletes relied solely on anecdotal support. As there has been an increase in the volume of research into recovery including a number of general reviews, an opportunity existed to narrow the focus specifically examining the use of hydrotherapy for recovery in team sport. A Boolean logic [AND] keyword search of databases was conducted: SPORTDiscus; AMED; CINAHL; MEDLINE. Data were extracted and the standardized mean differences were calculated with 95% confidence interval (CI). The analysis of pooled data was conducted using a random-effect model, with heterogeneity assessed using I. Twenty-three peer reviewed articles (n = 606) met the criteria. Meta-analyses results indicated CWI was beneficial for recovery at 24 hours (countermovement jump: p = 0.05, CI: -0.004 to 0.578; All-out sprint: p = 0.02, -0.056 to 0.801) following team sport. The CWI was beneficial for recovery at 72 hours (fatigue: p = 0.03, CI: 0.061-1.418) and CWT was beneficial for recovery at 48 hours (fatigue: p = 0.04, CI: 0.013-0.942) following team sport. The CWI was beneficial for neuromuscular recovery 24 hours following team sport, whereas CWT was not beneficial for recovery following team sport. In addition, when evaluating accumulated sprinting, CWI was not beneficial for recovery following team sports. In evaluating subjective measures, both CWI (72 hours) and CWT (24 hours) were beneficial for recovery of perceptions of fatigue, following team sport. However neither CWI nor CWT was beneficial for recovery, of perceptions of muscle soreness, following team sport.

  7. Possible adverse events in children treated by manual therapy: a review

    Directory of Open Access Journals (Sweden)

    Humphreys B Kim

    2010-06-01

    Full Text Available Abstract Background Pediatric manual therapy is controversial within the medical community particularly with respect to adverse events. Pediatric manual therapy (Ped MT is commonly used by a number of professions such as chiropractors, osteopaths and naturopaths for a variety of treatments in children. Ped MT interventions range from advice, light touch, massage, through to mobilisation and high velocity spinal manipulation. However, current evidence related to adverse events associated with Ped MT is not well understood. Objective To update the clinical research literature from the 2007 report by Vohra, Johnston, Cramer and Humphreys on possible adverse events in children treated by spinal manipulation. Methods A review of the clinical research literature from June 2004 until January 2010 as reported in MEDLINE, PubMed and PubMed Central for adverse events specifically related to the treatment of pediatric cases by manual therapy. Results Only three new clinical studies, one systematic review with meta-analysis and one evidence report were identified. Two clinical studies reported on chiropractic care and one on osteopathic spinal manipulation in children. The systematic review investigated all studies of adverse events and manual therapy and was not specific for pediatric patients. The evidence review focused on effectiveness of spinal manipulation in a variety of musculoskeletal conditions. No serious or catastrophic adverse events were reported in the clinical studies or systematic review. However for adults, it has been estimated that between 0.003% and 0.13% of manual therapy treatments may result in a serious adverse event. Although mild to moderate adverse events are common in adults, an accurate estimate from high quality pediatric studies is currently not available. Conclusions There is currently insufficient research evidence related to adverse events and manual therapy. However, clinical studies and systematic reviews from adult

  8. Possible adverse events in children treated by manual therapy: a review.

    Science.gov (United States)

    Humphreys, B Kim

    2010-06-02

    Pediatric manual therapy is controversial within the medical community particularly with respect to adverse events. Pediatric manual therapy (Ped MT) is commonly used by a number of professions such as chiropractors, osteopaths and naturopaths for a variety of treatments in children. Ped MT interventions range from advice, light touch, massage, through to mobilisation and high velocity spinal manipulation. However, current evidence related to adverse events associated with Ped MT is not well understood. To update the clinical research literature from the 2007 report by Vohra, Johnston, Cramer and Humphreys on possible adverse events in children treated by spinal manipulation. A review of the clinical research literature from June 2004 until January 2010 as reported in MEDLINE, PubMed and PubMed Central for adverse events specifically related to the treatment of pediatric cases by manual therapy. Only three new clinical studies, one systematic review with meta-analysis and one evidence report were identified. Two clinical studies reported on chiropractic care and one on osteopathic spinal manipulation in children. The systematic review investigated all studies of adverse events and manual therapy and was not specific for pediatric patients. The evidence review focused on effectiveness of spinal manipulation in a variety of musculoskeletal conditions. No serious or catastrophic adverse events were reported in the clinical studies or systematic review. However for adults, it has been estimated that between 0.003% and 0.13% of manual therapy treatments may result in a serious adverse event. Although mild to moderate adverse events are common in adults, an accurate estimate from high quality pediatric studies is currently not available. There is currently insufficient research evidence related to adverse events and manual therapy. However, clinical studies and systematic reviews from adult patients undergoing manual therapy, particularly spinal manipulation report that

  9. The Irish National Adverse Events Study (INAES): the frequency and nature of adverse events in Irish hospitals-a retrospective record review study.

    Science.gov (United States)

    Rafter, Natasha; Hickey, Anne; Conroy, Ronan M; Condell, Sarah; O'Connor, Paul; Vaughan, David; Walsh, Gillian; Williams, David J

    2017-02-01

    Irish healthcare has undergone extensive change recently with spending cuts and a focus on quality initiatives; however, little is known about adverse event occurrence. To assess the frequency and nature of adverse events in Irish hospitals. 1574 (53% women, mean age 54 years) randomly selected adult inpatient admissions from a sample of eight hospitals, stratified by region and size, across the Republic of Ireland in 2009 were reviewed using two-stage (nurse review of patient charts, followed by physician review of triggered charts) retrospective chart review with electronic data capture. Results were weighted to reflect the sampling strategy. The impact on adverse event rate of differing application of international adverse event criteria was also examined. 45% of charts were triggered. The prevalence of adverse events in admissions was 12.2% (95% CI 9.5% to 15.5%), with an incidence of 10.3 events per 100 admissions (95% CI 7.5 to 13.1). Over 70% of events were considered preventable. Two-thirds were rated as having a mild-to-moderate impact on the patient, 9.9% causing permanent impairment and 6.7% contributing to death. A mean of 6.1 added bed days was attributed to events, representing an expenditure of €5550 per event. The adverse event rate varied substantially (8.6%-17.0%) when applying different published adverse event eligibility criteria. This first study of adverse events in Ireland reports similar rates to other countries. In a time of austerity, adverse events in adult inpatients were estimated to cost over €194 million. These results provide important baseline data on the adverse event burden and, alongside web-based chart review, provide an incentive and methodology to monitor future patient-safety initiatives. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. Reporting of Adverse Events in Published and Unpublished Studies of Health Care Interventions: A Systematic Review

    Science.gov (United States)

    Golder, Su; Wright, Kath

    2016-01-01

    Background We performed a systematic review to assess whether we can quantify the underreporting of adverse events (AEs) in the published medical literature documenting the results of clinical trials as compared with other nonpublished sources, and whether we can measure the impact this underreporting has on systematic reviews of adverse events. Methods and Findings Studies were identified from 15 databases (including MEDLINE and Embase) and by handsearching, reference checking, internet searches, and contacting experts. The last database searches were conducted in July 2016. There were 28 methodological evaluations that met the inclusion criteria. Of these, 9 studies compared the proportion of trials reporting adverse events by publication status. The median percentage of published documents with adverse events information was 46% compared to 95% in the corresponding unpublished documents. There was a similar pattern with unmatched studies, for which 43% of published studies contained adverse events information compared to 83% of unpublished studies. A total of 11 studies compared the numbers of adverse events in matched published and unpublished documents. The percentage of adverse events that would have been missed had each analysis relied only on the published versions varied between 43% and 100%, with a median of 64%. Within these 11 studies, 24 comparisons of named adverse events such as death, suicide, or respiratory adverse events were undertaken. In 18 of the 24 comparisons, the number of named adverse events was higher in unpublished than published documents. Additionally, 2 other studies demonstrated that there are substantially more types of adverse events reported in matched unpublished than published documents. There were 20 meta-analyses that reported the odds ratios (ORs) and/or risk ratios (RRs) for adverse events with and without unpublished data. Inclusion of unpublished data increased the precision of the pooled estimates (narrower 95

  11. Team Sports

    Science.gov (United States)

    ... Living with Paralysis > Health > Staying active > Team sports Team sports ☷ ▾ Page contents Basketball Quad rugby Sled hockey ... on the East and West coasts. There are teams and divisions all over the country for men, ...

  12. A grey literature review of special events for promoting cancer screenings.

    Science.gov (United States)

    Escoffery, Cam; Rodgers, Kirsten C; Kegler, Michelle C; Ayala, Mary; Pinsker, Erika; Haardörfer, Regine

    2014-06-19

    Cancer remains the second leading cause of mortality in the United States. Special events such as health fairs, screening days or cultural festivals are employed often for community education about cancer screening. A previous systematic review of the published literature was conducted in 2012-2013. The purpose of this study was to conduct a grey literature component of special events that promote breast, cervical and colorectal cancer screening in the U.S. We conducted a grey literature search of dissertations/theses and conference abstracts. The theses/dissertations were restricted to those: 1) written in English, 2) published from January 1990 to December 2011, 3) examined at least one of the predefined categories of special events, 4) involved cancer screening for breast, cervical, and/or colorectal cancer, 5) included outcome data, and 6) conducted in the United States. A review of U.S. public health and cancer conference abstracts, that were readily available and had focused on at least of 3 cancer types and included outcome data, was conducted. Data were abstracted on the purpose, location, primary audience(s), activities conducted, screening provided onsite or referrals, and evaluation results. The grey literature review found 6 special events. The types of events found added to the numbers found in the systematic review, especially receptions or parties and cultural festivals/events. All focused on increasing breast and cervical cancer screening except one that focused on breast cancer only. The reach of these events was targeted at mostly minorities or underserved communities. Common evidence-based strategies were group education, small media, and reducing structural barriers. Group education involved presentations from physicians, lay-health advisors, or cancer survivors, while reducing structural barriers included activities such as providing screening appointment sign-ups at the event or providing transportation for event participants. Mammogram

  13. Lightning detection from Space Science and Applications Team review. [optical and radio frequency sensors

    Science.gov (United States)

    Few, A. A., Jr.

    1981-01-01

    The various needs for lightning data that exist among potential users of satellite lightning data were identified and systems were defined which utilize the optical and radio frequency radiations from lightning to serve as the satellite based lightning mapper. Three teams worked interactively with NASA to develop a system concept. An assessment of the results may be summarized as follows: (1) a small sensor system can be easily designed to operate on a geostationary satellite that can provide the bulk of the real time user requirements; (2) radio frequency systems in space may be feasible but would be much larger and more costly; RF technology for this problem lags the optical technology by years; and (3) a hybrid approach (optical in space and RF on the ground) would provide the most complete information but is probably unreasonably complex and costly at this time.

  14. Small-sided games in team sports training: a brief review.

    Science.gov (United States)

    Halouani, Jamel; Chtourou, Hamdi; Gabbett, Tim; Chaouachi, Anis; Chamari, Karim

    2014-12-01

    Small-sided games (SSGs) incorporating skills, sport-specific movements, at intensities sufficient to promote aerobic adaptations, are being increasingly implemented in professional team sport environments. Small-sided games are often employed by coaches based on the premise that the greatest training benefits occur when training simulates the specific movement patterns and physiological demands of the sport. At present, there is relatively little information regarding how SSG can best be used to improve physical capacities and technical and tactical skills in team sports. It is possible that with some modifications (e.g., number of players, pitch size, coach encouragement, and wrestling), such games may be physiologically beneficial for athletes with relatively high initial aerobic fitness levels. For instance, it has been shown that 3-a-side soccer SSG resulted in higher intensity (i.e., greater overall distance, less jogging and walking, higher heart rate, and more tackling, dribbling, goal attempts, and passes) than 5-a-side SSG. Likewise, when player numbers were kept constant, a larger playing area increased the intensity of the SSG with a smaller playing area having the opposite effect. It has also been demonstrated that energy expenditure was similar between badminton and volleyball courts, but lower than that obtained in a basketball court. Moreover, it has been demonstrated in rugby that wrestling can increase the physical demands of SSG. Consistent coach encouragement can also increase training intensity, although most rule changes have trivial or no effect on exercise intensity. Further research is required to examine the optimal periodization strategies of SSG training for the long-term development of physiological capacity, technical skill, and tactical proficiency, while also minimizing the associated risk of injuries.

  15. Pharmacist-led medication review to identify medication-related problems in older people referred to an Aged Care Assessment Team: a randomized comparative study.

    Science.gov (United States)

    Elliott, Rohan A; Martinac, Georgia; Campbell, Stephen; Thorn, Juliet; Woodward, Michael C

    2012-07-01

    Aged Care Assessment Teams (ACATs) in Australia assess the care needs of frail older people. Despite being at high risk of medication-related problems (MRPs), ACAT patients do not routinely receive a comprehensive medication review. The aims of the study were to compare three methods for facilitating a pharmacist-led comprehensive medication review for people referred to an ACAT, and compare MRPs identified via ACAT usual care with those identified via pharmacist-led medication reviews. A prospective, randomized, comparative study involving 80 community-dwelling patients (median age 84 years) referred to an ACAT in Melbourne, Australia, was conducted. Following ACAT assessment (usual care), a clinical pharmacist reviewed all participating patients' ACAT files to identify potential MRPs not identified by the ACAT (medication review method 1). Patients were then randomized into two groups. Group A received information about the Australian government-funded, general practitioner (GP)-initiated Home Medicines Review (HMR) programme, and a letter was sent to their GP recommending an HMR (GPHMR; medication review method 2). Group B patients were referred directly to a clinical pharmacist associated with the ACAT for an ACAT-initiated pharmacist home medicines review (APHMR; medication review method 3); the pharmacist arranged a home visit, obtained a thorough medication history and conducted a comprehensive medication review. The main outcome measures were the proportion of patients who received a pharmacist home visit within 28 days; the number of MRPs identified by ACAT usual care, pharmacist review of ACAT files, and APHMR, and their clinical risk (assessed by a geriatrician-pharmacist panel); and patients', GPs' and ACAT clinicians' opinions about pharmacist medication review. Three hundred patients were referred to the ACAT, and 80 were recruited into the study. Thirty-six of 40 APHMR patients (90.0%) received a pharmacist home visit within 28 days, compared with 7

  16. Frequency and significance of qSOFA criteria during adult rapid response team reviews: A prospective cohort study.

    Science.gov (United States)

    LeGuen, Maurice; Ballueer, Yvonne; McKay, Richard; Eastwood, Glenn; Bellomo, Rinaldo; Jones, Daryl

    2018-01-01

    A new definition of sepsis released by an international task-force has introduced the concept of quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA). This study aimed to measure the proportion of patients who fulfilled qSOFA criteria during a Rapid Response Team (RRT) review and to assess their associated outcomes. We conducted a prospective study of adult RRT reviews over a one month period between 6th June and 10th July 2016 in a large tertiary hospital in Melbourne Australia RESULTS: Over a one-month period, there were 282 RRT reviews, 258 of which were included. One hundred out of 258 (38.8%) RRT review patients fulfilled qSOFA criteria. qSOFA positive patients were more likely to be admitted to the intensive care unit (29% vs 18%, P=0.04), to have repeat RRT reviews (27% vs 13%; p=0.007) and die in hospital (31% vs 10%, P<0.001). qSOFA positive patients with suspected infection were more likely to be admitted to the intensive care unit compared to patients with infection alone (37% vs 15%, P=0.002). Eleven of 42 patients (26%) who had infection and qSOFA died whilst in hospital, compared to 8/55 (15%) of patients with infection alone (P=0.2). Adult patients who are qSOFA positive at the time of their RRT review are at increased risk of in-hospital mortality. The assessment of qSOFA may be a useful triage tool during a RRT review. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  17. Rating medical emergency teamwork performance: development of the Team Emergency Assessment Measure (TEAM).

    Science.gov (United States)

    Cooper, Simon; Cant, Robyn; Porter, Joanne; Sellick, Ken; Somers, George; Kinsman, Leigh; Nestel, Debra

    2010-04-01

    To develop a valid, reliable and feasible teamwork assessment measure for emergency resuscitation team performance. Generic and profession specific team performance assessment measures are available (e.g. anaesthetics) but there are no specific measures for the assessment of emergency resuscitation team performance. (1) An extensive review of the literature for teamwork instruments, and (2) development of a draft instrument with an expert clinical team. (3) Review by an international team of seven independent experts for face and content validity. (4) Instrument testing on 56 video-recorded hospital and simulated resuscitation events for construct, consistency, concurrent validity and reliability and (5) a final set of ratings for feasibility on fifteen simulated 'real time' events. Following expert review, selected items were found to have a high total content validity index of 0.96. A single 'teamwork' construct was identified with an internal consistency of 0.89. Correlation between the total item score and global rating (rho 0.95; pleadership, teamwork and task management. In this primary study TEAM was found to be a valid and reliable instrument and should be a useful addition to clinicians' tool set for the measurement of teamwork during medical emergencies. Further evaluation of the instrument is warranted to fully determine its psychometric properties. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

  18. Analysis of recurrent events: a systematic review of randomised controlled trials of interventions to prevent falls.

    Science.gov (United States)

    Donaldson, Meghan G; Sobolev, Boris; Cook, Wendy L; Janssen, Patti A; Khan, Karim M

    2009-03-01

    there are several well-developed statistical methods for analysing recurrent events. Although there are guidelines for reporting the design and methodology of randomised controlled trials (RCTs), analysis guidelines do not exist to guide the analysis for RCTs with recurrent events. Application of statistical methods that do not account for recurrent events may provide erroneous results when used to test the efficacy of an intervention. It is unknown what proportion of RCTs of falls prevention studies have utilised statistical methods that incorporate recurrent events. we conducted a systematic review of RCTs of interventions to prevent falls in community-dwelling older persons. We searched Medline from 1994 to November 2006. We determined the proportion of studies that reported using three statistical methods appropriate for the analysis of recurrent events (negative binomial regression, Andersen-Gill extension of the Cox model and the WLW marginal model). fewer than one-third of 83 papers that reported falls as an outcome utilised any appropriate statistical method (negative binomial regression, Andersen-Gill extension of the Cox model and Cox marginal model) to analyse recurrent events and fewer than 15% utilised graphical methods to represent falls data. RCTs that have a recurrent event end-point should include an analysis appropriate for recurrent event data such as negative binomial regression, Andersen-Gill extension of the Cox model and/or the WLW marginal model. We recommend that researchers and clinicians seek consultation with a statistician with expertise in recurrent event methodology.

  19. Effect of a vascular access team on central line-associated bloodstream infections in infants admitted to a neonatal intensive care unit: a systematic review.

    Science.gov (United States)

    Legemaat, Monique M; Jongerden, Irene P; van Rens, Roland M F P T; Zielman, Marjanne; van den Hoogen, Agnes

    2015-05-01

    To review the effect of a vascular access team on the incidence of central line-associated bloodstream infections in infants admitted to a neonatal intensive care unit. MEDLINE, CINAHL, Embase, Web-of-Science and the Cochrane Library were searched until December 2013. Studies that evaluated the implementation of a vascular access team, and focused on the incidence of central line-associated bloodstream infections in infants admitted to a neonatal intensive care unit, were selected. Incidence rates of central line-associated bloodstream infections were extracted, as well as information on vascular access team tasks and team composition. The quality of studies was critically appraised using the McMaster tool for quantitative studies. Seven studies involving 136 to 414 participants were included. In general, the implementation of a vascular access team coincided with the implementation of concurrent interventions. All vascular access teams included nurses, and occasionally included physicians. Main tasks included insertion and maintenance of central lines. In all studies, a relative decrease of 45-79% in central line-associated bloodstream infections was reported. A vascular access team is a promising intervention to decrease central line-associated bloodstream infections in infants admitted to a neonatal intensive care unit. However, level of evidence for effectiveness is low. Future research is required to improve the strength of evidence for vascular access teams. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Systematic review on the prevalence, frequency and comparative value of adverse events data in social media

    Science.gov (United States)

    Golder, Su; Norman, Gill; Loke, Yoon K

    2015-01-01

    Aim The aim of this review was to summarize the prevalence, frequency and comparative value of information on the adverse events of healthcare interventions from user comments and videos in social media. Methods A systematic review of assessments of the prevalence or type of information on adverse events in social media was undertaken. Sixteen databases and two internet search engines were searched in addition to handsearching, reference checking and contacting experts. The results were sifted independently by two researchers. Data extraction and quality assessment were carried out by one researcher and checked by a second. The quality assessment tool was devised in-house and a narrative synthesis of the results followed. Results From 3064 records, 51 studies met the inclusion criteria. The studies assessed over 174 social media sites with discussion forums (71%) being the most popular. The overall prevalence of adverse events reports in social media varied from 0.2% to 8% of posts. Twenty-nine studies compared the results from searching social media with using other data sources to identify adverse events. There was general agreement that a higher frequency of adverse events was found in social media and that this was particularly true for ‘symptom’ related and ‘mild’ adverse events. Those adverse events that were under-represented in social media were laboratory-based and serious adverse events. Conclusions Reports of adverse events are identifiable within social media. However, there is considerable heterogeneity in the frequency and type of events reported, and the reliability or validity of the data has not been thoroughly evaluated. PMID:26271492

  1. Systematic review on the prevalence, frequency and comparative value of adverse events data in social media.

    Science.gov (United States)

    Golder, Su; Norman, Gill; Loke, Yoon K

    2015-10-01

    The aim of this review was to summarize the prevalence, frequency and comparative value of information on the adverse events of healthcare interventions from user comments and videos in social media. A systematic review of assessments of the prevalence or type of information on adverse events in social media was undertaken. Sixteen databases and two internet search engines were searched in addition to handsearching, reference checking and contacting experts. The results were sifted independently by two researchers. Data extraction and quality assessment were carried out by one researcher and checked by a second. The quality assessment tool was devised in-house and a narrative synthesis of the results followed. From 3064 records, 51 studies met the inclusion criteria. The studies assessed over 174 social media sites with discussion forums (71%) being the most popular. The overall prevalence of adverse events reports in social media varied from 0.2% to 8% of posts. Twenty-nine studies compared the results from searching social media with using other data sources to identify adverse events. There was general agreement that a higher frequency of adverse events was found in social media and that this was particularly true for 'symptom' related and 'mild' adverse events. Those adverse events that were under-represented in social media were laboratory-based and serious adverse events. Reports of adverse events are identifiable within social media. However, there is considerable heterogeneity in the frequency and type of events reported, and the reliability or validity of the data has not been thoroughly evaluated. © 2015 The British Pharmacological Society.

  2. Incidence, causes, and consequences of preventable adverse drug events: protocol for an overview of reviews.

    Science.gov (United States)

    Hutton, Brian; Kanji, Salmaan; McDonald, Erika; Yazdi, Fatemeh; Wolfe, Dianna; Thavorn, Kednapa; Pepper, Sally; Chapman, Laurie; Skidmore, Becky; Moher, David

    2016-12-05

    Medication errors represent a noteworthy source of harm to patients. In recent years, several systematic reviews have assessed the frequency and causes of these events, as well as other factors such as commonly associated drugs, their incidence in different specialties, and their consequences to patients. Despite this past literature, there remains a need to study discrepancies between these reviews and establish the current state of the evidence. The planned review will bring together, compare, and contract existing evidence related to the occurrence of medication errors in acute and continuing/long-term care settings. A systematic review of reviews will be performed. A literature search designed by an experienced information specialist will be carried out in Medline, Embase, and the Cochrane Library. We will seek systematic reviews and meta-analyses of primary research studies that evaluate one or more of the following aspects of the occurrence of preventable adverse drug events in hospitals and long-term care centers: the incidence of preventable adverse drug events, either overall or within subgroups of interest related to setting; drug or patient characteristics; cited consequences of these events to patients, including death, emergency room visits, or other outcomes; and established causes of the preventable adverse drug events. Two researchers will independently screen all abstracts and full texts for study selection and subsequently perform data extraction from all included studies. Quality of the reviews will be assessed using the assessing the methodological quality of systematic reviews (AMSTAR) tool. Where objectives from two or more reviews overlap, we will employ the Jadad framework to assess the causes of any noted discrepancies between reviews. An overall summary of results will be performed using tabular and graphical approaches and will be supplemented by narrative description. This overview will help synthesize the broad degree of information

  3. Hospital Palliative Care Teams and Post-Acute Care in Nursing Facilities: An Integrative Review.

    Science.gov (United States)

    Carpenter, Joan G

    2017-01-01

    Although palliative care consultation teams are common in U.S. hospitals, follow up and outcomes of consultations for frail older adults discharged to nursing facilities are unclear. To summarize and critique research on the care of patients discharged to nursing facilities following a hospital-based palliative care consult, a systematic search of PubMed, CINAHL, Ageline, and PsycINFO was conducted in February 2016. Data from the articles (N = 12) were abstracted and analyzed. The results of 12 articles reflecting research conducted in five countries are presented in narrative form. Two studies focused on nurse perceptions only, three described patient/family/caregiver experiences and needs, and seven described patient-focused outcomes. Collectively, these articles demonstrate that disruption in palliative care service on hospital discharge and nursing facility admission may result in high symptom burden, poor communication, and inadequate coordination of care. High mortality was also noted. [Res Gerontol Nurs. 2017; 10(1):25-34.]. Copyright 2017, SLACK Incorporated.

  4. Annotated Bibliography and State-of-the-Art Review of the Field of Team Training as it Relates to Military Teams

    Science.gov (United States)

    1986-02-01

    record is obtained through video nnd/or audio tapes. Rphivior cnn he r-cordod in t’rms of militiry tactics, time to complete nctiviti-s, individual...tests), and npplication of advanced technology to team training (e.g., video -tape lecture, split screens comparing good with poor performance, use of...rrews that are assigned hilh porn eflt ng,* of untrained Indivilunts. nnd maonitoring~ performance. lluensn r7Ators. 1079, 17, :?96-Inn. Four i~onltcrinp

  5. The reporting of adverse events following spinal manipulation in randomized clinical trials-a systematic review.

    Science.gov (United States)

    Gorrell, Lindsay M; Engel, Roger M; Brown, Benjamin; Lystad, Reidar P

    2016-09-01

    Spinal manipulative therapy (SMT) is commonly used to treat spinal disorders. Although clinical practice guidelines recommend the use of SMT in the treatment of neck and back disorders, concerns exist about the nature and incidence of adverse events associated with the intervention. Comprehensive reporting of adverse events in clinical trials could allow for accurate incidence estimates through meta-analysis. However, it is not clear if randomized clinical trials (RCTs) that involve SMT are currently reporting adverse events adequately. This study aimed to describe the extent of adverse events reporting in published RCTs involving SMT, and to determine whether the quality of reporting has improved since publication of the 2010 Consolidated Standards Of Reporting Trials (CONSORT) statement. This is a systematic literature review. The Physiotherapy Evidence Database (PEDro) and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched for RCTs involving SMT. Domains of interest included classifications of adverse events, completeness of adverse events reporting, nomenclature used to describe the events, methodological quality of the study, and details of the publishing journal. Data were analyzed using descriptive statistics. Frequencies and proportions of trials reporting on each of the specified domains above were calculated. Differences in proportions between pre- and post-CONSORT trials were calculated with 95% confidence intervals using standard methods, and statistical comparisons were analyzed using tests for equality of proportions with continuity correction. There was no funding obtained for this study. The authors declare no conflict of interest. Of 7,398 records identified in the electronic searches, 368 articles were eligible for inclusion in this review. Adverse events were reported in 140 (38.0%) articles. There was a significant increase in the reporting of adverse events post-CONSORT (p=.001). There were two major adverse events

  6. Multidisciplinary Team Training in a Simulation Setting for Acute Obstetric Emergencies A Systematic Review

    NARCIS (Netherlands)

    Merién, A. E. R.; van de Ven, J.; Mol, B. W.; Houterman, S.; Oei, S. G.

    2010-01-01

    OBJECTIVE: To perform a systematic review of the literature on the effectiveness of multidisciplinary teamwork training in a simulation setting for the reduction of medical adverse outcomes in obstetric emergency situations. DATA SOURCES: We searched Medline, Embase, and the Cochrane Library from

  7. A Review of Recent Advances in Research on Extreme Heat Events

    Science.gov (United States)

    Horton, Radley M.; Mankin, Justin S.; Lesk, Corey; Coffel, Ethan; Raymond, Colin

    2016-01-01

    Reviewing recent literature, we report that changes in extreme heat event characteristics such as magnitude, frequency, and duration are highly sensitive to changes in mean global-scale warming. Numerous studies have detected significant changes in the observed occurrence of extreme heat events, irrespective of how such events are defined. Further, a number of these studies have attributed present-day changes in the risk of individual heat events and the documented global-scale increase in such events to anthropogenic-driven warming. Advances in process-based studies of heat events have focused on the proximate land-atmosphere interactions through soil moisture anomalies, and changes in occurrence of the underlying atmospheric circulation associated with heat events in the mid-latitudes. While evidence for a number of hypotheses remains limited, climate change nevertheless points to tail risks of possible changes in heat extremes that could exceed estimates generated from model outputs of mean temperature. We also explore risks associated with compound extreme events and nonlinear impacts associated with extreme heat.

  8. Management Teams

    CERN Document Server

    Belbin, R Meredith Meredith

    2012-01-01

    Meredith Belbin's work on teams has become part of everyday language in organizations all over the world. All kinds of teams and team behaviours are covered. At the end of the book is a self-perception inventory so that readers can match their own personalities to particular team roles. Management Teams is required reading for managers concerned with achieving results by getting the best from their key personnel.

  9. Genetics of the human electroencephalogram (EEG) and event-related brain potentials (ERPs): a review

    NARCIS (Netherlands)

    van Beijsterveldt, C.E.M.; Boomsma, D.I.

    1994-01-01

    Twin and family studies of normal variation in the human electroencephalogram (EEG) and event related potentials (ERPs) are reviewed. Most of these studies are characterized by small sample sizes. However, by summarizing these studies in one paper, we may be able to gain some insight into the

  10. Digital disease detection: A systematic review of event-based internet biosurveillance systems.

    Science.gov (United States)

    O'Shea, Jesse

    2017-05-01

    Internet access and usage has changed how people seek and report health information. Meanwhile,infectious diseases continue to threaten humanity. The analysis of Big Data, or vast digital data, presents an opportunity to improve disease surveillance and epidemic intelligence. Epidemic intelligence contains two components: indicator based and event-based. A relatively new surveillance type has emerged called event-based Internet biosurveillance systems. These systems use information on events impacting health from Internet sources, such as social media or news aggregates. These systems circumvent the limitations of traditional reporting systems by being inexpensive, transparent, and flexible. Yet, innovations and the functionality of these systems can change rapidly. To update the current state of knowledge on event-based Internet biosurveillance systems by identifying all systems, including current functionality, with hopes to aid decision makers with whether to incorporate new methods into comprehensive programmes of surveillance. A systematic review was performed through PubMed, Scopus, and Google Scholar databases, while also including grey literature and other publication types. 50 event-based Internet systems were identified, including an extraction of 15 attributes for each system, described in 99 articles. Each system uses different innovative technology and data sources to gather data, process, and disseminate data to detect infectious disease outbreaks. The review emphasises the importance of using both formal and informal sources for timely and accurate infectious disease outbreak surveillance, cataloguing all event-based Internet biosurveillance systems. By doing so, future researchers will be able to use this review as a library for referencing systems, with hopes of learning, building, and expanding Internet-based surveillance systems. Event-based Internet biosurveillance should act as an extension of traditional systems, to be utilised as an

  11. A review of the Office of Inspector General's reports on adverse event identification and reporting.

    Science.gov (United States)

    Howe, Christopher L

    2011-01-01

    The Office of Inspector General published a series of four reports from 2008 to 2010 after investigating the frequency and financial impact of "never events" on Medicare recipients. This series investigated healthcare's ability to identify the occurrence of these events and yielded a detailed analysis of data that must, or at least should, be reviewed to fully understand the clinical risks affecting organizations. These reports also shed light on the reality that there remains gross underreporting of adverse events in healthcare and begs several questions about healthcare's current efforts to fully identify and understand risk. This article summarizes the reports and considers their risk management implications, particularly regarding adverse events. © 2011 American Society for Healthcare Risk Management of the American Hospital Association.

  12. Standards of resuscitation during inter-hospital transportation: the effects of structured team briefing or guideline review - A randomised, controlled simulation study of two micro-interventions

    Directory of Open Access Journals (Sweden)

    Christensen Erika F

    2011-03-01

    Full Text Available Abstract Background Junior physicians are sometimes sent in ambulances with critically ill patients who require urgent transfer to another hospital. Unfamiliar surroundings and personnel, time pressure, and lack of experience may imply a risk of insufficient treatment during transportation as this can cause the physician to loose the expected overview of the situation. While health care professionals are expected to follow complex algorithms when resuscitating, stress can compromise both solo-performance and teamwork. Aim To examine whether inter-hospital resuscitation improved with a structured team briefing between physician and ambulance crew in preparation for transfer vs. review of resuscitation guidelines. The effect parameters were physician team leadership (requesting help, delegating tasks, time to resuscitation key elements (chest compressions, defibrillation, ventilations, medication, or a combination of these termed "the first meaningful action", and hands-off ratio. Methods Participants: 46 physicians graduated within 5 years. Design: A simulation intervention study with a control group and two interventions (structured team briefing or review of guidelines. Scenario: Cardiac arrest during simulated inter-hospital transfer. Results Forty-six candidates participated: 16 (control, 13 (review, and 17 (team briefing. Reviewing guidelines delayed requesting help to 162 seconds, compared to 21 seconds in control and team briefing groups (p = 0.021. Help was not requested in 15% of cases; never requesting help was associated with an increased hands-off ratio, from 39% if the driver's assistance was requested to 54% if not (p Conclusion Neither review nor team briefing improved the time to resuscitation key elements. Review led to an eight-fold increase in the delay to requesting help. The association between never requesting help and an increased hands-off ratio underpins the importance of prioritising available resources. Other medical

  13. Team Learning Ditinjau dari Team Diversity dan Team Efficacy

    OpenAIRE

    Vivi Gusrini Rahmadani Pohan; Djamaludin Ancok

    2015-01-01

    This research attempted to observe team learning from the level of team diversity and team efficacy of work teams. This research used an individual level of analysis rather than the group level. The team members measured the level of team diversity, team efficacy and team learning of the teams through three scales, namely team learning scale, team diversity scale, and team efficacy scale. Respondents in this research were the active team members in a company, PT. Alkindo Mitraraya. The total ...

  14. Team Learning Ditinjau dari Team Diversity dan Team Efficacy

    OpenAIRE

    Pohan, Vivi Gusrini Rahmadani; Ancok, Djamaludin

    2010-01-01

    This research attempted to observe team learning from the level of team diversity and team efficacy of work teams. This research used an individual level of analysis rather than the group level. The team members measured the level of team diversity, team efficacy and team learning of the teams through three scales, namely team learning scale, team diversity scale, and team efficacy scale. Respondents in this research were the active team members in a company, PT. Alkindo Mitraraya. The total ...

  15. Simulation-based education for building clinical teams.

    Science.gov (United States)

    Marshall, Stuart D; Flanagan, Brendan

    2010-10-01

    Failure to work as an effective team is commonly cited as a cause of adverse events and errors in emergency medicine. Until recently, individual knowledge and skills in managing emergencies were taught, without reference to the additional skills required to work as part of a team. Team training courses are now becoming commonplace, however their strategies and modes of delivery are varied. Just as different delivery methods of traditional education can result in different levels of retention and transfer to the real world, the same is true in team training of the material in different ways in traditional forms of education may lead to different levels of retention and transfer to the real world, the same is true in team training. As team training becomes more widespread, the effectiveness of different modes of delivery including the role of simulation-based education needs to be clearly understood. This review examines the basis of team working in emergency medicine, and the components of an effective emergency medical team. Lessons from other domains with more experience in team training are discussed, as well as the variations from these settings that can be observed in medical contexts. Methods and strategies for team training are listed, and experiences in other health care settings as well as emergency medicine are assessed. Finally, best practice guidelines for the development of team training programs in emergency medicine are presented.

  16. Life events and change in leisure time physical activity: a systematic review.

    Science.gov (United States)

    Engberg, Elina; Alen, Markku; Kukkonen-Harjula, Katriina; Peltonen, Juha E; Tikkanen, Heikki O; Pekkarinen, Heikki

    2012-05-01

    The global epidemic of chronic non-communicable diseases is closely related to changes in lifestyle, including decreasing leisure time physical activity (PA). Physical inactivity is a major public health challenge. To respond to that challenge, it is essential to know which personal and environmental factors affect PA behaviour. Certain life events may be one contributing factor, by creating emotional distress and disrupting a person's daily routine. The aim was to examine the literature concerning the effects of life events on changes in PA. A systematic literature search was performed on studies that assessed at least one major change in life circumstances and a change in PA. To be included, studies had to assess PA at two timepoints at least (before and after the event). Diseases as life events were excluded from this review. Thirty-four articles met the inclusion criteria. The studies examined the following life-change events: transition to university; change in employment status; marital transitions and changes in relationships; pregnancy/having a child; experiencing harassment at work, violence or disaster; and moving into an institution. The studies reviewed showed statistically significant changes in leisure PA associated with certain life events. In men and women, transition to university, having a child, remarriage and mass urban disaster decreased PA levels, while retirement increased PA. In young women, beginning work, changing work conditions, changing from being single to cohabiting, getting married, pregnancy, divorce/separation and reduced income decreased PA. In contrast, starting a new personal relationship, returning to study and harassment at work increased PA. In middle-aged women, changing work conditions, reduced income, personal achievement and death of a spouse/partner increased PA, while experiencing violence and a family member being arrested or jailed decreased PA. In older women, moving into an institution and interpersonal loss

  17. Research collaboration and team science a state-of-the-art review and agenda

    CERN Document Server

    Bozeman, Barry

    2014-01-01

    Today in most scientific and technical fields more than 90% of research studies and publications are collaborative, often resulting in high-impact research and development of commercial applications, as reflected in patents. Nowadays in many areas of science, collaboration is not a preference but, literally, a work prerequisite. The purpose of this book is to review and critique the burgeoning scholarship on research collaboration. The authors seek to identify gaps in theory and research and identify the ways in which existing research can be used to improve public policy for collaboration and to improve project-level management of collaborations using Scientific and Technical Human Capital (STHC) theory as a framework. Broadly speaking, STHC is the sum of scientific and technical and social knowledge, skills and resources embodied in a particular individual. It is both human capital endowments, such as formal education and training and social relations and network ties that bind scientists and the users of ...

  18. Economic Evaluations of the Health Impacts of Weather-Related Extreme Events: A Scoping Review

    Directory of Open Access Journals (Sweden)

    Laetitia H. M. Schmitt

    2016-11-01

    Full Text Available The frequency and severity of extreme events is expected to increase under climate change. There is a need to understand the economic consequences of human exposure to these extreme events, to underpin decisions on risk reduction. We undertook a scoping review of economic evaluations of the adverse health effects from exposure to weather-related extreme events. We searched PubMed, Embase and Web of Science databases with no restrictions to the type of evaluations. Twenty studies were included, most of which were recently published. Most studies have been undertaken in the U.S. (nine studies or Asia (seven studies, whereas we found no studies in Africa, Central and Latin America nor the Middle East. Extreme temperatures accounted for more than a third of the pool of studies (seven studies, closely followed by flooding (six studies. No economic study was found on drought. Whilst studies were heterogeneous in terms of objectives and methodology, they clearly indicate that extreme events will become a pressing public health issue with strong welfare and distributional implications. The current body of evidence, however, provides little information to support decisions on the allocation of scarce resources between risk reduction options. In particular, the review highlights a significant lack of research attention to the potential cost-effectiveness of interventions that exploit the capacity of natural ecosystems to reduce our exposure to, or ameliorate the consequences of, extreme events.

  19. Economic Evaluations of the Health Impacts of Weather-Related Extreme Events: A Scoping Review

    Science.gov (United States)

    Schmitt, Laetitia H. M.; Graham, Hilary M.; White, Piran C. L.

    2016-01-01

    The frequency and severity of extreme events is expected to increase under climate change. There is a need to understand the economic consequences of human exposure to these extreme events, to underpin decisions on risk reduction. We undertook a scoping review of economic evaluations of the adverse health effects from exposure to weather-related extreme events. We searched PubMed, Embase and Web of Science databases with no restrictions to the type of evaluations. Twenty studies were included, most of which were recently published. Most studies have been undertaken in the U.S. (nine studies) or Asia (seven studies), whereas we found no studies in Africa, Central and Latin America nor the Middle East. Extreme temperatures accounted for more than a third of the pool of studies (seven studies), closely followed by flooding (six studies). No economic study was found on drought. Whilst studies were heterogeneous in terms of objectives and methodology, they clearly indicate that extreme events will become a pressing public health issue with strong welfare and distributional implications. The current body of evidence, however, provides little information to support decisions on the allocation of scarce resources between risk reduction options. In particular, the review highlights a significant lack of research attention to the potential cost-effectiveness of interventions that exploit the capacity of natural ecosystems to reduce our exposure to, or ameliorate the consequences of, extreme events. PMID:27834843

  20. Economic Evaluations of the Health Impacts of Weather-Related Extreme Events: A Scoping Review.

    Science.gov (United States)

    Schmitt, Laetitia H M; Graham, Hilary M; White, Piran C L

    2016-11-08

    The frequency and severity of extreme events is expected to increase under climate change. There is a need to understand the economic consequences of human exposure to these extreme events, to underpin decisions on risk reduction. We undertook a scoping review of economic evaluations of the adverse health effects from exposure to weather-related extreme events. We searched PubMed, Embase and Web of Science databases with no restrictions to the type of evaluations. Twenty studies were included, most of which were recently published. Most studies have been undertaken in the U.S. (nine studies) or Asia (seven studies), whereas we found no studies in Africa, Central and Latin America nor the Middle East. Extreme temperatures accounted for more than a third of the pool of studies (seven studies), closely followed by flooding (six studies). No economic study was found on drought. Whilst studies were heterogeneous in terms of objectives and methodology, they clearly indicate that extreme events will become a pressing public health issue with strong welfare and distributional implications. The current body of evidence, however, provides little information to support decisions on the allocation of scarce resources between risk reduction options. In particular, the review highlights a significant lack of research attention to the potential cost-effectiveness of interventions that exploit the capacity of natural ecosystems to reduce our exposure to, or ameliorate the consequences of, extreme events.

  1. Is fasting safe? A chart review of adverse events during medically supervised, water-only fasting.

    Science.gov (United States)

    Finnell, John S; Saul, Bradley C; Goldhamer, Alan C; Myers, Toshia R

    2018-02-20

    Evidence suggests that fasting, during which only water is consumed, results in potentially health promoting physiological effects. However, peer-reviewed research assessing the safety of water-only fasting is lacking. To address this, we conducted a chart review to describe adverse events (AEs) that occurred during medically supervised, water-only fasting. Electronic charts from patient visits to a residential medical facility from 2006 to 2011 were reviewed. Patients who were at least 21 years of age and water-only fasted for ≥2 consecutive days with a refeeding period equal to half of the fast length were included. Out of 2539 charts, 768 visits met our inclusion and exclusion criteria. AEs were abstracted from chart notes and classified according to CTCAE (v4.03) and MedDRA (v12.1) terminology. Descriptive analysis of AEs is reported. During the protocol period, the highest grade AE (HGAE) in 555 visits was a grade 2 event or lower, in 212 visits it was a grade 3 event, in 1 visit it was a grade 4 event, and there were no grade 5 events. There were 2 (0.002%) visits with a serious adverse event (SAE). The majority of AEs identified were mild (n = 4490, 75%) in nature and known reactions to fasting. To our knowledge, this is the most comprehensive analysis of AEs experienced during medically supervised, water-only fasting conducted to date. Overall, our data indicate that the majority of AEs experienced were mild to moderate and known reactions to fasting. This suggests that the protocol used in this study can be safely implemented in a medical setting with minimal risk of a SAE.

  2. Association between exogenous testosterone and cardiovascular events: an overview of systematic reviews.

    Science.gov (United States)

    Onasanya, Oluwadamilola; Iyer, Geetha; Lucas, Eleanor; Lin, Dora; Singh, Sonal; Alexander, G Caleb

    2016-11-01

    Given the conflicting evidence regarding the association between exogenous testosterone and cardiovascular events, we systematically assessed published systematic reviews for evidence of the association between exogenous testosterone and cardiovascular events. We searched PubMed, MEDLINE, Embase, Cochrane Collaboration Clinical Trials, ClinicalTrials.gov, and the US Food and Drug Administration website for systematic reviews of randomised controlled trials published up to July 19, 2016. Two independent reviewers screened 954 full texts from 29 335 abstracts to identify systematic reviews of randomised controlled trials in which the cardiovascular effects of exogenous testosterone on men aged 18 years or older were examined. We extracted data for study characteristics, analytic methods, and key findings, and applied the AMSTAR (A Measurement Tool to Assess Systematic Reviews) checklist to assess methodological quality of each review. Our primary outcome measure was the direction and magnitude of association between exogenous testosterone and cardiovascular events. We identified seven reviews and meta-analyses, which had substantial clinical heterogeneity, differing statistical methods, and variable methodological quality and quality of data abstraction. AMSTAR scores ranged from 3 to 9 out of 11. Six systematic reviews that each included a meta-analysis showed no significant association between exogenous testosterone and cardiovascular events, with summary estimates ranging from 1·07 to 1·82 and imprecise confidence intervals. Two of these six meta-analyses showed increased risk in subgroup analyses of oral testosterone and men aged 65 years or older during their first treatment year. One meta-analysis showed a significant association between exogenous testosterone and cardiovascular events, in men aged 18 years or older generally, with a summary estimate of 1·54 (95% CI 1·09-2·18). Our optimal information size analysis showed that any randomised controlled

  3. Review of the GMD Benchmark Event in TPL-007-1

    Energy Technology Data Exchange (ETDEWEB)

    Backhaus, Scott N. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Rivera, Michael Kelly [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-07-21

    Los Alamos National Laboratory (LANL) examined the approaches suggested in NERC Standard TPL-007-1 for defining the geo-electric field for the Benchmark Geomagnetic Disturbance (GMD) Event. Specifically; 1. Estimating 100-year exceedance geo-electric field magnitude; The scaling of the GMD Benchmark Event to geomagnetic latitudes below 60 degrees north; and 3. The effect of uncertainties in earth conductivity data on the conversion from geomagnetic field to geo-electric field. This document summarizes the review and presents recommendations for consideration

  4. [Frailty as a predictor of adverse events in epidemiological studies: literature review].

    Science.gov (United States)

    Romero Rizos, Luis; Abizanda Soler, Pedro

    2013-01-01

    Several epidemiological studies have analyzed the association between frailty status and adverse geriatric health outcomes, with there being a clear relationship being demonstrated in mortality, disability, mobility loss, institutionalization and falls. However, different studies have evaluated different number of these adverse events, with different criteria, and with different follow-up periods. As a result of this relationship, the objective of geriatric medicine must not only be the prevention, diagnosis and treatment of diseases based on multidisciplinary team work and use of geriatric units according to functional status of patients, but the detection, prevention and treatment of frailty. Frailty must be considered as a pre-disability state that can be prevented and treated to delay its progression towards disability, institutionalization, and death. The characterization of frailty status can also help other medical specialties to stratify the risk of adverse health outcomes in oncology treatments, surgical interventions, or diagnostic procedures. Copyright © 2013 SEGG. Published by Elsevier Espana. All rights reserved.

  5. The human impact of tsunamis: a historical review of events 1900-2009 and systematic literature review.

    Science.gov (United States)

    Doocy, Shannon; Daniels, Amy; Dick, Anna; Kirsch, Thomas D

    2013-04-16

    Introduction. Although rare, tsunamis have the potential to cause considerable loss of life and injury as well as widespread damage to the natural and built environments. The objectives of this review were to describe the impact of tsunamis on human populations in terms of mortality, injury, and displacement and, to the extent possible, identify risk factors associated with these outcomes. This is one of five reviews on the human impact of natural disasters. Methods. Data on the impact of tsunamis were compiled using two methods, a historical review from 1900 to mid 2009 of tsunami events from multiple databases and a systematic literature review to October 2012 of publications. Analysis included descriptive statistics and bivariate tests for associations between tsunami mortality and characteristics using STATA 11. Findings. There were 255,195 deaths (range 252,619-275,784) and 48,462 injuries (range 45,466-51,457) as a result of tsunamis from 1900 to 2009. The majority of deaths (89%) and injuries reported during this time period were attributed to a single event -the 2004 Indian Ocean tsunami. Findings from the systematic literature review indicate that the primary cause of tsunami-related mortality is drowning, and that females, children and the elderly are at increased mortality risk. The few studies that reported on tsunami-related injury suggest that males and young adults are at increased injury-risk. Conclusions. Early warning systems may help mitigate tsunami-related loss of life.

  6. Smartphone and tablet apps for concussion road warriors (team clinicians): a systematic review for practical users.

    Science.gov (United States)

    Lee, Hopin; Sullivan, S John; Schneiders, Anthony G; Ahmed, Osman Hassan; Balasundaram, Arun Prasad; Williams, David; Meeuwisse, Willem H; McCrory, Paul

    2015-04-01

    Mobile technologies are steadily replacing traditional assessment approaches for the recognition and assessment of a sports concussion. Their ease of access, while facilitating the early identification of a concussion, also raises issues regarding the content of the applications (apps) and their suitability for different user groups. To locate and review apps that assist in the recognition and assessment of a sports concussion and to assess their content with respect to that of internationally accepted best-practice instruments. A search of international app stores and of the web using key terms such as 'concussion', 'sports concussion' and variants was conducted. For those apps meeting the inclusion criteria, data were extracted on the platform, intended users and price. The content of each app was benchmarked to the Sport Concussion Assessment Tool 2 (SCAT2) and Pocket SCAT2 using a custom scoring scheme to generate a percentage compliance statistic. 18 of the 155 apps identified met the inclusion criteria. Almost all (16/18) were available on an iOS platform and only five required a payment to purchase. The apps were marketed for a wide range of intended users from medical professionals to the general public. The content of the apps varied from 0% to 100% compliance with the selected standard, and 'symptom evaluation' components demonstrated the highest level of compliance. The surge in availability of apps in an unregulated market raises concerns as to the appropriateness of their content for different groups of end users. The consolidation of best-practice concussion instruments now provides a framework to inform the development of future apps. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. Review Team Focused Modeling Analysis of Radial Collector Well Operation on the Hypersaline Groundwater Plume beneath the Turkey Point Site near Homestead, Florida

    Energy Technology Data Exchange (ETDEWEB)

    Oostrom, Martinus [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Vail, Lance W. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-08-01

    Researchers at Pacific Northwest National Laboratory served as members of a U.S. Nuclear Regulatory Commission review team for the Florida Power & Light Company’s application for two combined construction permits and operating licenses (combined licenses or COLs) for two proposed new reactor units—Turkey Point Units 6 and 7. The review team evaluated the environmental impacts of the proposed action based on the October 29, 2014 revision of the COL application, including the Environmental Report, responses to requests for additional information, and supplemental information. As part of this effort, team members tasked with assessing the environmental effects of proposed construction and operation of Units 6 and 7 at the Turkey Point site reviewed two separate modeling studies that analyzed the interaction between surface water and groundwater that would be altered by the operation of radial collector wells (RCWs) at the site. To further confirm their understanding of the groundwater hydrodynamics and to consider whether certain actions, proposed after the two earlier modeling studies were completed, would alter the earlier conclusions documented by the review team in their draft environmental impact statement (EIS; NRC 2015), a third modeling analysis was performed. The third modeling analysis is discussed in this report.

  8. The health and socioeconomic impacts of major multi-sport events: systematic review (1978-2008).

    Science.gov (United States)

    McCartney, Gerry; Thomas, Sian; Thomson, Hilary; Scott, John; Hamilton, Val; Hanlon, Phil; Morrison, David S; Bond, Lyndal

    2010-05-20

    To assess the effects of major multi-sport events on health and socioeconomic determinants of health in the population of the city hosting the event. Systematic review. We searched the following sources without language restrictions for papers published between 1978 and 2008: Applied Social Science Index and Abstracts (ASSIA), British Humanities Index (BHI), Cochrane database of systematic reviews, Econlit database, Embase, Education Resources Information Center (ERIC) database, Health Management Information Consortium (HMIC) database, International Bibliography of the Social Sciences (IBSS), Medline, PreMedline, PsycINFO, Sociological Abstracts, Sportdiscus, Web of Knowledge, Worldwide Political Science Abstracts, and the grey literature. Review methods Studies of any design that assessed the health and socioeconomic impacts of major multi-sport events on the host population were included. We excluded studies that used exclusively estimated data rather than actual data, that investigated host population support for an event or media portrayals of host cities, or that described new physical infrastructure. Studies were selected and critically appraised by two independent reviewers. Fifty four studies were included. Study quality was poor, with 69% of studies using a repeat cross-sectional design and 85% of quantitative studies assessed as being below 2+ on the Health Development Agency appraisal scale, often because of a lack of comparison group. Five studies, each with a high risk of bias, reported health related outcomes, which were suicide, paediatric health service demand, presentations for asthma in children (two studies), and problems related to illicit drug use. Overall, the data did not indicate clear negative or positive health impacts of major multi-sport events on host populations. The most frequently reported outcomes were economic outcomes (18 studies). The outcomes used were similar enough to allow us to perform a narrative synthesis, but the overall

  9. The health and socioeconomic impacts of major multi-sport events: systematic review (1978-2008)

    Science.gov (United States)

    Thomas, Sian; Thomson, Hilary; Scott, John; Hamilton, Val; Hanlon, Phil; Morrison, David S; Bond, Lyndal

    2010-01-01

    Objective To assess the effects of major multi-sport events on health and socioeconomic determinants of health in the population of the city hosting the event. Design Systematic review. Data sources We searched the following sources without language restrictions for papers published between 1978 and 2008: Applied Social Science Index and Abstracts (ASSIA), British Humanities Index (BHI), Cochrane database of systematic reviews, Econlit database, Embase, Education Resources Information Center (ERIC) database, Health Management Information Consortium (HMIC) database, International Bibliography of the Social Sciences (IBSS), Medline, PreMedline, PsycINFO, Sociological Abstracts, Sportdiscus, Web of Knowledge, Worldwide Political Science Abstracts, and the grey literature. Review methods Studies of any design that assessed the health and socioeconomic impacts of major multi-sport events on the host population were included. We excluded studies that used exclusively estimated data rather than actual data, that investigated host population support for an event or media portrayals of host cities, or that described new physical infrastructure. Studies were selected and critically appraised by two independent reviewers. Results Fifty four studies were included. Study quality was poor, with 69% of studies using a repeat cross-sectional design and 85% of quantitative studies assessed as being below 2+ on the Health Development Agency appraisal scale, often because of a lack of comparison group. Five studies, each with a high risk of bias, reported health related outcomes, which were suicide, paediatric health service demand, presentations for asthma in children (two studies), and problems related to illicit drug use. Overall, the data did not indicate clear negative or positive health impacts of major multi-sport events on host populations. The most frequently reported outcomes were economic outcomes (18 studies). The outcomes used were similar enough to allow us to perform a

  10. Modeling recent climate change induced extreme events in Bangladesh: A review

    Directory of Open Access Journals (Sweden)

    M. Rehan Dastagir

    2015-03-01

    Full Text Available Bangladesh is a resourceful and densely populated country that has been experiencing frequent disasters viz. cyclones, tidal surges, floods, salinity intrusions, droughts etc. which cause large damage to lives and properties every year. The frequency and intensity of the extreme events have increased significantly in recent decades due to climate change and global warming. This review paper synthesizes extreme climatic events in Bangladesh in the context of the climate modeling data. The modeling results of extreme events showed significant trends in Bangladesh due to climate change. The results of these climate models are significant to show the importance of climate modeling in Bangladesh and it will help to promote research on climate modeling in least developed countries like Bangladesh.

  11. Predicting adverse obstetric outcome after early pregnancy events and complications: a review

    DEFF Research Database (Denmark)

    van Oppenraaij, R H F; Jauniaux, E; Christiansen, O B

    2009-01-01

    BACKGROUND The aim was to evaluate the impact of early pregnancy events and complications as predictors of adverse obstetric outcome. METHODS We conducted a literature review on the impact of first trimester complications in previous and index pregnancies using Medline and Cochrane databases......) after two or more miscarriages, the risk of placenta praevia, premature preterm rupture of membranes, VPTD and low birthweight (LBW) after recurrent miscarriage and the risk of VPTD after two or more termination of pregnancy. Clinically relevant associations of adverse obstetric outcome in the ongoing...... hyperemesis gravidarum. CONCLUSIONS Data from our literature review indicate, by finding significant associations, that specific early pregnancy events and complications are predictors for subsequent adverse obstetric and perinatal outcome. Though, some of these associations are based on limited or small...

  12. Adverse Events Associated with Yoga: A Systematic Review of Published Case Reports and Case Series

    OpenAIRE

    Holger Cramer; Carol Krucoff; Gustav Dobos

    2013-01-01

    While yoga is gaining increased popularity in North America and Europe, its safety has been questioned in the lay press. The aim of this systematic review was to assess published case reports and case series on adverse events associated with yoga. Medline/Pubmed, Scopus, CAMBase, IndMed and the Cases Database were screened through February 2013; and 35 case reports and 2 case series reporting a total of 76 cases were included. Ten cases had medical preconditions, mainly glaucoma and osteopeni...

  13. Who should lead a trauma team: Surgeon or non-surgeon? A systematic review and meta-analysis

    OpenAIRE

    Hajibandeh, Shahab; Hajibandeh, Shahin

    2017-01-01

    Abstract: Background: Presence of a trauma team leader (TTL) in the trauma team is associated with positive patient outcomes in major trauma. The TTL is traditionally a surgeon who coordinates the resuscitation and ensures adherence to Advanced Trauma Life Support (ATLS) guidelines. The necessity of routine surgical leadership in the resuscitative component of trauma care has been questioned by some authors. Therefore, it remains controversial who should lead the trauma team. We aimed to eval...

  14. Effectiveness of public health messaging and communication channels during smoke events: A rapid systematic review.

    Science.gov (United States)

    Fish, Jennifer A; Peters, Micah D J; Ramsey, Imogen; Sharplin, Greg; Corsini, Nadia; Eckert, Marion

    2017-05-15

    Exposure to smoke emitted from wildfire and planned burns (i.e., smoke events) has been associated with numerous negative health outcomes, including respiratory symptoms and conditions. This rapid review investigates recent evidence (post-2009) regarding the effectiveness of public health messaging during smoke events. The objectives were to determine the effectiveness of various communication channels used and public health messages disseminated during smoke events, for general and at-risk populations. A search of 12 databases and grey literature yielded 1775 unique articles, of which 10 were included in this review. Principal results were: 1) Smoke-related public health messages are communicated via a variety of channels, but limited evidence is available regarding their effectiveness for the general public or at-risk groups. 2) Messages that use simple language are more commonly recalled, understood, and complied with. Compliance differs according to socio-demographic characteristics. 3) At-risk groups may be advised to stay indoors before the general population, in order to protect the most vulnerable people in a community. The research included in this review was observational and predominantly descriptive, and is therefore unable to sufficiently answer questions regarding effectiveness. Experimental research, as well as evaluations, are required to examine the effectiveness of modern communication channels, channels to reach at-risk groups, and the 'stay indoors' message. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. External Peer Review Team Report for Corrective Action Unit 97: Yucca Flat/Climax Mine, Nevada National Security Site, Nye County, Nevada, Revision 0

    Energy Technology Data Exchange (ETDEWEB)

    Marutzky, Sam J. [Navarro-Intera, LLC (N-I), Las Vegas, NV (United States); Andrews, Robert [Navarro-Intera, LLC (N-I), Las Vegas, NV (United States)

    2015-01-01

    The peer review team commends the Navarro-Intera, LLC (N-I), team for its efforts in using limited data to model the fate of radionuclides in groundwater at Yucca Flat. Recognizing the key uncertainties and related recommendations discussed in Section 6.0 of this report, the peer review team has concluded that U.S. Department of Energy (DOE) is ready for a transition to model evaluation studies in the corrective action decision document (CADD)/corrective action plan (CAP) stage. The DOE, National Nuclear Security Administration Nevada Field Office (NNSA/NFO) clarified the charge to the peer review team in a letter dated October 9, 2014, from Bill R. Wilborn, NNSA/NFO Underground Test Area (UGTA) Activity Lead, to Sam J. Marutzky, N-I UGTA Project Manager: “The model and supporting information should be sufficiently complete that the key uncertainties can be adequately identified such that they can be addressed by appropriate model evaluation studies. The model evaluation studies may include data collection and model refinements conducted during the CADD/CAP stage. One major input to identifying ‘key uncertainties’ is the detailed peer review provided by independent qualified peers.” The key uncertainties that the peer review team recognized and potential concerns associated with each are outlined in Section 6.0, along with recommendations corresponding to each uncertainty. The uncertainties, concerns, and recommendations are summarized in Table ES-1. The number associated with each concern refers to the section in this report where the concern is discussed in detail.

  16. Health care professionals as second victims after adverse events: a systematic review.

    Science.gov (United States)

    Seys, Deborah; Wu, Albert W; Van Gerven, Eva; Vleugels, Arthur; Euwema, Martin; Panella, Massimiliano; Scott, Susan D; Conway, James; Sermeus, Walter; Vanhaecht, Kris

    2013-06-01

    Adverse events within health care settings can lead to two victims. The first victim is the patient and family and the second victim is the involved health care professional. The latter is the focus of this review. The objectives are to determine definitions of this concept, research the prevalence and the impact of the adverse event on the second victim, and the used coping strategies. Therefore a literature research was performed by using a three-step search procedure. A total of 32 research articles and 9 nonresearch articles were identified. The second victim phenomenon was first described by Wu in 2000. In 2009, Scott et al. introduced a detailed definition of second victims. The prevalence of second victims after an adverse event varied from 10.4% up to 43.3%. Common reactions can be emotional, cognitive, and behavioral. The coping strategies used by second victims have an impact on their patients, colleagues, and themselves. After the adverse event, defensive as well as constructive changes have been reported in practice. The second victim phenomenon has a significant impact on clinicians, colleagues, and subsequent patients. Because of this broad impact it is important to offer support for second victims. When an adverse event occurs, it is critical that support networks are in place to protect both the patient and involved health care providers.

  17. Injuries and other adverse events associated with yoga practice: A systematic review of epidemiological studies.

    Science.gov (United States)

    Cramer, Holger; Ostermann, Thomas; Dobos, Gustav

    2018-02-01

    To systematically assess the prevalence of yoga-associated injuries and other adverse events in epidemiological studies. Systematic review of observational studies. Medline/PubMed, Scopus, the Cochrane Library, and IndMed were searched through October 2016 for epidemiological studies assessing the prevalence of adverse events of yoga practice or comparing the risk of any adverse events between yoga practitioners and non-yoga practitioners. Nine observational studies with a total 9129 yoga practitioners and 9903 non-yoga practitioners were included. Incidence proportion of adverse events during a yoga class was 22.7% (95% confidence interval [CI]=21.1%-24.3%); 12-months prevalence was 4.6% (95%CI=3.8%-5.4%), and lifetime prevalence ranged from 21.3% (95%CI=19.7%-22.9%) to 61.8% (95%CI=52.8%-70.8%) of yoga practitioners. Serious adverse events occurred in 1.9% (95%CI=1.4%-2.4%). The most common adverse events related to the musculoskeletal system; the most common injuries were sprains and strains. Compared to non-yoga practitioners, yoga practitioners had a comparable risk of falls (odds ratio [OR]=0.90; 95%CI=0.76-1.08), and falls-related injuries (OR=1.04; 95%CI=0.83-1.29), and higher risk of meniscus injuries (OR=1.72; 95%CI=1.23-2.41). A considerable proportion of yoga practitioners experienced injuries or other adverse events; however most were mild and transient and risks were comparable to those of non-yoga practitioners. There is no need to discourage yoga practice for healthy people. People with serious acute or chronic illnesses should seek medical advice before practicing yoga. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  18. Out-of-Hospital Pediatric Patient Safety Events: Results of the CSI Chart Review.

    Science.gov (United States)

    Meckler, Garth; Hansen, Matthew; Lambert, William; O'Brien, Kerth; Dickinson, Caitlin; Dickinson, Kathryn; Van Otterloo, Joshua; Guise, Jeanne-Marie

    2017-10-12

    Studies of adult hospital patients have identified medical errors as a significant cause of morbidity and mortality. Little is known about the frequency and nature of pediatric patient safety events in the out-of-hospital setting. We sought to quantify pediatric patient safety events in EMS and identify patient, call, and care characteristics associated with potentially severe events. As part of the Children's Safety Initiative -EMS, expert panels independently reviewed charts of pediatric critical ambulance transports in a metropolitan area over a three-year period. Regression models were used to identify factors associated with increased risk of potentially severe safety events. Patient safety events were categorized as: Unintended injury; Near miss; Suboptimal action; Error; or Management complication ("UNSEMs") and their severity and potential preventability were assessed. Overall, 265 of 378 (70.1%) unique charts contained at least one UNSEM, including 146 (32.8%) errors and 199 (44.7%) suboptimal actions. Sixty-one UNSEMs were categorized as potentially severe (23.3% of UNSEMs) and nearly half (45.3%) were rated entirely preventable. Two factors were associated with heightened risk for a severe UNSEM: (1) age 29 days to 11 months (OR 3.3, 95% CI 1.25-8.68); (2) cases requiring resuscitation (OR 3.1, 95% CI 1.16-8.28). Severe UNSEMs were disproportionately higher among cardiopulmonary arrests (8.5% of cases, 34.4% of severe UNSEMs). During high-risk out-of-hospital care of pediatric patients, safety events are common, potentially severe, and largely preventable. Infants and those requiring resuscitation are important areas of focus to reduce out-of-hospital pediatric patient safety events.

  19. The Human Impact of Floods: a Historical Review of Events 1980-2009 and Systematic Literature Review

    Science.gov (United States)

    Doocy, Shannon; Daniels, Amy; Murray, Sarah; Kirsch, Thomas D.

    2013-01-01

    Background. Floods are the most common natural disaster and the leading cause of natural disaster fatalities worldwide. Risk of catastrophic losses due to flooding is significant given deforestation and the increasing proximity of large populations to coastal areas, river basins and lakeshores. The objectives of this review were to describe the impact of flood events on human populations in terms of mortality, injury, and displacement and, to the extent possible, identify risk factors associated with these outcomes. This is one of five reviews on the human impact of natural disasters Methods. Data on the impact of floods were compiled using two methods, a historical review of flood events from 1980 to 2009 from multiple databases and a systematic literature review of publications ending in October 2012. Analysis included descriptive statistics, bivariate tests for associations and multinomial logistic regression of flood characteristics and mortality using Stata 11.0. Findings. There were 539,811 deaths (range: 510,941 to 568,680), 361,974 injuries and 2,821,895,005 people affected by floods between 1980 and 2009. Inconsistent reporting suggests this is an underestimate, particularly in terms of the injured and affected populations. The primary cause of flood-related mortality is drowning; in developed countries being in a motor-vehicle and male gender are associated with increased mortality, whereas female gender may be linked to higher mortality in low-income countries. Conclusions. Expanded monitoring of floods, improved mitigation measures, and effective communication with civil authorities and vulnerable populations has the potential to reduce loss of life in future flood events. PMID:23857425

  20. Adverse Drug Events and Medication Errors in African Hospitals: A Systematic Review.

    Science.gov (United States)

    Mekonnen, Alemayehu B; Alhawassi, Tariq M; McLachlan, Andrew J; Brien, Jo-Anne E

    2018-03-01

    /training) and environmental factors, such as workplace distraction and high workload. Medication errors in the African healthcare setting are relatively common, and the impact of adverse drug events is substantial but many are preventable. This review supports the design and implementation of preventative strategies targeting the most likely contributing factors.

  1. A review of events that expose children to elemental mercury in the United States.

    Science.gov (United States)

    Lee, Robin; Middleton, Dan; Caldwell, Kathleen; Dearwent, Steve; Jones, Steven; Lewis, Brian; Monteilh, Carolyn; Mortensen, Mary Ellen; Nickle, Richard; Orloff, Kenneth; Reger, Meghan; Risher, John; Rogers, Helen Schurz; Watters, Michelle

    2009-06-01

    Concern for children exposed to elemental mercury prompted the Agency for Toxic Substances and Disease Registry and the Centers for Disease Control and Prevention to review the sources of elemental mercury exposures in children, describe the location and proportion of children affected, and make recommendations on how to prevent these exposures. In this review, we excluded mercury exposures from coal-burning facilities, dental amalgams, fish consumption, medical waste incinerators, or thimerosal-containing vaccines. We reviewed federal, state, and regional programs with information on mercury releases along with published reports of children exposed to elemental mercury in the United States. We selected all mercury-related events that were documented to expose (or potentially expose) children. We then explored event characteristics (i.e., the exposure source, location). Primary exposure locations were at home, at school, and at other locations such as industrial property not adequately remediated or medical facilities. Exposure to small spills from broken thermometers was the most common scenario; however, reports of such exposures are declining. Childhood exposures to elemental mercury often result from inappropriate handling or cleanup of spilled mercury. The information reviewed suggests that most releases do not lead to demonstrable harm if the exposure period is short and the mercury is properly cleaned up. Primary prevention should include health education and policy initiatives. For larger spills, better coordination among existing surveillance systems would assist in understanding the risk factors and in developing effective prevention efforts.

  2. Team Building through Physical Challenges.

    Science.gov (United States)

    Gibbons, Sandra L.

    The enhancement of positive self-concept has been identified as a key benefit of participation in team-building programs. This paper reviews research on the impact of team-building activities that include demanding physical challenges on the self-concept of physical education students. Team Building through Physical Challenges (TBPC) is a program…

  3. Teaming up

    DEFF Research Database (Denmark)

    Warhuus, Jan; Günzel-Jensen, Franziska; Robinson, Sarah

    Questions we care about (Objectives): When students have to work on challenging tasks, as it is often the case in entrepreneurship classrooms that leverage experiential learning, team success becomes central to the students learning. Yet, the formation of teams is often left up to the students....... A rigorous coding and inductive analysis process was undertaken. Pattern and relationship coding were used to reveal underlying factors, which helped to unveil important similarities and differences between student in different teams’ project progress and perception of learning. Results: When students...... functioning entrepreneurial student teams as most teams lack personal chemistry which makes them anchor their work too much in a pre-defined project. In contrast, we find that students that can form their own teams aim for less diverse teams than what is achieved by random assignment. However, the homophily...

  4. Adverse Health Events Related to Self-Medication Practices Among Elderly: A Systematic Review.

    Science.gov (United States)

    Locquet, Médéa; Honvo, Germain; Rabenda, Véronique; Van Hees, Thierry; Petermans, Jean; Reginster, Jean-Yves; Bruyère, Olivier

    2017-05-01

    Older adults often resort to self-medication to relieve symptoms of their current illnesses; however, the risks of this practice are multiplied in old age. In particular, this age group is more vulnerable to adverse drug events because of the physiological changes that occur due to senescence. The aim of the study was to obtain an overview of the adverse health events related to self-medication among subjects aged 60 years and over through a systematic review of the literature. A study of relevant articles was conducted among databases (MEDLINE, PsycINFO, and EBM Reviews-Cochrane Database of Systematic Reviews). Eligibility criteria were established and applied by two investigators to include suitable studies. The results and outcomes of interest were detailed in a descriptive report. The electronic search identified 4096 references, and the full texts of 74 were reviewed, of which four were retained in the analysis: three had a cross-sectional design and one prospectively followed elderly subjects. The first study showed a 26.7% prevalence of adverse drug reactions (ADRs) among elders, the second study found a 75% prevalence of side effects, and, finally, a prospective study showed an ADR incidence of 4.5% among self-medicated elders. These studies showed that adverse health events related to self-medication are relatively frequently reported. They also highlighted that analgesics and anti-inflammatory drugs are the most self-medicated products, while vitamins and dietary supplements also appear to be frequently self-administered, but by older individuals. Studies on self-medication in the elderly and its adverse health effects are clearly lacking. There is a need to perform prospective studies on this topic to gain a clear understanding of the extent of this problem and to enhance the awareness of health professionals to better inform seniors.

  5. [Classifications and definitions of adverse events in primary care: a systematic review].

    Science.gov (United States)

    Keriel-Gascou, Maud; Figon, Sophie; Letrilliart, Laurent; Chaneliére, Marc; Colin, Cyrille

    2011-11-01

    In an aim to standardize the terminology used in patient safety research, the World Health Organization (WHO) has recommended the use of internationally acceptable patient safety concepts for the collection and classification of adverse events and near misses in health care settings worldwide. The principal aims of this study were to clarify patient safety terminology and concepts, to suggest a comprehensible definition of medical error, and to propose patient safety classifications for use in primary health care. Systematic review and synthesis of the international medical literature. In order to define "medical error" as a health care term and to identify various published or unpublished classifications of medical errors, we searched the Medline, Web of Science, Cochrane Library, Pascal, and French Data Bank of Public Health bibliographical medical databases for the years 2000 through 2011. A grey literature search was carried out using the Google and Google Scholar search engines. We used the recommendations of WHO to analyze these classifications. The principal key words used were: primary care, family practice, patient safety event, adverse event and taxonomy. The online search identified 191 documents; among these, 51 articles, eight reports and two books were deemed appropriate. Twelve classifications were analyzed and compared using WHO recommendations. Eight definitions of medical error were identified during this analysis. The WHO Alliance for Patient Safety has clarified the definition of several terms - medical error, adverse event, patient safety event, and near miss - through the development of the International Patient Safety Event Classification. This conceptual framework and classification for patient safety should be applicable across the full spectrum of health care, including primary health care. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  6. Team cohesiveness, team size and team performance in team-based learning teams.

    Science.gov (United States)

    Thompson, Britta M; Haidet, Paul; Borges, Nicole J; Carchedi, Lisa R; Roman, Brenda J B; Townsend, Mark H; Butler, Agata P; Swanson, David B; Anderson, Michael P; Levine, Ruth E

    2015-04-01

    The purpose of this study was to explore the relationships among variables associated with teams in team-based learning (TBL) settings and team outcomes. We administered the National Board of Medical Examiners (NBME) Psychiatry Subject Test first to individuals and then to teams of Year three students at four medical schools that used TBL in their psychiatry core clerkships. Team cohesion was analysed using the Team Performance Scale (TPS). Bivariate correlation and linear regression analysis were used to analyse the relationships among team-level variables (mean individual TPS scores for each team, mean individual NBME scores of teams, team size, rotation and gender make-up) and team NBME test scores. A hierarchical linear model was used to test the effects of individual TPS and individual NBME test scores within each team, as well as the effects of the team-level variables of team size, team rotation and gender on team NBME test scores. Individual NBME test and TPS scores were nested within teams and treated as subsampling units. Individual NBME test scores and individual TPS scores were positively and statistically significantly (p team NBME test scores, when team rotation, team size and gender make-up were controlled for. Higher team NBME test scores were associated with teams rotating later in the year and larger teams (p teams at four medical schools suggest that larger teams on later rotations score higher on a team NBME test. Individual NBME test scores and team cohesion were positively and significantly associated with team NBME test scores. These results suggest the need for additional studies focusing on team outcomes, team cohesion, team size, rotation and other factors as they relate to the effective and efficient performance of TBL teams in health science education. © 2015 John Wiley & Sons Ltd.

  7. The effect of an active on-ward participation of hospital pharmacists in Internal Medicine teams on preventable Adverse Drug Events in elderly inpatients: protocol of the WINGS study (Ward-oriented pharmacy in newly admitted geriatric seniors

    Directory of Open Access Journals (Sweden)

    Dijkgraaf Marcel G

    2011-05-01

    Full Text Available Abstract Background The potential of clinical interventions, aiming at reduction of preventable Adverse Drug Events (preventable ADEs during hospital stay, have been studied extensively. Clinical Pharmacy is a well-established and effective service, usually consisting of full-time on-ward participation of clinical pharmacists in medical teams. Within the current Hospital Pharmacy organisation in the Netherlands, such on-ward service is less feasible and therefore not yet established. However, given the substantial incidence of preventable ADEs in Dutch hospitals found in recent studies, appears warranted. Therefore, "Ward-Oriented Pharmacy", an on-ward service tailored to the Dutch hospital setting, will be developed. This service will consist of multifaceted interventions implemented in the Internal Medicine wards by hospital pharmacists. The effect of this service on preventable ADEs in elderly inpatients will be measured. Elderly patients are at high risk for ADEs due to multi-morbidity, concomitant disabilities and polypharmacy. Most studies on the incidence and preventability of ADEs in elderly patients have been conducted in the outpatient setting or on admission to a hospital, and fewer in the inpatient setting. Moreover, recognition of ADEs by the treating physicians is challenging in elderly patients because their disease presentation is often atypical and complex. Detailed information about the performance of the treating physicians in ADE recognition is scarce. Methods/Design The design is a multi-centre, interrupted time series study. Patients of 65 years or older, consecutively admitted to Internal Medicine wards will be included. After a pre-measurement, a Ward-Oriented Pharmacy service will be introduced and the effect of this service will be assessed during a post-measurement. The primary outcome measures are the ADE prevalence on admission and ADE incidence during hospital stay. These outcomes will be assessed using structured

  8. Reporting adverse events in randomized controlled trials in periodontology: a systematic review.

    Science.gov (United States)

    Faggion, Clovis M; Tu, Yu-Kang; Giannakopoulos, Nikolaos N

    2013-09-01

    Reporting of adverse events is of paramount importance in randomized controlled trials (RCTs) to guide the implementation of new therapeutic approaches in clinical practice. The aim of this study was to assess the quality of adverse events reporting in RCTs published in the periodontal literature. Two authors (CMF and NNG) searched the PubMed and LILACS electronic databases independently and in duplicate to identify RCTs published in periodontology from 2002 to 2003 and from 2011 to 2012. Reporting quality in RCTs was assessed with reference to the 2004 CONSORT Extension for Harms checklist. Differences in adverse events reporting between industry- and non-industry-funded RCTs were also determined. Cohen's kappa statistic was used to determine the extent of inter-reviewer agreement. Fischer's exact test was used to assess differences in reporting between the two samples. The analysis included 246 publications. One hundred twenty-four of 990 (13%) items and 223 of 1460 (15%) items were adequately reported in publications from 2002 to 2003 and from 2011 to 2012 respectively. Three checklist topics were significantly better reported in the 2011-2012 sample; two recommendations were better reported in non-industry-funded trials in publications from both periods. Improvement and standardization of adverse events reporting in periodontology are needed. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Six habits to enhance MET performance under stress: A discussion paper reviewing team mechanisms for improved patient outcomes.

    Science.gov (United States)

    Fein, Erich C; Mackie, Benjamin; Chernyak-Hai, Lily; O'Quinn, C Richard V; Ahmed, Ezaz

    2016-05-01

    Effective team decision making has the potential to improve the quality of health care outcomes. Medical Emergency Teams (METs), a specific type of team led by either critical care nurses or physicians, must respond to and improve the outcomes of deteriorating patients. METs routinely make decisions under conditions of uncertainty and suboptimal care outcomes still occur. In response, the development and use of Shared Mental Models (SMMs), which have been shown to promote higher team performance under stress, may enhance patient outcomes. This discussion paper specifically focuses on the development and use of SMMs in the context of METs. Within this process, the psychological mechanisms promoting enhanced team performance are examined and the utility of this model is discussed through the narrative of six habits applied to MET interactions. A two stage, reciprocal model of both nonanalytic decision making within the acute care environment and analytic decision making during reflective action learning was developed. These habits are explored within the context of a MET, illustrating how applying SMMs and action learning processes may enhance team-based problem solving under stress. Based on this model, we make recommendations to enhance MET decision making under stress. It is suggested that the corresponding habits embedded within this model could be imparted to MET members and tested by health care researchers to assess the efficacy of this integrated decision making approach in respect to enhanced team performance and patient outcomes. Copyright © 2015. Published by Elsevier Ltd.

  10. Adverse Events of Massage Therapy in Pain-Related Conditions: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Ping Yin

    2014-01-01

    Full Text Available Pain-related massage, important in traditional Eastern medicine, is increasingly used in the Western world. So the widening acceptance demands continual safety assessment. This review is an evaluation of the frequency and severity of adverse events (AEs reported mainly for pain-related massage between 2003 and 2013. Relevant all-languages reports in 6 databases were identified and assessed by two coauthors. During the 11-year period, 40 reports of 138 AEs were associated with massage. Author, year of publication, country of occurrence, participant related (age, sex or number of patients affected, the details of manual therapy, and clinician type were extracted. Disc herniation, soft tissue trauma, neurologic compromise, spinal cord injury, dissection of the vertebral arteries, and others were the main complications of massage. Spinal manipulation in massage has repeatedly been associated with serious AEs especially. Clearly, massage therapies are not totally devoid of risks. But the incidence of such events is low.

  11. Sporting legacies of sports mega-events: a review of the available literature

    Directory of Open Access Journals (Sweden)

    Doralice Lange de Souza

    2013-11-01

    Full Text Available The goal of this paper is to present a literature review about sport legacies of sports mega-events. We used the following key-words and their equivalents in Portuguese:  “sport mega-events”, “legacy”, “sport legacy”. We present the main empirical academic studies available, dedicating especial attention to “London 2012”. We also synthetize recommendations for the development of positive sport legacies to future host cities/countries. We conclude that the nature of research on this theme is extremely complex and that there isn´t enough scientific evidence showing a correlation between the realization of mega-events and the involvement of people with sports and physical activity.

  12. The human impact of volcanoes: a historical review of events 1900-2009 and systematic literature review.

    Science.gov (United States)

    Doocy, Shannon; Daniels, Amy; Dooling, Shayna; Gorokhovich, Yuri

    2013-04-16

    Introduction. More than 500 million people live within the potential exposure range of a volcano. The risk of catastrophic losses in future eruptions is significant given population growth, proximities of major cities to volcanoes, and the possibility of larger eruptions. The objectives of this review are to describe the impact of volcanoes on the human population, in terms of mortality, injury, and displacement and, to the extent possible, identify risk factors associated with these outcomes. This is one of five reviews on the human impact of natural disasters. Methods. Data on the impact of volcanoes were compiled using two methods, a historical review of volcano events from 1900 to 2009 from multiple databases and a systematic literature review of publications ending in October 2012. Analysis included descriptive statistics and bivariate tests for associations between volcano mortality and characteristics using STATA 11. Findings. There were a total of 91,789 deaths (range: 81,703-102,372), 14,068 injuries (range 11,541-17,922), and 4.72 million people affected by volcanic events between 1900 and 2008. Inconsistent reporting suggests this is an underestimate, particularly in terms of numbers injured and affected. The primary causes of mortality in recent volcanic eruptions were ash asphyxiation, thermal injuries from pyroclastic flow, and trauma. Mortality was concentrated with the ten deadliest eruptions accounting for more than 80% of deaths; 84% of fatalities occurred in four locations (the Island of Martinique (France), Colombia, Indonesia, and Guatemala). Conclusions. Changes in land use practices and population growth provide a background for increasing risk; in conjunction with increasing urbanization in at risk areas, this poses a challenge for future volcano preparedness and mitigation efforts.

  13. Event-related potentials elicited by social commerce and electronic-commerce reviews.

    Science.gov (United States)

    Bai, Yan; Yao, Zhong; Cong, Fengyu; Zhang, Linlin

    2015-12-01

    There is an increasing interest regarding the use of electroencephalography (EEG) in social commerce and electronic commerce (e-commerce) research. There are several reviews in the field of social commerce or e-commerce; these have great potential value and mining them is fundamental and significant. To our knowledge, EEG is rarely applied to study these. In this study, we examined the neural correlates of social commerce reviews (SCRs) and e-commerce reviews (ECRs) by using them as stimuli to evoke event-related potentials. All SCRs were from friends through a social media platform, whereas ECRs were from strangers through an e-commerce platform. The experimental design was similar to that of a priming paradigm, and included 40 pairs of stimuli consisting of product information (prime stimulus) and reviews (target stimulus). The results showed that the P300 component was successfully evoked by SCR and ECR stimuli. Moreover, the P300 components elicited by SCRs had higher amplitudes than those elicited by ECRs. These findings indicate that participants paid more attention to SCRs than to ECRs. In addition, the associations between neural responses and reviews in social commerce have the potential to assist companies in studying consumer behaviors, thus permitting them to enhance their social commerce strategies.

  14. Editorial Team

    African Journals Online (AJOL)

    Editorial Team. Journal Home > About the Journal > Editorial Team. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Editors. admin · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

  15. Aditya Team

    Indian Academy of Sciences (India)

    Home; Journals; Pramana – Journal of Physics. Aditya Team. Articles written in Pramana – Journal of Physics. Volume 55 Issue 5-6 November-December 2000 pp 727-732 Contributed Papers. Tokamak Plasmas : Mirnov coil data analysis for tokamak ADITYA · D Raju R Jha P K Kaw S K Mattoo Y C Saxena Aditya Team.

  16. Team player styles, team design variables and team work effectiveness in Egypt

    OpenAIRE

    Hassan El-Kot, Ghada Awed

    2001-01-01

    The literature has revealed few studies of management in Arab countries in general and particularly in Egypt. Many Egyptian organisations implemented the team concept a number of years ago, however, there do not appear to be any studies investicitaýt inc",D team work effectiveness in Egypt. The literature review and the findings of a pilot study emphasised the need for empirical research in team work in Egypt. Team effectiveness models are examined in order to identify the fact...

  17. Extreme weather events in developing countries and related injuries and mental health disorders - a systematic review.

    Science.gov (United States)

    Rataj, Elisabeth; Kunzweiler, Katharina; Garthus-Niegel, Susan

    2016-09-29

    Due to climate change, extreme weather events have an incremental impact on human health. Injuries and mental health disorders are a particular burden of disease, which is broadly investigated in high income countries. Most distressed populations are, however, those in developing countries. Therefore, this study investigates mental and physical health impacts arising from extreme weather events in these populations. Post-traumatic Stress Disorder (PTSD), injury [primary outcomes], anxiety and depressive disorders [secondary outcomes], caused by weather extremes were systematically analyzed in people of developing countries. A systematic review of observational studies was conducted searching six databases, complemented by hand search, and utilizing two search engines. Review processing was done independently by two reviewers. Prevalence rates were analyzed in a pre/post design; an additional semi-structured search was conducted, to provide reference data for studies not incorporating reference values. All 17 identified studies (70,842 individuals) indicate a disease increase, compared to the reference data. Increase ranges from 0.7-52.6 % for PTSD, and from 0.3-37.3 % for injury. No studies on droughts and heatwaves were identified. All studies were conducted in South America and Asia. There is an increased burden of psychological diseases and injury. This finding needs to be incorporated into activities of prevention, preparedness and general health care of those developing countries increasingly experiencing extreme weather events. There is also a gap in research in Africa (in quantity and quality) of studies in this field and a predominant heterogeneity of health assessment tools. PROSPERO registration no.: CRD42014009109.

  18. Extreme weather events in developing countries and related injuries and mental health disorders - a systematic review

    Directory of Open Access Journals (Sweden)

    Elisabeth Rataj

    2016-09-01

    Full Text Available Abstract Background Due to climate change, extreme weather events have an incremental impact on human health. Injuries and mental health disorders are a particular burden of disease, which is broadly investigated in high income countries. Most distressed populations are, however, those in developing countries. Therefore, this study investigates mental and physical health impacts arising from extreme weather events in these populations. Method Post-traumatic Stress Disorder (PTSD, injury [primary outcomes], anxiety and depressive disorders [secondary outcomes], caused by weather extremes were systematically analyzed in people of developing countries. A systematic review of observational studies was conducted searching six databases, complemented by hand search, and utilizing two search engines. Review processing was done independently by two reviewers. Prevalence rates were analyzed in a pre/post design; an additional semi-structured search was conducted, to provide reference data for studies not incorporating reference values. Results All 17 identified studies (70,842 individuals indicate a disease increase, compared to the reference data. Increase ranges from 0.7–52.6 % for PTSD, and from 0.3–37.3 % for injury. No studies on droughts and heatwaves were identified. All studies were conducted in South America and Asia. Conclusion There is an increased burden of psychological diseases and injury. This finding needs to be incorporated into activities of prevention, preparedness and general health care of those developing countries increasingly experiencing extreme weather events. There is also a gap in research in Africa (in quantity and quality of studies in this field and a predominant heterogeneity of health assessment tools. PROSPERO registration no.: CRD42014009109

  19. Adverse events associated with single dose oral analgesics for acute postoperative pain in adults - an overview of Cochrane reviews.

    Science.gov (United States)

    Moore, R Andrew; Derry, Sheena; Aldington, Dominic; Wiffen, Philip J

    2015-10-13

    This is an update of a Cochrane overview published in Issue 9, 2011; that overview considered both efficacy and adverse events. This overview considers adverse events, with efficacy dealt with in a separate overview.Thirty-nine Cochrane reviews of randomised trials have examined the adverse events associated with individual drug interventions in acute postoperative pain. This overview brings together the results of those individual reviews. To provide an overview of adverse event rates associated with single-dose oral analgesics, compared with placebo, for acute postoperative pain in adults. We identified systematic reviews in The Cochrane Database of Systematic Reviews on The Cochrane Library through a simple search strategy. All reviews were overseen by a single review group. We extracted information related to participants experiencing any adverse event, and reports of serious adverse events, and deaths from the individual reviews. Information was available from 39 Cochrane reviews for 41 different analgesics or analgesic combinations (51 drug/dose/formulations) tested in single oral doses in participants with moderate or severe postoperative pain. This involved around 350 unique studies involving about 35,000 participants. Most studies involved younger participants with pain following removal of molar teeth.For most nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol, and combinations not containing opioids, there were few examples where participants experienced significantly more or fewer adverse events than with placebo. For aspirin 1000 mg and diflunisal 1000 mg, opioids, or fixed-dose combination drugs containing opioids, participants typically experienced significantly more adverse events than with placebo. Studies of combinations of ibuprofen and paracetamol reported significantly fewer adverse events.Serious adverse events were rare, occurring a rate of about 1 in 3200 participants.Most reviews did not report specific adverse events. Despite

  20. The human impact of tropical cyclones: a historical review of events 1980-2009 and systematic literature review.

    Science.gov (United States)

    Doocy, Shannon; Dick, Anna; Daniels, Amy; Kirsch, Thomas D

    2013-04-16

    Background. Cyclones have significantly affected populations in Southeast Asia, the Western Pacific, and the Americas over the past quarter of a century. Future vulnerability to cyclones will increase due to factors including population growth, urbanization, increasing coastal settlement, and global warming. The objectives of this review were to describe the impact of cyclones on human populations in terms of mortality, injury, and displacement and, to the extent possible, identify risk factors associated with these outcomes. This is one of five reviews on the human impact of natural disasters. Methods. Data on the impact of cyclones were compiled using two methods, a historical review from 1980 to 2009 of cyclone events from multiple databases and a systematic literature review of publications ending in October 2012. Analysis included descriptive statistics and bivariate tests for associations between cyclone characteristics and mortality using Stata 11.0. Findings. There were 412,644 deaths, 290,654 injured, and 466.1 million people affected by cyclones between 1980 and 2009, and the mortality and injury burden was concentrated in less developed nations of Southeast Asia and the Western Pacific. Inconsistent reporting suggests this is an underestimate, particularly in terms of the injured and affected populations. The primary cause of cyclone-related mortality is drowning; in developed countries male gender was associated with increased mortality risk, whereas females experienced higher mortality in less developed countries. Conclusions. Additional attention to preparedness and early warning, particularly in Asia, can lessen the impact of future cyclones.

  1. Effectiveness of team nursing compared with total patient care on staff wellbeing when organizing nursing work in acute care wards: a systematic review.

    Science.gov (United States)

    King, Allana; Long, Lesley; Lisy, Karolina

    2015-11-01

    The organization of the work of nurses, according to recognized models of care, can have a significant impact on the wellbeing and performance of nurses and nursing teams. This review focuses on two models of nursing care delivery, namely, team and total patient care, and their effect on nurses' wellbeing. To examine the effectiveness of team nursing compared to total patient care on staff wellbeing when organizing nursing work in acute care wards. Participants were nurses working on wards in acute care hospitals.The intervention was the use of a team nursing model when organizing nursing work. The comparator was the use of a total patient care model.This review considered quantitative study designs for inclusion in the review.The outcome of interest was staff wellbeing which was measured by staff outcomes in relation to job satisfaction, turnover, absenteeism, stress levels and burnout. The search strategy aimed to find both published and unpublished studies from 1995 to April 21, 2014. Quantitative papers selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute. Data was extracted from papers included in the review using the standardized data extraction tool from the Joanna Briggs Institute. The data extracted included specific details about the interventions, populations, study methods and outcomes of significance to the review question and its specific objectives. Due to the heterogeneity of the included quantitative studies, meta-analysis was not possible. Results have been presented in a narrative form. The database search returned 10,067 records. Forty-three full text titles were assessed, and of these 40 were excluded, resulting in three studies being included in the review. Two of the studies were quasi experimental designs and the other was considered an uncontrolled before and after experimental study

  2. Review of evoked and event-related delta responses in the human brain.

    Science.gov (United States)

    Güntekin, Bahar; Başar, Erol

    2016-05-01

    In the last decade, the brain's oscillatory responses have invaded the literature. The studies on delta (0.5-3.5Hz) oscillatory responses in humans upon application of cognitive paradigms showed that delta oscillations are related to cognitive processes, mainly in decision making and attentional processes. The present manuscript comprehensively reviews the studies on delta oscillatory responses upon cognitive stimulation in healthy subjects and in different pathologies, namely Alzheimer's disease, Mild Cognitive Impairment (MCI), bipolar disorder, schizophrenia and alcoholism. Further delta oscillatory response upon presentation of faces, facial expressions, and affective pictures are reviewed. The relationship between pre-stimulus delta activity and post-stimulus evoked and event-related responses and/or oscillations is discussed. Cross-frequency couplings of delta oscillations with higher frequency windows are also included in the review. The conclusion of this review includes several important remarks, including that delta oscillatory responses are involved in cognitive and emotional processes. A decrease of delta oscillatory responses could be a general electrophysiological marker for cognitive dysfunction (Alzheimer's disease, MCI, bipolar disorder, schizophrenia and alcoholism). The pre-stimulus activity (phase or amplitude changes in delta activity) has an effect on post-stimulus EEG responses. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. Using Teams to Improve Outcomes and Performance.

    Science.gov (United States)

    Ulrich, Beth; Crider, Nancy Manning

    2017-01-01

    Mastering the use of teams in healthcare organizations can maximize outcomes and optimize the use of resources. Most work in healthcare organizations is done by teams, whether it's the clinical team taking care of patients on a unit, the leadership team accountable for operations of the organization, or a team formed to solve a specific problem, improve quality, or plan an event. Effective teams make organizations successful; ineffective teams can create more problems than they solve. This article describes how to successfully use the power of teams within the healthcare setting, create and develop teams, be a team leader or member, create conditions for team effectiveness and high performance, and provide team training. Copyright© by the American Nephrology Nurses Association.

  4. Racial and Ethnic Disparities in Adverse Drug Events: A Systematic Review of the Literature.

    Science.gov (United States)

    Baehr, Avi; Peña, Juliet C; Hu, Dale J

    2015-12-01

    The 2014 National Action Plan for Adverse Drug Event Prevention has recognized adverse drug events (ADEs) as a national priority in order to facilitate a nationwide reduction in patient harms from these events. Throughout this effort, it will be integral to identify populations that may be at particular risk in order to improve care for these patients. We have undertaken a systematic review to evaluate the evidence regarding racial or ethnic disparities in ADEs with particular emphasis on anticoagulants, diabetes agents, and opioids due to the clinical significance and preventability of ADEs associated with these medication classes. From an initial search yielding 3302 studies, we identified 40 eligible studies. Twenty-seven of these included studies demonstrated the presence of a racial or ethnic disparity. There was no consistent evidence for racial or ethnic disparities in the eight studies of ADEs in general. Asians were most frequently determined to be at higher risk of anticoagulant-related ADEs, and black patients were most frequently determined to be at higher risk for diabetes agents-related ADEs. Whites were most frequently identified as at increased risk for opioid-related ADEs. However, few of these studies were specifically designed to evaluate racial or ethnic disparities, lacking a standardized approach to racial/ethnic categorization as well as control for potential confounders. We suggest the need for targeted interventions to reduce ADEs in populations that may be at increased risk, and we suggest strategies for future research.

  5. International Data Centre: Reviewed Event Bulletin vs. Waveform Cross Correlation Bulletin

    CERN Document Server

    Bobrov, Dmitry; Given, Jeffrey; Khukhuudei, Urtnasan; Kitov, Ivan; Sitnikov, Kirill; Spiliopoulos, Spilio; Zerbo, Lassina

    2012-01-01

    Our objective is to assess the performance of waveform cross-correlation technique, as applied to automatic and interactive processing of the aftershock sequence of the 2012 Sumatera earthquake relative to the Reviewed Event Bulletin (REB) issued by the International Data Centre. The REB includes 1200 aftershocks between April 11 and May 25 with body wave magnitudes from 3.05 to 6.19. To automatically recover the sequence, we selected sixteen aftershocks with mb between 4.5 and 5.0. These events evenly but sparsely cover the area of the most intensive aftershock activity as recorded during the first two days after the main shock. In our study, waveform templates from only seven IMS array stations with the largest SNRs estimated for the signals from the main shock were used to calculate cross-correlation coefficients over the entire period of 44 days. Approximately 1000000 detections obtained using cross-correlation were then used to build events according to the IDC definition. After conflict resolution betwe...

  6. Nursing workload and occurrence of adverse events in intensive care: a systematic review

    Directory of Open Access Journals (Sweden)

    Andrea Carvalho de Oliveira

    Full Text Available Abstract OBJECTIVE To identifyevidences of the influence of nursing workload on the occurrence of adverse events (AE in adult patients admitted to the intensive care unit (ICU. METHOD A systematic literature review was conducted in the databases MEDLINE, CINAHL, LILACS, SciELO, BDENF, and Cochrane from studies in English, Portuguese, or Spanish, published by 2015. The analyzed AE were infection, pressure ulcer (PU, patient falls, and medication errors. RESULTS Of 594 potential studies, eight comprised the final sample of the review. TheNursing Activities Score (NAS; 37.5% and the Therapeutic Intervention Scoring System(TISS; 37.5% were the instruments most frequently used for assessing nursing workload. Six studies (75.0% identified the influence of work overload in events of infection, PU, and medicationerrors. An investigation found that the NAS was a protective factor for PU. CONCLUSION The nursing workload required by patients in the ICU influenced the occurrence of AE, and nurses must monitor this variable daily to ensure proper sizing of staff and safety of care.

  7. Health effects of Asian dust events: a review of the literature.

    Science.gov (United States)

    Hashizume, Masahiro; Ueda, Kayo; Nishiwaki, Yuji; Michikawa, Takehiro; Onozuka, Daisuke

    2010-05-01

    Asian dust, called 'kosa' in Japan, is the long-range transport of atmospheric pollutants originating from the desert areas of China and Mongolia. Although Asian dust has a long history of appearing in Japan, it is only quite recently that there is increasing concern for its possible adverse health effects. We reviewed the epidemiologic evidence of potential health effects of Asian dust events. PubMed was used to search for the following keywords: Asian dust, yellow sand, desert dust, dust storm, sandstorm, mortality, death, morbidity, hospitalization, hospital admission, health, pulmonary and respiratory. The search was limited to the epidemiologic studies published between January 1980 and May 2009. JMEDPlus was used to search for Japanese literature. Seventeen studies were retrieved from PubMed and one study from JMEDPlus. In addition, one study was identified for reviewing from the references of another study. In total, we identified 19 epidemiologic studies (3 for mortality, 13 for hospital visits or admissions and 3 for respiratory functions or symptoms) mainly from Taiwan and Korea. There were many combinations of outcomes and lagged exposures examined, and some suggested possible associations of dust exposure with an increase in mortality and hospital visits and admissions due to cardiovascular and respiratory diseases, whereas the rest of the studies did not show statistically significant associations. The evidence from these studies was limited because exposure assessments were inadequately described and potential confounders were insufficiently controlled. Well-designed epidemiological studies are required to clarify any potential health effects of Asian dust events in Japan.

  8. [Resistance to aspirin: prevalence, mechanisms of action and association with thromboembolic events. A narrative review].

    Science.gov (United States)

    Cañivano Petreñas, L; García Yubero, C

    2010-01-01

    The purpose of this study is to review the prevalence of aspirin resistance in patients with a high risk of cardiovascular events, and secondly, to investigate its epidemiology and mechanism of action, and the clinical consequences it can provoke. A search was run on PubMed, EMBASE and Reviews Database for English or Spanish articles on aspirin resistance published up to November 2008. Additional studies were obtained by searching the reference lists in the selected articles for articles relevant to our secondary objectives. Aspirin resistance is described as affecting 0 to 57% of the population, and is related to a decreased protective effect against strokes and cardiovascular events. Many modifiable and unmodifiable factors can affect the efficacy of antiplatelet drugs. Possible strategies for overcoming this decreased antiaggregant effect include increasing the aspirin dosage or dual therapy with another antiplatelet agent. Lack of response to aspirin decreases its protective effects. However, lack of a standard definition for aspirin resistance, the absence of diagnostic reference methods to identify resistant patients, and the different mechanisms of action involved in platelet aggregation call the clinical importance of this fact into question. Additional well-designed studies are needed to detect patients with real resistance in order to have more effective prevention of cardiovascular morbidity and mortality. Copyright (c) 2009 SEFH. Published by Elsevier Espana. All rights reserved.

  9. Ceftriaxone-Associated Biliary and Cardiopulmonary Adverse Events in Neonates: A Systematic Review of the Literature.

    Science.gov (United States)

    Donnelly, Patrick C; Sutich, Rebecca M; Easton, Ryan; Adejumo, Oluwatunmise A; Lee, Todd A; Logan, Latania K

    2017-02-01

    Ceftriaxone is a third-generation cephalosporin with broad-spectrum activity against both Gram-positive and Gram-negative bacteria. Despite its effectiveness, its use for the treatment of infections in neonatal patients has been limited because of concern about its potential toxicity. Our aim was to review the literature for an association between ceftriaxone and cardiopulmonary events, hyperbilirubinemia, and pseudolithiasis among neonates. We searched PubMed and EMBASE and included studies that evaluated ceftriaxone safety in neonates. Study bias was evaluated in the following domains: exposure measurement, outcome measurement, attrition, generalizability, confounding, statistical analysis, and reporting. We included nine studies regarding ceftriaxone side effects, primarily spontaneous reports, published case reports, and small case series. Reports of bilirubin displacement attributed to ceftriaxone included increases in serum bilirubin necessitating antibiotic change in a subset of infants after administration of ceftriaxone. One study described self-resolving biliary sludge after ceftriaxone administration in six of 80 infants. Cardiopulmonary adverse events included a report of eight cardiopulmonary events related to concomitant ceftriaxone-calcium infusion, including seven infant deaths. Additional cardiopulmonary events reported included perinatal asphyxia, pulmonary hypertension, and thrombocytosis. However, the available literature had small sample sizes, poor external validity, and inconsistent outcome ascertainment methods, which made it impossible to estimate the magnitude of risk. Concomitant administration of intravenous ceftriaxone and calcium-containing solutions should be avoided in neonates. However, further controlled studies are needed to assess whether bilirubin displacement associated with the use of ceftriaxone is clinically relevant, particularly in healthy term and near-term neonates with mild hyperbilirubinemia.

  10. How Diversity Matters in the US Science and Engineering Workforce: A Critical Review Considering Integration in Teams, Fields, and Organizational Contexts

    Directory of Open Access Journals (Sweden)

    Laurel Smith-Doerr

    2017-04-01

    Full Text Available How the race and gender diversity of team members is related to innovative science and technology outcomes is debated in the scholarly literature. Some studies find diversity is linked to creativity and productivity, other studies find that diversity has no effect or even negative effects on team outcomes. Based on a critical review of the literature, this paper explains the seemingly contradictory findings through careful attention to the organizational contexts of team diversity. We distinguish between representational diversity and full integration of minority scientists. Representational diversity, where organizations have workforces that match the pool of degree recipients in relevant fields, is a necessary but not sufficient condition for diversity to yield benefits. Full integration of minority scientists (i.e., including women and people of color in an interaction context that allows for more level information exchange, unimpeded by the asymmetrical power relationships that are common across many scientific organizations, is when the full potential for diversity to have innovative outcomes is realized. Under conditions of equitable and integrated work environments, diversity leads to creativity, innovation, productivity, and positive reputational (status effects. Thus, effective policies for diversity in science and engineering must also address integration in the organizational contexts in which diverse teams are embedded.

  11. Systematic review of strategies to manage and allocate scarce resources during mass casualty events.

    Science.gov (United States)

    Timbie, Justin W; Ringel, Jeanne S; Fox, D Steven; Pillemer, Francesca; Waxman, Daniel A; Moore, Melinda; Hansen, Cynthia K; Knebel, Ann R; Ricciardi, Richard; Kellermann, Arthur L

    2013-06-01

    Efficient management and allocation of scarce medical resources can improve outcomes for victims of mass casualty events. However, the effectiveness of specific strategies has never been systematically reviewed. We analyze published evidence on strategies to optimize the management and allocation of scarce resources across a wide range of mass casualty event contexts and study designs. Our literature search included MEDLINE, Scopus, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Global Health, Web of Science, and the Cochrane Database of Systematic Reviews, from 1990 through late 2011. We also searched the gray literature, using the New York Academy of Medicine's Grey Literature Report and key Web sites. We included both English- and foreign-language articles. We included studies that evaluated strategies used in actual mass casualty events or tested through drills, exercises, or computer simulations. We excluded studies that lacked a comparison group or did not report quantitative outcomes. Data extraction, quality assessment, and strength of evidence ratings were conducted by a single researcher and reviewed by a second; discrepancies were reconciled by the 2 reviewers. Because of heterogeneity in outcome measures, we qualitatively synthesized findings within categories of strategies. From 5,716 potentially relevant citations, 74 studies met inclusion criteria. Strategies included reducing demand for health care services (18 studies), optimizing use of existing resources (50), augmenting existing resources (5), implementing crisis standards of care (5), and multiple categories (4). The evidence was sufficient to form conclusions on 2 strategies, although the strength of evidence was rated as low. First, as a strategy to reduce demand for health care services, points of dispensing can be used to efficiently distribute biological countermeasures after a bioterrorism attack or influenza pandemic, and their organization influences speed of

  12. DIFFERENT DIMENSIONS OF TEAMS

    Directory of Open Access Journals (Sweden)

    Goparaju Purna SUDHAKAR

    2014-01-01

    Full Text Available Popularity ofteams is growing in 21st Century. Organizations are getting theirwork done through different types of teams. Teams have proved that thecollective performance is more than the sum of the individual performances.Thus, the teams have got different dimensions such as quantitative dimensionsand qualitative dimensions. The Quantitative dimensions of teams such as teamperformance, team productivity, team innovation, team effectiveness, teamefficiency, team decision making and team conflicts and Qualitative dimensionsof teams such as team communication, team coordination, team cooperation, teamcohesion, team climate, team creativity, team leadership and team conflictshave been discussed in this article.

  13. Using Rapid Improvement Events for Disaster After-Action Reviews: Experience in a Hospital Information Technology Outage and Response.

    Science.gov (United States)

    Little, Charles M; McStay, Christopher; Oeth, Justin; Koehler, April; Bookman, Kelly

    2018-02-01

    The use of after-action reviews (AARs) following major emergency events, such as a disaster, is common and mandated for hospitals and similar organizations. There is a recurrent challenge of identified problems not being resolved and repeated in subsequent events. A process improvement technique called a rapid improvement event (RIE) was used to conduct an AAR following a complete information technology (IT) outage at a large urban hospital. Using RIE methodology to conduct the AAR allowed for the rapid development and implementation of major process improvements to prepare for future IT downtime events. Thus, process improvement methodology, particularly the RIE, is suited for conducting AARs following disasters and holds promise for improving outcomes in emergency management. Little CM , McStay C , Oeth J , Koehler A , Bookman K . Using rapid improvement events for disaster after-action reviews: experience in a hospital information technology outage and response. Prehosp Disaster Med. 2018;33(1):98-100.

  14. A Reflective Look at Reflecting Teams

    Science.gov (United States)

    Pender, Rebecca L.; Stinchfield, Tracy

    2012-01-01

    This article reviewed existing literature and research on the reflecting team process. There is a dearth of empirical research that explores the reflecting team process and the outcome of counseling that uses reflecting teams. Implications of using reflecting teams for counselors, counselor educators, and clients will be discussed. A call for…

  15. Combining Chemical Information Literacy, Communication Skills, Career Preparation, Ethics, and Peer Review in a Team-Taught Chemistry Course

    Science.gov (United States)

    Jones, Mary Lou Baker; Seybold, Paul G.

    2016-01-01

    The widely acknowledged need to include chemical information competencies and communication skills in the undergraduate chemistry curriculum can be accommodated in a variety of ways. We describe a team-taught, semester-length course at Wright State University which combines chemical information literacy, written and oral communication skills,…

  16. Effect of Interventions on Potential, Modifiable Risk Factors for Knee Injury in Team Ball Sports : A Systematic Review

    NARCIS (Netherlands)

    ter Stege, Marloes H. P.; Dallinga, Joan M.; Benjaminse, Anne; Lemmink, Koen A. P. M.

    2014-01-01

    Background Knee injuries are one of the most common types of injuries in team ball sports, and prevention is crucial because of health and economic implications. To set up effective prevention programs, these programs must be designed to target potential, modifiable risk factors. In addition, it is

  17. The Effectiveness of Teamwork Training on Teamwork Behaviors and Team Performance: A Systematic Review and Meta-Analysis of Controlled Interventions.

    Science.gov (United States)

    McEwan, Desmond; Ruissen, Geralyn R; Eys, Mark A; Zumbo, Bruno D; Beauchamp, Mark R

    2017-01-01

    The objective of this study was to conduct a systematic review and meta-analysis of teamwork interventions that were carried out with the purpose of improving teamwork and team performance, using controlled experimental designs. A literature search returned 16,849 unique articles. The meta-analysis was ultimately conducted on 51 articles, comprising 72 (k) unique interventions, 194 effect sizes, and 8439 participants, using a random effects model. Positive and significant medium-sized effects were found for teamwork interventions on both teamwork and team performance. Moderator analyses were also conducted, which generally revealed positive and significant effects with respect to several sample, intervention, and measurement characteristics. Implications for effective teamwork interventions as well as considerations for future research are discussed.

  18. Impact of post-event avoidance behavior on commercial facilities sector venues-literature review.

    Energy Technology Data Exchange (ETDEWEB)

    Samsa, M. E.; Baldwin, T. E.; Berry, M. S.; Guzowski, L. B.; Martinez-Moyano, I.; Nieves, A. L.; Ramarasad, A. (Decision and Information Sciences)

    2011-03-24

    The terrorist attacks of September 11, 2001 (9/11), focused a great deal of interest and concern on how individual and social perceptions of risk change behavior and subsequently affect commercial sector venues. Argonne conducted a review of the literature to identify studies that quantify the direct and indirect economic consequences of avoidance behaviors that result from terrorist attacks. Despite a growing amount of literature addressing terrorism impacts, relatively little is known about the causal relationships between risk perception, human avoidance behaviors, and the economic effects on commercial venues. Nevertheless, the technical and academic literature does provide some evidence, both directly and by inference, of the level and duration of post-event avoidance behaviors on commercial venues. Key findings are summarized in this Executive Summary. Also included as an appendix is a more detailed summary table of literature findings reproduced from the full report.

  19. Event-related potentials, emotion, and emotion regulation: an integrative review.

    Science.gov (United States)

    Hajcak, Greg; MacNamara, Annmarie; Olvet, Doreen M

    2010-01-01

    Progress in the study of emotion and emotion regulation has increasingly been informed by neuroscientific methods. This article focuses on two components of the event-related potential (ERP)--the P300 and the late positive potential (LPP)--and how they can be used to understand the interaction between the more automatic and controlled processing of emotional stimuli. Research is reviewed exploring: the dynamics of emotional response as indexed at early and late latencies; neurobiological correlates of emotional response; individual and developmental differences; ways in which the LPP can be utilized as a measure of emotion regulation. Future directions for the application of ERP/electroencephalogram (EEG) in achieving a more complete understanding of emotional processing and its regulation are presented.

  20. Systematic review of the incidence and characteristics of preventable adverse drug events in ambulatory care

    DEFF Research Database (Denmark)

    Thomsen, Linda Aagaard; Winterstein, Almut G; Søndergaard, Birthe

    2007-01-01

    OBJECTIVE: To estimate the incidence and describe characteristics of preventable adverse drug events (pADEs) in ambulatory care. DATA SOURCES: Studies were searched in PubMed (1966-March 2007), International Pharmaceutical Abstracts (1970-December 2006), the Cochrane database of systematic reviews...... (1993-March 2007), EMBASE (1980-February 2007), and Web of Science (1945-March 2007). Key words included medication error, adverse drug reaction, iatrogenic disease, outpatient, ambulatory care, primary health care, general practice, patient admission, hospitalization, observational study, retrospective...... of adverse outcome, associated drug groups, or medication errors were extracted. DATA SYNTHESIS: Twenty-nine studies met inclusion criteria: 14 were ambulatory-based and 15 were hospital-based. Seven studies enrolled only elderly patients. The median ADE incidence was 14.9 (range 4.0-91.3) per 1000 person...

  1. Single Event Upset Detection and Hardening schemes for CNTFET SRAM – A Review

    Directory of Open Access Journals (Sweden)

    T.R.Rajalakshmi

    2015-12-01

    Full Text Available Carbon nanotubes (CNT provide a better alternative of silicon, when it comes to nano scales. Thanks to its high stability and high performance of carbon nanotube, CNT based FET (CNTFET devices which are gaining popularity of late. Single Event Upset (SEU in a device is caused due to radiation. Radiation can be through two ways, one due to charge particles present in the atmosphere and other due to alpha particles. In this article we review some of the detection and hardening schemes in CMOS SRAM and make related simulations on CNTFET SRAM. The aim of this paper is to present the challenges the CNTFET SRAM is facing when the radiation effects are introduced. A full experimentation of all the schemes of detection and correction schemes will be beyond the scope, so only certain experiments that can be well carried out with CNTFET SRAM memory is more focussed.

  2. Do prescription stimulants increase the risk of adverse cardiovascular events?: A systematic review

    Directory of Open Access Journals (Sweden)

    Westover Arthur N

    2012-06-01

    Full Text Available Abstract Background There is increasing concern that prescription stimulants may be associated with adverse cardiovascular events such as stroke, myocardial infarction, and sudden death. Public health concerns are amplified by increasing use of prescription stimulants among adults. Methods The objective of this study was to conduct a systematic review of the evidence of an association between prescription stimulant use and adverse cardiovascular outcomes. PUBMED, MEDLINE, EMBASE and Google Scholar searches were conducted using key words related to these topics (MESH: ADHD; Adults; Amphetamine; Amphetamines; Arrhythmias, Cardiac; Cardiovascular Diseases; Cardiovascular System; Central Nervous Stimulants; Cerebrovascular; Cohort Studies; Case–control Studies; Death; Death, Sudden, Cardiac; Dextroamphetamine; Drug Toxicity; Methamphetamine; Methylphenidate; Myocardial Infarction; Stimulant; Stroke; Safety. Eligible studies were population-based studies of children, adolescents, or adults using prescription stimulant use as the independent variable and a hard cardiovascular outcome as the dependent variable. Results Ten population-based observational studies which evaluated prescription stimulant use with cardiovascular outcomes were reviewed. Six out of seven studies in children and adolescents did not show an association between stimulant use and adverse cardiovascular outcomes. In contrast, two out of three studies in adults found an association. Conclusions Findings of an association between prescription stimulant use and adverse cardiovascular outcomes are mixed. Studies of children and adolescents suggest that statistical power is limited in available study populations, and the absolute risk of an event is low. More suggestive of a safety signal, studies of adults found an increased risk for transient ischemic attack and sudden death/ventricular arrhythmia. Interpretation was limited due to differences in population, cardiovascular outcome

  3. A systematic review of adverse event reporting in companion animal clinical trials evaluating cancer treatment.

    Science.gov (United States)

    Giuffrida, Michelle A

    2016-11-01

    OBJECTIVE To evaluate methods used to ascertain, define, and report adverse events (AEs) in companion animal clinical trials involving cancer treatment. DESIGN Systematic review. SAMPLE English-language articles describing prospective clinical trials involving dogs and cats with naturally occurring cancer published in peer-reviewed journals between 2008 and 2014. PROCEDURES Reports were identified via MEDLINE and CAB database searches combined with a hand-searching strategy. General article characteristics were abstracted and summarized. Data for AE reporting were collected with a 14-item checklist adapted from the 2004 CONSORT extension for reporting harms. Study characteristics associated with the AE reporting checklist score were identified by means of linear regression analysis. RESULTS 168 articles with data for 6,132 animals were included. Standardized terminology was significantly more likely to be used to describe AEs for trials that included chemotherapy (92/115 [80.0%]) than for trials that did not (16/53 [30.2%]). Median AE reporting checklist score was 5 out of 14 (range, 0 to 12). Poorly reported items included methods and time frame of AE ascertainment, AE data analysis, and reasons for treatment discontinuation and death. Trials with industry funding, a single-arm design, and treatment with chemotherapy were associated with a significantly higher quality of AE reporting. CONCLUSIONS AND CLINICAL RELEVANCE Reporting of adverse events in veterinary clinical trials evaluating cancer treatment was selective and heterogeneous. Harms associated with cancer treatments could be underestimated because of suboptimal collection and reporting of AE data. Findings supported the adoption of a higher standard for AE surveillance and reporting in veterinary patients.

  4. Adverse events associated with yoga: a systematic review of published case reports and case series.

    Science.gov (United States)

    Cramer, Holger; Krucoff, Carol; Dobos, Gustav

    2013-01-01

    While yoga is gaining increased popularity in North America and Europe, its safety has been questioned in the lay press. The aim of this systematic review was to assess published case reports and case series on adverse events associated with yoga. Medline/Pubmed, Scopus, CAMBase, IndMed and the Cases Database were screened through February 2013; and 35 case reports and 2 case series reporting a total of 76 cases were included. Ten cases had medical preconditions, mainly glaucoma and osteopenia. Pranayama, hatha yoga, and Bikram yoga were the most common yoga practices; headstand, shoulder stand, lotus position, and forceful breathing were the most common yoga postures and breathing techniques cited. Twenty-seven adverse events (35.5%) affected the musculoskeletal system; 14 (18.4%) the nervous system; and 9 (11.8%) the eyes. Fifteen cases (19.7%) reached full recovery; 9 cases (11.3%) partial recovery; 1 case (1.3%) no recovery; and 1 case (1.3%) died. As any other physical or mental practice, yoga should be practiced carefully under the guidance of a qualified instructor. Beginners should avoid extreme practices such as headstand, lotus position and forceful breathing. Individuals with medical preconditions should work with their physician and yoga teacher to appropriately adapt postures; patients with glaucoma should avoid inversions and patients with compromised bone should avoid forceful yoga practices.

  5. Adverse events associated with yoga: a systematic review of published case reports and case series.

    Directory of Open Access Journals (Sweden)

    Holger Cramer

    Full Text Available While yoga is gaining increased popularity in North America and Europe, its safety has been questioned in the lay press. The aim of this systematic review was to assess published case reports and case series on adverse events associated with yoga. Medline/Pubmed, Scopus, CAMBase, IndMed and the Cases Database were screened through February 2013; and 35 case reports and 2 case series reporting a total of 76 cases were included. Ten cases had medical preconditions, mainly glaucoma and osteopenia. Pranayama, hatha yoga, and Bikram yoga were the most common yoga practices; headstand, shoulder stand, lotus position, and forceful breathing were the most common yoga postures and breathing techniques cited. Twenty-seven adverse events (35.5% affected the musculoskeletal system; 14 (18.4% the nervous system; and 9 (11.8% the eyes. Fifteen cases (19.7% reached full recovery; 9 cases (11.3% partial recovery; 1 case (1.3% no recovery; and 1 case (1.3% died. As any other physical or mental practice, yoga should be practiced carefully under the guidance of a qualified instructor. Beginners should avoid extreme practices such as headstand, lotus position and forceful breathing. Individuals with medical preconditions should work with their physician and yoga teacher to appropriately adapt postures; patients with glaucoma should avoid inversions and patients with compromised bone should avoid forceful yoga practices.

  6. A systematic review of utility values for chemotherapy-related adverse events.

    Science.gov (United States)

    Shabaruddin, Fatiha H; Chen, Li-Chia; Elliott, Rachel A; Payne, Katherine

    2013-04-01

    Chemotherapy offers cancer patients the potential benefits of improved mortality and morbidity but may cause detrimental outcomes due to adverse drug events (ADEs), some of which requiring time-consuming, resource-intensive and costly clinical management. To appropriately assess chemotherapy agents in an economic evaluation, ADE-related parameters such as the incidence, (dis)utility and cost of ADEs should be reflected within the model parameters. To date, there has been no systematic summary of the existing literature that quantifies the utilities of ADEs due to healthcare interventions in general and chemotherapy treatments in particular. This review aimed to summarize the current evidence base of reported utility values for chemotherapy-related ADEs. A structured electronic search combining terms for utility, utility valuation methods and generic terms for cancer treatment was conducted in MEDLINE and EMBASE in June 2011. Inclusion criteria were: (1) elicitation of utility values for chemotherapy-related ADEs and (2) primary data. Two reviewers identified studies and extracted data independently. Any disagreements were resolved by a third reviewer. Eighteen studies met the inclusion criteria from the 853 abstracts initially identified, collectively reporting 218 utility values for chemotherapy-related ADEs. All 18 studies used short descriptions (vignettes) to obtain the utility values, with nine studies presenting the vignettes used in the valuation exercises. Of the 218 utility values, 178 were elicited using standard gamble (SG) or time trade-off (TTO) approaches, while 40 were elicited using visual analogue scales (VAS). There were 169 utility values of specific chemotherapy-related ADEs (with the top ten being anaemia [34 values], nausea and/or vomiting [32 values], neuropathy [21 values], neutropenia [12 values], diarrhoea [12 values], stomatitis [10 values], fatigue [8 values], alopecia [7 values], hand-foot syndrome [5 values] and skin reaction [5 values

  7. Anxiety-related adverse events following immunization (AEFI): A systematic review of published clusters of illness.

    Science.gov (United States)

    Loharikar, Anagha; Suragh, Tiffany A; MacDonald, Noni E; Balakrishnan, Madhava R; Benes, Oleg; Lamprianou, Smaragda; Hyde, Terri B; McNeil, Michael M

    2018-01-04

    Clusters of anxiety-related adverse events following immunization (AEFI) have been observed in several countries and have disrupted country immunization programs. We conducted a systematic literature review to characterize these clusters, to generate prevention and management guidance for countries. We searched seven peer-reviewed databases for English language reports of anxiety-related AEFI clusters (≥2 persons) with pre-specified keywords across 4 categories: symptom term, cluster term, vaccine term, and cluster AEFI phenomenon term/phrase. All relevant reports were included regardless of publication date, case-patient age, or vaccine. Two investigators independently reviewed abstracts and identified articles for full review. Data on epidemiologic/clinical information were extracted from full text review including setting, vaccine implicated, predominant case-patient symptoms, clinical management, community and media response, and outcome/impact on the vaccination program. Of 1472 abstracts reviewed, we identified eight published clusters, from all six World Health Organization (WHO) regions except the African Region. Seven clusters occurred among children in school settings, and one was among adult military reservists. The size and nature of these clusters ranged from 7 patients in one school to 806 patients in multiple schools. Patients' symptoms included dizziness, headache, and fainting with rapid onset after vaccination. Implicated vaccines included tetanus (2), tetanus-diphtheria (1), hepatitis B (1), oral cholera (1), human papillomavirus (1), and influenza A (H1N1)pdm09 (2). In each report, all affected individuals recovered rapidly; however, vaccination program disruption was noted in some instances, sometimes for up to one year. Anxiety-related AEFI clusters can be disruptive to vaccination programs, reducing public trust in immunizations and impacting vaccination coverage; response efforts to restore public confidence can be resource intensive

  8. Triple antiplatelet therapy for preventing vascular events: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Bath Philip MW

    2010-06-01

    Full Text Available Abstract Background Dual antiplatelet therapy is usually superior to mono therapy in preventing recurrent vascular events (VEs. This systematic review assesses the safety and efficacy of triple antiplatelet therapy in comparison with dual therapy in reducing recurrent vascular events. Methods Completed randomized controlled trials investigating the effect of triple versus dual antiplatelet therapy in patients with ischaemic heart disease (IHD, cerebrovascular disease or peripheral vascular disease were identified using electronic bibliographic searches. Data were extracted on composite VEs, myocardial infarction (MI, stroke, death and bleeding and analysed with Cochrane Review Manager software. Odds ratios (OR and 95% confidence intervals (CI were calculated using random effects models. Results Twenty-five completed randomized trials (17,383 patients with IHD were included which involving the use of intravenous (iv GP IIb/IIIa inhibitors (abciximab, eptifibatide, tirofiban, aspirin, clopidogrel and/or cilostazol. In comparison with aspirin-based therapy, triple therapy using an intravenous GP IIb/IIIa inhibitor significantly reduced composite VEs and MI in patients with non-ST elevation acute coronary syndromes (NSTE-ACS (VE: OR 0.69, 95% CI 0.55-0.86; MI: OR 0.70, 95% CI 0.56-0.88 and ST elevation myocardial infarction (STEMI (VE: OR 0.39, 95% CI 0.30-0.51; MI: OR 0.26, 95% CI 0.17-0.38. A significant reduction in death was also noted in STEMI patients treated with GP IIb/IIIa based triple therapy (OR 0.69, 95% CI 0.49-0.99. Increased minor bleeding was noted in STEMI and elective percutaneous coronary intervention (PCI patients treated with GP IIb/IIIa based triple therapy. Stroke events were too infrequent for us to be able to identify meaningful trends and no data were available for patients recruited into trials on the basis of stroke or peripheral vascular disease. Conclusions Triple antiplatelet therapy based on iv GPIIb/IIIa inhibitors

  9. Enhancing Patient Safety Event Reporting. A Systematic Review of System Design Features.

    Science.gov (United States)

    Gong, Yang; Kang, Hong; Wu, Xinshuo; Hua, Lei

    2017-08-30

    Electronic patient safety event reporting (e-reporting) is an effective mechanism to learn from errors and enhance patient safety. Unfortunately, the value of e-reporting system (a software or web server based platform) in patient safety research is greatly overshadowed by low quality reporting. This paper aims at revealing the current status of system features, detecting potential gaps in system design, and accordingly proposing suggestions for future design and implementation of the system. Three literature databases were searched for publications that contain informative descriptions of e-reporting systems. In addition, both online publicly accessible reporting forms and systems were investigated. 48 systems were identified and reviewed. 11 system design features and their frequencies of occurrence (Top 5: widgets (41), anonymity or confidentiality (29), hierarchy (20), validator (17), review notification (15)) were identified and summarized into a system hierarchical model. The model indicated the current e-reporting systems are at an immature stage in their development, and discussed their future development direction toward efficient and effective systems to improve patient safety.

  10. [Event-related EEG potentials associated with error detection in psychiatric disorder: literature review].

    Science.gov (United States)

    Balogh, Lívia; Czobor, Pál

    2010-01-01

    Error-related bioelectric signals constitute a special subgroup of event-related potentials. Researchers have identified two evoked potential components to be closely related to error processing, namely error-related negativity (ERN) and error-positivity (Pe), and they linked these to specific cognitive functions. In our article first we give a brief description of these components, then based on the available literature, we review differences in error-related evoked potentials observed in patients across psychiatric disorders. The PubMed and Medline search engines were used in order to identify all relevant articles, published between 2000 and 2009. For the purpose of the current paper we reviewed publications summarizing results of clinical trials. Patients suffering from schizophrenia, anorexia nervosa or borderline personality disorder exhibited a decrease in the amplitude of error-negativity when compared with healthy controls, while in cases of depression and anxiety an increase in the amplitude has been observed. Some of the articles suggest specific personality variables, such as impulsivity, perfectionism, negative emotions or sensitivity to punishment to underlie these electrophysiological differences. Research in the field of error-related electric activity has come to the focus of psychiatry research only recently, thus the amount of available data is significantly limited. However, since this is a relatively new field of research, the results available at present are noteworthy and promising for future electrophysiological investigations in psychiatric disorders.

  11. Adverse events while awaiting myocardial revascularization: a systematic review and meta-analysis.

    Science.gov (United States)

    Head, Stuart J; da Costa, Bruno R; Beumer, Berend; Stefanini, Giulio G; Alfonso, Fernando; Clemmensen, Peter M; Collet, Jean-Philippe; Cremer, Jochen; Falk, Volkmar; Filippatos, Gerasimos; Hamm, Christian; Kappetein, A Pieter; Kastrati, Adnan; Knuuti, Juhani; Kolh, Philippe; Landmesser, Ulf; Laufer, Günther; Neumann, Franz-Josef; Richter, Dimitrios J; Schauerte, Patrick; Taggart, David P; Torracca, Lucia; Valgimigli, Marco; Wijns, William; Witkowski, Adam; Windecker, Stephan; Jüni, Peter; Sousa-Uva, Miguel

    2017-08-01

    The aim of the current study was to estimate adverse event rates while awaiting myocardial revascularization and review criteria for prioritizing patients. A PubMed search was performed on 19 January 2015, to identify English-language, original, observational studies reporting adverse events while awaiting coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). Rates of death, non-fatal myocardial infarction (MI) and emergency revascularization were calculated as occurrence rates per 1000 patient-weeks and pooled using random-effects models. The search yielded 1323 articles, of which 22 were included with 66 410 patients and 607 675 patient-weeks on the wait list. When awaiting CABG, rates per 1000 patient-weeks were 1.1 [95% confidence interval 0.9-1.3] for death, 1.0 [0.6-1.6] for non-fatal MI and 1.8 [0.8-4.1] for emergency revascularization. Subgroup analyses demonstrated consistent outcomes, and sensitivity analyses demonstrated comparable event rates with low heterogeneity. Higher urgency of revascularization was based primarily on angiographic complexity, angina severity, left ventricular dysfunction and symptoms on stress testing, and such patients with a semi-urgent status had a higher risk of death than patients awaiting elective revascularization (risk ratio at least 2.8). Individual studies identified angina severity and left ventricular dysfunction as most important predictors of death when awaiting CABG. Adverse rates per 1000 patient-weeks for patients awaiting PCI were 0.1 [95% confidence interval 0.0-0.4] for death, 0.4 [0.1-1.2] for non-fatal MI and 0.7 [0.4-1.4] for emergency revascularization but were based on only a few old studies. Rates of death, non-fatal MI and emergency revascularization when awaiting myocardial revascularization are infrequent but higher in specific patients. Countries that not yet have treatment recommendations related to waiting times should consider introducing a maximum to limit adverse

  12. Can catheter ablation reduce the incidence of thromboembolic events in patients with atrial fibrillation?: Protocol for a systematic review and meta-analysis.

    Science.gov (United States)

    Liu, Menghui; Wang, Yuanping; Chen, Xiaohong; Li, Xiaohui; Zhuang, Xiaodong; Wang, Lichun

    2017-12-01

    Atrial fibrillation (AF), the most common cardiac arrhythmia, is a major risk factor for thromboembolic events, especially ischemic stroke. Catheter ablation is an effective method to maintain sinus rhythm in patients with AF. Although some observational studies have shown a relatively lower stroke rate after catheter ablation, whether catheter ablation can reduce the thromboembolic risk in patients with AF remains unclear. We aim to perform a systematic review to determine whether catheter ablation can prevent thromboembolism in patients with AF.PubMed, Embase, the Web of Science, and the Cochrane Library will be searched from January 2000 to the present for randomized controlled trials (RCTs) and non-randomized studies on catheter ablation in patients with AF. Other relevant sources, such as the references and conference proceedings, will also be manually retrieved. All studies will be limited to publication in English. The primary outcome will be thromboembolic events, including stroke, transient ischemic attack, and systemic embolic events. Study screening, data collection, and study quality assessment will be independently performed by 2 researchers. Disagreements will be resolved through team discussion or consultation with a third arbitrator. The risk of bias will be appraised using the Cochrane Collaboration tool and the Newcastle-Ottawa scale according to the different study designs, and a meta-analysis will be performed using RevMan V.5.3 software. The results will be presented as risk ratios and 95% confidence intervals for dichotomous data and continuous outcomes.Catheter ablation is an effective method to cure atrial fibrillation and maintain sinus rhythm. Although it is intuitive that if AF is eliminated, the thromboembolism in the heart would be abolished, and sequently the incidence of thromboembolic events would be decreased, this in fact has not yet been clarified. This systematic review and meta-analysis will be performed with the aim of

  13. Half-time strategies to enhance second-half performance in team-sports players: a review and recommendations.

    Science.gov (United States)

    Russell, Mark; West, Daniel J; Harper, Liam D; Cook, Christian J; Kilduff, Liam P

    2015-03-01

    A number of intermittent team sports require that two consecutive periods of play (lasting for ~30-45 min) are separated by a 10-20 min half-time break. The half-time practices employed by team-sports players generally include returning to the changing rooms, temporarily relaxing from the cognitive and physical demands of the first half, rehydration and re-fuelling strategies, addressing injury or equipment concerns, and receiving tactical instruction and coach feedback. However, the typically passive nature of these actions has been associated with physiological changes that impair performance during the second half. Both physical and cognitive performances have been found to decline in the initial stages of subsequent exercise that follows half-time. An increased risk of injury has also been observed during this period. Therefore, half-time provides sports scientists and strength and conditioning coaches with an opportunity to optimise second-half performance. An overview of strategies thought to benefit team-sports athletes is presented; specifically, the efficacy of heat maintenance strategies (including passive and active methods), post-activation potentiation, hormonal priming, and modified hydro-nutritional practices are discussed. A theoretical model of applying these strategies in a manner that compliments current practice is also offered.

  14. DIFFERENT DIMENSIONS OF TEAMS

    OpenAIRE

    Goparaju Purna SUDHAKAR

    2013-01-01

    Popularity of teams is growing in 21st Century. Organizations are getting their work done through different types of teams. Teams have proved that the collective performance is more than the sum of the individual performances. Thus, the teams have got different dimensions such as quantitative dimensions and qualitative dimensions. The Quantitative dimensions of teams such as team performance, team productivity, team innovation, team effectiveness, team efficiency, team decision making and tea...

  15. What can we learn from the deadly flash floods? Post Event Review Capability (PERC) analysis of the Bavaria and Baden-Wurttemberg flood events in Summer 2016

    Science.gov (United States)

    Szoenyi, Michael

    2017-04-01

    In May/June 2016, stationary low pressure systems brought intense rainfall with record-braking intensities of well above 100 mm rain in few hours locally in the southern states of Baden-Wurttemberg and Bavaria, Germany. In steep terrains, small channels and creeks became devastating torrents impacting, among others, the villages of Simbach/Inn, Schwäbisch-Gmünd and Braunsbach. Just few days prior, France had also seen devastating rainfall and flooding. Damage in Germany alone is estimated at 2.8 M USD, of which less than 50% are insured. The loss of life was significant, with 18 fatalities reported across the events. This new forensic event analysis as part of Zurich's Post Event Review Capability (PERC) investigates the flash flood events following these record rainfalls in Southern Germany and tries to answer the following questions holistically, across the five capitals (5C) and the full disaster risk management (DRM) cycle, which are key to understanding how to become more resilient to such flood events: - Why have these intense rainfall events led to such devastating consequences? The EU Floods directive and its implementation in the various member states, as well as the 2002 and 2013 Germany floods, have focused on larger rivers and the main asset concentration. The pathway and mechanism of the 2016 floods are very different and need to be better understood. Flash floods and surface flooding may need to become the new focus and be much better communicated to people at risk, as the awareness for such perils has been identified as low. - How can the prevalence for such flash floods be better identified and mapped? Research indicated that affected people and decision makers alike attribute the occurrence of such flash floods as arbitrary, but we argue that hotspots can and must be identified based on an overlay of rainfall intensity maps, topography leading to flash flood processes, and vulnerable assets. In Germany, there are currently no comprehensive hazard

  16. Instruments to identify prescription medication misuse, abuse, and related events in clinical trials: an ACTTION systematic review

    OpenAIRE

    Shannon M Smith; Paillard, Florence; McKeown, Andrew; Burke, Laurie B.; Edwards, Robert R.; Katz, Nathaniel P; Papadopoulos, Elektra J.; Rappaport, Bob A.; Slagle, Ashley; Strain, Eric C.; Wasan, Ajay D.; Turk, Dennis C.; Dworkin, Robert H.

    2015-01-01

    Measurement of inappropriate medication use events (e.g., abuse, misuse) in clinical trials is important in characterizing a medication���s abuse potential. However, no ���gold standard��� assessment of inappropriate use events in clinical trials has been identified. In this systematic review, we examine the measurement properties (i.e., content validity, cross-sectional reliability and construct validity, longitudinal construct validity, ability to detect change, and responder definitions) o...

  17. Work team

    Directory of Open Access Journals (Sweden)

    RBE Editorial

    2016-06-01

    Full Text Available Work Team 2016 (Jan-Jul1. Editorial TeamChief-editorsBayardo Bapstista Torres, Instituto de Química (USP, BrasilEduardo Galembeck, Depto. Bioquímica, Instituto de Biologia, Universidade de Campinas (Unicamp, Brasil Co-editorsGabriel Gerber Hornink, Depto. Bioquímica, Instituto de Ciências Biomédicas, Universidade - Federal de Alfenas (Unifal-MG, BrasilVera Maria Treis Trindade, Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul (UFRGS, Brasil Editorial BoardAdriana Cassina, Department of Biochemistry, Facultad de Medicina, Universidad de la República, UruguayAngel Herráez, Departamento de Bioquímica y Biología molecular, Universidad de Alcalá de Henares, Madrid, SpainAndré Amaral Gonçalves Bianco, Universidade Federal de São Paulo (Unifesp, BrasilDenise Vaz de Macedo, Depto. Bioquímica, Instituto de Biologia, Universidade Estadual de Campinas (Unicamp, BrasilEneida de Paula, Depto. Bioquímica, Instituto de Biologia, Universidade Estadual de Campinas (Unicamp, BrasilJose Antonio Martinez Oyanedel, Universidad de Concepción, ChileJosep Maria Fernández Novell, Department of Molecular Biology & Biochemistry, Universitat de Barcelona, SpainLeila Maria Beltramini, Instituto de Física de São Carlos, Universidade Estadual de São Paulo (USP, BrasilManuel João da Costa, Escola de Ciências da Saúde, Universidade do Minho, PortugalMaria Lucia Bianconi, Instituto de Bioquímica Médica, Universidade Federal do Rio de Janeiro (UFRJ, BrasilMaría Noel Alvarez, Department of Biochemistry, Facultad de Medicina, Universidad de la República, UruguayMiguel Ángel Medina Torres, Department of Molecular Biology & Biochemistry Faculty of Sciences University of Málaga, SpainNelma Regina Segnini Bossolan, Instituto de Física de São Carlos, Universidade de São Paulo (USP, BrasilPaulo De Avila Junior, Centro de Ciências Naturais e Humanas (CCNH Universidade Federal do ABC (UFABC

  18. Metamizole-associated adverse events: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Thomas Kötter

    Full Text Available Metamizole is used to treat pain in many parts of the world. Information on the safety profile of metamizole is scarce; no conclusive summary of the literature exists.To determine whether metamizole is clinically safe compared to placebo and other analgesics.We searched CENTRAL, MEDLINE, EMBASE, CINAHL, and several clinical trial registries. We screened the reference lists of included trials and previous systematic reviews. We included randomized controlled trials that compared the effects of metamizole, administered to adults in any form and for any indication, to other analgesics or to placebo. Two authors extracted data regarding trial design and size, indications for pain medication, patient characteristics, treatment regimens, and methodological characteristics. Adverse events (AEs, serious adverse events (SAEs, and dropouts were assessed. We conducted separate meta-analyses for each metamizole comparator, using standard inverse-variance random effects meta-analysis to pool the estimates across trials, reported as risk ratios (RRs. We calculated the DerSimonian and Laird variance estimate T2 to measure heterogeneity between trials. The pre-specified primary end point was any AE during the trial period.Of the 696 potentially eligible trials, 79 trials including almost 4000 patients with short-term metamizole use of less than two weeks met our inclusion criteria. Fewer AEs were reported for metamizole compared to opioids, RR = 0.79 (confidence interval 0.79 to 0.96. We found no differences between metamizole and placebo, paracetamol and NSAIDs. Only a few SAEs were reported, with no difference between metamizole and other analgesics. No agranulocytosis or deaths were reported. Our results were limited by the mediocre overall quality of the reports.For short-term use in the hospital setting, metamizole seems to be a safe choice when compared to other widely used analgesics. High-quality, adequately sized trials assessing the intermediate- and

  19. Metamizole-associated adverse events: a systematic review and meta-analysis.

    Science.gov (United States)

    Kötter, Thomas; da Costa, Bruno R; Fässler, Margrit; Blozik, Eva; Linde, Klaus; Jüni, Peter; Reichenbach, Stephan; Scherer, Martin

    2015-01-01

    Metamizole is used to treat pain in many parts of the world. Information on the safety profile of metamizole is scarce; no conclusive summary of the literature exists. To determine whether metamizole is clinically safe compared to placebo and other analgesics. We searched CENTRAL, MEDLINE, EMBASE, CINAHL, and several clinical trial registries. We screened the reference lists of included trials and previous systematic reviews. We included randomized controlled trials that compared the effects of metamizole, administered to adults in any form and for any indication, to other analgesics or to placebo. Two authors extracted data regarding trial design and size, indications for pain medication, patient characteristics, treatment regimens, and methodological characteristics. Adverse events (AEs), serious adverse events (SAEs), and dropouts were assessed. We conducted separate meta-analyses for each metamizole comparator, using standard inverse-variance random effects meta-analysis to pool the estimates across trials, reported as risk ratios (RRs). We calculated the DerSimonian and Laird variance estimate T2 to measure heterogeneity between trials. The pre-specified primary end point was any AE during the trial period. Of the 696 potentially eligible trials, 79 trials including almost 4000 patients with short-term metamizole use of less than two weeks met our inclusion criteria. Fewer AEs were reported for metamizole compared to opioids, RR = 0.79 (confidence interval 0.79 to 0.96). We found no differences between metamizole and placebo, paracetamol and NSAIDs. Only a few SAEs were reported, with no difference between metamizole and other analgesics. No agranulocytosis or deaths were reported. Our results were limited by the mediocre overall quality of the reports. For short-term use in the hospital setting, metamizole seems to be a safe choice when compared to other widely used analgesics. High-quality, adequately sized trials assessing the intermediate- and long

  20. Multidisciplinary safety team (MDST) factors of success.

    Science.gov (United States)

    2014-11-01

    This project included a literature review and summary that focused on subjects related to team building, team/committee member : motivational strategies, and tools for effective and efficient committee meetings. It also completed an online survey of ...

  1. A Review of the Research on Response to Improvised Nuclear Device Events

    Energy Technology Data Exchange (ETDEWEB)

    Bentz, A; Buddemeier, B; Dombroski, M

    2008-07-01

    Following the events of September 11, a litany of imaginable horribles was trotted out before an anxious and concerned public. To date, government agencies and academics are still grappling with how to best respond to such catastrophes, and as Senator Lieberman's quote says above, now is the time to plan and prepare for such events. One of the nation's worst fears is that terrorists might detonate an improvised nuclear device (IND) in an American city. With 9/11 serving as the catalyst, the government and many NGOs have invested money into research and development of response capabilities throughout the country. Yet, there is still much to learn about how to best respond to an IND event. Understanding the state of knowledge, identifying gaps, and making recommendations for how to fill those gaps, this paper will provide a framework under which past findings can be understood and future research can fit. The risk of an improvised nuclear device (IND) detonation may seem unlikely; and while this is hopefully true, due to its destructive capability, IND events must be prepared for. Many people still live under the Cold War mentality that if a city is attacked with a nuclear weapon, there is little chance of survival. This assumption, while perhaps true in the case of multiple, thermonuclear weapons exchanges, does not hold for the current threat. If a single IND were detonated in the United States, there would be many casualties at the point of impact; however, there would also be many survivors and the initial response by two major groups will mean the difference between life and death for many people. These groups are the first responders and the public. Understanding how these two groups prepare, react and interact will improve response to nuclear terrorism. Figure 1 provides a visualization of the response timeline of an IND event. For the purposes of this assessment, it is assumed that to accurately inform the public, three functions need to be

  2. Nursing workload and occurrence of adverse events in intensive care: a systematic review.

    Science.gov (United States)

    Oliveira, Andrea Carvalho de; Garcia, Paulo Carlos; Nogueira, Lilia de Souza

    2016-01-01

    To identifyevidences of the influence of nursing workload on the occurrence of adverse events (AE) in adult patients admitted to the intensive care unit (ICU). A systematic literature review was conducted in the databases MEDLINE, CINAHL, LILACS, SciELO, BDENF, and Cochrane from studies in English, Portuguese, or Spanish, published by 2015. The analyzed AE were infection, pressure ulcer (PU), patient falls, and medication errors. Of 594 potential studies, eight comprised the final sample of the review. TheNursing Activities Score (NAS; 37.5%) and the Therapeutic Intervention Scoring System(TISS; 37.5%) were the instruments most frequently used for assessing nursing workload. Six studies (75.0%) identified the influence of work overload in events of infection, PU, and medicationerrors. An investigation found that the NAS was a protective factor for PU. The nursing workload required by patients in the ICU influenced the occurrence of AE, and nurses must monitor this variable daily to ensure proper sizing of staff and safety of care. Identificar evidências sobre a influência da carga de trabalho de enfermagem na ocorrência de eventos adversos (EA) em pacientes adultos internados em Unidade de Terapia Intensiva (UTI). Revisão sistemática da literatura realizada nas bases de dados MEDLINE, CINAHL, LILACS, SciELO, BDENF e Cochrane deestudosem inglês, português ou espanhol, publicados até 2015. Os EA analisados foram infecção, úlcera por pressão (UPP), quedas e erros associados a medicamentos. Das 594 pesquisas potenciais identificadas, oito compuseram a amostra final da revisão. O NursingActivities Score -NAS (37,5%) e o TherapeuticInterventionScoring System -TISS (37,5%) foram os instrumentos mais utilizados para avaliação da carga de trabalho de enfermagem. Seis pesquisas (75,0%) identificaram influência da sobrecarga de trabalho na ocorrência de infecção, UPP e uso de medicamentos. Uma investigação identificou que o NAS foi fator de prote

  3. Team designing

    DEFF Research Database (Denmark)

    Denise J. Stokholm, Marianne

    2012-01-01

    Future wellbeing is depending on human competences in order to strengthen a sustainable development. This requires system thinking and ability to deal with complexity, dynamic and a vast of information. `We need to move away from present principles of breaking down problems into components and give...... and intercultural teams in design and the understanding of design as a process of transformation and information management call for a model with capacity to facilitate both `the what` and `the how` This paper will describe a systemic model of design based on a holistic approach to design developed by the author...... in relation to a design-engineering education at Aalborg University. It will exemplify how the model has been used in workshops on team designing, challenged design learning and affected design competence. In specific it will investigate the influence of visual models of the perception of design, design...

  4. Team building: conceptual, methodological, and applied considerations.

    Science.gov (United States)

    Beauchamp, Mark R; McEwan, Desmond; Waldhauser, Katrina J

    2017-08-01

    Team building has been identified as an important method of improving the psychological climate in which teams operate, as well as overall team functioning. Within the context of sports, team building interventions have consistently been found to result in improvements in team effectiveness. In this paper we review the extant literature on team building in sport, and address a range of conceptual, methodological, and applied considerations that have the potential to advance theory, research, and applied intervention initiatives within the field. This involves expanding the scope of team building strategies that have, to date, primarily focused on developing group cohesion. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. MEASURING PRODUCTIVITY OF SOFTWARE DEVELOPMENT TEAMS

    Directory of Open Access Journals (Sweden)

    Goparaju Purna Sudhakar

    2012-02-01

    Full Text Available This paper gives an exhaustive literature review of the techniques and models available tomeasure the productivity of software development teams. Definition of productivity, measuringindividual programmer’s productivity, and measuring software development team productivity arediscussed. Based on the literature review it was found that software productivity measurement canbe done using SLOC (Source Lines of Code, function points, use case points, object points, andfeature points. Secondary research findings indicate that the team size, response time, taskcomplexity, team climate and team cohesion have an impact on software development teamproductivity. List of factors affecting the software development team productivity are studied andreviewed.

  6. Experiences of pre-licensure or pre-registration health professional students and their educators in working with intra-professional teams: a qualitative systematic review.

    Science.gov (United States)

    Butcher, Diane L; MacKinnon, Karen; Bruce, Anne; Gordon, Carol; Koning, Clare

    2017-04-01

    Inter-professional initiatives are prevalent in the healthcare landscape, requiring professionals to collaborate effectively to provide quality patient care. Little attention has been given to intra-professional relationships, where professionals within one disciplinary domain (such as degree and diploma nursing students) collaborate to provide care. New care models are being introduced where baccalaureate and diploma students of a particular discipline (such as nursing, occupational therapy, dentistry or physiotherapy) work closely together in teams to deliver care. Questions thus arise as to how students and educators learn to work on intra-professional teams. To identify and synthesize evidence regarding experiences of pre-licensure health professional students and their educators on intra-professional teams and to draw recommendations to enhance policy and/or curriculum development. Pre-licensure students and educators, focusing on regulated health professions that have had more than one point of entry into practice. Experiences of intra-professional team learning or teaching within various entry-to-practice categories of a particular health-related discipline. Eight qualitative studies were included in the review. Seven studies were descriptive in nature; one study was a critical analysis. A comprehensive search of various databases was conducted between June 2, 2015 and August 16, 2015, and repeated in March 2016. The search considered all studies reported and published from January 1, 2001 to March 7, 2016. Only studies published in English were included in this review. Included papers were of low-to-moderate quality; however, it is important to consider that post-positivist assumptions underpinned much of the primary research, which could explain why researcher positionality and/or influence on the research would not be addressed. Data were extracted using the standardized data extraction tool from the Joanna Briggs Institute Qualitative Assessment and

  7. A systematic review of adverse drug events associated with administration of common asthma medications in children

    Science.gov (United States)

    Johnson, David W.; Sperou, Arissa J.; Crotts, Jennifer; Saude, Erik; Hartling, Lisa; Stang, Antonia

    2017-01-01

    Objective To systematically review the literature and determine frequencies of adverse drug events (ADE) associated with pediatric asthma medications. Methods Following PRISMA guidelines, we systematically searched six bibliographic databases between January 1991 and January 2017. Study eligibility, data extraction and quality assessment were independently completed and verified by two reviewers. We included randomized control trials (RCT), case-control, cohort, or quasi-experimental studies where the primary objective was identifying ADE in children 1 month– 18 years old exposed to commercial asthma medications. The primary outcome was ADE frequency. Findings Our search identified 14,540 citations. 46 studies were included: 24 RCT, 15 cohort, 4 RCT pooled analyses, 1 case-control, 1 open-label trial and 1 quasi-experimental study. Studies examined the following drug classes: inhaled corticosteroids (ICS) (n = 24), short-acting beta-agonists (n = 10), long-acting beta-agonists (LABA) (n = 3), ICS + LABA (n = 3), Leukotriene Receptor Antagonists (n = 3) and others (n = 3). 29 studies occurred in North America, and 29 were industry funded. We report a detailed index of 406 ADE descriptions and frequencies organized by drug class. The majority of data focuses on ICS, with 174 ADE affecting 13 organ systems including adrenal and growth suppression. We observed serious ADE, although they were rare, with frequency ranging between 0.9–6% per drug. There were no confirmed deaths, except for 13 potential deaths in a LABA study including combined adult and pediatric participants. We identified substantial methodological concerns, particularly with identifying ADE and determining severity. No studies utilized available standardized causality, severity or preventability assessments. Conclusion The majority of studies focus on ICS, with adrenal and growth suppression described. Serious ADE are relatively uncommon, with no confirmed pediatric deaths. We identify substantial

  8. Adverse Event Reporting in Clinical Trials of Intravenous and Invasive Pain Treatments: An ACTTION Systematic Review.

    Science.gov (United States)

    Williams, Mark R; McKeown, Andrew; Pressman, Zachary; Hunsinger, Matthew; Lee, Kendrick; Coplan, Paul; Gilron, Ian; Katz, Nathaniel P; McDermott, Michael P; Raja, Srinivasa N; Rappaport, Bob A; Rowbotham, Michael C; Turk, Dennis C; Dworkin, Robert H; Smith, Shannon M

    2016-11-01

    Thorough assessment and reporting of adverse events (AEs) facilitates a detailed understanding of a treatment's risk-benefit profile. Although the Consolidated Standards of Reporting Trials (CONSORT) 2004 statement provides recommendations regarding AE reporting, adherence to these standards is often inadequate. We investigated AE reporting in clinical trials of intravenous and invasive pain treatments published in 6 major anesthesiology and pain journals between 2000 to 2003 and 2006 to 2012. We examined whether AE reporting improved after publication of the 2004 CONSORT recommendations and also comprehensively reviewed AE assessment using the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) AE reporting recommendations. No improvement was found overall in CONSORT harms reporting scores from pre- to postpublication of the CONSORT recommendations, with only 5 of 10 fulfilled on average. AE reporting assessed using the ACTTION coding manual was generally inadequate, and 8% of articles failed to report any AE information at all. Anesthesiology and pain journals were similar in AE reporting quality, although industry-sponsored trials reported more AE information than nonindustry sponsored trials. Improvement is needed in AE reporting in analgesic clinical trials. The CONSORT checklist and ACTTION AE recommendations can assist investigators and editors in improving clinical trial transparency and quality. This systematic review of AE reporting in intravenous and invasive pain treatment trials shows that little improvement has been made since the 2004 CONSORT harms reporting guidelines. Better assessment and reporting of treatment AEs is necessary to understand the full clinical effect of intravenous and invasive treatments. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

  9. Post-event reviews: Using a quantitative approach for analysing incident response to demonstrate the value of business continuity programmes and increase planning efficiency.

    Science.gov (United States)

    Vaidyanathan, Karthik

    2017-01-01

    Business continuity management is often thought of as a proactive planning process for minimising impact from large-scale incidents and disasters. While this is true, and it is critical to plan for the worst, consistently validating plan effectiveness against smaller disruptions can enable an organisation to gain key insights about its business continuity readiness, drive programme improvements, reduce costs and provide an opportunity to quantitatively demonstrate the value of the programme to management. This paper describes a post mortem framework which is used as a continuous improvement mechanism for tracking, reviewing and learning from real-world events at Microsoft Customer Service & Support. This approach was developed and adopted because conducting regular business continuity exercises proved difficult and expensive in a complex and distributed operations environment with high availability requirements. Using a quantitative approach to measure response to incidents, and categorising outcomes based on such responses, enables business continuity teams to provide data-driven insights to leadership, change perceptions of incident root cause, and instil a higher level of confidence towards disaster response readiness and incident management. The scope of the framework discussed here is specific to reviewing and driving improvements from operational incidents. However, the concept can be extended to learning and evolving readiness plans for other types of incidents.

  10. A Systematic Review of Testicle Survival Time After a Torsion Event.

    Science.gov (United States)

    Mellick, Larry Bruce; Sinex, James E; Gibson, Robert W; Mears, Kim

    2017-09-25

    The time window for possible salvage and survival of a torsed testicle is commonly thought to be 6 to 8 hours. However, survival of torsed testicles with or without subsequent atrophy is known to occur outside that critical time window. In this article, we performed a systematic review of the English literature to provide a more accurate understanding of reported time frames of testicle survival after a torsion event. The primary research question was to determine the relationship between time to treatment and the rate of survival for testicles of male patients presenting with testicular torsion (TT). A systematic review of the literature was performed and structured according to PRISMA guidelines. An exhaustive library search was performed after search strategies were developed for multiple databases that included PubMed, Cochrane library, Ovid MEDLINE, Web of Science, and ProQuest Theses and Dissertations. Two different searches were developed including "testicular torsion" and TT with the search term "time" added. Articles specifically reporting TT case series, testicle outcomes, and time to surgical or manual treatment were selected for review. In addition to and preceding the systematic review, an exhaustive manual search of the literature was also performed by the authors. As a result of these searches, a total of 30 studies with data considered relevant to the research question were included. The information extracted from the articles was tabulated with regard to time intervals to treatment and survival outcome. The systematic review process and protocol are reported in this article. A total of 30 studies were found that reported case series of TT patients and their outcomes as well as time to treatment reported in useful time frames. From these reports, a total of 2116 TT patients were culled, and their outcomes and time to treatment are reported. Because the time to treatment was reported variously in different case series, the 3 most common formats for

  11. Creativity and Creative Teams

    Science.gov (United States)

    Wood, Richard M.; Bauer, Steven X. S.; Hunter, Craig A.

    2001-01-01

    A review of the linkage between knowledge, creativity, and design is presented and related to the best practices of multidisciplinary design teams. The discussion related to design and design teams is presented in the context of both the complete aerodynamic design community and specifically the work environment at the NASA Langley Research Center. To explore ways to introduce knowledge and creativity into the research and design environment at NASA Langley Research Center a creative design activity was executed within the context of a national product development activity. The success of the creative design team activity gave rise to a need to communicate the experience in a straightforward and managed approach. As a result the concept of creative potential its formulated and assessed with a survey of a small portion of the aeronautics research staff at NASA Langley Research Center. The final section of the paper provides recommendations for future creative organizations and work environments.

  12. A systematic review of special events to promote breast, cervical and colorectal cancer screening in the United States.

    Science.gov (United States)

    Escoffery, Cam; Rodgers, Kirsten C; Kegler, Michelle C; Haardörfer, Regine; Howard, David H; Liang, Shuting; Pinsker, Erika; Roland, Katherine B; Allen, Jennifer D; Ory, Marcia G; Bastani, Roshan; Fernandez, Maria E; Risendal, Betsy C; Byrd, Theresa L; Coronado, Gloria D

    2014-03-24

    Special events are common community-based strategies for health promotion. This paper presents findings from a systematic literature review on the impact of special events to promote breast, cervical or colorectal cancer education and screening. Articles in English that focused on special events involving breast, cervical, and/or colorectal cancer conducted in the U.S. and published between January 1990 and December 2011 were identified from seven databases: Ovid, Web of Science, CINAHL, PsycINFO, Sociological Abstract, Cochrane Libraries, and EconLit. Study inclusion and data extraction were independently validated by two researchers. Of the 20 articles selected for screening out of 1,409, ten articles on special events reported outcome data. Five types of special events were found: health fairs, parties, cultural events, special days, and plays. Many focused on breast cancer only, or in combination with other cancers. Reach ranged from 50-1732 participants. All special events used at least one evidence-based strategy suggested by the Community Guide to Preventive Services, such as small media, one-on-one education, and reducing structural barriers. For cancer screening as an outcome of the events, mammography screening rates ranged from 4.8% to 88%, Pap testing was 3.9%, and clinical breast exams ranged from 9.1% to 100%. For colorectal screening, FOBT ranged from 29.4% to 76%, and sigmoidoscopy was 100% at one event. Outcome measures included intentions to get screened, scheduled appointments, uptake of clinical exams, and participation in cancer screening. Special events found in the review varied and used evidence-based strategies. Screening data suggest that some special events can lead to increases in cancer screening, especially if they provide onsite screening services. However, there is insufficient evidence to demonstrate that special events are effective in increasing cancer screening. The heterogeneity of populations served, event activities, outcome

  13. Emotional intelligence and affective events in nurse education: A narrative review.

    Science.gov (United States)

    Lewis, Gillian M; Neville, Christine; Ashkanasy, Neal M

    2017-06-01

    To investigate the current state of knowledge about emotional intelligence and affective events that arise during nursing students' clinical placement experiences. Narrative literature review. CINAHL, MEDLINE, PsycINFO, Scopus, Web of Science, ERIC and APAIS-Health databases published in English between 1990 and 2016. Data extraction from and constant comparative analysis of ten (10) research articles. We found four main themes: (1) emotional intelligence buffers stress; (2) emotional intelligence reduces anxiety associated with end of life care; (3) emotional intelligence promotes effective communication; and (4) emotional intelligence improves nursing performance. The articles we analysed adopted a variety of emotional intelligence models. Using the Ashkanasy and Daus "three-stream" taxonomy (Stream 1: ability models; 2: self-report; 3: mixed models), we found that Stream 2 self-report measures were the most popular followed by Stream 3 mixed model measures. None of the studies we surveyed used the Stream 1 approach. Findings nonetheless indicated that emotional intelligence was important in maintaining physical and psychological well-being. We concluded that developing emotional intelligence should be a useful adjunct to improve academic and clinical performance and to reduce the risk of emotional distress during clinical placement experiences. We call for more consistency in the use of emotional intelligence tests as a means to create an empirical evidence base in the field of nurse education. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. The Diabetic Foot as a Proxy for Cardiovascular Events and Mortality Review.

    Science.gov (United States)

    Dietrich, Isa; Braga, Gustavo Arruda; de Melo, Fernanda Gomes; da Costa Silva Silva, Ana Carolina Calmon

    2017-10-02

    This article reviewed very recent papers (2016) discussing or bringing clinical evidences of the possible common pathways leading to diabetic foot syndrome (DFS) and increased mortality rates. Diabetic patients with diabetic foot syndrome have a mortality rate greater than twofold when compared with non-ulcerated diabetics. In addition, the 5-year mortality rate following amputation is estimated at 39-68%, a life expectancy comparable to aggressive types of cancer or advanced congestive heart failure. The majority of patients with diabetic foot ulcer also present insulin resistance, central obesity, dyslipidemia, and hypertension that characterize the metabolic syndrome that, in turn, is associated with an elevated risk of major cardiovascular events. Sensory neuropathy is the primary cause of more the 60% of diabetic foot ulcer. Diabetic peripheral neuropathy is a microvascular complication of diabetes mellitus and in type 2 diabetes, not only hyperglycemia but also other metabolic alterations and persistent inflammatory status due to adiposity play a major role in axon injury. Elevated triglycerides have been showed to be an independent risk factor for lower extremity amputation in diabetic patients. Also, toxic adiposity, oxidative stress, mitochondrial dysfunction, activation of the polyol pathway, accumulation of advanced glycation end products (AGEs), and elevation of inflammatory markers are also implicated in diabetic vascular disease and neuropathy. The hypotheses that the association between DFS and increased rates of mortality reflects the progression of micro- and macrovascular complications are reinforced by the additional association of DFU to renal failure and retinopathy.

  15. Medication Exposures and Subsequent Development of Ewing Sarcoma: A Review of FDA Adverse Event Reports

    Directory of Open Access Journals (Sweden)

    Judith U. Cope

    2015-01-01

    Full Text Available Background. Ewing sarcoma family of tumors (ESFT are rare but deadly cancers of unknown etiology. Few risk factors have been identified. This study was undertaken to ascertain any possible association between exposure to therapeutic drugs and ESFT. Methods. This is a retrospective, descriptive study. A query of the FDA Adverse Event Reporting System (FAERS was conducted for all reports of ESFT, January 1, 1998, through December 31, 2013. Report narratives were individually reviewed for patient characteristics, underlying conditions and drug exposures. Results. Over 16 years, 134 ESFT reports were identified, including 25 cases of ESFT following therapeutic drugs and biologics including immunosuppressive agents and hormones. Many cases were confounded by concomitant medications and other therapies. Conclusions. This study provides a closer look at medication use and underlying disorders in patients who later developed ESFT. While this study was not designed to demonstrate any clear causative association between ESFT and prior use of a single product or drug class, many drugs were used to treat immune-related disease and growth or hormonal disturbances. Further studies may be warranted to better understand possible immune or neuroendocrine abnormalities or exposure to specific classes of drugs that may predispose to the later development of ESFT.

  16. Adverse event reporting in studies of penetrating acupuncture during pregnancy: a systematic review.

    Science.gov (United States)

    Clarkson, Carl E; O'mahony, Deborah; Jones, Diana E

    2015-05-01

    Acupuncture within pregnancy has frequently been investigated, often finding this to be more effective than standard care. However, the adverse event severity, types and occurrence are unclear. To investigate the quality of reporting adverse events and to attempt to identify occurrence, type and severity of adverse events in acupuncture and non-acupuncture groups. MEDLINE, CINAHL, Allied and Complementary Medicine Database, and Physiotherapy Evidence Database (PEDro) were searched for relevant studies between 2000 and 2014. Seventeen studies using penetrating acupuncture and making comment on adverse events experienced were included. Quality appraisal of the selected publications was performed using either the PEDro scale or the Downs and Black checklist. Quality of reporting was evaluated against STRICTA and CONSORT guidelines, with data on adverse events extracted in accordance with CONSORT and Good Clinical Practice adverse event guidelines. Overall quality of reporting of adverse events was poor, with information describing the adverse events often lacking in detail. A number of trends were noted: adverse events occurring within a treatment session was 3-17% in the acupuncture groups and 4-25% in the non-acupuncture groups. The percentage of women affected by an adverse event was between 14 and 17% in the acupuncture groups and between 15 and 19% in non-acupuncture groups. Adverse event reporting within acupuncture trials is generally poor. The trends noted were that adverse events do occur, but would appear to be largely minor and comparable to non-acupuncture-related interventions. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  17. Water-borne diseases and extreme weather events in Cambodia: review of impacts and implications of climate change.

    Science.gov (United States)

    Davies, Grace I; McIver, Lachlan; Kim, Yoonhee; Hashizume, Masahiro; Iddings, Steven; Chan, Vibol

    2014-12-23

    Cambodia is prone to extreme weather events, especially floods, droughts and typhoons. Climate change is predicted to increase the frequency and intensity of such events. The Cambodian population is highly vulnerable to the impacts of these events due to poverty; malnutrition; agricultural dependence; settlements in flood-prone areas, and public health, governance and technological limitations. Yet little is known about the health impacts of extreme weather events in Cambodia. Given the extremely low adaptive capacity of the population, this is a crucial knowledge gap. A literature review of the health impacts of floods, droughts and typhoons in Cambodia was conducted, with regional and global information reviewed where Cambodia-specific literature was lacking. Water-borne diseases are of particular concern in Cambodia, in the face of extreme weather events and climate change, due to, inter alia, a high pre-existing burden of diseases such as diarrhoeal illness and a lack of improved sanitation infrastructure in rural areas. A time-series analysis under quasi-Poisson distribution was used to evaluate the association between floods and diarrhoeal disease incidence in Cambodian children between 2001 and 2012 in 16 Cambodian provinces. Floods were significantly associated with increased diarrhoeal disease in two provinces, while the analysis conducted suggested a possible protective effect from toilets and piped water. Addressing the specific, local pre-existing vulnerabilities is vital to promoting population health resilience and strengthening adaptive capacity to extreme weather events and climate change in Cambodia.

  18. Water-Borne Diseases and Extreme Weather Events in Cambodia: Review of Impacts and Implications of Climate Change

    Science.gov (United States)

    Davies, Grace I.; McIver, Lachlan; Kim, Yoonhee; Hashizume, Masahiro; Iddings, Steven; Chan, Vibol

    2014-01-01

    Cambodia is prone to extreme weather events, especially floods, droughts and typhoons. Climate change is predicted to increase the frequency and intensity of such events. The Cambodian population is highly vulnerable to the impacts of these events due to poverty; malnutrition; agricultural dependence; settlements in flood-prone areas, and public health, governance and technological limitations. Yet little is known about the health impacts of extreme weather events in Cambodia. Given the extremely low adaptive capacity of the population, this is a crucial knowledge gap. A literature review of the health impacts of floods, droughts and typhoons in Cambodia was conducted, with regional and global information reviewed where Cambodia-specific literature was lacking. Water-borne diseases are of particular concern in Cambodia, in the face of extreme weather events and climate change, due to, inter alia, a high pre-existing burden of diseases such as diarrhoeal illness and a lack of improved sanitation infrastructure in rural areas. A time-series analysis under quasi-Poisson distribution was used to evaluate the association between floods and diarrhoeal disease incidence in Cambodian children between 2001 and 2012 in 16 Cambodian provinces. Floods were significantly associated with increased diarrhoeal disease in two provinces, while the analysis conducted suggested a possible protective effect from toilets and piped water. Addressing the specific, local pre-existing vulnerabilities is vital to promoting population health resilience and strengthening adaptive capacity to extreme weather events and climate change in Cambodia. PMID:25546280

  19. Water-Borne Diseases and Extreme Weather Events in Cambodia: Review of Impacts and Implications of Climate Change

    Directory of Open Access Journals (Sweden)

    Grace I. Davies

    2014-12-01

    Full Text Available Cambodia is prone to extreme weather events, especially floods, droughts and typhoons. Climate change is predicted to increase the frequency and intensity of such events. The Cambodian population is highly vulnerable to the impacts of these events due to poverty; malnutrition; agricultural dependence; settlements in flood-prone areas, and public health, governance and technological limitations. Yet little is known about the health impacts of extreme weather events in Cambodia. Given the extremely low adaptive capacity of the population, this is a crucial knowledge gap. A literature review of the health impacts of floods, droughts and typhoons in Cambodia was conducted, with regional and global information reviewed where Cambodia-specific literature was lacking. Water-borne diseases are of particular concern in Cambodia, in the face of extreme weather events and climate change, due to, inter alia, a high pre-existing burden of diseases such as diarrhoeal illness and a lack of improved sanitation infrastructure in rural areas. A time-series analysis under quasi-Poisson distribution was used to evaluate the association between floods and diarrhoeal disease incidence in Cambodian children between 2001 and 2012 in 16 Cambodian provinces. Floods were significantly associated with increased diarrhoeal disease in two provinces, while the analysis conducted suggested a possible protective effect from toilets and piped water. Addressing the specific, local pre-existing vulnerabilities is vital to promoting population health resilience and strengthening adaptive capacity to extreme weather events and climate change in Cambodia.

  20. Practitioner Review: Current Best Practice in the Management of Adverse Events during Treatment with ADHD Medications in Children and Adolescents

    Science.gov (United States)

    Cortese, Samuele; Holtmann, Martin; Banaschewski, Tobias; Buitelaar, Jan; Coghill, David; Danckaerts, Marina; Dittmann, Ralf W.; Graham, John; Taylor, Eric; Sergeant, Joseph

    2013-01-01

    Background: Medication is an important element of therapeutic strategies for ADHD. While medications for ADHD are generally well-tolerated, there are common, although less severe, as well as rare but severe adverse events AEs during treatment with ADHD drugs. The aim of this review is to provide

  1. Multidisciplinary team care in rehabilitation

    DEFF Research Database (Denmark)

    Momsen, Anne-Mette; Rasmussen, Jens Ole; Nielsen, Claus Vinther

    2012-01-01

    Objectives: To systematically investigate current scientific evidence about the effectiveness of multidisciplinary team rehabilitation for different health problems. Data sources: A comprehensive literature search was conducted in Cochrane, Medline, DARE, Embase, and Cinahl databases, and research...... from existing systematic reviews was critically appraised and summarized. Study selection: Using the search terms "rehabilitation", "multidisciplinary teams" or "team care", references were identified for existing studies published after 2000 that examined multidisciplinary rehabilitation team care......, interventions, and findings. Data synthesis: A total of 14 reviews were included to summarize the findings of 12 different study populations. Evidence was found to support improved functioning following multidisciplinary rehabilitation team care for 10 of 12 different study population: elderly people, elderly...

  2. Review of the UNC Team Epi-Aid graduate student epidemiology response program six years after implementation.

    Science.gov (United States)

    MacDonald, Pia D M; Davis, Meredith K; Horney, Jennifer A

    2010-01-01

    Service learning is one way that academia can contribute to assuring the public's health. The University of North Carolina's Team Epi-Aid service-learning program started in 2003. Since then, 145 graduate student volunteers have contributed 4,275 hours working with the state and local health departments during 57 activities, including outbreak investigations, community health assessments, and emergency preparedness and response. Survey data from student participants and public health partners indicates that the program is successful in meeting its goal of creating effective partnerships among the university, the North Carolina Center for Public Health Preparedness, and state and local health departments; supplying needed surge capacity to health departments; and providing students with applied public health experience and training. In this article, we discuss the programmatic lessons learned around administration, maintaining student interest, program sustainability, and challenges since program implementation.

  3. Adverse events in cardiovascular-related training programs in people with spinal cord injury: a systematic review.

    Science.gov (United States)

    Warms, Catherine A; Backus, Deborah; Rajan, Suparna; Bombardier, Charles H; Schomer, Katherine G; Burns, Stephen P

    2014-11-01

    There are anecdotal reports of adverse events (AEs) associated with exercise in people with spinal cord injury (SCI) and consequent concern by people with SCI and their providers about potential risks of exercise. Enumeration of specific events has never been performed and the extent of risk of exercise to people with SCI is not understood. To systematically review published evidence to identify and enumerate reports of adverse events or AEs associated with training in persons with SCI. Review was limited to peer-reviewed studies published in English from 1970 to 2011: (1) in adults with SCI, (2) evaluating training protocols consisting of repeated sessions over at least 4 weeks to maintain or improve cardiovascular health, (3) including volitional exercise modalities and functional electrical stimulation (FES)-enhanced exercise modalities, and (4) including a specific statement about AEs. Trained reviewers initially identified a total of 145 studies. After further screening, 38 studies were included in the review. Quality of evidence was evaluated using established procedures. There were no serious AEs reported. There were no common AEs reported across most types of interventions, except for musculoskeletal AEs related to FES walking. There were few AEs in volitional exercise studies. There is no evidence to suggest that cardiovascular exercise done according to guidelines and established safety precautions is harmful. To improve the strength of these conclusions, future publications should include definition of AEs, information about pre-intervention screening, and statements of the nature and extent of AEs.

  4. Active and passive surveillance of yellow fever vaccine 17D or 17DD-associated serious adverse events: systematic review.

    Science.gov (United States)

    Thomas, Roger E; Lorenzetti, Diane L; Spragins, Wendy; Jackson, Dave; Williamson, Tyler

    2011-06-20

    To identify the rate of serious adverse events attributable to yellow fever vaccination with 17D and 17DD strains reported in active and passive surveillance data. We conducted a systematic review of published literature on adverse events associated with yellow fever. We searched 9 electronic databases for peer reviewed and grey literature in all languages. There were no restrictions on date of publication. Reference lists of key studies were also reviewed to identify additional studies. We identified 66 relevant studies: 24 used active, 17 a combination of passive and active (15 of which were pharmacovigilance databases), and 25 passive surveillance. ACTIVE SURVEILLANCE: A total of 2,660,929 patients in general populations were followed for adverse events after vaccination, heavily weighted (97.7%) by one large Brazilian study. There were no observed cases of viscerotropic or neurotropic disease, one of anaphylaxis and 26 cases of urticaria (hypersensitivity). We also identified four studies of infants and children (n=2199), four studies of women (n=1334), and one study of 174 HIV+, and no serious adverse events were observed. PHARMACOVIGILANCE DATABASES: 10 of the 15 databases contributed data to this review, with 107,621,154 patients, heavily weighted (94%) by the Brazilian database. The estimates for Australia were low at 0/210,656 for "severe neurological disease" and 1/210,656 for YEL-AVD, and also low for Brazil with 9 hypersensitivity events, 0.23 anaphylactic shock events, 0.84 neurologic syndrome events and 0.19 viscerotropic events cases/million doses. The five analyses of partly overlapping periods for the US VAERS database provided an estimate of 6.6 YEL-AVD and YEL-AND cases per million, and estimates between 11.1 and 15.6 of overall "serious adverse events" per million. The estimates for the UK were higher at 34 "serious adverse events" and also for Switzerland with 14.6 "neurologic events" and 40 "serious events not neurological"/million doses

  5. The Effectiveness of Injury Prevention Programs to Modify Risk Factors for Non-Contact Anterior Cruciate Ligament and Hamstring Injuries in Uninjured Team Sports Athletes: A Systematic Review.

    Science.gov (United States)

    Monajati, Alireza; Larumbe-Zabala, Eneko; Goss-Sampson, Mark; Naclerio, Fernando

    2016-01-01

    Hamstring strain and anterior cruciate ligament injuries are, respectively, the most prevalent and serious non-contact occurring injuries in team sports. Specific biomechanical and neuromuscular variables have been used to estimate the risk of incurring a non-contact injury in athletes. The aim of this study was to systematically review the evidences for the effectiveness of injury prevention protocols to modify biomechanical and neuromuscular anterior cruciate and/or hamstring injuries associated risk factors in uninjured team sport athletes. PubMed, Science Direct, Web of Science, Cochrane Libraries, U.S. National Institutes of Health clinicaltrials.gov, Sport Discuss and Google Scholar databases were searched for relevant journal articles published until March 2015. A manual review of relevant articles, authors, and journals, including bibliographies was performed from identified articles. Nineteen studies were included in this review. Four assessment categories: i) landing, ii) side cutting, iii) stop-jump, and iv) muscle strength outcomes, were used to analyze the effectiveness of the preventive protocols. Eight studies using multifaceted interventions supported by video and/or technical feedback showed improvement in landing and/or stop-jump biomechanics, while no effects were observed on side-cutting maneuver. Additionally, multifaceted programs including hamstring eccentric exercises increased hamstring strength, hamstring to quadriceps functional ratio and/or promoted a shift of optimal knee flexion peak torque toward a more open angle position. Multifaceted programs, supported by proper video and/or technical feedback, including eccentric hamstring exercises would positively modify the biomechanical and or neuromuscular anterior cruciate and/or hamstring injury risk factors.

  6. The Effectiveness of Injury Prevention Programs to Modify Risk Factors for Non-Contact Anterior Cruciate Ligament and Hamstring Injuries in Uninjured Team Sports Athletes: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Alireza Monajati

    Full Text Available Hamstring strain and anterior cruciate ligament injuries are, respectively, the most prevalent and serious non-contact occurring injuries in team sports. Specific biomechanical and neuromuscular variables have been used to estimate the risk of incurring a non-contact injury in athletes.The aim of this study was to systematically review the evidences for the effectiveness of injury prevention protocols to modify biomechanical and neuromuscular anterior cruciate and/or hamstring injuries associated risk factors in uninjured team sport athletes.PubMed, Science Direct, Web of Science, Cochrane Libraries, U.S. National Institutes of Health clinicaltrials.gov, Sport Discuss and Google Scholar databases were searched for relevant journal articles published until March 2015. A manual review of relevant articles, authors, and journals, including bibliographies was performed from identified articles.Nineteen studies were included in this review. Four assessment categories: i landing, ii side cutting, iii stop-jump, and iv muscle strength outcomes, were used to analyze the effectiveness of the preventive protocols. Eight studies using multifaceted interventions supported by video and/or technical feedback showed improvement in landing and/or stop-jump biomechanics, while no effects were observed on side-cutting maneuver. Additionally, multifaceted programs including hamstring eccentric exercises increased hamstring strength, hamstring to quadriceps functional ratio and/or promoted a shift of optimal knee flexion peak torque toward a more open angle position.Multifaceted programs, supported by proper video and/or technical feedback, including eccentric hamstring exercises would positively modify the biomechanical and or neuromuscular anterior cruciate and/or hamstring injury risk factors.

  7. Serious adverse events are uncommon with combination neonatal antiretroviral prophylaxis: a retrospective case review.

    Directory of Open Access Journals (Sweden)

    Christiana Smith

    Full Text Available Six weeks of zidovudine (ZDV is recommended for postnatal prophylaxis of HIV-exposed infants, but combination antiretrovirals are indicated if HIV transmission risk is increased. We investigated the frequency and severity of adverse events (AE in infants receiving multiple drug prophylaxis compared to ZDV alone. In this retrospective review of 148 HIV-exposed uninfected infants born between 1997-2009, we determined clinical and laboratory AE that occurred between days of life 8-42. Thirty-six infants received combination prophylaxis; among those, a three-drug regimen containing ZDV, lamivudine, and nevirapine was most common (53%. Rates of laboratory AE grade ≥1 were as follows for the combination prophylaxis and ZDV alone groups, respectively: neutropenia 55% and 39%; anemia 50% and 39%; thrombocytopenia 0 and 3%; elevated aspartate aminotransferase 3% and 3%; elevated alanine aminotransferase 0 and 1%; hyperbilirubinemia 19% and 42%. Anemia occurred more frequently in infants who received three-drug prophylaxis compared to infants who received ZDV alone (63% vs. 39%, p = 0.04; all anemia AE were grade 1 or 2 in the three-drug prophylaxis group. Overall, 75% of infants on combination prophylaxis and 66% of infants on ZDV alone developed grade ≥1 AE (p = 0.32, and 17% of infants in either group developed grade ≥3 AE. Stavudine was substituted for ZDV in 23 infants due to anemia or neutropenia. After this antiretroviral change, 50% of evaluable infants demonstrated improvement in AE grade, and 25% had no change. In conclusion, low grade anemia, neutropenia, and hyperbilirubinemia occurred frequently regardless of the prophylactic regimen, but serious AE were uncommon. Although most AE were typical of ZDV toxicity, the combination of ZDV with lamivudine and nevirapine resulted in an increased frequency of low-grade anemia. Further studies are needed to identify prophylactic regimens with less toxicity for infants born to HIV-infected mothers.

  8. Adverse event reporting in nonpharmacologic, noninterventional pain clinical trials: ACTTION systematic review.

    Science.gov (United States)

    Hunsinger, Matthew; Smith, Shannon M; Rothstein, Daniel; McKeown, Andrew; Parkhurst, Melissa; Hertz, Sharon; Katz, Nathaniel P; Lin, Allison H; McDermott, Michael P; Rappaport, Bob A; Turk, Dennis C; Dworkin, Robert H

    2014-11-01

    Assessment of treatment safety is 1 of the primary goals of clinical trials. Organizations and working groups have created reporting guidelines for adverse events (AEs). Previous research examining AE reporting for pharmacologic clinical trials of analgesics in major pain journals found many reporting inadequacies, suggesting that analgesic trials are not adhering to existing AE reporting guidelines. The present systematic review documented AE reporting in 3 main pain journals for nonpharmacologic, noninterventional (NP/NI) trials examining pain treatments. To broaden our pool of nonpharmacologic trials, we also included trials examining acupuncture, leech therapy, and noninvasive stimulation techniques (eg, transcutaneous electrical nerve stimulation). We documented AE reporting at 2 levels of specificity using coding manuals based on the Consolidated Standards of Reporting Trials (CONSORT) harms reporting standards and Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) AE reporting checklist. We identified a number of inadequacies in AE reporting across the 3 journals. For example, using the ACTTION coding manual, we found that less than one-half of the trials reported specific AE assessment methods; approximately one-third of the trials reported withdrawals due to AEs for each study arm; and about one-fourth of the trials reported all specific AEs. We also examined differences in AE reporting across several trial characteristics, finding that AE reporting was generally more detailed in trials with patients versus those using healthy volunteers undergoing experimentally evoked pain. These results suggest that investigators conducting and reporting NP/NI clinical trials are not adequately describing the assessment and occurrence of AEs. Copyright © 2014 International Association for the Study of Pain. All rights reserved.

  9. Added value of CAC in risk stratification for cardiovascular events: a systematic review.

    Science.gov (United States)

    Peters, Sanne A E; Bakker, Marina; den Ruijter, Hester M; Bots, Michiel L

    2012-01-01

    Identification of individuals at high risk for cardiovascular disease (CVD) is important to initiate adequate treatment and to prevent future events. Moreover, identification of low-risk individuals is important to refrain from unneeded therapy. Current risk prediction models do not accurately predict the risk of CVD in individuals, and new markers have been sought to improve the risk assessment in individuals. Coronary artery calcification (CAC) is a marker of atherosclerosis that might improve current risk assessment when added to traditional risk factors. We performed a systematic review on PubMed search (1 February 2011) on studies reporting on the added value of CAC in risk prediction in asymptomatic individuals. Of 39 publications on CAC and CVD, nine studies were carried out in asymptomatic individuals. All studies showed an increase in area under the curve ranging from 0.05 to 0.20 when CAC was added to the risk model. Four studies reported on improvements of individuals in low-, intermediate-, and high-risk categories. Addition of CAC to the risk model resulted in a net reclassification improvement ranging from 14% to 30%, meaning that CAC measurement reclassified a substantial proportion of individuals into correct risk categories. This improvement was most pronounced in those at intermediate Framingham risk. The available studies consistently showed that CAC scoring improves risk stratification in CVD risk categories when added to traditional risk factors only, especially among individuals at intermediate risk for CVD. Cost-effectiveness analyses together with a randomized controlled trial are needed before widespread introduction of CAC in clinical care. © 2011 The Authors. European Journal of Clinical Investigation © 2011 Stichting European Society for Clinical Investigation Journal Foundation.

  10. Does small-sided games training improve physical-fitness and specific skills for team sports? A systematic review with meta-analysis.

    Science.gov (United States)

    Hammami, Amri; Gabbett, Tim J; Slimani, Maamer; Bouhlel, Ezdine

    2017-10-24

    This paper aimed to systematically review and meta-analyse the training effects of small-sided games (SSG) on physical fitness and specific skills related to team sport according to the level of play and the period of the season. The search covered the following electronic databases (PubMed, Google Scholar, and ScienceDirect). The publications' search period ranged from 2000 to 2016. The terms (small- sided game, training, skill-based game, aerobic fitness, sprint, agility, jump and team sports) were used either singularly or combined in a systematic sequence. Appraisal of 16 articles (15 were meta-analysed) was performed after the application of exclusion criteria and quality assurance processes and the standardized mean effects were measured using random effects. The results revealed that SSG training had a large beneficial effect on maximal oxygen uptake VO2max (effect size 1.94; 95 % CL 0.15, 3.74; I2 = 94 %), agility (-1.49; 95% CL -2.27, -0.71; I2 = 80%), and repeated sprint ability (-1.19; 95% CL - 2.17, -0.21; I2= 53%).There was a moderate beneficial effect on 10- and 20-m sprint performance (-0.89; 95 % CL -1.7, -0.07; I2 =88%), jump height (0.68; 95% CL 0.03, 1.33; I2= 79%), and intermittent endurance (0.61; 95% CL 0.17, 1.05; I2= 0%). The results also showed greater positive effects on specific skills (specific endurance and agility tests and techniques) after SSG when compared with generic or agility training. Small-sided games may represent an effective strategy of multicomponent training that can induce greater positive effects on specific skills tasks when compared with interval or agility training and moderate to large improvements in team sport-related physical fitness.

  11. Serious Adverse Events and Spinal Manipulative Therapy of the Low Back Region: A Systematic Review of Cases.

    Science.gov (United States)

    Hebert, Jeffrey J; Stomski, Norman J; French, Simon D; Rubinstein, Sidney M

    2015-01-01

    The purpose of this study was to systematically search the literature for studies reporting serious adverse events following lumbopelvic spinal manipulative therapy (SMT) and to describe the case details. A systematic search was conducted in PubMed including MEDLINE, EMBASE, CINAHL, and The Cochrane Library up to January 12, 2012, by an experienced reference librarian. Study selection was performed by 2 independent reviewers using predefined criteria. We included cases involving individuals 18 years or older who experienced a serious adverse event following SMT applied to the lumbar spine or pelvis by any type of provider (eg, chiropractic, medical, physical therapy, osteopathic, layperson). A serious adverse event was defined as an untoward occurrence that results in death or is life threatening, requires hospital admission, or results in significant or permanent disability. We included studies published in English, German, Dutch, and Swedish. A total of 2046 studies were screened, and 41 studies reporting on 77 cases were included. Important case details were frequently unreported, such as descriptions of SMT technique, the pre-SMT presentation of the patient, the specific details of the adverse event, time from SMT to the adverse event, factors contributing to the adverse event, and clinical outcome. Adverse events consisted of cauda equina syndrome (29 cases, 38% of total); lumbar disk herniation (23 cases, 30%); fracture (7 cases, 9%); hematoma or hemorrhagic cyst (6 cases, 8%); or other serious adverse events (12 cases, 16%) such as neurologic or vascular compromise, soft tissue trauma, muscle abscess formation, disrupted fracture healing, and esophageal rupture. This systematic review describes case details from published articles that describe serious adverse events that have been reported to occur following SMT of the lumbopelvic region. The anecdotal nature of these cases does not allow for causal inferences between SMT and the events identified in this

  12. Dealing With Major Life Events and Transitions: A Systematic Literature Review on and Occupational Analysis of Spirituality.

    Science.gov (United States)

    Maley, Christine M; Pagana, Nicole K; Velenger, Christa A; Humbert, Tamera Keiter

    2016-01-01

    This systematic literature review analyzed the construct of spirituality as perceived by people who have experienced or are experiencing a major life event or transition. The researchers investigated studies that used narrative analysis or a phenomenological methodology related to the topic. Thematic analysis resulted in three major themes: (1) avenues to and through spirituality, (2) the experience of spirituality, and (3) the meaning of spirituality. The results provide insights into the intersection of spirituality, meaning, and occupational engagement as understood by people experiencing a major life event or transition and suggest further research that addresses spirituality in occupational therapy and interdisciplinary intervention. Copyright © 2016 by the American Occupational Therapy Association, Inc.

  13. The seismic signature of rockslides: a review of events in the Central Alps

    Science.gov (United States)

    Dammeier, F.; Moore, J. R.; Haslinger, F.; Loew, S.

    2010-12-01

    Seismic recordings from regional networks may be used to identify and locate rockslide events, and can provide unique information on event characteristics that could otherwise only be established by eye witnesses. Here we analyze the seismic signals from 20 large rockslide events that occurred in the Swiss and French Alps during the last twenty years. Rockslide seismic signals have a typical ‘cigar’ shape characterized by an emergent onset and slowly decaying tail. The majority of seismic energy is contained in frequencies below ~4 Hz, and near the source, the signal generally cannot be separated into different wave types. Five seismic metrics were used to quantify differences between rockslide seismograms: seismic duration, peak amplitude of the seismic velocity envelope (ePGV), average ground velocity (AGV), rise time (RT) from event onset to ePGV, and the area of the seismic velocity envelope (EA). Three seismic metrics (EA, AGV, ePGV) exhibited loglog attenuation behavior, RT exhibited semilog attenuation behavior and duration did not show any clear attenuation with distance. For comparison between events, each seismic metric was extrapolated to a common distance of 30 km; for duration the value at the nearest station was used. Event potential energy correlated well with seismic duration and ePGV, and rock/ice avalanches could be identified by unusually low ePGV. Event volume correlated with seismic duration and EA, and rock collapses could be identified by unusually low EA. Analyzing six events that occurred from the same slope with similar runout, the correlation of ePGV and event volume was better than that for all events, indicating that runout path has an important effect on ePGV. For these six events, a plot of EA versus duration showed that rockslides with more than one sub-event lie far from the fitted curve. We also attempted to match seismic waveform features to event dynamics as observed in video footage. A high amplitude signal on a horizontal

  14. Life After the Event: A Review of Basic Life Support Training for Parents Following Apparent Life-Threatening Events and Their Experience and Practices Following Discharge

    LENUS (Irish Health Repository)

    2017-05-01

    Apparent Life-Threatening Events (ALTEs) are a common presentation to paediatric hospitals and represent a significant cause of parental anxiety. Basic Life Support (BLS) training is recommended for all caregivers following ALTEs. This study aimed to assess the rate of caregiver BLS training and reviewed parents experience following discharge. Parents were interviewed by phone following discharge. Over the study period 25 children attended the Emergency Department with ALTE, 17\\/25 (68%) were trained and 13\\/17 (76%) were contactable for interview. All parents found training decreased their anxiety level and were interested in attending for re-training. BLS resuscitation was subsequently required by 2\\/13 (15%) of children. Non-medical grade monitors were in use by 10\\/13 (77%) of caregivers following discharge. Caregivers are eager to engage in BLS training and it effectively reduces their caregiver anxiety. We recommend an increase in instructor staff and use of group re-training post discharge

  15. Forming Student Online Teams for Maximum Performance

    Science.gov (United States)

    Olson, Joel D.; Ringhand, Darlene G.; Kalinski, Ray C.; Ziegler, James G.

    2015-01-01

    What is the best way to assign graduate business students to online team-based projects? Team assignments are frequently made on the basis of alphabet, time zones or previous performance. This study reviews personality as an indicator of student online team performance. The personality assessment IDE (Insights Discovery Evaluator) was administered…

  16. A systematic review and meta-analysis on herpes zoster and the risk of cardiac and cerebrovascular events.

    Directory of Open Access Journals (Sweden)

    Nathaniel Erskine

    Full Text Available Patients who develop herpes zoster or herpes zoster ophthalmicus may be at risk for cerebrovascular and cardiac complications. We systematically reviewed the published literature to determine the association between herpes zoster and its subtypes with the occurrence of cerebrovascular and cardiac events.Systematic searches of PubMed (MEDLINE, SCOPUS (Embase and Google Scholar were performed in December 2016. Eligible studies were cohort, case-control, and self-controlled case-series examining the association between herpes zoster or subtypes of herpes zoster with the occurrence of cerebrovascular and cardiac events including stroke, transient ischemic attack, coronary heart disease, and myocardial infarction. Data on the occurrence of the examined events were abstracted. Odds ratios and their accompanying confidence intervals were estimated using random and fixed effects models with statistical heterogeneity estimated with the I2 statistic. Twelve studies examining 7.9 million patients up to 28 years after the onset of herpes zoster met our pre-defined eligibility criteria. Random and fixed effects meta-analyses showed that herpes zoster, type unspecified, and herpes zoster ophthalmicus were associated with a significantly increased risk of cerebrovascular events, without any evidence of statistical heterogeneity. Our meta-analysis also found a significantly increased risk of cardiac events associated with herpes zoster, type unspecified.Our results are consistent with the accumulating body of evidence that herpes zoster and herpes zoster ophthalmicus are significantly associated with cerebrovascular and cardiovascular events.

  17. Advanced practice nursing, health care teams, and perceptions of team effectiveness.

    Science.gov (United States)

    Kilpatrick, Kelley; Lavoie-Tremblay, Mélanie; Ritchie, Judith A; Lamothe, Lise

    2014-01-01

    This article summarizes the results of an extensive review of the organizational and health care literature of advanced practice nursing (APN) roles, health care teams, and perceptions of team effectiveness. Teams have a long history in health care. Managers play an important role in mobilizing resources, guiding expectations of APN roles in teams and within organizations, and facilitating team process. Researchers have identified a number of advantages to the addition of APN roles in health care teams. The process within health care teams are dynamic and responsive to their surrounding environment. It appears that teams and perceptions of team effectiveness need to be understood in the broader context in which the teams are situated. Key team process are identified for team members to perceive their team as effective. The concepts of teamwork, perceptions of team effectiveness, and the introduction of APN roles in teams have been studied disparately. An exploration of the links between these concepts may further our understanding the health care team's perceptions of team effectiveness when APN roles are introduced. Such knowledge could contribute to the effective deployment of APN roles in health care teams and improve the delivery of health care services to patients and families.

  18. The impact of multidisciplinary team meetings on patient assessment, management and outcomes in oncology settings: A systematic review of the literature.

    Science.gov (United States)

    Pillay, Brindha; Wootten, Addie C; Crowe, Helen; Corcoran, Niall; Tran, Ben; Bowden, Patrick; Crowe, Jane; Costello, Anthony J

    2016-01-01

    Conducting regular multidisciplinary team (MDT) meetings requires significant investment of time and finances. It is thus important to assess the empirical benefits of such practice. A systematic review was conducted to evaluate the literature regarding the impact of MDT meetings on patient assessment, management and outcomes in oncology settings. Relevant studies were identified by searching OVID MEDLINE, PsycINFO, and EMBASE databases from 1995 to April 2015, using the keywords: multidisciplinary team meeting* OR multidisciplinary discussion* OR multidisciplinary conference* OR case review meeting* OR multidisciplinary care forum* OR multidisciplinary tumour board* OR case conference* OR case discussion* AND oncology OR cancer. Studies were included if they assessed measurable outcomes, and used a comparison group and/or a pre- and post-test design. Twenty-seven articles met inclusion criteria. There was limited evidence for improved survival outcomes of patients discussed at MDT meetings. Between 4% and 45% of patients discussed at MDT meetings experienced changes in diagnostic reports following the meeting. Patients discussed at MDT meetings were more likely to receive more accurate and complete pre-operative staging, and neo-adjuvant/adjuvant treatment. Quality of studies was affected by selection bias and the use of historical cohorts impacted study quality. MDT meetings impact upon patient assessment and management practices. However, there was little evidence indicating that MDT meetings resulted in improvements in clinical outcomes. Future research should assess the impact of MDT meetings on patient satisfaction and quality of life, as well as, rates of cross-referral between disciplines. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Event-related potentials as a measure of sleep disturbance: A tutorial review

    Directory of Open Access Journals (Sweden)

    Kenneth Campbell

    2010-01-01

    Full Text Available This article reviews event-related potentials (ERPs the minute responses of the human brain that are elicited by external auditory stimuli and how the ERPs can be used to measure sleep disturbance. ERPs consist of a series of negative- and positive-going components. A negative component peaking at about 100 ms, N1, is thought to reflect the outcome of a transient detector system, activated by change in the transient energy in an acoustic stimulus. Its output and thus the amplitude of N1 increases as the intensity level of the stimulus is increased and when the rate of presentation is slowed. When the output reaches a certain critical level, operations of the central executive are interrupted and attention is switched to the auditory channel. This switching of attention is thought to be indexed by a later positivity, P3a, peaking between 250 and 300 ms. In order to sleep, consciousness for all but the most relevant of stimuli must be prevented. Thus, during sleep onset and definitive non-rapid eye movement (NREM sleep, the amplitude of N1 diminishes to near-baseline level. The amplitude of P2, peaking from 180 to 200 ms, is however larger in NREM sleep than in wakefulness. P2 is thought to reflect an inhibitory process protecting sleep from irrelevant disturbance. As stimulus input becomes increasingly obtrusive, the amplitude of P2 also increases. With increasing obtrusiveness particularly when stimuli are presented slowly, a later large negativity, peaking at about 350 ms, N350, becomes apparent. N350 is unique to sleep, its amplitude also increasing as the stimulus becomes more obtrusive. Many authors postulate that when the N350 reaches a critical amplitude, a very large amplitude N550, a component of the K-Complex is elicited. The K-Complex can only be elicited during NREM sleep. The P2, N350 and N550 processes are thus conceived as sleep protective mechanisms, activated sequentially as the risk for disturbance increases. During REM sleep

  20. Nursing unit teams matter: Impact of unit-level nurse practice environment, nurse work characteristics, and burnout on nurse reported job outcomes, and quality of care, and patient adverse events--a cross-sectional survey.

    Science.gov (United States)

    Van Bogaert, Peter; Timmermans, Olaf; Weeks, Susan Mace; van Heusden, Danny; Wouters, Kristien; Franck, Erik

    2014-08-01

    To investigate the impact of nurse practice environment factors, nurse work characteristics, and burnout on nurse reported job outcomes, quality of care, and patient adverse events variables at the nursing unit level. Nurse practice environment studies show growing insights and knowledge about determining factors for nurse workforce stability, quality of care, and patient safety. Until now, international studies have primarily focused on variability at the hospital level; however, insights at the nursing unit level can reveal key factors in the nurse practice environment. A cross-sectional design with a survey. In a cross-sectional survey, a sample of 1108 nurses assigned to 96 nursing units completed a structured questionnaire composed of various validated instruments measuring nurse practice environment factors, nurse work characteristics, burnout, nurse reported job outcomes, quality of care, and patient adverse events. Associations between the variables were examined using multilevel modelling techniques. Various unit-level associations (simple models) were identified between nurse practice environment factors, nurse work characteristics, burnout dimensions, and nurse reported outcome variables. Multiple multilevel models showed various independent variables such as nursing management at the unit level, social capital, emotional exhaustion, and depersonalization as important predictors of nurse reported outcome variables such job satisfaction, turnover intentions, quality of care (at the unit, the last shift, and in the hospital within the last year), patient and family complaints, patient and family verbal abuse, patient falls, nosocomial infections, and medications errors. Results suggested a stable nurse work force, with the capability to achieve superior quality and patient safety outcomes, is associated with unit-level favourable perceptions of nurse work environment factors, workload, decision latitude, and social capital, as well low levels of burnout

  1. Adverse Events Due to Chiropractic and Other Manual Therapies for Infants and Children: A Review of the Literature.

    Science.gov (United States)

    Todd, Angela J; Carroll, Matthew T; Robinson, Anske; Mitchell, Eleanor K L

    2015-01-01

    The purpose of this study was to review the literature for cases of adverse events in infants and children treated by chiropractors or other manual therapists, identifying treatment type and if a preexisting pathology was present. English language, peer-reviewed journals and non-peer-reviewed case reports discussing adverse events (ranging from minor to serious) were systematically searched from inception of the relevant searchable bibliographic databases through March 2014. Articles not referring to infants or children were excluded. Thirty-one articles met the selection criteria. A total of 12 articles reporting 15 serious adverse events were found. Three deaths occurred under the care of various providers (1 physical therapist, 1 unknown practitioner, and 1 craniosacral therapist) and 12 serious injuries were reported (7 chiropractors/doctors of chiropractic, 1 medical practitioner, 1 osteopath, 2 physical therapists, and 1 unknown practitioner). High-velocity, extension, and rotational spinal manipulation was reported in most cases, with 1 case involving forcibly applied craniosacral dural tension and another involving use of an adjusting instrument. Underlying preexisting pathology was identified in a majority of the cases. Published cases of serious adverse events in infants and children receiving chiropractic, osteopathic, physiotherapy, or manual medical therapy are rare. The 3 deaths that have been reported were associated with various manual therapists; however, no deaths associated with chiropractic care were found in the literature to date. Because underlying preexisting pathology was associated in a majority of reported cases, performing a thorough history and examination to exclude anatomical or neurologic anomalies before applying any manual therapy may further reduce adverse events across all manual therapy professions. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  2. No-fault compensation following adverse events attributed to vaccination: a review of international programmes

    National Research Council Canada - National Science Library

    Looker, Clare; Kelly, Heath

    2011-01-01

    Programmes that provide no-fault compensation for an adverse event following vaccination have been implemented in 19 countries worldwide, the first in Germany in 1961 and the most recent in Hungary in 2005...

  3. A method for measuring team skills.

    Science.gov (United States)

    Annett, J; Cunningham, D; Mathias-Jones, P

    2000-08-01

    A method for identifying and measuring team skills, specifying team training objectives and the objective assessment of team performance is described. First, a theoretical model of team performance is outlined and then a version of Hierarchical Task Analysis specially adapted to analysing team tasks is described. The two are then combined into an event-related measurement scheme, which provides a set of objective criteria by which key team skills can be assessed. The method is illustrated by an example from a basic Anti-Submarine Warfare training exercise which forms part of the Principal Warfare Officer's course at the Royal Naval School of Maritime Operations. The potential of the method is discussed, including the opportunities it may provide for the standardization of team performance assessment and in the use of new technology in the partial automation of shore-based and ship-board team training.

  4. Serious adverse events after HPV vaccination: a critical review of randomized trials and post-marketing case series.

    Science.gov (United States)

    Martínez-Lavín, Manuel; Amezcua-Guerra, Luis

    2017-10-01

    This article critically reviews HPV vaccine serious adverse events described in pre-licensure randomized trials and in post-marketing case series. HPV vaccine randomized trials were identified in PubMed. Safety data were extracted. Post-marketing case series describing HPV immunization adverse events were reviewed. Most HPV vaccine randomized trials did not use inert placebo in the control group. Two of the largest randomized trials found significantly more severe adverse events in the tested HPV vaccine arm of the study. Compared to 2871 women receiving aluminum placebo, the group of 2881 women injected with the bivalent HPV vaccine had more deaths on follow-up (14 vs. 3, p = 0.012). Compared to 7078 girls injected with the 4-valent HPV vaccine, 7071 girls receiving the 9-valent dose had more serious systemic adverse events (3.3 vs. 2.6%, p = 0.01). For the 9-valent dose, our calculated number needed to seriously harm is 140 (95% CI, 79-653). The number needed to vaccinate is 1757 (95% CI, 131 to infinity). Practically, none of the serious adverse events occurring in any arm of both studies were judged to be vaccine-related. Pre-clinical trials, post-marketing case series, and the global drug adverse reaction database (VigiBase) describe similar post-HPV immunization symptom clusters. Two of the largest randomized HPV vaccine trials unveiled more severe adverse events in the tested HPV vaccine arm of the study. Nine-valent HPV vaccine has a worrisome number needed to vaccinate/number needed to harm quotient. Pre-clinical trials and post-marketing case series describe similar post-HPV immunization symptoms.

  5. Do great teams think alike? An examination of team mental models and their impact on team performance.

    Science.gov (United States)

    Gardner, Aimee K; Scott, Daniel J; AbdelFattah, Kareem R

    2017-05-01

    Team mental models represent the shared understanding of team members within their relevant environment. Thus, team mental models should have a substantial impact on a team's ability to engage in purposeful and coordinated action. We sought to examine the impact of shared team mental models on team performance and to investigate if team mental models increase over time as teams continue to work together. New surgery interns were assigned randomly to 1 of 10 teams. Each team participated in one unique simulation every day for 5 days, each followed by video-based debriefing with a facilitator. Participants also completed independently a concept similarity tool validated previously in nonmedical team literature to assess team mental models. All performances were video recorded and evaluated with a scenario-specific team performance tool by a single, blinded junior surgeon under an institutional review board-approved protocol. Changes in performance and team mental models over time were assessed with paired samples t tests. Regression analysis was used to examine the extent to which team mental models predicted team performance. Thirty interns (age 27; 77% men) participated in the training program. Percentage of items achieved (x¯ ± SD) on the performance evaluation was 39 ± 20, 51 ± 14, 22 ± 17, 63 ± 14, and 77 ± 25 for Days 1-5, respectively. Team mental models were 30 ± 5, 28 ± 6, 27 ± 8, 26 ± 7, and 25 ± 6 for Days 1-5 respectively, such that larger values corresponded to greater differences in team mental models. Paired sample t tests indicated that both average performance and team mental models similarity improved from the first to last day (P team mental models predicted team performance on Days 2-5 (all P team mental models among the teams leads to better team performance. Additionally, the increase in team mental models over time suggests that engaging in team-based simulation may catalyze the process by which surgery

  6. Outbursts of anger as a trigger of acute cardiovascular events: a systematic review and meta-analysis†

    Science.gov (United States)

    Mostofsky, Elizabeth; Penner, Elizabeth Anne; Mittleman, Murray A.

    2014-01-01

    Aim Short-term psychological stress is associated with an immediate physiological response and may be associated with a transiently higher risk of cardiovascular events. The aim of this study was to determine whether brief episodes of anger trigger the onset of acute myocardial infarction (MI), acute coronary syndromes (ACS), ischaemic and haemorrhagic stroke, and ventricular arrhythmia. Methods and results We performed a systematic review of studies evaluating whether outbursts of anger are associated with the short-term risk of heart attacks, strokes, and disturbances in cardiac rhythm that occur in everyday life. We performed a literature search of the CINAHL, Embase, PubMed, and PsycINFO databases from January 1966 to June 2013 and reviewed the reference lists of retrieved articles and included meeting abstracts and unpublished results from experts in the field. Incidence rate ratios and 95% confidence intervals were calculated with inverse-variance-weighted random-effect models. The systematic review included nine independent case-crossover studies of anger outbursts and MI/ACS (four studies), ischaemic stroke (two studies), ruptured intracranial aneurysm (one study), and ventricular arrhythmia (two studies). There was evidence of substantial heterogeneity between the studies (I2 = 92.5% for MI/ACS and 89.8% for ischaemic stroke). Despite the heterogeneity, all studies found that, compared with other times, there was a higher rate of cardiovascular events in the 2h following outbursts of anger. Conclusion There is a higher risk of cardiovascular events shortly after outbursts of anger. PMID:24591550

  7. Enhancing the effectiveness of team debriefings in medical simulation: more best practices.

    Science.gov (United States)

    Lyons, Rebecca; Lazzara, Elizabeth H; Benishek, Lauren E; Zajac, Stephanie; Gregory, Megan; Sonesh, Shirley C; Salas, Eduardo

    2015-03-01

    Teamwork is a vital component of optimal patient care. In both clinical settings and medical education, a variety of approaches are used for the development of teamwork skills. Yet, for team members to receive the full educational benefit of these experiential learning opportunities, postsimulation feedback regarding the team's performance must be incorporated. Debriefings are among the most widely used form of feedback regarding team performance. A team debriefing is a facilitated or guided dialogue that takes place between team members following an action period to review and reflect on team performance. Team members discuss their perceptions of what occurred, why it occurred, and how they can enhance their performance. Simulation debriefing allows for greater control and planning than are logistically feasible for on-the-job performance. It is also unique in that facilitators of simulation-based training are generally individuals external to the team, whereas debriefing on the job is commonly led by an internal team member or conducted without a specified facilitator. Consequently, there is greater opportunity for selecting and training facilitators for team simulation events. Thirteen Best Practices: The 13 best practices, extracted from existing training and debriefing research, are organized under three general categories: (1) preparing for debriefing, (2) facilitator responsibilities during debriefing, and (3) considerations for debriefing content. For each best practice, considerations and practical implications are provided to facilitate the implementation of the recommended practices. The 13 best practices presented in this article should help health care organizations by guiding team simulation administrators, self-directed medical teams, and debriefing facilitators in the optimization of debriefing to support learning for all team members.

  8. Event soil loss, runoff and the Universal Soil Loss Equation family of models: A review

    Science.gov (United States)

    Kinnell, P. I. A.

    2010-05-01

    SummaryThe Universal Soil Loss Equation (USLE) is the most widely used and misused prediction equation in the world. Although it was designed to predict long-term average annual soil loss, it has the capacity to predict event soil losses reasonably well at some geographic locations and not well at others. Its lack of capacity to predict event erosion is highly influenced by the fact the event rainfall-runoff factor used in the USLE and its revisions (RUSLE, RUSLE2) does not consider runoff explicitly. While including direct consideration of runoff in the event rainfall-runoff factor improves the capacity to predict event erosion when runoff is measured, that capacity is reduced by inaccurate runoff prediction methods. Even so, the predictions may be better than when the traditional event rainfall-runoff factor is used if the rainfall-runoff model used to predict runoff works reasonably well. Direct consideration of runoff in the rainfall-runoff factor may improve the ability of the model to account for seasonal effects. It also enhances the ability of the model to account for the spatial variations in soil loss on hillslopes which result from spatial variations in soil and vegetation. However, the USLE model will not provide a capacity to account for deposition taking place on concave hillslopes unless it is coupled with an appropriate sediment transport model, as in done in RUSLE2. Changing the basis of the event rainfall-runoff factor has consequences on a number of the other factors used in the model, in particular new values of the soil erodibility factor need to be determined. Using runoff values from cropped areas is necessary to account for differences in infiltration capacities between vegetated and tilled bare fallow areas, but requires re-evaluation of the crop factors.

  9. Event-related potentials elicited by social commerce and electronic-commerce reviews

    OpenAIRE

    Bai, Yan; Yao, Zhong; Cong, Fengyu; Zhang, Linlin

    2015-01-01

    There is an increasing interest regarding the use of electroencephalography (EEG) in social commerce and electronic commerce (e-commerce) research. There are several reviews in the field of social commerce or e-commerce; these have great potential value and mining them is fundamental and significant. To our knowledge, EEG is rarely applied to study these. In this study, we examined the neural correlates of social commerce reviews (SCRs) and e-commerce reviews (ECRs) by using them as stimuli t...

  10. Use of probiotics to correct dysbiosis of normal microbiota following disease or disruptive events: a systematic review

    Science.gov (United States)

    McFarland, Lynne V

    2014-01-01

    Objective To assess the evidence for the claim probiotics can correct dysbiosis of the normal microbiota resulting from disease or disruptive events. Setting Systematic review of published clinical trials of patients receiving a probiotic intervention for the prevention or treatment of various diseases. Data sources Sources searched (1985–2013): PubMed, EMBASE, Cochrane Database of Systematic Reviews, CINAHL, AMED and ISI Web of Science. Three on-line clinical trial registries were searched: Cochrane Central Register of Controlled trials, MetaRegister of Controlled Trials and National Institutes of Health. Review methods Included studies were randomised clinical trials of probiotic interventions having microbiological assays. Studies were evaluated following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for specific probiotic strains. A standard data extraction form was used to collect the raw data. Outcome measures The primary outcome is the degree of microbiota correction by specific probiotic strains. Secondary outcome was the association between the degree of dysbiosis correction and clinical efficacy. Results The review of the literature found three distinct study designs: model A (restoration) assayed patients enrolled with a healthy, undisturbed microbiota and then assayed postdisruptive event and probiotic therapy; model B (alteration) assayed patients with pre-existing disrupted microbiota and then postprobiotic therapy; model C (no dysbiosis) assayed volunteers with no disruptive event prebiotic and postprobiotic. From a total of 63 trials, 83% of the probiotic products using model A restored the microbiota, 56% using model B improved the microbiota and only 21% using model C had any effect on microbiota. Clinical efficacy was more commonly associated with strains capable of restoration of the normal microbiota. Conclusions The ability to assess the degree of dysbiosis improvement is dependent on the enrolled population

  11. Adverse events from spinal manipulation in the pregnant and postpartum periods: a critical review of the literature

    Directory of Open Access Journals (Sweden)

    Stuber Kent

    2012-03-01

    Full Text Available Abstract Background The safety of spinal manipulation during pregnancy and the postpartum periods has been a matter of debate among manual therapists. Spinal manipulative therapy during these periods is a commonly performed intervention as musculoskeletal pain is common in these patients. To date there has not been an evaluation of the literature on this topic exclusively. Methods A literature search was conducted on PubMed, CINAHL and the Index to Chiropractic Literature along with reference searching for articles published in English and French in the peer-reviewed literature that documented adverse effects of spinal manipulation during either pregnancy or postpartum. Case reports, case series, and any other clinical study designs were deemed acceptable for inclusion, as were systematic reviews. The appropriate Scottish Intercollegiate Guidelines Network (SIGN tools were used to rate included articles for quality when applicable. Results Five articles identifying adverse events in seven subjects following spinal manipulation were included in this review, along with two systematic reviews. The articles were published between 1978 and 2009. Two articles describing adverse effects from spinal manipulation on two postpartum patients were included, while the remaining three articles on five patients with adverse effects following spinal manipulation were on pregnant patients. Injury severity ranged from minor injury such as increasing pain after treatment that resolved within a few days to more severe injuries including fracture, stroke, and epidural hematoma. SIGN scores of the prospective observational cohort study and systematic reviews indicated acceptable quality. Conclusions There are only a few reported cases of adverse events following spinal manipulation during pregnancy and the postpartum period identified in the literature. While improved reporting of such events is required in the future, it may be that such injuries are relatively rare.

  12. Short-term heat acclimation training improves physical performance: a systematic review, and exploration of physiological adaptations and application for team sports.

    Science.gov (United States)

    Chalmers, Samuel; Esterman, Adrian; Eston, Roger; Bowering, K Jane; Norton, Kevin

    2014-07-01

    met the inclusion criteria of the review. STHA training can be applied in the team-sport environment during a range of instances within the competitive season. A mixed high-intensity protocol may only require five sessions with a duration of 60 min to potentially improve aerobic-based performance in trained athletes.

  13. 2013 Immune Risk Standing Review Panel Evidence Review for: The Risk of Crew Adverse Health Event Due to Altered Immune Response

    Science.gov (United States)

    Steinberg, Susan

    2014-01-01

    The 2013 Immune Risk Standing Review Panel (from here on referred to as the SRP) met for a site visit in Houston, TX on February 3-4, 2014. The SRP reviewed the new Evidence Report for the Risk of Crew Adverse Health Event Due to Altered Immune Response (from here on referred to as the 2013 Immune Evidence Report), as well as the Research Plan for this Risk that is in the current version of the Human Research Program’s (HRP) Integrated Research Plan (IRP).

  14. A Systematic Review of the Use of the Palliative Care Outcome Scale and the Support Team Assessment Schedule in Palliative Care.

    Science.gov (United States)

    Collins, Emily S; Witt, Jana; Bausewein, Claudia; Daveson, Barbara A; Higginson, Irene J; Murtagh, Fliss E M

    2015-12-01

    The Palliative care Outcome Scale (POS) and the Support Team Assessment Schedule (STAS) are two outcome measures used in palliative care settings to assess palliative concerns, needs, and quality of care. This systematic review builds on the findings of a previous review to appraise the use of the POS and STAS since 2010, particularly the context and nature of their use. MEDLINE, Embase, PsycINFO, British Nursing Index, and CINAHL were searched for studies published between February 2010 and June 2014. Relevant authors were contacted, and reference lists of included studies were searched. Studies reporting validation or the use of the POS or STAS were included, and data on sample population, how the outcome measure was being used, study design, study aim, and results of the study were extracted. Forty-three studies were included (POS n = 35, STAS n = 8). There was an increase in the use of the POS and STAS in Europe and Africa with the publication of 13 new translations of the POS. Most studies focused on the use, rather than further validation, of the POS and STAS. There has been increasing use of these measures within non-cancer patient groups. The POS and STAS are now used in a wide variety of settings and countries. These tools may be used in the future to compare palliative care needs and quality of care across diverse contexts and patient groups. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  15. The human impact of volcanoes: a historical review of events 1900-2009 and systematic literature review

    National Research Council Canada - National Science Library

    Doocy, Shannon; Daniels, Amy; Dooling, Shayna; Gorokhovich, Yuri

    2013-01-01

    .... The objectives of this review are to describe the impact of volcanoes on the human population, in terms of mortality, injury, and displacement and, to the extent possible, identify risk factors...

  16. Effectiveness of current policing-related mental health interventions in England and Wales and Crisis Intervention Teams as a future potential model: a systematic review.

    Science.gov (United States)

    Kane, Eddie; Evans, Emily; Shokraneh, Farhad

    2017-04-17

    Experiencing mental ill health adds a layer of complexity for individuals in touch with the justice system and for those responsible for working in the justice service with these individuals, such as frontline police officers. In England and Wales, there are three commonly used but not necessarily commonly designed or operated, mental health interventions associated with policing, Liaison and Diversion, Street Triage and specialist staff embedded in Police Contact Control Rooms. A fourth US designed model, Crisis Intervention Teams (CITs), is now attracting some interest in England and Wales, and these four are to be considered in this review. A fifth intervention, Mental Health Courts, was trialed but has now been abandoned in England and Wales and so has been excluded, but remains in use elsewhere. In recent years, there has been an increase in the level of investment related to these intervention options. This has largely been without an evidence base being available to aid design, structure, and consistency of approach. The review will address this gap and provide a systematic review of each of these options. This will provide a baseline of research evidence for those who commission and provide services for individuals experiencing mental ill health and who are in contact with the justice system. Twenty-nine relevant databases and sources have been selected which will be systematically searched to locate relevant studies. These studies have to meet the set inclusion criteria which require them to report an objective outcome measure(s) in respect of offending or mental health outcomes and to have an experimental or quasi-experimental design including a comparator group(s) or a pre/post comparison. The review will exclude PhD theses, papers in non-English languages and papers published prior to 1980. Keywords have been collected through canvassing experts' opinion, literature review, controlled vocabulary and reviewing the results of a primary scoping review

  17. Work stress and the risk of recurrent coronary heart disease events: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Jian Li

    2015-02-01

    Full Text Available Though much evidence indicates that work stress increases the risk of incident of coronary heart disease (CHD, little is known about the role of work stress in the development of recurrent CHD events. The objective of this study was to review and synthesize the existing epidemiological evidence on whether work stress increases the risk of recurrent CHD events in patients with the first CHD. A systematic literature search in the PubMed database (January 1990 – December 2013 for prospective studies was performed. Inclusion criteria included: peer-reviewed English papers with original data, studies with substantial follow-up (> 3 years, end points defined as cardiac death or nonfatal myocardial infarction, as well as work stress assessed with reliable and valid instruments. Meta-analysis using random-effects modeling was conducted in order to synthesize the observed effects across the studies. Five papers derived from 4 prospective studies conducted in Sweden and Canada were included in this systematic review. The measurement of work stress was based on the Demand- Control model (4 papers or the Effort-Reward Imbalance model (1 paper. According to the estimation by meta-analysis based on 4 papers, a significant effect of work stress on the risk of recurrent CHD events (hazard ratio: 1.65, 95% confidence interval: 1.23–2.22 was observed. Our findings suggest that, in patients with the first CHD, work stress is associated with an increased relative risk of recurrent CHD events by 65%. Due to the limited literature, more well-designed prospective research is needed to examine this association, in particular, from other than western regions of the world.

  18. Work stress and the risk of recurrent coronary heart disease events: A systematic review and meta-analysis.

    Science.gov (United States)

    Li, Jian; Zhang, Min; Loerbroks, Adrian; Angerer, Peter; Siegrist, Johannes

    2015-01-01

    Though much evidence indicates that work stress increases the risk of incident of coronary heart disease (CHD), little is known about the role of work stress in the development of recurrent CHD events. The objective of this study was to review and synthesize the existing epidemiological evidence on whether work stress increases the risk of recurrent CHD events in patients with the first CHD. A systematic literature search in the PubMed database (January 1990 - December 2013) for prospective studies was performed. Inclusion criteria included: peer-reviewed English papers with original data, studies with substantial follow-up (> 3 years), end points defined as cardiac death or nonfatal myocardial infarction, as well as work stress assessed with reliable and valid instruments. Meta-analysis using random-effects modeling was conducted in order to synthesize the observed effects across the studies. Five papers derived from 4 prospective studies conducted in Sweden and Canada were included in this systematic review. The measurement of work stress was based on the Demand- Control model (4 papers) or the Effort-Reward Imbalance model (1 paper). According to the estimation by meta-analysis based on 4 papers, a significant effect of work stress on the risk of recurrent CHD events (hazard ratio: 1.65, 95% confidence interval: 1.23-2.22) was observed. Our findings suggest that, in patients with the first CHD, work stress is associated with an increased relative risk of recurrent CHD events by 65%. Due to the limited literature, more well-designed prospective research is needed to examine this association, in particular, from other than western regions of the world. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  19. Instruments to Identify Prescription Medication Misuse, Abuse, and Related Events in Clinical Trials: An ACTTION Systematic Review.

    Science.gov (United States)

    Smith, Shannon M; Paillard, Florence; McKeown, Andrew; Burke, Laurie B; Edwards, Robert R; Katz, Nathaniel P; Papadopoulos, Elektra J; Rappaport, Bob A; Slagle, Ashley; Strain, Eric C; Wasan, Ajay D; Turk, Dennis C; Dworkin, Robert H

    2015-05-01

    Measurement of inappropriate medication use events (eg, abuse or misuse) in clinical trials is important in characterizing a medication's abuse potential. However, no gold standard assessment of inappropriate use events in clinical trials has been identified. In this systematic review, we examine the measurement properties (ie, content validity, cross-sectional reliability and construct validity, longitudinal construct validity, ability to detect change, and responder definitions) of instruments assessing inappropriate use of opioid and nonopioid prescription medications to identify any that meet U.S. and European regulatory agencies' rigorous standards for outcome measures in clinical trials. Sixteen published instruments were identified, most of which were not designed for the selected concept of interest and context of use. For this reason, many instruments were found to lack adequate content validity (or documentation of content validity) to evaluate current inappropriate medication use events; for example, evaluating inappropriate use across the life span rather than current use, including items that did not directly assess inappropriate use (eg, questions about anger), or failing to capture information pertinent to inappropriate use events (eg, intention and route of administration). In addition, the psychometric data across all instruments were generally limited in scope. A further limitation is the heterogeneous, nonstandardized use of inappropriate medication use terminology. These observations suggest that available instruments are not well suited for assessing current inappropriate medication use within the specific context of clinical trials. Further effort is needed to develop reliable and valid instruments to measure current inappropriate medication use events in clinical trials. This systematic review evaluates the measurement properties of inappropriate medication use (eg, abuse or misuse) instruments to determine whether any meet regulatory

  20. EPA Region 7 and Four States Water Quality Standards Review Process Kaizen Event Case Study

    Science.gov (United States)

    In June, 2007, participants from EPA headquarters, EPA Region 7, and the four States in EPA Region 7 (IA, KS, MO, and NE) conducted a Lean business kaizen event on the EPA–State process for developing and revising water quality standards (WQS).

  1. Patient record review of the incidence, consequences, and causes of diagnostic adverse events

    NARCIS (Netherlands)

    Zwaan, L.; de Bruijne, M.; Wagner, C.; Thijs, A.; Smits, M.; van der Wal, G.; Timmermans, D.R.M.

    2010-01-01

    Background: Diagnostic errors often result in patient harm. Previous studies have shown that there is large variability in results in different medical specialties. The present study explored diagnostic adverse events (DAEs) across all medical specialties to determine their incidence and to gain

  2. Patient record review of the incidence, consequences, and causes of diagnostic adverse events.

    NARCIS (Netherlands)

    Zwaan, L.; Bruijne, M. de; Wagner, C.; Thijs, A.; Smits, M.; Wal, G. van der; Timmermans, D.R.M.

    2010-01-01

    Background: Diagnostic errors often result in patient harm. Previous studies have shown that there is large variability in results in different medical specialties. The present study explored diagnostic adverse events (DAEs) across all medical specialties to determine their incidence and to gain

  3. Adverse Events in the Netherlands Vaccination Programme : Reports in 2010 and Review 1994-2010

    NARCIS (Netherlands)

    Vermeer-de Bondt PE; Moorer-Lanser N; PHaff TAJ; Oostvogels B; Wesselo C; van der Maas NAT; LCI; cib

    2012-01-01

    In 2010, 800,000 children received one or more vaccines on 1.3 million dates, with more than 7 million vaccine components. There is always some chance of adverse reactions but these are usually not severe, though sometimes frightening. This year, RIVM received 1380 reports of adverse events

  4. Forest operations, extreme flooding events, and considerations for hydrologic modeling in the Appalachians--A review

    Science.gov (United States)

    M.A. Eisenbies; W.M. Aust; J.A. Burger; M.B. Adams

    2007-01-01

    The connection between forests and water resources is well established, but the relationships among controlling factors are only partly understood. Concern over the effects of forestry operations, particularly harvesting, on extreme flooding events is a recurrent issue in forest and watershed management. Due to the complexity of the system, and the cost of installing...

  5. INTRATHECAL BACLOFEN OVERDOSE - REPORT OF 7 EVENTS IN 5 PATIENTS AND REVIEW OF THE LITERATURE

    NARCIS (Netherlands)

    DELHAAS, EM; BROUWERS, JRBJ

    This study is intended to alert the clinician to the insidious symptoms of baclofen overdose, its prevention and treatment. In a group of 43 patients suffering from previously intractable spasticity and a total treatment time of 2,422 weeks, 7 events of intrathecal baclofen overdose happened in 5

  6. Review FRB Event Rate Predictions for the Ooty Wide Field Array

    Indian Academy of Sciences (India)

    ing models, (b) the minimum total energy required to detect events, (c) the redshift distribution and (d) the detection rates of FRBs for the ... the scattering model I and remain flat and extend up to high redshifts (z ≲ 5) for the scattering model II. Keywords. ... FRBs often show ∼5−20 times excess DMs compared to what is ...

  7. Costs of clinical events in diabetes type 2 patients in The Netherlands: A systematic review

    NARCIS (Netherlands)

    Van Schoonhoven, A.; De Vries, M.; Gout-Zwart, J.; Vemer, P.; Van Boven, J.; Dvortsin, E.; Postma, M.J.

    2017-01-01

    Objectives: Diabetes mellitus type 2 (T2DM) is an established risk factor for vascular complications, cardiovascular events, and kidney failure. Prevalence of T2DM is expected to be as high as 8% in the year 2025. This will result in significant clinical impact and increases in healthcare

  8. Accumulation of adverse childhood events and overweight in children : A systematic review and meta-analysis

    NARCIS (Netherlands)

    Elsenburg, Leonie K.; van Wijk, Kim J.E.; Liefbroer, Aart C.; Smidt, Nynke

    2017-01-01

    Objective: This study systematically summarizes the evidence of all observational studies investigating the relation between accumulation of adverse life events and measures of overweight in children <18 years. Methods: MEDLINE, Embase, PsycINFO, and CINAHL were systematically searched (last search

  9. Neuropsychiatric Adverse Events of Varenicline A Systematic Review of Published Reports

    NARCIS (Netherlands)

    Ahmed, Amir I. A.; Ali, Abdullah N. A.; Kramers, Cees; Harmark, Linda V. D.; Burger, David M.; Verhoeven, Willem M. A.

    Introduction: Over the past years, the impact of varenicline in patients with mental illness has been debated as serious neuropsychiatric adverse events (AEs) have been reported with varenicline use. Aim: To identify and summarize published case reports of neuropsychiatric AEs ascribed to

  10. Trust in Diverse Teams

    DEFF Research Database (Denmark)

    Clausen, Lisbeth

    Multicultural membership and diversity in teams are important to maintain effectiveness in organizations in a global business environment. Multicultural teams offer great potential in international collaboration just as top management teams are becoming increasingly diversified. However......, maintaining team cohesiveness in multicultural teams to collaborate effectively presents a number of challenges. The present study employs the concept of trust to explore influences on team collaboration in high performing teams. The study is based on observation of teams in seven multinational corporations...... as nationalities, gender, functional expertise and international experience. The study contributes insights to diverse teams through a processual study of micro-processes in global organizational contexts crossing multicultural boundaries....

  11. The impact of brief team communication, leadership and team behavior training on ad hoc team performance in trauma care settings.

    Science.gov (United States)

    Roberts, Nicole K; Williams, Reed G; Schwind, Cathy J; Sutyak, John A; McDowell, Christopher; Griffen, David; Wall, Jarrod; Sanfey, Hilary; Chestnut, Audra; Meier, Andreas H; Wohltmann, Christopher; Clark, Ted R; Wetter, Nathan

    2014-02-01

    Communication breakdowns and care coordination problems often cause preventable adverse patient care events, which can be especially acute in the trauma setting, in which ad hoc teams have little time for advanced planning. Existing teamwork curricula do not address the particular issues associated with ad hoc emergency teams providing trauma care. Ad hoc trauma teams completed a preinstruction simulated trauma encounter and were provided with instruction on appropriate team behaviors and team communication. Teams completed a postinstruction simulated trauma encounter immediately afterward and 3 weeks later, then completed a questionnaire. Blinded raters rated videotapes of the simulations. Participants expressed high levels of satisfaction and intent to change practice after the intervention. Participants changed teamwork and communication behavior on the posttest, and changes were sustained after a 3-week interval, though there was some loss of retention. Brief training exercises can change teamwork and communication behaviors on ad hoc trauma teams. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Review/decide and inquiry/decide. Two approaches to decision making. Report from a team syntegrity meeting. Project RISCOM

    Energy Technology Data Exchange (ETDEWEB)

    Andersson, Kjell [ed.] [Karinta-Konsult, Taeby (Sweden)

    1998-01-01

    The meeting addressed the question how it is possible to make decision processes and risk assessment for deep repository development more transparent. The two dominant decision approaches used in Sweden and the UK, review/decide(r/d) and inquiry/decide(i/d), were discussed. The main conclusions from group discussions were: It was acknowledged that the concept of transparency includes three equally important aspects: factual issues, value issues, and stake holder`s authenticity. There is a need in both countries to bring in the best aspects of both the r/d and the i/d approaches. Both approaches seem to offer possibilities and suffer limitations with respect to the segregation of facts, uncertainties and value judgements, and some sort of combination of the two may present a valuable development. However, neither the i/d nor the r/d approach seems to provide a good framework for clarification of the value issue. Experts have dominated the decision process in both countries. There is a need for a more genuine consultation process. The Swedish EIA is evolving in this direction. The regulator should take part in the process, also at an early stage. It is important that the integrity of the regulator is maintained. Rules and responsibilities of implementers, regulators, planning authorities and other decision-makers should be established early in the process. The public should know that they have access to a process that clarifies value judgements, facts, uncertainties and questions. It is necessary for the public to know what the technical issues are, and to have the means to evaluate the authenticity of the experts. It is important that political decisions are not taken without due consideration of scientific and technical arguments. There are factors beside safety assessments which are completely legitimate to consider. An approach with intense interaction between politicians, experts and the public is needed.

  13. Competition Versus Collaboration in Health Care Teams.

    Science.gov (United States)

    Chapa, Orlando R; Fuller, Sobha M; Hernandez, Lisa J; McCray, TaShauna

    2017-05-01

    Innumerable teams have emerged in health care, spurred by the desire to improve patient quality and satisfaction, provide better population outcomes, and reduce per capita cost. Team leaders are faced with many choices in team development, such as collaboration or competition. Although each approach has unique advantages and disadvantages, is one approach better suited to building the teams needed in today's environment? This review examines these two distinct team-building approaches. A literature review of these two approaches in light of the theoretical frameworks of social identity theory and team role theory shows support for both ends of the spectrum; however, collaboration was linked more often with highly successful and effective teams. Ultimately, the literature demonstrates that collaboration is better suited to developing teamwork capable of achieving today's complex health care goals.

  14. Trauma and recent life events in individuals at ultra high risk for psychosis: review and meta-analysis.

    Science.gov (United States)

    Kraan, Tamar; Velthorst, Eva; Smit, Filip; de Haan, Lieuwe; van der Gaag, Mark

    2015-02-01

    Childhood trauma and recent life-events have been related to psychotic disorders. The aim of the present study was to examine whether childhood trauma and recent life-events are significantly more prevalent in patients at Ultra High Risk (UHR) of developing a psychotic disorder compared to healthy controls. A search of PsychInfo and Embase was conducted, relevant papers were reviewed, and three random-effects meta-analyses were performed. One meta-analysis assessed the prevalence rate of childhood trauma in UHR subjects and two meta-analyses were conducted to compare UHR subjects and healthy control subjects on the experience of childhood trauma and recent life-events. We found 12 studies on the prevalence of (childhood) trauma in UHR populations and 4 studies on recent life-events in UHR populations. We performed a meta-analysis on 6 studies (of which trauma prevalence rates were available) on childhood trauma in UHR populations, yielding a mean prevalence rate of 86.8% (95% CI 77%-93%). Childhood trauma was significantly more prevalent in UHR subjects compared to healthy control groups (Random effects Hedges' g=1.09; Z=4.60, pchildhood trauma is highly prevalent among UHR subjects and that childhood trauma is related to UHR status. These results are in line with studies on childhood trauma in psychotic populations. In contrast to studies on recent life-events in psychotic populations, our results show that recent life-events are not associated with UHR status. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Statins and interstitial lung disease: a systematic review of the literature and of food and drug administration adverse event reports.

    Science.gov (United States)

    Fernández, Antonio B; Karas, Richard H; Alsheikh-Ali, Alawi A; Thompson, Paul D

    2008-10-01

    To systematically review all published case reports and the US Food and Drug Administration adverse event reporting (FDA-AER) database to examine the relationship between statins and interstitial lung disease (ILD). PubMed (1987 to September 2007) and the FDA-AER database (as of June 2007) were searched for reports of ILD in which a statin was listed as a causative suspect. Two authors (one author for Pub Med cases and one for FDA-AER cases) independently abstracted patient data. Given the paucity of information, all case reports and case series in English and French were included. All adverse event reports from the FDA-AER database in which a statin was listed as causative suspect were included. The literature search using PubMed yielded eight articles describing a total of 14 case reports of ILD in association with statin use. The FDA-AER system database contained 162 cases of reported statin-induced ILD as of June 2007. For every 10,000 reports of a statin-associated adverse event, approximately 1 to 40 reports were for ILD. Statin-induced ILD is a possible newly recognized side effect of statin therapy. The mechanism of lung injury is not defined. The current review provides novel information from the FDA-AER that supports a possible, although unusual, pulmonary class effect of statins.

  16. Review of the Oconee-3 probabilistic risk assessment: external events, core damage frequency. Volume 2

    Energy Technology Data Exchange (ETDEWEB)

    Hanan, N.A.; Ilberg, D.; Xue, D.; Youngblood, R.; Reed, J.W.; McCann, M.; Talwani, T.; Wreathall, J.; Kurth, P.D.; Bandyopadhyay, K.

    1986-03-01

    A review of the Oconee-3 Probabilistic Risk Assessment (OPRA) was conducted with the broad objective of evaluating qualitatively and quantitatively (as much as possible) the OPRA assessment of the important sequences that are ''externally'' generated and lead to core damage. The review included a technical assessment of the assumptions and methods used in the OPRA within its stated objective and with the limited information available. Within this scope, BNL performed a detailed reevaluation of the accident sequences generated by internal floods and earthquakes and a less detailed review (in some cases a scoping review) for the accident sequences generated by fires, tornadoes, external floods, and aircraft impact. 12 refs., 24 figs., 31 tabs.

  17. Epidermal Growth Factor Receptor Inhibitors: A Review of Cutaneous Adverse Events and Management

    Directory of Open Access Journals (Sweden)

    K. Chanprapaph

    2014-01-01

    Full Text Available Epidermal growth factor inhibitors (EGFRI, the first targeted cancer therapy, are currently an essential treatment for many advance-stage epithelial cancers. These agents have the superior ability to target cancers cells and better safety profile compared to conventional chemotherapies. However, cutaneous adverse events are common due to the interference of epidermal growth factor receptor (EGFR signaling in the skin. Cutaneous toxicities lead to poor compliance, drug cessation, and psychosocial discomfort. This paper summarizes the current knowledge concerning the presentation and management of skin toxicity from EGFRI. The common dermatologic adverse events are papulopustules and xerosis. Less common findings are paronychia, regulatory abnormalities of hair growth, maculopapular rash, mucositis, and postinflammatory hyperpigmentation. Radiation enhances EGFRI rash due to synergistic toxicity. There is a positive correlation between the occurrence and severity of cutaneous adverse effects and tumor response. To date, prophylactic systemic tetracycline and tetracycline class antibiotics have proven to be the most effective treatment regime.

  18. Code Team Training: Demonstrating Adherence to AHA Guidelines During Pediatric Code Blue Activations.

    Science.gov (United States)

    Stewart, Claire; Shoemaker, Jamie; Keller-Smith, Rachel; Edmunds, Katherine; Davis, Andrew; Tegtmeyer, Ken

    2017-10-16

    Pediatric code blue activations are infrequent events with a high mortality rate despite the best effort of code teams. The best method for training these code teams is debatable; however, it is clear that training is needed to assure adherence to American Heart Association (AHA) Resuscitation Guidelines and to prevent the decay that invariably occurs after Pediatric Advanced Life Support training. The objectives of this project were to train a multidisciplinary, multidepartmental code team and to measure this team's adherence to AHA guidelines during code simulation. Multidisciplinary code team training sessions were held using high-fidelity, in situ simulation. Sessions were held several times per month. Each session was filmed and reviewed for adherence to 5 AHA guidelines: chest compression rate, ventilation rate, chest compression fraction, use of a backboard, and use of a team leader. After the first study period, modifications were made to the code team including implementation of just-in-time training and alteration of the compression team. Thirty-eight sessions were completed, with 31 eligible for video analysis. During the first study period, 1 session adhered to all AHA guidelines. During the second study period, after alteration of the code team and implementation of just-in-time training, no sessions adhered to all AHA guidelines; however, there was an improvement in percentage of sessions adhering to ventilation rate and chest compression rate and an improvement in median ventilation rate. We present a method for training a large code team drawn from multiple hospital departments and a method of assessing code team performance. Despite subjective improvement in code team positioning, communication, and role completion and some improvement in ventilation rate and chest compression rate, we failed to consistently demonstrate improvement in adherence to all guidelines.

  19. Wheeze as an Adverse Event in Pediatric Vaccine and Drug Randomized Controlled Trials: A Systematic Review

    Science.gov (United States)

    Marangu, Diana; Kovacs, Stephanie; Walson, Judd; Bonhoeffer, Jan; Ortiz, Justin R.; John-Stewart, Grace; Horne, David J.

    2016-01-01

    Introduction Wheeze is an important sign indicating a potentially severe adverse event in vaccine and drug trials, particularly in children. However, there are currently no consensus definitions of wheeze or associated respiratory compromise in randomized controlled trials (RCTs). Objective To identify definitions and severity grading scales of wheeze as an adverse event in vaccine and drug RCTs enrolling children Vaccines made up the majority (90%) of interventions, particularly influenza vaccines (65%). Only 15 trials provided explicit definitions of wheeze. Of 24 studies that described severity, 11 described wheeze severity in the context of an explicit wheeze definition. The remaining 13 studies described wheeze severity where wheeze was defined as part of a respiratory illness or a wheeze equivalent. Wheeze descriptions were elicited from caregiver reports (14%), physical examination by a health worker (45%) or a combination (41%). There were 21/58 studies in which wheeze definitions included combined caregiver report and healthcare worker assessment. The use of these two methods appeared to have the highest combined sensitivity and specificity. Conclusion Standardized wheeze definitions and severity grading scales for use in pediatric vaccine or drug trials are lacking. Standardized definitions of wheeze are needed for assessment of possible adverse events as new vaccines and drugs are evaluated. PMID:26319071

  20. Perceptions of teamwork among code team members.

    Science.gov (United States)

    Mahramus, Tara; Frewin, Sarah; Penoyer, Daleen Aragon; Sole, Mary Lou

    2013-01-01

    Cardiopulmonary arrest (CPA) teams, known as code teams, provide coordinated and evidenced-based interventions by various disciplines during a CPA. Teamwork behaviors are essential during CPA resuscitation and may have an impact on patient outcomes. The purpose of this study was to explore the perceptions of teamwork during CPA events among code team members and to determine if differences in perception existed between disciplines within the code team. A prospective, descriptive, comparative design using the Code Teamwork Perception Tool online survey was used to assess the perception of teamwork during CPA events by medical residents, critical care nurses, and respiratory therapists. Sixty-six code team members completed the Code Teamwork Perception Tool. Mean teamwork scores were 2.63 on a 5-point scale (0-4). No significant differences were found in mean scores among disciplines. Significant differences among scores were found on 7 items related to code leadership, roles and responsibilities between disciplines, and in those who had participated on a code team for less than 2 years and certified in Advanced Cardiac Life Support for less than 4 years. Teamwork perception among members of the code team was average. Teamwork training for resuscitation with all disciplines on the code team may promote more effective teamwork during actual CPA events. Clinical nurse specialists can aid in resuscitation efforts by actively participating on committees, identifying opportunities for improvement, being content experts, leading the development of team training programs, and conducting research in areas lacking evidence.

  1. Teaching Engineering Students Team Work

    Science.gov (United States)

    Levi, Daniel

    1998-01-01

    The purpose of this manual is to provide professor's in engineering classes which the background necessary to use student team projects effectively. This manual describes some of the characteristics of student teams and how to use them in class. It provides a set of class activities and films which can be used to introduce and support student teams. Finally, a set of teaching modules used in freshmen, sophomore, and senior aeronautical engineering classes are presented. This manual was developed as part of a NASA sponsored project to improve the undergraduate education of aeronautical engineers. The project has helped to purchase a set of team work films which can be checked out from Cal Poly's Learning Resources Center in the Kennedy Library. Research for this project has included literature reviews on team work and cooperative learning; interviews, observations, and surveys of Cal Poly students from Industrial and Manufacturing Engineering, Aeronautical Engineering and Psychology; participation in the Aeronautical Engineering senior design lab; and interviews with engineering faculty. In addition to this faculty manual, there is a student team work manual which has been designed to help engineering students work better in teams.

  2. Nonphysician Out-of-Hospital Rapid Sequence Intubation Success and Adverse Events: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Fouche, Pieter F; Stein, Christopher; Simpson, Paul; Carlson, Jestin N; Doi, Suhail A

    2017-10-01

    Rapid sequence intubation performed by nonphysicians such as paramedics or nurses has become increasingly common in many countries; however, concerns have been stated in regard to the safe use and appropriateness of rapid sequence intubation when performed by these health care providers. The aim of our study is to compare rapid sequence intubation success and adverse events between nonphysician and physician in the out-of-hospital setting. A systematic literature search of key databases including MEDLINE, EMBASE, and the Cochrane Library was conducted. Eligibility, data extraction, and assessment of risk of bias were assessed independently by 2 reviewers. A bias-adjusted meta-analysis using a quality-effects model was conducted for the primary outcomes of overall intubation success and first-pass intubation success and for adverse events when possible. Eighty-three studies were included in the meta-analysis. There was a 2% difference in successful intubation proportion for physicians versus nonphysicians, 99% (95% confidence interval [CI] 98% to 99%) versus 97% (95% CI 95% to 99%). A 10% difference in first-pass rapid sequence intubation success was noted between physicians versus nonphysicians, 88% (95% CI 83% to 93%) versus 78% (95% CI 65% to 89%). For airway trauma, bradycardia, cardiac arrest, endobronchial intubation, hypertension, and hypotension, lower prevalences of adverse events were noted for physicians. However, nonphysicians had a lower prevalence of hypoxia and esophageal intubations. Similar proportions were noted for pulmonary aspiration and emesis. Nine adverse events estimates lacked precision, except for endobronchial intubation, and 4 adverse event analyses showed evidence of possible publication bias. Consequently, no reliable evidence exists for differences between physicians and nonphysicians for adverse events. This analysis shows that physicians have a higher rapid sequence intubation first-pass and overall success, as well as mostly lower

  3. A review of the number and severity of injuries sustained following a single motocross event.

    Science.gov (United States)

    Dick, Charles G; White, Simon; Bopf, Daniel

    2014-03-01

    Competitive and recreational motocross is an increasingly popular sport in Australia and worldwide. Children as young as 4-year-old can participate in this activity. It is recognised that this is a high risk sport despite the use of protective equipment and developments in course design. Injuries sustained range from minor contusions and fractures to severe life threatening spine and head injuries in adults and the paediatric population. In addition organised events can generate a surge of trauma that can burden small local hospitals, resulting in an unpredicted increase in the workload with subsequent delays to treatment. We present the trauma workload generated in a district hospital following a single motocross event. All patients attending a district hospital emergency department with injuries sustained during a single motocross event were identified through hospital and ambulance records. The nature of their injuries and the treatment required, the length of hospital stay and operative theatre time generated by their injuries were obtained from hospital and theatre records. 14 patients attended the emergency department over a 24-hour period, requiring 5 ambulances from the scene. 7 patients required hospital admission with 7 operations performed, consuming 12.2 h of operating theatre time and 21 days of hospital beds. 2 patients sustained head injuries requiring observation, one of which was transferred to a spinal unit for management of their spinal injuries. Motocross is a popular sport and at times has unacceptable risks of injury in organised competitions, especially with regards to paediatric injuries. Better course design, restrictions on participant age and limitations in vehicle speeds may help reduce the number of severe injuries. These events can also generate a sudden trauma burden to local hospital facilities with knock on effects on waiting times for theatre and potentially compromising not only treatment of the injured participants but also

  4. A systematic review of teamwork in the intensive care unit: what do we know about teamwork, team tasks, and improvement strategies?

    Science.gov (United States)

    Dietz, Aaron S; Pronovost, Peter J; Mendez-Tellez, Pedro Alejandro; Wyskiel, Rhonda; Marsteller, Jill A; Thompson, David A; Rosen, Michael A

    2014-12-01

    Teamwork is essential for ensuring the quality and safety of health care delivery in the intensive care unit (ICU). This article addresses what we know about teamwork, team tasks, and team improvement strategies in the ICU to identify the strengths and limitations of the existing knowledge base to guide future research. A keyword search of the PubMed database was conducted in February 2013. Keyword combinations focused on 3 areas: (1) teamwork, (2) the ICU, and (3) training/quality improvement interventions. All studies that investigated teamwork, team tasks, or team interventions within the ICU (ie, intradepartment) were selected for inclusion. Teamwork has been investigated across an array of research contexts and task types. The terminology used to describe team factors varied considerably across studies. The most common team tasks involved strategy and goal formulation. Team training and structured protocols were the most widely implemented quality improvement strategies. Team research is burgeoning in the ICU, yet low-hanging fruit remains that can further advance the science of teams in the ICU if addressed. Constructs must be defined, and theoretical frameworks should be referenced. The functional characteristics of tasks should also be reported to help determine the extent to which study results might generalize to other contexts of work. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Outbursts of anger as a trigger of acute cardiovascular events: a systematic review and meta-analysis.

    Science.gov (United States)

    Mostofsky, Elizabeth; Penner, Elizabeth Anne; Mittleman, Murray A

    2014-06-01

    Short-term psychological stress is associated with an immediate physiological response and may be associated with a transiently higher risk of cardiovascular events. The aim of this study was to determine whether brief episodes of anger trigger the onset of acute myocardial infarction (MI), acute coronary syndromes (ACS), ischaemic and haemorrhagic stroke, and ventricular arrhythmia. We performed a systematic review of studies evaluating whether outbursts of anger are associated with the short-term risk of heart attacks, strokes, and disturbances in cardiac rhythm that occur in everyday life. We performed a literature search of the CINAHL, Embase, PubMed, and PsycINFO databases from January 1966 to June 2013 and reviewed the reference lists of retrieved articles and included meeting abstracts and unpublished results from experts in the field. Incidence rate ratios and 95% confidence intervals were calculated with inverse-variance-weighted random-effect models. The systematic review included nine independent case-crossover studies of anger outbursts and MI/ACS (four studies), ischaemic stroke (two studies), ruptured intracranial aneurysm (one study), and ventricular arrhythmia (two studies). There was evidence of substantial heterogeneity between the studies (I(2) = 92.5% for MI/ACS and 89.8% for ischaemic stroke). Despite the heterogeneity, all studies found that, compared with other times, there was a higher rate of cardiovascular events in the 2h following outbursts of anger. There is a higher risk of cardiovascular events shortly after outbursts of anger. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  6. Leading Strategic Leader Teams

    Science.gov (United States)

    2008-03-25

    develop teams which provide them capacity and diversity to make sound decisions.1 Strategic leader and top management teams exist throughout...looks at whether a leader should use a team to make a decision; it does not look at how to manage a team process to produce desired outcomes. Yet, the...choices on how to operate his/her team. Leaders of strategic leader teams must recognize and understand how they can manage the processes utilized

  7. A multidisciplinary team model of caring for patients with perianal Crohn's disease incorporating a literature review, topical therapy and personal practice.

    Science.gov (United States)

    Garrick, Vikki; Stenhouse, Emily; Haddock, Graham; Russell, Richard K

    2013-04-01

    Crohn's disease (CD) is characterised by periods of relapse and remission. Over time the disease leads almost inevitably to the complications of stricturing, penetration and fistulisation. Perianal CD involves areas of chronic abscess formation, ulceration, skin tags or fistula formation. This can be a particularly challenging and complex problem to manage, and a range of potential treatment modalities exist. This review covers the management of perianal CD and provides recommendations for practice for the multidisciplinary team (MDT), including the use of wound management products and relevant clinical images. Current practice focuses predominantly on the use of antibiotic therapy, immunosuppression, immunomodulation and surgery. These therapies are used individually or in combination. The majority of evidence suggests that a combination of medical and surgical management produces the best disease outcomes. However, this treatment regime can be debilitating for the patient and compliance can be difficult. Published work on the use of topical therapy in the management of perianal CD focuses specifically on topical drug therapy; it does not, however, address the basic guiding principles of chronic wound management-in particular, optimal moisture control and the management of bacterial burden on the wound surface. Honey and silver-containing wound management products act as topical antimicrobial agents and therefore address these principles. Perianal CD is the archetypal condition that exemplifies the need for an MDT approach in caring for patients with inflammatory bowel disease. A combination of treatment modalities that includes topical wound management is likely to produce the best patient outcomes.

  8. Review of the late-Holocene storm events along the European Atlantic coasts

    Science.gov (United States)

    Pouzet, Pierre; Maanan, Mohamed; Piotrowska, Natalia; Baltzer, Agnès; Stephan, Pierre

    2017-04-01

    The chronology of the mid- to late-Holocene coastal storms was reconstructed from vibracore samplings, 14C dating and sedimentary analysis from Yeu island (French Atlantic coast). The methodology used is based on the identification of disturbing sedimentary events recognized within three Holocene sedimentary transgressive sequences selected along the northern coast of the island. These sequences correspond to the present-day coastal salt-marshes and swamps. The sediment cores were centimeter-sampled and studied from several sedimentological proxies (Loss of Ignition, sand fraction, mean grain size) with a high temporal resolution. Chronology was built by age-depth model based on eleven 14C measures of organic sediments and shell samples. Ten paleo-storm events were recorded: a 2100-1950 calBP interval as a deeply stormy-disturbed period; five others major impacted times: 600-500 calBP, 2850-2350 calBP, 3500-3270 calBP, 5400-5370 calBP and 6650-6510 calBP; and four final less meaningful storminess hypothesis near 1590 calBP, 6000 calBP, 7000 calBP, and between 7670 and 7470 calBP. This chronology was compared with enhanced storminess periods recognized along the European Atlantic coast. Four stormy periods stand out from the last 4000 years: 600-300 BP, 1100-1700 BP, 2500-2900 BP and 3300-3500 BP, corresponding to late Holocene global cold events. These results suggests that these changes in coastal hydrodynamics were in phase with those identified over the North-eastern Atlantic and seem to correspond to Holocene cooling first shown in the North Atlantic and associated with decreases in sea surface temperature.

  9. Use of simulation based team training for obstetric crises in resident education.

    Science.gov (United States)

    Daniels, Kay; Lipman, Steven; Harney, Kimberly; Arafeh, Julie; Druzin, Maurice

    2008-01-01

    Obstetric crises are unexpected and random. Traditionally, medical training for these acute events has included lectures combined with arbitrary clinical experiences. This educational paradigm has inherent limitations. During actual crises insufficient time exists for discussion and analysis of patient care. Our objective was to create a simulation program to fill this experiential gap. Ten L&D teams participated in high fidelity simulation training. A team consisted of two or three nurses, one anesthesia resident and one or two obstetric residents. Each team participated in two scenarios; epidural-induced hypotension followed by an amniotic fluid embolism. Each simulation was followed by a facilitated debriefing. All simulations were videotaped. Clinical performances of the obstetric residents were graded by two reviewers using the videotapes and a faculty-developed checklist. Recurrent errors were analyzed and graded using Health Failure Modes Effects Analysis. All team members completed a course evaluation. Performance deficiencies of the obstetric residents were identified by an expert team of reviewers. From this list of errors, the "most valuable lessons" requiring further focused teaching were identified and included 1) Poor communication with the pediatric team, 2) Not assuming a leadership role during the code, 3) Poor distribution of workload, and 4) Lack of proper use of low/outlet forceps. Participants reported the simulation course allowed them to learn new skills needed by teams during a crisis. Simulated obstetric crises training offers the opportunity for educators to identify specific performance deficits of their residents and the subsequent development of teaching modules to address these weaknesses.

  10. The TIP Theory: Prescriptions for Designing Instruction for Teams.

    Science.gov (United States)

    Armstrong, Richard B.; Reigeluth, Charles M.

    1991-01-01

    Describes the Team Instructional Prescriptions (TIP) theory, which was developed to synthesize team training research into an integrated theory that defines instructional outcomes and conditions and prescribes instructional methods. Literature concerning team training is reviewed, and three models are explained that incorporate team development…

  11. How safe are recently FDA-approved antimicrobials? A review of the FDA adverse event reporting system database.

    Science.gov (United States)

    Khadem, Tina M; van Manen, Robbert P; Brown, Jack

    2014-12-01

    To review quantitatively and qualitatively the U.S. Food and Drug Administration (FDA) Adverse Event Reporting System (AERS) database to provide clinicians with a general understanding of the comparative occurrence of clinically meaningful adverse events associated with 15 antimicrobial new molecular entities approved by the FDA since 2006: anidulafungin, darunavir, maraviroc, raltegravir, doripenem, telavancin, ceftaroline, boceprevir, telaprevir, fidaxomicin, bedaquiline, dolutegravir, simeprevir, sofosbuvir, and dalbavancin. Retrospective analysis. FDA AERS database. Empirica Signal software was used to query the AERS database from November 1968 to December 2012. Using disproportionality analyses, we calculated a relative reporting ratio (RRR) estimate for reports of antimicrobial adverse events. The RRR estimate compares the occurrence of a specific adverse event with an index drug of interest to the occurrence of the same adverse event with similar agents or with all other FDA-approved prescription drugs. Common industry practice considers an RRR meaningful if the 5th percentile of the distribution is at least 2 (RRR05 of 2.0 or higher). Antimicrobials were compared with agents within their respective antimicrobial therapeutic class as well as with all agents in the AERS database. Seventeen adverse signals with an RRR05 of 2.0 or higher were identified from the database for six agents. Ten of the 17 signals were not included in the most up-to-date manufacturers' package inserts for four of the six agents: doripenem-associated hepatic dysfunction (RRR05 3.7) and hyperchloremia (RRR05 2.6); boceprevir-associated weight loss (RRR05 2.2); darunavir-associated premature labor (RRR05 3.1), sudden infant death syndrome (RRR05 2.9), ventricular hypertrophy (RRR05 2.7), acute coronary syndrome (RRR05 2.4), and congenital anomaly in offspring (RRR05 2.4); and raltegravir-associated congenital heart valve disorders (RRR05 2.5) and SIDS (RRR05 2.3). Clinically meaningful

  12. Team Learning in Teacher Teams: Team Entitativity as a Bridge between Teams-in-Theory and Teams-in-Practice

    Science.gov (United States)

    Vangrieken, Katrien; Dochy, Filip; Raes, Elisabeth

    2016-01-01

    This study aimed to investigate team learning in the context of teacher teams in higher vocational education. As teacher teams often do not meet all criteria included in theoretical team definitions, the construct "team entitativity" was introduced. Defined as the degree to which a group of individuals possesses the quality of being a…

  13. Geospatial Information Response Team

    Science.gov (United States)

    Witt, Emitt C.

    2010-01-01

    Extreme emergency events of national significance that include manmade and natural disasters seem to have become more frequent during the past two decades. The Nation is becoming more resilient to these emergencies through better preparedness, reduced duplication, and establishing better communications so every response and recovery effort saves lives and mitigates the long-term social and economic impacts on the Nation. The National Response Framework (NRF) (http://www.fema.gov/NRF) was developed to provide the guiding principles that enable all response partners to prepare for and provide a unified national response to disasters and emergencies. The NRF provides five key principles for better preparation, coordination, and response: 1) engaged partnerships, 2) a tiered response, 3) scalable, flexible, and adaptable operations, 4) unity of effort, and 5) readiness to act. The NRF also describes how communities, tribes, States, Federal Government, privatesector, and non-governmental partners apply these principles for a coordinated, effective national response. The U.S. Geological Survey (USGS) has adopted the NRF doctrine by establishing several earth-sciences, discipline-level teams to ensure that USGS science, data, and individual expertise are readily available during emergencies. The Geospatial Information Response Team (GIRT) is one of these teams. The USGS established the GIRT to facilitate the effective collection, storage, and dissemination of geospatial data information and products during an emergency. The GIRT ensures that timely geospatial data are available for use by emergency responders, land and resource managers, and for scientific analysis. In an emergency and response capacity, the GIRT is responsible for establishing procedures for geospatial data acquisition, processing, and archiving; discovery, access, and delivery of data; anticipating geospatial needs; and providing coordinated products and services utilizing the USGS' exceptional pool of

  14. Penile ossification: A traumatic event or evolutionary throwback? Case report and review of the literature.

    Science.gov (United States)

    Yilmaz, Ibrahim Edhem; Barazani, Yagil; Tareen, Basir

    2013-01-01

    Penile ossification is very rare, with only a handful of histologically confirmed reported cases. The most common condition leading to penile ossification is Peyronie's disease. Other conditions, such as gout, end-stage renal disease, diabetes mellitus, hyperparathyroidism and local trauma, have also been associated with penile ossification. We report a unique case of near-complete penile ossification of the corporal bodies with histologic confirmation on pathologic review. Our report summarizes the literature regarding this rare entity.

  15. Metamizole-Associated Adverse Events: A Systematic Review and Meta-Analysis

    OpenAIRE

    Thomas Kötter; da Costa, Bruno R.; Margrit Fässler; Eva Blozik; Klaus Linde; Peter Jüni; Stephan Reichenbach; Martin Scherer

    2017-01-01

    BACKGROUND Metamizole is used to treat pain in many parts of the world. Information on the safety profile of metamizole is scarce; no conclusive summary of the literature exists. OBJECTIVE To determine whether metamizole is clinically safe compared to placebo and other analgesics. METHODS We searched CENTRAL, MEDLINE, EMBASE, CINAHL, and several clinical trial registries. We screened the reference lists of included trials and previous systematic reviews. We included random...

  16. Disagreements between central clinical events committee and site investigator assessments of myocardial infarction end- points in an international clinical trial: Review of the PURSUIT study

    NARCIS (Netherlands)

    K.W. Mahaffey (Kenneth); R.A. Harrington (Robert Alex); K.M. Akkerhuis (Martijn); N.S. Kleiman (Neal); L.G. Berdan (Lisa); B.S. Crenshaw (Brian); B.E. Tardiff (Barbara); C.B. Granger (Christopher); I. DeJong (Ingrid); M. Bhapkar (Manju); P. Widimsky (Petr); R. Corbalon (Ramón); K.L. Lee (Kerry); J.W. Deckers (Jaap); M.L. Simoons (Maarten); E.J. Topol (Eric); R.M. Califf (Robert)

    2001-01-01

    textabstractBackground. Limited information has been published regarding how specific processes for event adjudication can affect event rates in trials. We reviewed nonfatal myocardial infarctions (MIs) reported by site investigators in the international Platelet Glycoprotein IIb/IIIa in Unstable

  17. Disagreements between central clinical events committee and site investigator assessments of myocardial infarction end-points in an international clinical trial: review of the PURSUIT study

    NARCIS (Netherlands)

    K.W. Mahaffey (Kenneth); R.A. Harrington (Robert Alex); N.S. Kleiman (Neal); L.G. Berdan (Lisa); B.S. Crenshaw (Brian); B.E. Tardiff (Barbara); C.B. Granger (Christopher); I. DeJong (Ingrid); M. Bhapkar (Manju); P. Widimsky (Petr); R. Corbalon (Ramón); K.L. Lee (Kerry); J.W. Deckers (Jaap); M.L. Simoons (Maarten); E.J. Topol (Eric); R.M. Califf (Robert); K.M. Akkerhuis (Martijn)

    2001-01-01

    textabstractAbstract: Background Limited information has been published regarding how specific processes for event adjudication can affect event rates in trials. We reviewed nonfatal myocardial infarctions (MIs) reported by site investigators in the international Platelet Glycoprotein IIb/IIIa in

  18. Postoperative Adverse Events Inconsistently Improved by the World Health Organization Surgical Safety Checklist: A Systematic Literature Review of 25 Studies.

    Science.gov (United States)

    de Jager, Elzerie; McKenna, Chloe; Bartlett, Lynne; Gunnarsson, Ronny; Ho, Yik-Hong

    2016-08-01

    The World Health Organization Surgical Safety Checklist (SSC) has been widely implemented in an effort to decrease surgical adverse events. This systematic literature review examined the effects of the SSC on postoperative outcomes. The review included 25 studies: two randomised controlled trials, 13 prospective and ten retrospective cohort trials. A meta-analysis was not conducted as combining observational studies of heterogeneous quality may be highly biased. The quality of the studies was largely suboptimal; only four studies had a concurrent control group, many studies were underpowered to examine specific postoperative outcomes and teamwork-training initiatives were often combined with the implementation of the checklist, confounding the results. The effects of the checklist were largely inconsistent. Postoperative complications were examined in 20 studies; complication rates significantly decreased in ten and increased in one. Eighteen studies examined postoperative mortality. Rates significantly decreased in four and increased in one. Postoperative mortality rates were not significantly decreased in any studies in developed nations, whereas they were significantly decreased in 75 % of studies conducted in developing nations. The checklist may be associated with a decrease in surgical adverse events and this effect seems to be greater in developing nations. With the observed incongruence between specific postoperative outcomes and the overall poor study designs, it is possible that many of the positive changes associated with the use of the checklist were due to temporal changes, confounding factors and publication bias.

  19. Advancing team-based primary health care: a comparative analysis of policies in western Canada.

    Science.gov (United States)

    Suter, Esther; Mallinson, Sara; Misfeldt, Renee; Boakye, Omenaa; Nasmith, Louise; Wong, Sabrina T

    2017-07-17

    We analyzed and compared primary health care (PHC) policies in British Columbia, Alberta and Saskatchewan to understand how they inform the design and implementation of team-based primary health care service delivery. The goal was to develop policy imperatives that can advance team-based PHC in Canada. We conducted comparative case studies (n = 3). The policy analysis included: Context review: We reviewed relevant information (2007 to 2014) from databases and websites. Policy review and comparative analysis: We compared and contrasted publically available PHC policies. Key informant interviews: Key informants (n = 30) validated narratives prepared from the comparative analysis by offering contextual information on potential policy imperatives. Advisory group and roundtable: An expert advisory group guided this work and a key stakeholder roundtable event guided prioritization of policy imperatives. The concept of team-based PHC varies widely across and within the three provinces. We noted policy gaps related to team configuration, leadership, scope of practice, role clarity and financing of team-based care; few policies speak explicitly to monitoring and evaluation of team-based PHC. We prioritized four policy imperatives: (1) alignment of goals and policies at different system levels; (2) investment of resources for system change; (3) compensation models for all members of the team; and (4) accountability through collaborative practice metrics. Policies supporting team-based PHC have been slow to emerge, lacking a systematic and coordinated approach. Greater alignment with specific consideration of financing, reimbursement, implementation mechanisms and performance monitoring could accelerate systemic transformation by removing some well-known barriers to team-based care.

  20. Exogenous testosterone, cardiovascular events, and cardiovascular risk factors in elderly men: a review of trial data.

    Science.gov (United States)

    Carson, Culley C; Rosano, Giuseppe

    2012-01-01

    Increasing interest in the use of supplemental testosterone has led to a heightened focus on the safety of testosterone in elderly males, with a particular emphasis on cardiovascular risk. To evaluate, based on available clinical trial data, whether exogenous testosterone administration in middle-aged to elderly men increases cardiovascular risk, and to assess whether these effects differ in hypogonadal vs. eugonadal subjects. MEDLINE search from 2004 to present of all meta-analyses and randomized, controlled clinical trials of testosterone administration in male subjects ≥ 45 years old that included measurements of cardiovascular outcomes or known cardiovascular risk factors before and after treatment with testosterone. The effects of testosterone treatment on cardiovascular events and cardiovascular risk factors were assessed. In clinical trials where testosterone has been used in patients with preexisting cardiovascular conditions, the effect on disease symptoms has typically been either neutral or beneficial. Based on clinical trial data, testosterone treatment has minimal effect on cardiovascular risk factors with the exception of an increase in hematocrit, which is consistently seen with testosterone treatment, and a decrease in high-density lipoprotein cholesterol, which is an inconsistent response. Responses of hypogonadal and eugonadal men to testosterone treatment in terms of cardiovascular risk are generally similar. Testosterone treatment has not been reported to increase the incidence of cardiovascular events with the possible exception of one trial in frail elderly men. Available clinical trial data indicate that the use of testosterone in middle-aged to elderly men does not increase cardiovascular risk nor does it unfavorably modify cardiovascular risk profile. Prospective data from large, well-designed, long-term trials of testosterone treatment are lacking and will be required to verify the cardiovascular efficacy/safety of chronic treatment.

  1. Use of probiotics to correct dysbiosis of normal microbiota following disease or disruptive events: a systematic review.

    Science.gov (United States)

    McFarland, Lynne V

    2014-08-25

    To assess the evidence for the claim probiotics can correct dysbiosis of the normal microbiota resulting from disease or disruptive events. Systematic review of published clinical trials of patients receiving a probiotic intervention for the prevention or treatment of various diseases. Sources searched (1985-2013): PubMed, EMBASE, Cochrane Database of Systematic Reviews, CINAHL, AMED and ISI Web of Science. Three on-line clinical trial registries were searched: Cochrane Central Register of Controlled trials, MetaRegister of Controlled Trials and National Institutes of Health. Included studies were randomised clinical trials of probiotic interventions having microbiological assays. Studies were evaluated following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for specific probiotic strains. A standard data extraction form was used to collect the raw data. The primary outcome is the degree of microbiota correction by specific probiotic strains. Secondary outcome was the association between the degree of dysbiosis correction and clinical efficacy. The review of the literature found three distinct study designs: model A (restoration) assayed patients enrolled with a healthy, undisturbed microbiota and then assayed postdisruptive event and probiotic therapy; model B (alteration) assayed patients with pre-existing disrupted microbiota and then postprobiotic therapy; model C (no dysbiosis) assayed volunteers with no disruptive event prebiotic and postprobiotic. From a total of 63 trials, 83% of the probiotic products using model A restored the microbiota, 56% using model B improved the microbiota and only 21% using model C had any effect on microbiota. Clinical efficacy was more commonly associated with strains capable of restoration of the normal microbiota. The ability to assess the degree of dysbiosis improvement is dependent on the enrolled population and the timing of microbiological assays. The functional claim for correcting

  2. Measuring severe adverse events and medication selection using a “PEER Report” for nonpsychotic patients: a retrospective chart review

    Directory of Open Access Journals (Sweden)

    Hoffman DA

    2012-06-01

    Full Text Available Daniel A Hoffman,1 Charles DeBattista,2 Rob J Valuck,3 Dan V Iosifescu41Neuro-Therapy Clinic, Inc, Denver, CO, USA; 2Stanford University School of Medicine, Palo Alto, CA, USA; 3University of Colorado, SKAGES School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA; 4Mood and Anxiety Disorders Program, Mount Sinai School of Medicine, New York, NY, USAAbstract: We previously reported on an objective new tool that uses quantitative electroencephalography (QEEG normative- and referenced-electroencephalography sampling databases (currently called Psychiatric EEG Evaluation Registry [PEER], which may assist physicians in determining medication selection for optimal efficacy to overcome trial-and-error prescribing. The PEER test compares drug-free QEEG features for individual patients to a database of patients with similar EEG patterns and known outcomes after pharmacological interventions. Based on specific EEG data elements and historical outcomes, the PEER Report may also serve as a marker of future severe adverse events (eg, agitation, hostility, aggressiveness, suicidality, homicidality, mania, hypomania with specific medications. We used a retrospective chart review to investigate the clinical utility of such a registry in a naturalistic environment.Results: This chart review demonstrated significant improvement on the global assessment scales Clinical Global Impression – Improvement and Quality of Life Enjoyment and Satisfaction – Short Form as well as time to maximum medical improvement and decreased suicidality occurrences. The review also showed that 54.5% of previous medications causing a severe adverse event would have been raised as a caution had the PEER Report been available at the time the drug was prescribed. Finally, due to the significant amount of off-label prescribing of psychotropic medications, additional, objective, evidence-based data aided the prescriber toward better choices.Conclusion: The PEER Report may be

  3. Assessing Team Performance.

    Science.gov (United States)

    Trimble, Susan; Rottier, Jerry

    Interdisciplinary middle school level teams capitalize on the idea that the whole is greater than the sum of its parts. Administrators and team members can maximize the advantages of teamwork using team assessments to increase the benefits for students, teachers, and the school environment. Assessing team performance can lead to high performing…

  4. Speeding Up Team Learning.

    Science.gov (United States)

    Edmondson, Amy; Bohmer, Richard; Pisano, Gary

    2001-01-01

    A study of 16 cardiac surgery teams looked at how the teams adapted to new ways of working. The challenge of team management is to implement new processes as quickly as possible. Steps for creating a learning team include selecting a mix of skills and expertise, framing the challenge, and creating an environment of psychological safety. (JOW)

  5. Travelling with football teams

    African Journals Online (AJOL)

    Football fans will always converge at a stadium on the day of the match to watch their favourite team play against a visiting team. The atmosphere at these matches is almost always electric with fans cheering their favourite teams on. The focus for everybody is ultimately on the performance of the teams on the playing field ...

  6. The Role of Trauma and Stressful Life Events among Individuals at Clinical High Risk for Psychosis: A Review

    Directory of Open Access Journals (Sweden)

    Danessa Mayo

    2017-04-01

    Full Text Available The experience of childhood trauma (CT and stressful life events (SLEs is associated with subsequent development of a variety of mental health conditions, including psychotic illness. Recent research identifying adolescents and young adults at clinical high risk (CHR for psychosis allows for prospective evaluation of the impact of trauma and adverse life events on psychosis onset and other outcomes, addressing etiological questions that cannot be answered in studies of fully psychotic or non-clinical populations. This article provides a comprehensive review of the current emerging literature on trauma and adverse life events in the CHR population. Up to 80% of CHR youth endorse a lifetime history of childhood traumatic events and victimization (e.g., bullying. Several studies have shown that the experience of CT predicts psychosis onset among CHR individuals, while the literature on the influence of recent SLEs (e.g., death of a loved one remains inconclusive. Multiple models have been proposed to explain the link between trauma and psychosis, including the stress-vulnerability and stress-sensitivity hypotheses, with emphases on both cognitive processes and neurobiological mechanisms (e.g., the hypothalamic–pituitary–adrenal axis. Despite the preponderance of CHR individuals who endorse either CT or SLEs, no clinical trials have been conducted evaluating interventions for trauma in CHR youth to date. Furthermore, the current process of formal identification and assessment of trauma, SLEs, and their impact on CHR youth is inconsistent in research and clinical practice. Recommendations for improving trauma assessment, treatment, and future research directions in the CHR field are provided.

  7. Device-Related Adverse Events During Percutaneous Nephrolithotomy: Review of the Manufacturer and User Facility Device Experience Database.

    Science.gov (United States)

    Patel, Neel H; Schulman, Ariel A; Bloom, Jonathan B; Uppaluri, Nikil; Phillips, John L; Konno, Sensuke; Choudhury, Muhammad; Eshghi, Majid

    2017-10-01

    Percutaneous nephrolithotomy (PCNL) is an established technique for removal of large stones from the upper urinary tract. It is a complex multistep procedure requiring several classes of instruments that are subject to operator misuse and device malfunction. We report device-related adverse events during PCNL from the Manufacturer and User Facility Device Experience (MAUDE) database using a recently developed standardized classification system. The MAUDE database was queried for "percutaneous nephrolithotomy" from 2006 to 2016. The circumstances and patient complications associated with classes of devices used during PCNL were identified. We then utilized a novel MAUDE classification system to categorize clinical events. Logistic regression analysis was performed to identify associations between device classes and severe adverse events. A total of 218 device-related events were reported. The most common classes included: lithotripter 53 (24.3%), wires 43 (19.7%), balloon dilators 30 (13.8%), and occlusion balloons 28 (12.8%). Reported patient complications included need for a second procedure 12 (28.6%), bleeding 8 (19.0%), retained fragments 7 (16.7%), prolonged procedure 4 (9.5%), ureteral injury 2 (4.8%), and conversion to an open procedure 3 (7.1%). Using a MAUDE classification system, 176 complications (81%) were Level I (mild/none), 26 (12%) were Level II (moderate), 15 (7%) were Level III (severe), and 1 (0.5%) was Level IV (life threatening). On univariate analysis, balloon dilators had the highest risk of Level II-IV complications compared with the other device classes [odds ratio: 4.33, confidence interval: 1.978, 9.493, p < 0.001]. The device was evaluated by the manufacturer in 93 (42.7%) cases, with 54.8% of reviewed cases listing the source of malfunction as misuse by the operator. PCNL is subject to a wide range of device-related adverse events. A MAUDE classification system is useful for standardized, clinically-relevant reporting of events. Our

  8. A scoping review of spatial cluster analysis techniques for point-event data

    Directory of Open Access Journals (Sweden)

    Charles E. Fritz

    2013-05-01

    Full Text Available Spatial cluster analysis is a uniquely interdisciplinary endeavour, and so it is important to communicate and disseminate ideas, innovations, best practices and challenges across practitioners, applied epidemiology researchers and spatial statisticians. In this research we conducted a scoping review to systematically search peer-reviewed journal databases for research that has employed spatial cluster analysis methods on individual-level, address location, or x and y coordinate derived data. To illustrate the thematic issues raised by our results, methods were tested using a dataset where known clusters existed. Point pattern methods, spatial clustering and cluster detection tests, and a locally weighted spatial regression model were most commonly used for individual-level, address location data (n = 29. The spatial scan statistic was the most popular method for address location data (n = 19. Six themes were identified relating to the application of spatial cluster analysis methods and subsequent analyses, which we recommend researchers to consider; exploratory analysis, visualization, spatial resolution, aetiology, scale and spatial weights. It is our intention that researchers seeking direction for using spatial cluster analysis methods, consider the caveats and strengths of each approach, but also explore the numerous other methods available for this type of analysis. Applied spatial epidemiology researchers and practitioners should give special consideration to applying multiple tests to a dataset. Future research should focus on developing frameworks for selecting appropriate methods and the corresponding spatial weighting schemes.

  9. A scoping review of spatial cluster analysis techniques for point-event data.

    Science.gov (United States)

    Fritz, Charles E; Schuurman, Nadine; Robertson, Colin; Lear, Scott

    2013-05-01

    Spatial cluster analysis is a uniquely interdisciplinary endeavour, and so it is important to communicate and disseminate ideas, innovations, best practices and challenges across practitioners, applied epidemiology researchers and spatial statisticians. In this research we conducted a scoping review to systematically search peer-reviewed journal databases for research that has employed spatial cluster analysis methods on individual-level, address location, or x and y coordinate derived data. To illustrate the thematic issues raised by our results, methods were tested using a dataset where known clusters existed. Point pattern methods, spatial clustering and cluster detection tests, and a locally weighted spatial regression model were most commonly used for individual-level, address location data (n = 29). The spatial scan statistic was the most popular method for address location data (n = 19). Six themes were identified relating to the application of spatial cluster analysis methods and subsequent analyses, which we recommend researchers to consider; exploratory analysis, visualization, spatial resolution, aetiology, scale and spatial weights. It is our intention that researchers seeking direction for using spatial cluster analysis methods, consider the caveats and strengths of each approach, but also explore the numerous other methods available for this type of analysis. Applied spatial epidemiology researchers and practitioners should give special consideration to applying multiple tests to a dataset. Future research should focus on developing frameworks for selecting appropriate methods and the corresponding spatial weighting schemes.

  10. Developing Your Dream Team

    Science.gov (United States)

    Gatlin, Kenda

    2005-01-01

    Almost anyone has held various roles on a team, be it a family unit, sports team, or a project-oriented team. As an educator, one must make a conscious decision to build and invest in a team. Gathering the best team possible will help one achieve one's goals. This article explores some of the key reasons why it is important to focus on the team…

  11. Vitamin-D concentrations, cardiovascular risk and events - a review of epidemiological evidence.

    Science.gov (United States)

    Grübler, Martin Robert; März, Winfried; Pilz, Stefan; Grammer, Tanja B; Trummer, Christian; Müllner, Christian; Schwetz, Verena; Pandis, Marlene; Verheyen, Nicolas; Tomaschitz, Andreas; Fiordelisi, Antonella; Laudisio, Daniela; Cipolletta, Ersilia; Iaccarino, Guido

    2017-06-01

    Vitamin D has long been established as an elemental factor of bone physiology. Beyond mineral metabolism, the expression of the vitamin D receptor has been identified throughout the cardiovascular (CV) system. Experimental studies showed beneficial effects of vitamin D on heart and vessels, but vitamin D intoxication in animals also led to hypercalcemia and vascular calcification. Our knowledge has been extended by epidemiological studies that showed that 25-hydroxyvitamin D (25(OH)D) levels are inversely associated with an increased CV risk itself, but also with established CV risk factors, such as arterial hypertension, endothelial dysfunction and atherosclerosis. Conversely, randomized controlled trials could not document significant and consistent effects of vitamin D supplementation on CV risk or events. Potential explanations may lie in differences in reference ranges or the possibility that low vitamin D in CV disease is only an epiphenomenon. In the latter case, the key question is why low 25(OH)D levels are such a strong predictor of health. While we wait for new data, the current conclusion is that vitamin D is a strong risk marker for CV risk factors and for CV diseases itself.

  12. Secondary stressors and extreme events and disasters: a systematic review of primary research from 2010-2011.

    Science.gov (United States)

    Lock, Sarah; Rubin, G James; Murray, Virginia; Rogers, M Brooke; Amlôt, Richard; Williams, Richard

    2012-10-29

    Introduction Extreme events and disasters, such as earthquakes and floods, cause distress and are associated with some people developing mental disorders. Primary stressors inherent in many disasters can include injuries sustained or watching someone die. The literature recognises the distress which primary stressors cause and their association with mental disorders. Secondary stressors such as a lack of financial assistance, the gruelling process of submitting an insurance claim, parents' worries about their children, and continued lack of infrastructure can manifest their effects shortly after a disaster and persist for extended periods of time. Secondary stressors, and their roles in affecting people's longer-term mental health, should not be overlooked. We draw attention in this review to the nature of secondary stressors that are commonly identified in the literature, assess how they are measured, and develop a typology of these stressors that often affect people after extreme events. Methods We searched for relevant papers from 2010 and 2011 using MEDLINE®, Embase and PsycINFO®. We selected primary research papers that evaluated the associations between secondary stressors and distress or mental disorders following extreme events, and were published in English. We extracted information on which secondary stressors were assessed, and used thematic analysis to group the secondary stressors into a typology. Results Thirty-two relevant articles published in 2010 and 2011 were identified. Many secondary stressors were poorly defined and difficult to differentiate from primary stressors or other life events. We identified 11 categories of secondary stressors, though some extend over more than one category. The categories include: economic stressors such as problems with compensation, recovery of and rebuilding homes; loss of physical possessions and resources; health-related stressors; stress relating to education and schooling; stress arising from media

  13. Secondary stressors and extreme events and disasters: a systematic review of primary research from 2010-2011

    Science.gov (United States)

    Lock, Sarah; Rubin, G. James; Murray, Virginia; Rogers, M. Brooke; Amlôt, Richard; Williams, Richard

    2012-01-01

    Introduction Extreme events and disasters, such as earthquakes and floods, cause distress and are associated with some people developing mental disorders. Primary stressors inherent in many disasters can include injuries sustained or watching someone die. The literature recognises the distress which primary stressors cause and their association with mental disorders. Secondary stressors such as a lack of financial assistance, the gruelling process of submitting an insurance claim, parents’ worries about their children, and continued lack of infrastructure can manifest their effects shortly after a disaster and persist for extended periods of time. Secondary stressors, and their roles in affecting people’s longer-term mental health, should not be overlooked. We draw attention in this review to the nature of secondary stressors that are commonly identified in the literature, assess how they are measured, and develop a typology of these stressors that often affect people after extreme events. Methods We searched for relevant papers from 2010 and 2011 using MEDLINE®, Embase and PsycINFO®. We selected primary research papers that evaluated the associations between secondary stressors and distress or mental disorders following extreme events, and were published in English. We extracted information on which secondary stressors were assessed, and used thematic analysis to group the secondary stressors into a typology. Results Thirty-two relevant articles published in 2010 and 2011 were identified. Many secondary stressors were poorly defined and difficult to differentiate from primary stressors or other life events. We identified 11 categories of secondary stressors, though some extend over more than one category. The categories include: economic stressors such as problems with compensation, recovery of and rebuilding homes; loss of physical possessions and resources; health-related stressors; stress relating to education and schooling; stress arising from media

  14. Promoters and barriers in hospital team communication

    DEFF Research Database (Denmark)

    Rabøl, Louise Isager; McPhail, Mette Arnsfelt; Østergaard, Doris

    2012-01-01

    the common characteristics of team communication among multiprofessional teams at four Danish acute care university hospitals. Method: Four focus group interviews with multiprofessional hospital teams (N = 24). Results: Communication is particularly vulnerable during handover of patient information between......Purpose: Poor teamwork and communication in healthcare teams have been correlated to adverse events and higher patient morbidity and mortality. However, detailed insight into the link between team communication and medical error is still lacking. The objective of this study is to identify...... shifts or units, when a team has to establish skills and roles during teamwork and when staff has to await and combine information from different chart systems. Established frameworks for communication, mutual knowledge, ease of speaking up, experience in getting the message through, and focus...

  15. A comment on Farwell : brain fingerprinting: a comprehensive tutorial review of detection of concealed information with event-related brain potentials

    NARCIS (Netherlands)

    Meijer, E.H.; Ben-Shakhar, G.; Verschuere, B.; Donchin, E.

    2013-01-01

    In a recent issue of Cognitive Neurodynamics Farwell (Cogn Neurodyn 6:115-154, 2012) published a comprehensive tutorial review of the use of Event Related Brain Potentials (ERP) in the detection of concealed information. Farwell’s review covered much of his own work employing his ‘‘brain

  16. Times to key events in Zika virus infection and implications for blood donation: a systematic review.

    Science.gov (United States)

    Lessler, Justin; Ott, Cassandra T; Carcelen, Andrea C; Konikoff, Jacob M; Williamson, Joe; Bi, Qifang; Kucirka, Lauren M; Cummings, Derek At; Reich, Nicholas G; Chaisson, Lelia H

    2016-11-01

    To estimate the timing of key events in the natural history of Zika virus infection. In February 2016, we searched PubMed, Scopus and the Web of Science for publications containing the term Zika. By pooling data, we estimated the incubation period, the time to seroconversion and the duration of viral shedding. We estimated the risk of Zika virus contaminated blood donations. We identified 20 articles on 25 patients with Zika virus infection. The median incubation period for the infection was estimated to be 5.9 days (95% credible interval, CrI: 4.4-7.6), with 95% of people who developed symptoms doing so within 11.2 days (95% CrI: 7.6-18.0) after infection. On average, seroconversion occurred 9.1 days (95% CrI: 7.0-11.6) after infection. The virus was detectable in blood for 9.9 days (95% CrI: 6.9-21.4) on average. Without screening, the estimated risk that a blood donation would come from an infected individual increased by approximately 1 in 10 000 for every 1 per 100 000 person-days increase in the incidence of Zika virus infection. Symptom-based screening may reduce this rate by 7% (relative risk, RR: 0.93; 95% CrI: 0.89-0.99) and antibody screening, by 29% (RR: 0.71; 95% CrI: 0.28-0.88). Neither symptom- nor antibody-based screening for Zika virus infection substantially reduced the risk that blood donations would be contaminated by the virus. Polymerase chain reaction testing should be considered for identifying blood safe for use in pregnant women in high-incidence areas.

  17. Adverse Event Profile of Pyrimethamine-Based Therapy in Toxoplasmosis: A Systematic Review.

    Science.gov (United States)

    Ben-Harari, Ruben R; Goodwin, Elizabeth; Casoy, Julio

    2017-12-01

    Approximately a third of the population worldwide is chronically infected with Toxoplasma gondii. Pyrimethamine-based regimens are recommended for the treatment of toxoplasmosis. The aim was to evaluate the safety profile of pyrimethamine-based treatment for the three main Toxoplasma manifestations: toxoplasmic encephalitis (TE), ocular toxoplasmosis, and congenital toxoplasmosis. PubMed, Cochrane Library, and Google Scholar databases were searched through August 1, 2016. Randomized, observational, prospective/retrospective, and cohort studies were eligible. Thirty-one studies were included with a total of 2975 patients. Of these, 13 were in congenital toxoplasmosis (n = 929), 11 in ocular toxoplasmosis (n = 1284), and seven in TE (n = 687). Across manifestations, adverse event (AE)-related treatment discontinuation and/or change in therapy involved ≤37% of patients and occurred in >55% of studies: 100% for ocular toxoplasmosis, 57.1% for TE, and 61.5% for congenital toxoplasmosis. The most commonly observed AEs were bone marrow suppression, dermatologic, and gastrointestinal (GI). The prevalence of bone marrow suppression-related AEs was ≤50% in congenital toxoplasmosis, ≤42.7% in TE, and ≤9.0% in ocular toxoplasmosis. The frequency of GI and dermatologic AEs were ≤100 and ≤11.1%, respectively, for ocular toxoplasmosis, ≤10.7 and ≤17.9% for TE, and ≤10.8 and ≤2.1% for congenital toxoplasmosis. Steven-Johnson syndrome was reported in two patients with ocular toxoplasmosis and one with TE. The AE profile associated with pyrimethamine-based treatments differed by each manifestation of toxoplasmosis and within a given manifestation. Hematologic AEs occurred across all manifestations indicating the importance of monitoring the blood of patients administered pyrimethamine-based regimens.

  18. Reporting of adverse events in randomized controlled trials of highly active antiretroviral therapy: systematic review.

    Science.gov (United States)

    Chowers, Michal Y; Gottesman, Bat Sheva; Leibovici, Leonard; Pielmeier, Ulrike; Andreassen, Steen; Paul, Mical

    2009-08-01

    Our objectives were to systematically assess the quality of reporting of adverse events (AEs) in publications of randomized trials of highly active antiretroviral therapy (HAART), and to examine whether reporting quality affects the effect estimates reported for AEs. We searched the PubMed, Cochrane library and EMBASE electronic databases up to December 2008. We included all published randomized controlled trials assessing HAART for treatment-naive adult HIV-infected individuals, with 48 weeks' follow-up. The quality of AE reporting was extracted according to CONSORT guidelines. We pooled the relative risks for AEs and compared results by sponsorship and different reporting methods. Forty-nine trials, including 19 882 patients, published between 2000 and 2008, met the inclusion criteria. Only one of the trials reported on AE collection methods. Twenty-six trials reported only AEs attributed to drugs, 17 of which did not refer to the attribution methods. AE reporting was nearly always selective and selection criteria were highly variable, based on severity grading or occurrence threshold. Presentation of AEs above an occurrence threshold was more common in studies sponsored by industry (30/31) than in studies sponsored by non-profit organizations (3/18). Moreover, we showed that differences in the methods of reporting AEs may affect the results reported for AEs. No significant improvement in AE reporting was seen over this period. We found substantial variability in AE reporting. Variability was influenced by sponsor identity and affected outcomes. These facts obstruct our ability to choose HAART based on currently published data.

  19. A Review of Dietary Supplement Adverse Event Report Data From the FDA Center for Food Safety and Applied Nutrition Adverse Event Reporting System (CAERS), 2004-2013.

    Science.gov (United States)

    Timbo, Babgaleh B; Chirtel, Stuart J; Ihrie, John; Oladipo, Taiye; Velez-Suarez, Loy; Brewer, Vickery; Mozersky, Robert

    2017-11-01

    The Food and Drug Administration (FDA)'s Center for Food Safety and Applied Nutrition (CFSAN) oversees the safety of the nation's foods, dietary supplements, and cosmetic products. To present a descriptive analysis of the 2004-2013 dietary supplement adverse event report (AER) data from CAERS and evaluate the 2006 Dietary Supplements and Nonprescription Drug Consumer Protection Act as pertaining to dietary supplements adverse events reporting. We queried CAERS for data from the 2004-2013 AERs specifying at least 1 suspected dietary supplement product. We extracted the product name(s), the symptom(s) reported, age, sex, and serious adverse event outcomes. We examined time trends for mandatory and voluntary reporting and performed analysis using SAS v9.4 and R v3.3.0 software. Of the total AERs (n = 15 430) received from January 1, 2004, through December 31, 2013, indicating at least 1 suspected dietary supplement product, 66.9% were mandatory, 32.2% were voluntary, and 0.9% were both mandatory and voluntary. Reported serious outcomes included death, life-threatening conditions, hospitalizations, congenital anomalies/birth defects and events requiring interventions to prevent permanent impairments (5.1%). The dietary supplement adverse event reporting rate in the United States was estimated at ~2% based on CAERS data. This study characterizes CAERS dietary supplement adverse event data for the 2004-2013 eriod and estimates a reporting rate of 2% for dietary supplement adverse events based on CAERS data. The findings show that the 2006 Dietary Supplements and Nonprescription Drug Consumer Protection Act had a substantial impact on the reporting of adverse events.

  20. Patient safety events in out-of-hospital paediatric airway management: a medical record review by the CSI-EMS.

    Science.gov (United States)

    Hansen, Matthew; Meckler, Garth; Lambert, William; Dickinson, Caitlin; Dickinson, Kathryn; Van Otterloo, Joshua; Guise, Jeanne-Marie

    2016-11-11

    To describe the frequency and characterise the nature of patient safety events in paediatric out-of-hospital airway management. We conducted a retrospective cross-sectional medical record review of all 'lights and sirens' emergency medicine services transports from 2008 to 2011 in patients <18 years of age in the Portland Oregon metropolitan area. A chart review tool (see online supplementary appendix) was adapted from landmark patient safety studies and revised after pilot testing. Expert panels of physicians and paramedics performed blinded reviews of each chart, identified safety events and described their nature. The primary outcomes were presence and severity of patient safety events related to airway management including oxygen administration, bag-valve-mask ventilation (BVM), airway adjuncts and endotracheal intubation (ETI).DC1SM110.1136/bmjopen-2016-012259.supp1supplementary appendix RESULTS: From the 11 328 paediatric transports during the study period, there were 497 'lights and sirens' (code 3) transports (4.4%). 7 transports were excluded due to missing data. Of the 490 transports included in the analysis, 329 had a total of 338 airway management procedures (some had more than 1 procedure): 61.6% were treated with oxygen, 15.3% with BVM, 8.6% with ETI and 2% with airway adjuncts. The frequency of errors was: 21% (71/338) related to oxygen use, 9.8% (33/338) related to BVM, 9.5% (32/338) related to intubation and 0.9% (3/338) related to airway adjunct use. 58% of intubations required 3 or more attempts or failed altogether. Cardiac arrest was associated with higher odds of a severe error. Errors in paediatric out-of-hospital airway management are common, especially in the context of intubations and during cardiac arrest. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  1. Human factors and team performance

    OpenAIRE

    Haerkens, M.H.T.M.

    2017-01-01

    Despite modern equipment, increasing emphasis on patient safety, and excellent training facilities medical care frequently results in unintentional harm to patients. Human Factors (HF) appear to play an important role in adverse events, especially in high risk clinical departments. A sound safety climate is considered essential, as it is positively related to safety outcomes. This thesis focused on HF and critical team performance in clinical medicine. First, an overview of existing literatur...

  2. Social capital, mortality, cardiovascular events and cancer: a systematic review of prospective studies.

    Science.gov (United States)

    Choi, Minkyoung; Mesa-Frias, Marco; Nuesch, Eveline; Hargreaves, James; Prieto-Merino, David; Bowling, Ann; Snith, G Davey; Ebrahim, Shah; Dale, Caroline; Casas, Juan P

    2014-12-01

    Social capital is considered to be an important determinant of life expectancy and cardiovascular health. Evidence on the association between social capital and all-cause mortality, cardiovascular disease (CVD) and cancer was systematically reviewed. Prospective studies examining the association of social capital with these outcomes were systematically sought in Medline, Embase and PsycInfo, all from inception to 8 October 2012. We categorized the findings from studies according to seven dimensions of social capital, including social participation, social network, civic participation,social support, trust, norm of reciprocity and sense of community, and pooled the estimates across studies to obtain summary relative risks of the health outcomes for each social capital dimension. We excluded studies focusing on children, refugees or immigrants and studies conducted in the former Soviet Union. Fourteen prospective studies were identified. The pooled estimates showed no association between most social capital dimensions and all-cause mortality, CVD or cancer. Limited evidence was found for association of increased mortality with social participation and civic participation when comparing the most extreme risk comparisons. Evidence to support an association between social capital and health outcomes is limited. Lack of consensus on measurements for social capital hinders the comparability of studies and weakens the evidence base.

  3. Second language syntactic processing revealed through event-related potentials: an empirical review.

    Science.gov (United States)

    Caffarra, Sendy; Molinaro, Nicola; Davidson, Doug; Carreiras, Manuel

    2015-04-01

    Learning a second language (L2) can be crucial in the present globalized society. However, reaching the level of L1 performance of native speakers is still a challenge for many. Distinct factors could account for the persistent gap observed between natives' and non-natives' syntactic abilities: L1-L2 differences, AoA, proficiency, L2 immersion duration, L2 training duration. Although different theoretical approaches described the role of these several factors, not all studies using on-line measures have investigated them comprehensively and consistently. The present work reviews available ERP studies on L2 syntactic analysis in order to establish the relative weight of each factor on the time course of L2 processing. Logistic regression analyses were performed on the presence or absence of ERP effects reported in response to L2 syntactic violations, including all the influential factors as categorical independent variables. The results showed that immersion duration has an influence on the ERP correlates linked to early mechanisms of syntactic processing, while the global proficiency level has an impact on the ERP correlates related to late, language-monitoring activity. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. The Boston Marathon bombings: a post-event review of the robust emergency response.

    Science.gov (United States)

    2013-07-01

    With as many as five level I trauma centers, Boston is well-positioned to mount an emergency response, but the two terrorist bombs that went off near the finish line of the city's annual marathon on April 15 put high levels of stress and demand on emergency personnel. In post-crisis reviews, hospital administrators say that all the emergency planning and drilling that they carry out on a regular basis was instrumental in helping them quickly care for nearly 200 victims while also securing their facilities at a time when the threat to the city was not well understood. Medical personnel working in tents on site at the marathon were able to respond to the injured quickly, while also giving area EDs a heads-up on what to expect. ED leaders report that a robust effort from the upper floors of their hospitals was critical in: helping them clear their EDs for incoming patients; establishing a security perimeter around the facilities to thoroughly check any people entering or leaving to guard against potential external threats; and focusing on improving how many extra staff show up to help during the crisis because it actually requires extra resources to manage the personnel.

  5. Structuring Successful Global Virtual Teams

    Science.gov (United States)

    2015-01-01

    effectively complete complex tasks that are beyond the scope of what an individual could reasonably accomplish. In particular, teams ...conditions for team effectiveness (Tannenbaum, Mathieu, Salas, & Cohen, 2012). When compared to traditional or conventional teams , organizational leaders may...following topics will be combined: global teams , virtual teams , multicultural teams , distributed teams , team diversity, S. Miloslavic et al. 21 22 23

  6. Combined hormonal contraceptive use among obese women and risk for cardiovascular events: A systematic review.

    Science.gov (United States)

    Horton, Leah G; Simmons, Katharine B; Curtis, Kathryn M

    2016-12-01

    Combined hormonal contraceptive (CHC) use may modify the risk of cardiovascular events in obese [body mass index (BMI) ≥30kg/m(2)] women. The objective was to evaluate from the literature whether CHC use modifies the risk of acute myocardial infarction (AMI), stroke, cerebral venous thrombosis (CVT) and venous thromboembolism (VTE) in obese women and to evaluate evidence for a dose-response relationship between BMI and VTE. We searched PubMed for all articles published between database inception and February 2016 providing direct evidence on BMI, CHCs, and cardiovascular outcomes. We also searched for indirect evidence related to a dose-response relationship between BMI and risk of VTE in the general population, as these data were lacking for CHC users. The quality of each individual study was assessed using the system for grading evidence developed by the United States Preventive Services Task Force. The direct evidence search yielded 3 pooled analyses, 11 case-control studies and 1 cohort study. There was conflicting evidence about the risk of AMI or stroke among obese combined oral contraceptive (COC) users compared to obese nonusers, with one study finding no increased risk for AMI or stroke for COC users overall or stratified by BMI. A second study found significantly increased risk of AMI and stroke for COC users, with the highest risk estimates for high-BMI COC users. A single study suggested that obese COC users may be at higher risk for CVT compared with normal-weight nonusers. For VTE, obese COC users consistently had a risk that was 5 to 8 times that of obese nonusers and approximately 10 times that of nonobese nonusers. Five prospective cohort studies were identified as indirect evidence, and all found increased risk for VTE as BMI increased, suggesting a dose-response relationship between BMI and risk for VTE. No studies on the contraceptive patch or vaginal ring were identified that met the inclusion criteria. Limited evidence of Level II-2, fair

  7. Training a team with simulated team members

    NARCIS (Netherlands)

    Schaafstal, A.M.; Hoeft, R.M.; Schaik, M. van

    2002-01-01

    The process of training teams increasingly occurs in synthetic environments. However, it is often still modeled after live team training, including the disadvantages of live training, for example, the fact that all teammates must be available. This paper explores overcoming the disadvantages of

  8. Beyond Quality Circles: Self-Managing Teams.

    Science.gov (United States)

    Sims, Henry P., Jr.; Dean, James W., Jr.

    1985-01-01

    This article reviews the quality circle concept, shows why its characteristics appeal to American executives, and examines some of its limitations. It looks at self-managing teams and discusses the reasons that adoptions have been relatively few. It then shows what organizational conditions are necessary for quality circles to evolve into teams.…

  9. Creating Teams Increases Extension Educator Productivity

    Science.gov (United States)

    Chalker-Scott, Linda; Daniels, Catherine H.; Martini, Nicole

    2016-01-01

    The Garden Team at Washington State University is a transdisciplinary group of faculty, staff, and students with expertise in applied plant and soil sciences and an interest in Extension education. The team's primary mission is to create current, relevant, and peer-reviewed materials as Extension publications for home gardeners. The average yearly…

  10. Operative and nonoperative adverse events in the management of traumatic fractures of the thoracolumbar spine: a systematic review.

    Science.gov (United States)

    Ghobrial, George M; Maulucci, Christopher M; Maltenfort, Mitchell; Dalyai, Richard T; Vaccaro, Alexander R; Fehlings, Michael G; Street, John; Arnold, Paul M; Harrop, James S

    2014-01-01

    Thoracolumbar spine injuries are commonly encountered in patients with trauma, accounting for almost 90% of all spinal fractures. Thoracolumbar burst fractures comprise a high percentage of these traumatic fractures (45%), and approximately half of the patients with this injury pattern are neurologically intact. However, a debate over complication rates associated with operative versus nonoperative management of various thoracolumbar fracture morphologies is ongoing, particularly concerning those patients presenting without a neurological deficit. A MEDLINE search for pertinent literature published between 1966 and December 2013 was conducted by 2 authors (G.G. and R.D.), who used 2 broad search terms to maximize the initial pool of manuscripts for screening. These terms were "operative lumbar spine adverse events" and "nonoperative lumbar spine adverse events." In an advanced MEDLINE search of the term "operative lumbar spine adverse events" on January 8, 2014, 1459 results were obtained. In a search of "nonoperative lumbar spine adverse events," 150 results were obtained. After a review of all abstracts for relevance to traumatic thoracolumbar spinal injuries, 62 abstracts were reviewed for the "operative" group and 21 abstracts were reviewed for the "nonoperative" group. A total of 14 manuscripts that met inclusion criteria for the operative group and 5 manuscripts that met criteria for the nonoperative group were included. There were a total of 919 and 436 patients in the operative and nonoperative treatment groups, respectively. There were no statistically significant differences between the groups with respect to age, sex, and length of stay. The mean ages were 43.17 years in the operative and 34.68 years in the nonoperative groups. The majority of patients in both groups were Frankel Grade E (342 and 319 in operative and nonoperative groups, respectively). Among the studies that reported the data, the mean length of stay was 14 days in the operative group

  11. The podiatrist as a member of the sports medicine team.

    Science.gov (United States)

    Jenkins, David W

    2015-04-01

    This article reviews the history of sports medicine highlighting the "jogging boom" of the 1970s and the advocacy of Dr George Sheehan, which boosted the position of podiatry in sports medicine. Significant events in mainstream sports medicine that promoted the rise of podiatric medicine are discussed. Reasons as to why podiatric medicine should be a member of the sports medicine team are outlined, and lastly, examples that highlight podiatric medicine as participants alongside other specialties in the evaluation and care of athletes are given. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Self-management Following a Cardiac Event in People of Chinese Ethnicity Living in Western Countries: A Scoping Review.

    Science.gov (United States)

    Zhang, Ling; Gallagher, Robyn; Ding, Ding; Neubeck, Lis

    2017-04-13

    Health outcomes and impact of cardiovascular disease vary between populations, where ethnic minorities and immigrant groups are more likely to be disadvantaged. Compared with the majority residents, health outcomes, especially short-term mortality from coronary heart disease event are worse in people of Chinese ethnicity, potentially due to poor self-management and experiences with the healthcare system in host countries. A scoping review was conducted. Four overarching themes were found: (1) understanding of heart disease, risk factors and symptom recognition, (2) adherence to medication and lifestyle modification, (3) health service/information choice, and (4) family role in disease self-management and decision making. All themes were greatly influenced by English language proficiency and cultural practices. English language proficiency and cultural practices should be taken into consideration when providing healthcare services for people of Chinese ethnicity, as it plays an important role in self-management and experiences with the healthcare system.

  13. Effects of transcranial magnetic stimulation on the cognitive event-related potential p300: a literature review.

    Science.gov (United States)

    Rêgo, Samuel R M; Marcolin, Marco A; May, Geoffrey; Gjini, Klevest

    2012-10-01

    The objective of this study was to perform a systematic review regarding the effects of transcranial magnetic stimulation (TMS) on the cognitive event-related potential P300. A search was performed of the PubMed database, using the keywords "transcranial magnetic stimulation" and "P300." Eight articles were selected and, after analysis of references, one additional article was added to the list. We found the comparison among studies to be difficult, as the information regarding the effects of TMS on P300 is both scarce and heterogeneous with respect to the parameters used in TMS stimulation and the elicitation of P300. However, 7 of 9 studies found positive results. New studies need to be carried out in order to understand the contribution of these variables and others to the alteration in the latency and amplitude of the P300 wave.

  14. The effectiveness of interventions to reduce psychological harm from traumatic events among children and adolescents: a systematic review.

    Science.gov (United States)

    Wethington, Holly R; Hahn, Robert A; Fuqua-Whitley, Dawna S; Sipe, Theresa Ann; Crosby, Alex E; Johnson, Robert L; Liberman, Akiva M; Mościcki, Eve; Price, Leshawndra N; Tuma, Farris K; Kalra, Geetika; Chattopadhyay, Sajal K

    2008-09-01

    Children and adolescents in the U.S. and worldwide are commonly exposed to traumatic events, yet practitioners treating these young people to reduce subsequent psychological harm may not be aware of-or use-interventions based on the best available evidence. This systematic review evaluated interventions commonly used to reduce psychological harm among children and adolescents exposed to traumatic events. Guide to Community Preventive Services (Community Guide) criteria were used to assess study design and execution. Meta-analyses were conducted, stratifying by traumatic exposures. Evaluated interventions were conducted in high-income economies, published up to March 2007. Subjects in studies were interventions were individual cognitive-behavioral therapy, group cognitive behavioral therapy, play therapy, art therapy, psychodynamic therapy, and pharmacologic therapy for symptomatic children and adolescents, and psychological debriefing, regardless of symptoms. The main outcome measures were indices of depressive disorders, anxiety and posttraumatic stress disorder, internalizing and externalizing disorders, and suicidal behavior. Strong evidence (according to Community Guide rules) showed that individual and group cognitive-behavioral therapy can decrease psychological harm among symptomatic children and adolescents exposed to trauma. Evidence was insufficient to determine the effectiveness of play therapy, art therapy, pharmacologic therapy, psychodynamic therapy, or psychological debriefing in reducing psychological harm. Personnel treating children and adolescents exposed to traumatic events should use interventions for which evidence of effectiveness is available, such as individual and group cognitive-behavior therapy. Interventions should be adapted for use in diverse populations and settings. Research should be pursued on the effectiveness of interventions for which evidence is currently insufficient.

  15. Adverse events associated with medium- and long-term use of opioids for chronic non-cancer pain: an overview of Cochrane Reviews.

    Science.gov (United States)

    Els, Charl; Jackson, Tanya D; Kunyk, Diane; Lappi, Vernon G; Sonnenberg, Barend; Hagtvedt, Reidar; Sharma, Sangita; Kolahdooz, Fariba; Straube, Sebastian

    2017-10-30

    Chronic pain is common and can be challenging to manage. Despite increased utilisation of opioids, the safety and efficacy of long-term use of these compounds for chronic non-cancer pain (CNCP) remains controversial. This overview of Cochrane Reviews complements the overview entitled 'High-dose opioids for chronic non-cancer pain: an overview of Cochrane Reviews'. To provide an overview of the occurrence and nature of adverse events associated with any opioid agent (any dose, frequency, or route of administration) used on a medium- or long-term basis for the treatment of CNCP in adults. We searched the Cochrane Database of Systematic Reviews (the Cochrane Library) Issue 3, 2017 on 8 March 2017 to identify all Cochrane Reviews of studies of medium- or long-term opioid use (2 weeks or more) for CNCP in adults aged 18 and over. We assessed the quality of the reviews using the AMSTAR criteria (Assessing the Methodological Quality of Systematic Reviews) as adapted for Cochrane Overviews. We assessed the quality of the evidence for the outcomes using the GRADE framework. We included a total of 16 reviews in our overview, of which 14 presented unique quantitative data. These 14 Cochrane Reviews investigated 14 different opioid agents that were administered for time periods of two weeks or longer. The longest study was 13 months in duration, with most in the 6- to 16-week range. The quality of the included reviews was high using AMSTAR criteria, with 11 reviews meeting all 10 criteria, and 5 of the reviews meeting 9 out of 10, not scoring a point for either duplicate study selection and data extraction, or searching for articles irrespective of language and publication type. The quality of the evidence for the generic adverse event outcomes according to GRADE ranged from very low to moderate, with risk of bias and imprecision being identified for the following generic adverse event outcomes: any adverse event, any serious adverse event, and withdrawals due to adverse

  16. Clopidogrel and modified-release dipyridamole for the prevention of occlusive vascular events (review of Technology Appraisal No. 90): a systematic review and economic analysis.

    Science.gov (United States)

    Greenhalgh, J; Bagust, A; Boland, A; Martin Saborido, C; Oyee, J; Blundell, M; Dundar, Y; Dickson, R; Proudlove, C; Fisher, M

    2011-09-01

    Occlusive vascular events such as myocardial infarction (MI), ischaemic stroke and transient ischaemic attack (TIA) are the result of a reduction in blood flow associated with an artery becoming narrow or blocked through atherosclerosis and atherothrombosis. Peripheral arterial disease is the result of narrowing of the arteries that supply blood to the muscles and other tissues, usually in the lower extremities. The primary objective in the treatment of all patients with a history of occlusive vascular events and peripheral arterial disease is to prevent the occurrence of new occlusive vascular events. To assess the clinical effectiveness and cost-effectiveness of clopidogrel and modified-release dipyridamole (MRD) alone or with aspirin (ASA) compared with ASA (and each other where appropriate) in the prevention of occlusive vascular events in patients with a history of MI, ischaemic stroke/TIA or established peripheral arterial disease. To consider the clinical effectiveness and cost-effectiveness of clopidogrel in patients with multivascular disease. This review is an update of the evidence base for the National Institute for Health and Clinical Excellence (NICE) guidance Technology Appraisal No. 90 (TA90) entitled Clopidogrel and modified-release dipyridamole for the prevention of occlusive vascular events (2005). Four electronic databases (EMBASE, MEDLINE, Web of Science and The Cochrane Library) were searched for randomised controlled trials (RCTs) and economic evaluations. Submissions to NICE by the manufacturers of the interventions were also considered. A systematic review of clinical effectiveness and cost-effectiveness was conducted. To manage heterogeneity between trials, indirect analysis (using a mixed-treatment methodology) was performed on selected clinical outcomes. A new economic model was developed to assess incremental costs per life-year gained [quality-adjusted life-years (QALYs)]. For evidence of clinical effectiveness, four RCTs were

  17. The interventional cardiologist as cath lab team leader.

    Science.gov (United States)

    Blankenship, James C; Feldman, Barry; Ranaweera, Priyantha; Dent, John; Huang, Xiaoyan; Singer, Sara

    2015-06-01

    Interventional cardiologists act as leaders every time they step into a catheterization laboratory (cath lab), but leadership training is rarely included in cardiology training programs. Cath lab physicians should cultivate and practice effective leadership skills. Specifically, (1) before each procedure assess whether the cath lab team is prepared; (2) delegate authority to trainees and team members when appropriate; (3) use every procedure to improve the performance of team members through teaching, coaching, and mentorship; (4) debrief the team after adverse events; (5) develop the traits, styles, and skills associated with successful leadership; and (6) provide team training for the cath lab team.

  18. Implementation of team training in medical education in Denmark

    DEFF Research Database (Denmark)

    Østergaard, H T; Østergaard, Ditte; Lippert, A

    2008-01-01

    In the field of medicine, team training aiming at improving team skills such as leadership, communication, co-operation, and followership at the individual and the team level seems to reduce risk of serious events and therefore increase patient safety. The preferred educational method for this type...... of this framework is illustrated by the present multiprofessional team training in advanced cardiac life support, trauma team training and neonatal resuscitation in Denmark. The challenges of addressing all aspects of team skills, the education of the facilitators, and establishment of evaluation strategies...

  19. Issues for the Traveling Team Physician.

    Science.gov (United States)

    Kaeding, Christopher C; Borchers, James

    2016-07-01

    This article outlines the value of having the team physician traveling with athletes to away venues for competitions or training sessions. At present, this travel presents several issues for the team physician who crosses state lines for taking care of the athletes. In this article, these issues and their possible remedies are discussed. A concern for the travelling team physician is practicing medicine while caring for the team in a state where the physician is not licensed. Another issue can be the transportation of controlled substances in the course of providing optimal care for the team athletes. These two issues are regulatory and legislative issues at both the state and federal levels. On the practical side of being a team physician, the issues of emergency action plans, supplies, and when to transport injured or ill patients are also reviewed. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  20. Toward Learning Teams

    DEFF Research Database (Denmark)

    Hoda, Rashina; Babb, Jeff; Nørbjerg, Jacob

    2013-01-01

    Today's software development challenges require learning teams that can continuously apply new engineering and management practices, new and complex technical skills, cross-functional skills, and experiential lessons learned. The pressure of delivering working software often forces software teams...... to sacrifice learning-focused practices. Effective learning under pressure involves conscious efforts to implement original agile practices such as retrospectives and adapted strategies such as learning spikes. Teams, their management, and customers must all recognize the importance of creating learning teams...

  1. Importance of Prevention and Early Intervention of Adverse Events in Pediatric Cardiac Catheterization: A Review of Three Years of Experience

    Directory of Open Access Journals (Sweden)

    Yu-Chih Huang

    2009-12-01

    Conclusion: Although the complication of severe AE during CC may not be totally preventable, it is important to be aware of every early sign of AE and to initiate an effective intervention by a well trained resuscitation team.

  2. Ten principles of good interdisciplinary team work.

    Science.gov (United States)

    Nancarrow, Susan A; Booth, Andrew; Ariss, Steven; Smith, Tony; Enderby, Pam; Roots, Alison

    2013-05-10

    Interdisciplinary team work is increasingly prevalent, supported by policies and practices that bring care closer to the patient and challenge traditional professional boundaries. To date, there has been a great deal of emphasis on the processes of team work, and in some cases, outcomes. This study draws on two sources of knowledge to identify the attributes of a good interdisciplinary team; a published systematic review of the literature on interdisciplinary team work, and the perceptions of over 253 staff from 11 community rehabilitation and intermediate care teams in the UK. These data sources were merged using qualitative content analysis to arrive at a framework that identifies characteristics and proposes ten competencies that support effective interdisciplinary team work. Ten characteristics underpinning effective interdisciplinary team work were identified: positive leadership and management attributes; communication strategies and structures; personal rewards, training and development; appropriate resources and procedures; appropriate skill mix; supportive team climate; individual characteristics that support interdisciplinary team work; clarity of vision; quality and outcomes of care; and respecting and understanding roles. We propose competency statements that an effective interdisciplinary team functioning at a high level should demonstrate.

  3. Leadership for Distributed Teams

    NARCIS (Netherlands)

    De Rooij, J.P.G.

    2009-01-01

    The aim of this dissertation was to study the little examined, yet important issue of leadership for distributed teams. Distributed teams are defined as: “teams of which members are geographically distributed and are therefore working predominantly via mediated communication means on an

  4. Tracking dynamic team activity

    Energy Technology Data Exchange (ETDEWEB)

    Tambe, M. [Univ. of Southern California, Marina del Rey, CA (United States)

    1996-12-31

    AI researchers are striving to build complex multi-agent worlds with intended applications ranging from the RoboCup robotic soccer tournaments, to interactive virtual theatre, to large-scale real-world battlefield simulations. Agent tracking - monitoring other agent`s actions and inferring their higher-level goals and intentions - is a central requirement in such worlds. While previous work has mostly focused on tracking individual agents, this paper goes beyond by focusing on agent teams. Team tracking poses the challenge of tracking a team`s joint goals and plans. Dynamic, real-time environments add to the challenge, as ambiguities have to be resolved in real-time. The central hypothesis underlying the present work is that an explicit team-oriented perspective enables effective team tracking. This hypothesis is instantiated using the model tracing technology employed in tracking individual agents. Thus, to track team activities, team models are put to service. Team models are a concrete application of the joint intentions framework and enable an agent to track team activities, regardless of the agent`s being a collaborative participant or a non-participant in the team. To facilitate real-time ambiguity resolution with team models: (i) aspects of tracking are cast as constraint satisfaction problems to exploit constraint propagation techniques; and (ii) a cost minimality criterion is applied to constrain tracking search. Empirical results from two separate tasks in real-world, dynamic environments one collaborative and one competitive - are provided.

  5. Leadership for Distributed Teams

    NARCIS (Netherlands)

    Andriessen, J.H.T.H.; Den Hartog, D.N.; De Rooij, J.P.G.

    The aim of this dissertation was to study the little examined, yet important issue of leadership for distributed teams. Distributed teams are defined as: “teams of which members are geographically distributed and are therefore working predominantly via mediated communication means on an

  6. Multicultural team conflict management

    Directory of Open Access Journals (Sweden)

    Krystyna Heinz

    2014-06-01

    Full Text Available The article presents the potential problems related to conflict resolution while cooperating in multicultural teams. Special attention is paid to specific character of such teams as well as to the concept of productive conflict and the ways of resolving it. The experiences gained in the Erasmus Intenstive Programme - Effective Working in Multicultural Teams were used.

  7. Multicultural team conflict management

    OpenAIRE

    Krystyna Heinz

    2014-01-01

    The article presents the potential problems related to conflict resolution while cooperating in multicultural teams. Special attention is paid to specific character of such teams as well as to the concept of productive conflict and the ways of resolving it. The experiences gained in the Erasmus Intenstive Programme - Effective Working in Multicultural Teams were used.

  8. Fostering teachers' team learning

    NARCIS (Netherlands)

    Bouwmans, Machiel; Runhaar, Piety; Wesselink, Renate; Mulder, Martin

    2017-01-01

    The implementation of educational innovations by teachers seems to benefit from a team approach and team learning. The study's goal is to examine to what extent transformational leadership is associated with team learning, and to investigate the mediating roles of participative decision-making,

  9. Endogenous leadership in teams

    OpenAIRE

    Huck, S; Rey Biel, P.

    2004-01-01

    In this paper we study the mechanics of ``leading by example'' in teams. Leadership is beneficial for the entire team when agents are conformists, i.e., dislike effort differentials. We also show how leadership can arise endogenously and discuss what type of leader benefits a team most.

  10. Insight and Lessons Learned on Organizational Factors and Safety Culture from the Review of Human Error-related Events of NPPs in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Tae; Lee, Dhong Hoon; Choi, Young Sung [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2014-08-15

    Event investigation is one of the key means of enhancing nuclear safety deriving effective measures and preventing recurrences. However, it is difficult to analyze organizational factors and safety culture. This paper tries to review human error-related events from perspectives of organizational factors and safety culture, and to derive insights and lessons learned in developing the regulatory infrastructure of plant oversight on safety culture.

  11. Comparison of the Adverse Event Profile of TheraSphere(®) with SIR-Spheres(®) for the Treatment of Unresectable Hepatocellular Carcinoma: A Systematic Review.

    Science.gov (United States)

    Kallini, Joseph Ralph; Gabr, Ahmed; Thorlund, Kristian; Balijepalli, Chakrapani; Ayres, Dieter; Kanters, Steve; Ebrahim, Shanil; Mills, Edward; Lewandowski, Robert J; Salem, Riad

    2017-07-01

    To compare the safety profiles of TheraSphere(®) (glass) and SIR-Spheres(®) (resin) Y90 microspheres for the treatment of hepatocellular carcinoma. A systematic review was conducted using the databases MEDLINE, Embase, and Cochrane Trials Register to identify all relevant studies. Baseline characteristics and adverse events of all grades related to gastrointestinal, hepatobiliary, and respiratory systems were collected along with commonly reported outcomes related to post-embolization syndrome. For all outcomes, data from each study were tabulated for each intervention. Adverse events and patients were summed across studies on TheraSphere(®) and SIR-Spheres(®), respectively, and the resulting proportion of patients experiencing an outcome for both interventions was calculated. Thirty-one observational studies were included in the review. In the adverse events of all grades, more patients treated with resin microspheres reported gastric ulcers, hepatic encephalopathy, cholecystitis, hepatic failure, and pleural effusion. Patients treated with resin microspheres also had more hepatobiliary adverse events of grade 3 or higher. In the events related to post-embolization syndrome, glass microspheres exhibited a similar safety profile compared to resin microspheres. Ascites and nausea grade 3 or higher were recorded more frequently with glass microsphere treatment. Based on this review of the published literature, glass microspheres exhibit a safety profile with fewer gastrointestinal and pulmonary adverse events compared to resin microspheres in the treatment of hepatocellular carcinoma.

  12. Assessing Team Leadership in Emergency Medicine: The Milestones and Beyond

    Science.gov (United States)

    Rosenman, Elizabeth D.; Branzetti, Jeremy B.; Fernandez, Rosemarie

    2016-01-01

    Background Team leadership is a critical skill for emergency medicine physicians that directly affects team performance and the quality of patient care. There exists a robust body of team science research supporting team leadership conceptual models and behavioral skill sets. However, to date, this work has not been widely incorporated into health care team leadership education. Objective This narrative review has 3 aims: (1) to synthesize the team science literature and to translate important concepts and models to health care team leadership; (2) to describe how team leadership is currently represented in the health care literature and in the Accreditation Council for Graduate Medical Education Milestones for emergency medicine; and (3) to propose a novel, evidence-based framework for the assessment of team leadership in emergency medicine. Methods We conducted a narrative review of the team science and health care literature. We summarized our findings and identified a list of team leadership behaviors that were then used to create a framework for team leadership assessment. Results Current health care team leadership measurement tools do not incorporate evidence-based models of leadership concepts from other established domains. The emergency medicine milestones include several team leadership behaviors as part of a larger resident evaluation program. However, they do not offer a comprehensive or cohesive representation of the team leadership construct. Conclusions Despite the importance of team leadership to patient care, there is no standardized approach to team leadership assessment in emergency medicine. Based on the results of our review, we propose a novel team leadership assessment framework that is supported by the team science literature. PMID:27413434

  13. Alcohol and Immediate Risk of Cardiovascular Events: A Systematic Review and Dose-Response Meta-Analysis.

    Science.gov (United States)

    Mostofsky, Elizabeth; Chahal, Harpreet S; Mukamal, Kenneth J; Rimm, Eric B; Mittleman, Murray A

    2016-03-08

    Although considerable research describes the cardiovascular effects of habitual moderate and heavy alcohol consumption, the immediate risks following alcohol intake have not been well characterized. Based on its physiological effects, alcohol may have markedly different effects on immediate and long-term risk. We searched CINAHL, Embase, and PubMed from inception to March 12, 2015, supplemented with manual screening for observational studies assessing the association between alcohol intake and cardiovascular events in the following hours and days. We calculated pooled relative risks and 95% confidence intervals for the association between alcohol intake and myocardial infarction, ischemic stroke, and hemorrhagic stroke using DerSimonian and Laird random-effects models to model any alcohol intake or dose-response relationships of alcohol intake and cardiovascular events. Among 1056 citations and 37 full-text articles reviewed, 23 studies (29 457 participants) were included. Moderate alcohol consumption was associated with an immediately higher cardiovascular risk that was attenuated after 24 hours, and even protective for myocardial infarction and hemorrhagic stroke (≈2-4 drinks: relative risk=30% lower risk) and protective against ischemic stroke within 1 week (≈6 drinks: 19% lower risk). In contrast, heavy alcohol drinking was associated with higher cardiovascular risk in the following day (≈6-9 drinks: relative risk=1.3-2.3) and week (≈19-30 drinks: relative risk=2.25-6.2). There appears to be a consistent finding of an immediately higher cardiovascular risk following any alcohol consumption, but, by 24 hours, only heavy alcohol intake conferred continued risk. © 2016 American Heart Association, Inc.

  14. A systematic review of immune-related adverse event reporting in clinical trials of immune checkpoint inhibitors.

    Science.gov (United States)

    Chen, T W; Razak, A R; Bedard, P L; Siu, L L; Hansen, A R

    2015-09-01

    There are limited data about the quality of immune-related adverse event (irAE) reporting in immune checkpoint inhibitor (ICI) clinical trial publications. A systematic search of citations from Medline, EMBASE and Cochrane databases identified prospective clinical trials involving ICIs in advanced solid tumors from 2003 to 2013. A 21-point quality score (QS) was adapted from the CONSORT harms extension statement. Linear regression was used to identify factors associated with quality reporting. After a review of 2628 articles, 50 trial reports were included, with ICIs as either monotherapy (54%) or part of a combination regimen (46%). The mean QS was 11.21 points (range 3.50-17.50 points). The median grade 3/4 AE rate reported was 21% (range 0%-66%) and 29/50 (58%) trials concluded that irAEs were tolerable. Multivariate regression analysis revealed that year of publication (within last 5 years, P = 0.01) and journal impact factor >15 (P = 0.004) were associated with higher QS. Complete reporting of specific characteristics of irAEs including onset, management and reversibility were reported by 14%, 8% and 6% of studies, respectively. The incidence of grade 3/4 adverse events was higher for inhibitors against CTLA-4 compared with other immune checkpoints (P reporting of irAEs is suboptimal. A standardized reporting method of irAEs that accounts for tolerability, management and reversibility is needed and would enable a more precise evaluation of the therapeutic risk benefit ratio of ICIs. © The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  15. Tocilizumab-induced pancreatitis: case report and review of data from the FDA Adverse Event Reporting System.

    Science.gov (United States)

    Flaig, T; Douros, A; Bronder, E; Klimpel, A; Kreutz, R; Garbe, E

    2016-12-01

    Tocilizumab (TCZ) is a humanized monoclonal antibody acting against the IL-6 receptor. It is a drug used in the treatment of rheumatoid arthritis and can be either given intravenously every 4 weeks or subcutaneously once a week. Known adverse events (AE) associated with TCZ include: infections of the upper respiratory tract, arterial hypertension, hypercholesterolaemia and hypertriglyceridaemia. Here, we present the first well-documented case of TCZ-induced acute pancreatitis (AP) and a systematic review of the literature including data from the Food and Drug Administration Adverse Event Reporting System (FAERS) database. Patient data collection was performed within the Berlin Case-Control Surveillance Study. A literature search for TCZ-induced AP was conducted. Analysis of the FAERS database concerning TCZ-associated pancreatic AE from the period of 2009 until the first quarter of 2013 was conducted. A 40-year-old man presented with a 2-day history of progressive upper abdominal pain with elevated serum lipase and triglyceride levels. Biliary pancreatitis was ruled out by abdominal sonography and CT scan. Cessation of intravenously administered TCZ resulted in improvement of the patient's condition and a decline in elevated laboratory values, suggesting a probable relationship between TCZ intake and AP. Analysis of the FAERS database retrieved 52 cases of TCZ-associated AP that accounted for 70% of all pancreatic AE in association with TCZ use. Further literature search detected three additional cases in which TCZ use was associated with AP. Physicians should be aware of the probable association between TCZ use and AP. Targeted post-authorization studies are needed to confirm and quantify the risk of TCZ-induced AP. © 2016 John Wiley & Sons Ltd.

  16. [Renal impairment in patients with thromboembolic event: prevalence and clinical implications. A systematic review of the literature].

    Science.gov (United States)

    Wilke, Thomas; Wehling, Martin; Amann, Steffen; Bauersachs, Rupert M; Böttger, Björn

    2015-08-01

    The assessment of the renal function of patients with a deep vein thrombosis/pulmonary embolism (VTE patients) is of utmost importance for the selection/dosage of an agent in the initial anticoagulation management of these patients because the majority of available anticoagulants are cleared renally. Specifically, there is a high risk of drug accumulation and subsequent bleedings in patients with severe renal insufficiency. Consequently, specific recommendations have been made for the initial anticoagulation management of these patients in both product labels and AWMF treatment recommendations: some drugs should not be used in these patients, for other drugs a careful use, intensified screening (anti-Xa), or, in the case of enoxaparin, a dose-adjustment are recommended.This literature review aimed to answer the following questions: · What is the prevalence of renal insufficiency in VTE patients?. · Which data are available with regard to the real-world initial anticoagulation management and corresponding clinical outcomes (recurrent VTE events, bleedings, mortality) of these patients? We did a systematic review of existing publications in german or english published in 2004-2014. Only quantitative analyses have been included in the review. We identified 1,135 publications, 37 of them were included in our review. The prevalence of renal insufficiency in VTE patients, defined as CrCl management of VTE patients face the risk of drug accumulation in renally insufficent patients. So, for example, a standard enoxaparin dosage was shown to be associated with elevated bleeding risk compared to adjusted enoxaparin dosage in renally insufficient patients. However, similar data do not exist for other low molecular weight heparins (LMWHs) or unfractioned heparins (UFHs). Only for two LMWHs, Certoparin and Tinzaparin, safety data with regard to renally insufficient patients have been published so far.None of the included studies showed advantages of UFH therapy in

  17. Team-Based Peer Review as a Form of Formative Assessment--The Case of a Systems Analysis and Design Workshop

    Science.gov (United States)

    Lavy, Ilana; Yadin, Aharon

    2010-01-01

    The present study was carried out within a systems analysis and design workshop. In addition to the standard analysis and design tasks, this workshop included practices designed to enhance student capabilities related to non-technical knowledge areas, such as critical thinking, interpersonal and team skills, and business understanding. Each task…

  18. The ability of environmental healthcare design strategies To impact event related anxiety in paediatric patients: A comprehensive systematic review.

    Science.gov (United States)

    Norton-Westwood, Deborah; Pearson, Alan; Robertson-Malt, Suzanne

    2011-01-01

    Background Children's' hospitals are by definition hospitals specialized in all aspects of children's care, but are they and if so, how is that achieved? Are healthcare facilities more than a 'space' in which to ask medical questions, seek answers and obtain treatment? Some suggest that the very design of a space can positively or negatively impact healing, hence the term referred to by those in the architectural community as 'healing spaces'. To date empirical studies to provide evidence to this effect, although growing in number, are still few. What is known is that hospitals, doctor's offices and dental offices alike unintentionally create an atmosphere, particularly for children, that add to an already heightened level of anxiety and fear. Designing a children's hospital, unlike a generalist facility, presents a unique and significant challenge. Those involved in designing such hospitals are faced with the opportunity and responsibility to care for and respond to the needs of children across the age spectrum; infants to toddlers, school aged children to adolescents. As healthcare professionals and architects, it is our responsibility to create healthcare facilities that are of purposeful design; anticipating and alleviating children's anxiety and fear wherever possible.Objectives The objective of this systematic review is to evaluate the effects of environmental design strategies in healthcare institutions such as hospitals and dental offices on event-related anxiety in the paediatric population.Inclusion Criteria This comprehensive systematic review involved children from the age of 1 to 18 years of age admitted to a healthcare facility with the primary outcomes of interest being four key design strategies: positive distraction; elimination of environmental stressors; access to social support and choice (control); and connection to nature.Search Strategy Using the Joanna Briggs defined three step search strategy, both published and unpublished studies were

  19. 2013 Immune Risk Standing Review Panel Research Plan Review for: The Risk of Crew Adverse Health Event Due to Altered Immune Response

    Science.gov (United States)

    Steinberg, Susan

    2014-01-01

    The 2013 Immune Risk Standing Review Panel (from here on referred to as the SRP) participated in a meeting with representatives from the Human Research Program (HRP) Human Health Countermeasures (HHC) Element and HRP management on February 3-4, 2014 in Houston, TX to review the updated Research Plan for the Risk of Crew Adverse Health Event Due to Altered Immune Response in the HRP Integrated Research Plan. The SRP is impressed with the work the immune discipline has done since the 2012 SRP review and agrees with the new wording of the Gaps, no longer questions, now statements. The SRP also likes the addition of adding targets for closing the Gaps, but it is not clear how they got to some of the interim stages (interval percentages). A major concern that the SRP has mentioned since the initial 2009 SRP meeting is that there is still not enough emphasis on the interdisciplinary aspect of the immune risk associated with other risks (i.e., nutrition, radiation, etc.). The SRP recommends that a "translational SRP" or advisory group be developed that is composed of members from all of the HRP SRPs. The SRP also thinks that the immune discipline should consider a more systems biology approach. Lastly, the SRP is concerned that the risks observed in research from low Earth orbit (LEO) missions may not accurately reflect all the risks of longer duration flight beyond LEO. Also, there does not seem to be a concern for immune responses that may occur when someone is in space longer than six months, for example, a Mars mission would take three years. The absence of disease in past and current flight scenarios does not mean the risk may not be there in future flight settings.

  20. Preventable and non-preventable adverse drug events in hospitalized patients: a prospective chart review in the Netherlands.

    Science.gov (United States)

    Dequito, Aileen B; Mol, Peter G M; van Doormaal, Jasperien E; Zaal, Rianne J; van den Bemt, Patricia M L A; Haaijer-Ruskamp, Flora M; Kosterink, Jos G W

    2011-11-01

    Medication safety research and clinical pharmacy practice today is primarily focused on managing preventable adverse drug events (pADEs). Determinants of both pADEs and non-preventable adverse drug reactions (ADRs) have been identified. However, relatively little is known on the overlap between these determinants and the balance of preventable and non-preventable harm inpatients experience in modern computerized hospitals. The aim of this study was to analyse the prevalence of pADEs and non-preventable ADRs as well as the determinants, including multimorbidity, of these ADEs, i.e. both pADEs and ADRs. Adverse events experienced by patients admitted to two Dutch hospitals with functioning computerized physician order entry (CPOE) systems were prospectively identified through chart review. Adverse events were divided into pADEs (i.e. as a result of a medication error) and non-preventable ADRs. In both cases, a causal relationship between adverse events and patients' drugs was established using the simplified Yale algorithm. Study data were collected anytime between April 2006 and May 2008 over a 5-month period at each hospital ward included in the study, beginning from 8 weeks after CPOE was implemented at the ward. pADEs and non-preventable ADRs were experienced by 349 (58%) patients, of whom 307 (88%) had non-preventable ADRs. Multimorbidity (adjusted odds ratio [OR(adj)] 1.90; 95% CI 1.44, 2.50; OR(adj) 1.28; 95% CI 1.14, 1.45, respectively), length of stay (OR(adj) 1.13; 95% CI 1.06, 1.21; OR(adj) 1.11; 95% CI 1.07, 1.16, respectively), admission to the geriatric ward (OR(adj) 7.78; 95% CI 2.15, 28.13; OR(adj) 3.82; 95% CI 1.73, 8.45, respectively) and number of medication orders (OR(adj) 1.25; 95% CI 1.16, 1.35; OR(adj) 1.13; 95% CI 1.06, 1.21, respectively) were statistically significantly associated with pADEs and ADRs. Admission to the gastroenterology/rheumatology ward (OR(adj) 0.22; 95% CI 0.06, 0.77; OR(adj) 0.40; 95% CI 0.24, 0.65, respectively) was

  1. Neutropenia as an Adverse Event following Vaccination: Results from Randomized Clinical Trials in Healthy Adults and Systematic Review

    Science.gov (United States)

    Muturi-Kioi, Vincent; Lewis, David; Launay, Odile; Leroux-Roels, Geert; Anemona, Alessandra; Loulergue, Pierre; Bodinham, Caroline L.; Aerssens, Annelies; Groth, Nicola; Saul, Allan; Podda, Audino

    2016-01-01

    Background In the context of early vaccine trials aimed at evaluating the safety profile of novel vaccines, abnormal haematological values, such as neutropenia, are often reported. It is therefore important to evaluate how these trials should be planned not to miss potentially important safety signals, but also to understand the implications and the clinical relevance. Methodology We report and discuss the results from five clinical trials (two with a new Shigella vaccine in the early stage of clinical development and three with licensed vaccines) where the absolute neutrophil counts (ANC) were evaluated before and after vaccination. Additionally, we have performed a systematic review of the literature on cases of neutropenia reported during vaccine trials to discuss our results in a more general context. Principal Findings Both in our clinical trials and in the literature review, several cases of neutropenia have been reported, in the first two weeks after vaccination. However, neutropenia was generally transient and had a benign clinical outcome, after vaccination with either multiple novel candidates or well-known licensed vaccines. Additionally, the vaccine recipients with neutropenia frequently had lower baseline ANC than non-neutropenic vaccinees. In many instances neutropenia occurred in subjects of African descent, known to have lower ANC compared to western populations. Conclusions It is important to include ANC and other haematological tests in early vaccine trials to identify potential safety signals. Post-vaccination neutropenia is not uncommon, generally transient and clinically benign, but many vaccine trials do not have a sampling schedule that allows its detection. Given ethnic variability in the level of circulating neutrophils, normal ranges taking into account ethnicity should be used for determination of trial inclusion/exclusion criteria and classification of neutropenia related adverse events. Trial registration ClinicalTrials.gov NCT02017899

  2. Building effective clinical teams in healthcare.

    Science.gov (United States)

    Ezziane, Zoheir; Maruthappu, Mahiben; Gawn, Lynsey; Thompson, Emily A; Athanasiou, Thanos; Warren, Oliver J

    2012-01-01

    This article aims to review teamwork and the creation of effective teams within healthcare. By combining research material found in management, psychology and health services research the article explores the drivers increasing the importance of teamwork, reviews the current knowledge base on how to build a team and focuses on some of the barriers to effective team performance. The simultaneous inflation of healthcare costs and necessity to improve quality of care has generated a demand for novel solutions in policy, strategy, commissioning and provider organisations. A critical, but commonly undervalued means by which quality can be improved is through structured, formalised incentivisation and development of teams, and the ability of individuals to work collectively and in collaboration. Several factors appear to contribute to the development of successful teams, including effective communication, comprehensive decision making, safety awareness and the ability to resolve conflict. Not only is strong leadership important if teams are to function effectively but the concept and importance of followership is also vital. Building effective clinical teams is difficult. The research in this area is currently limited, as is the authors' understanding of the different requirements faced by those working in different areas of the health and social care environment. This article provides a starting place for those interested in leading and developing teams of clinicians.

  3. Nursing and medical students teaming up: Results of an interprofessional project.

    Science.gov (United States)

    Feather, Rebecca A; Carr, Douglas E; Garletts, Derrick M; Reising, Deanna L

    2017-09-01

    Health professions programmes are increasing the number of interprofessional events in their curricula. Many of these programmes are grounded in case study or simulation events in order to prepare students for eventual practice. We designed an interprofessional education collaborative practice (IPECP) that provides direct interprofessional practice experience while students are still in their health profession programmes. In our programme, teams of senior baccalaureate nursing and third-year medical students provided health coaching to patients in need of chronic disease management. The purpose of the project and study was to determine whether repeated exposure to opportunities for interprofessional communication would lead to improvement in the individual and team communication skills. Teams met with their assigned patients monthly to provide coaching and had follow-up conversations with the patients between meetings. Faculty were present at each meeting to review the healthcare and coaching plans, observe the teams' interactions, and provide a debriefing after each meeting. Results demonstrated that both individual and team communication skills significantly increased over time. The IPECP project was successful in providing a context where students could develop and improve upon key interprofessional communication skills.

  4. A Systematic Literature Review of Adverse Events Associated with Systemic Treatments Used in Advanced Soft Tissue Sarcoma

    Directory of Open Access Journals (Sweden)

    Ann Colosia

    2016-01-01

    Full Text Available This systematic literature review describes adverse events (AEs among patients with soft tissue sarcoma (STS who received second-line or later anticancer therapies. Searches were conducted in PubMed, EMBASE, and Cochrane Central Register of Controlled Trials for studies of adults with advanced or metastatic STS who received systemic anticancer therapy before enrollment in a randomized-controlled trial of pazopanib, another targeted cancer agent, or cytotoxic chemotherapy. Of 204 publications identified, seven articles representing six unique studies met inclusion criteria. Additional safety results for pazopanib were identified on ClinicalTrials.gov. Hematologic toxicities were common with all therapies evaluated (pazopanib, trabectedin, dacarbazine ± gemcitabine, gemcitabine ± docetaxel, cyclophosphamide, and ifosfamide. Studies differed in AE type, timing of assessment, and outcomes reported, although patient populations and AE assessment timing were relatively similar for pazopanib and trabectedin. AEs that were more common with trabectedin than pazopanib were anemia, neutropenia, nausea/vomiting, and elevations in aspartate aminotransferase and alanine aminotransferase. An AE that was more common with pazopanib than trabectedin was anorexia. Only the pazopanib study reported AE frequencies versus placebo. A planned meta-analysis was not feasible, as there was no common comparator. More well-designed studies that include common comparators are needed for comparison of safety effects among treatments for STS.

  5. The incremental value of brachial flow-mediated dilation measurements in risk stratification for incident cardiovascular events: a systematic review.

    Science.gov (United States)

    Peters, Sanne A E; den Ruijter, Hester M; Bots, Michiel L

    2012-06-01

    Abstract Adequate risk assessment for cardiovascular disease (CVD) is essential as a guide to initiate drug treatment. Current methods based on traditional risk factors could be improved considerably. Although brachial flow-mediated dilation (FMD) predicts subsequent cardiovascular events, its predictive value on top of traditional risk factors is unknown. We performed a systematic review to evaluate the incremental predictive value of FMD on top of traditional risk factors in asymptomatic individuals. Using PubMed and reference tracking, three studies were identified that reported on the incremental value of FMD using change in the area under the curve (AUC). Two large cohort studies found no improvement in AUC when FMD was added to traditional risk prediction models, whereas one small case-control study found an improvement. One study used the net reclassification improvement (NRI) to assess whether FMD measurement leads to correct risk stratification in risk categories. Although this study did not find an improvement in AUC, the NRI was statistically significant. Based on the reclassification results of this study, FMD measurement might be helpful in risk prediction. Evidence supporting the use of FMD measurement in clinical practice for risk stratification for CVD on top of traditional risk factors is limited, and future studies are needed.

  6. [New technology for prevention of embolic events in atrial fibrillation: a systematic review on percutaneous endovascular left atrial appendage closure].

    Science.gov (United States)

    Danna, Paolo; Sagone, Antonio; Proietti, Riccardo; Arensi, Andrea; Viecca, Maurizio; Santangeli, Pasquale; Di Biase, Luigi; Natale, Andrea

    2012-09-01

    Atrial fibrillation (AF) is the most common cardiac arrhythmia. The mortality rate of patients with AF is doubled as compared to non-fibrillating controls. The most relevant complication of AF is a major increase in the risk of stroke. The gold standard in reducing cerebrovascular events in AF is warfarin therapy, which is not free from contraindications and limitations. The left atrial appendage (LAA) is the main source of emboli causing stroke in AF. LAA closure is a seducing approach to stroke risk reduction in AF without anticoagulation. Since 1949, heart surgeons have performed LAA closure or amputation in patients with AF. Percutaneous endovascular LAA closure is a new, less invasive, technique to reach the goal. Several devices have been used to perform this intervention, and the results of published trials are encouraging in terms of effectiveness and relative safety of this attractive technique. In this review we examine the published trials and data on percutaneous LAA closure, with particular attention to the risks and benefits of this procedure.

  7. Ramadan fasting is not usually associated with the risk of cardiovascular events: A systematic review and meta-analysis.

    Science.gov (United States)

    Turin, Tanvir C; Ahmed, Salim; Shommu, Nusrat S; Afzal, Arfan R; Al Mamun, Mohammad; Qasqas, Mahdi; Rumana, Nahid; Vaska, Marcus; Berka, Noureddine

    2016-01-01

    Over one billion Muslims worldwide fast during the month of Ramadan. Ramadan fasting brings about some changes in the daily lives of practicing Muslims, especially in their diet and sleep patterns, which are associated with the risk of cardiovascular diseases. Over the years, many original studies have made the effort to identify the possible impact of the Ramadan fast on cardiovascular diseases. This systematic review and meta-analysis is an attempt to present the summary of key findings from those articles and an appraisal of selected literature. A systematic search using keywords of ";Ramadan fasting" and ";cardiovascular diseases" was conducted in primary research article and gray-literature repositories, in combination with hand searching and snow balling. Fifteen studies were finally selected for data extraction on the outcomes of stroke, myocardial infarction, and congestive heart failure. The analysis revealed that the incidence of cardiovascular events during the Ramadan fast was similar to the nonfasting period. Ramadan fast is not associated with any change in incidence of acute cardiovascular disease.

  8. Ramadan fasting is not usually associated with the risk of cardiovascular events: A systematic review and meta-analysis

    Science.gov (United States)

    Turin, Tanvir C.; Ahmed, Salim; Shommu, Nusrat S.; Afzal, Arfan R.; Al Mamun, Mohammad; Qasqas, Mahdi; Rumana, Nahid; Vaska, Marcus; Berka, Noureddine

    2016-01-01

    Over one billion Muslims worldwide fast during the month of Ramadan. Ramadan fasting brings about some changes in the daily lives of practicing Muslims, especially in their diet and sleep patterns, which are associated with the risk of cardiovascular diseases. Over the years, many original studies have made the effort to identify the possible impact of the Ramadan fast on cardiovascular diseases. This systematic review and meta-analysis is an attempt to present the summary of key findings from those articles and an appraisal of selected literature. A systematic search using keywords of “;Ramadan fasting” and “;cardiovascular diseases” was conducted in primary research article and gray-literature repositories, in combination with hand searching and snow balling. Fifteen studies were finally selected for data extraction on the outcomes of stroke, myocardial infarction, and congestive heart failure. The analysis revealed that the incidence of cardiovascular events during the Ramadan fast was similar to the nonfasting period. Ramadan fast is not associated with any change in incidence of acute cardiovascular disease. PMID:27186152

  9. Implementation of a team-based learning course: Work required and perceptions of the teaching team.

    Science.gov (United States)

    Morris, Jenny

    2016-11-01

    Team-based learning was selected as a strategy to help engage pre-registration undergraduate nursing students in a second-year evidence-informed decision making course. To detail the preparatory work required to deliver a team-based learning course; and to explore the perceptions of the teaching team of their first experience using team-based learning. Descriptive evaluation. Information was extracted from a checklist and process document developed by the course leader to document the work required prior to and during implementation. Members of the teaching team were interviewed by a research assistant at the end of the course using a structured interview schedule to explore perceptions of first time implementation. There were nine months between the time the decision was made to use team-based learning and the first day of the course. Approximately 60days were needed to reconfigure the course for team-based learning delivery, develop the knowledge and expertise of the teaching team, and develop and review the resources required for the students and the teaching team. This reduced to around 12days for the subsequent delivery. Interview data indicated that the teaching team were positive about team-based learning, felt prepared for the course delivery and did not identify any major problems during this first implementation. Implementation of team-based learning required time and effort to prepare the course materials and the teaching team. The teaching team felt well prepared, were positive about using team-based learning and did not identify any major difficulties. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  10. Methods for Enhancing Efficiency of Interdisciplinary Team Decision Making.

    Science.gov (United States)

    Day, Pat Spencer

    The paper reviews difficulties in special education interdisciplinary team decision making and relates the experiences of one team's efforts to increase intra-team communication. Among problems cited are lack of focus in discussions, unequal levels of participation, and limited abilities to produce recommendations or provide therapy in a truly…

  11. Are self-directed work teams successful and effective tools for today`s organization?

    Energy Technology Data Exchange (ETDEWEB)

    Arnwine, A.D.

    1995-03-01

    The purpose of this research is to (1) show the effectiveness and success of self-directed work teams within the organization, (2) emphasize the importance of team building in the success of the team, and (3) assist organizations in building self-directed work teams. The researcher used a direct survey and studied the following team building techniques: (1) Is the team`s mission clearly defined to each team member? (2) Are the goals clearly defined and achievable by all team members? (3) Will empowerment (decision-making power) be given equally to all team members? (4) Will open and honest communication be allowed among team members? (5) Will each team member be respected and valued for his/her position on the team? (6) Are self-directed work teams effectively rewarded for accomplishments? (7) Have team members received adequate training to effectively complete their job tasks? Upon completion of the literature review and statistical data, and after analyzing the seven areas of team building techniques, it was determined three of the four teams were successful and effective. The only area of concern to the organization is that the participants felt they did not have true ownership of their teams; that is, team members were not given full empowerment. According to this study and the review of literature, full empowerment must be given to achieve successful and effective teams. If true empowerment is not given, the team will suffer in other areas of team building, and the organization will lose a valuable tool.

  12. Can You Work with Me? Using a Qualitative Meta Analytic Review to Understand the Effects of Culture on the Formation of Swift Trust within Global Virtual Teams

    Science.gov (United States)

    2011-01-01

    sociologist Talcott Parsons . Basically, the five dimensions explain the differences in cultural values when it comes to conducting business and...be given training to help them develop cross-cultural competencies. For instance, team members may first need to be educated by making them aware of...systematic efforts based on our specific research question. The research assistants were educated as to the overarching research agenda and the aim of

  13. Advancing Interprofessional Collaborative Teams in the Winnipeg Health Region.

    Science.gov (United States)

    Klaasen, Kathleen; Bowman, Susan; Komenda, Paul

    2016-01-01

    This project developed an evaluation platform aimed at diagnosing team functioning using evidence-informed, measurable indicators to provide an actionable roadmap to guide teams in improving their interprofessional collaborative team performance. A scoping literature review, stakeholder consultation, survey and focus groups were conducted to inform both the final selection of eight indicators of effective, high-performing teams and the process to assess and evaluate teams against these indicators. The program was piloted with two interprofessional teams in the Winnipeg Health Region. Focus groups and questionnaires were used to evaluate the program.

  14. Effectiveness of Child Advocacy Centers and the multidisciplinary team approach on prosecution rates of alleged sex offenders and satisfaction of non-offending caregivers with allegations of child sexual abuse: a systematic review.

    Science.gov (United States)

    Nwogu, Ngozi N; Agrawal, Lynet; Chambers, Stephanie; Buagas, Archiel B; Daniele, Rose Mary; Singleton, Joanne K

    2016-01-15

    Child sexual abuse is a multifaceted issue that negatively affects the lives of millions of children worldwide. These children suffer numerous medical and psychological long-term adverse effects both in childhood and adulthood. It is imperative to implement evidence- based interventions for the investigation of this crime. The use of Child Advocacy Centers and the multidisciplinary team approach may improve the investigation of child sexual abuse. To evaluate the effectiveness of Child Advocacy Centers and the multidisciplinary team approach on prosecution rates of alleged sex offenders and satisfaction of non-offending caregivers of children less than 18 years of age, with allegations of child sexual abuse. Children under 18 years, of any race, ethnicity or gender with allegations of child sexual abuse. Other participants included in this review are non-offending caregivers of children with allegations of child sexual abuse, and alleged sex offenders. Type of intervention : The use of Child Advocacy Centers and the multidisciplinary team approach on child sexual abuse investigations. Types of outcomes : Prosecution rates of alleged sex offenders and the satisfaction of non-offending caregivers of children with allegations of child sexual abuse. Types of studies: This review includes quasi-experimental and descriptive studies. The search strategy aimed to find published and unpublished articles in the English language published from 1985 through April 2015 for inclusion. The databases searched include: PubMed, CINAHL, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), Health Source: Nursing/Academic Edition, Criminal Justice Periodicals, ProQuest Dissertations & Theses and Criminal Justice Collections. An additional grey literature search was conducted. Two reviewers evaluated the included studies for methodological quality using standardized critical appraisal instruments from the Joanna Briggs Institute. Data were extracted using

  15. Leadership for Distributed Teams

    OpenAIRE

    De Rooij, J.P.G.

    2009-01-01

    The aim of this dissertation was to study the little examined, yet important issue of leadership for distributed teams. Distributed teams are defined as: “teams of which members are geographically distributed and are therefore working predominantly via mediated communication means on an interdependent task and in realizing a joint goal” (adapted from Bell & Kozlowski, 2002 and Dubé & Paré, 2004). Chapter 1 first presents the outline of the dissertation. Next, several characteristics of distri...

  16. Managing multicultural teams.

    Science.gov (United States)

    Brett, Jeanne; Behfar, Kristin; Kern, Mary C

    2006-11-01

    Multicultural teams offer a number of advantages to international firms, including deep knowledge of different product markets, culturally sensitive customer service, and 24-hour work rotations. But those advantages may be outweighed by problems stemming from cultural differences, which can seriously impair the effectiveness of a team or even bring itto a stalemate. How can managers best cope with culture-based challenges? The authors conducted in-depth interviews with managers and members of multicultural teams from all over the world. Drawing on their extensive research on dispute resolution and teamwork and those interviews, they identify four problem categories that can create barriers to a team's success: direct versus indirect communication, trouble with accents and fluency, differing attitudes toward hierarchy and authority, and conflicting norms for decision making. If a manager--or a team member--can pinpoint the root cause of the problem, he or she is likelier to select an appropriate strategy for solving it. The most successful teams and managers, the authors found, dealt with multicultural challenges in one of four ways: adaptation (acknowledging cultural gaps openly and working around them), structural intervention (changing the shape or makeup of the team), managerial intervention (setting norms early or bringing in a higher-level manager), and exit (removing a team member when other options have failed). Which strategy is best depends on the particular circumstances--and each has potential complications. In general, though, managers who intervene early and set norms; teams and managers who try to engage everyone on the team; and teams that can see challenges as stemming from culture, not personality, succeed in solving culture-based problems with good humor and creativity. They are the likeliest to harvest the benefits inherent in multicultural teams.

  17. Adverse Event Recording and Reporting in Clinical Trials Comparing Lumbar Disk Replacement with Lumbar Fusion: A Systematic Review.

    Science.gov (United States)

    Hiratzka, Jayme; Rastegar, Farbod; Contag, Alec G; Norvell, Daniel C; Anderson, Paul A; Hart, Robert A

    2015-12-01

    Study Design Systematic review. Objectives (1) To compare the quality of adverse event (AE) methodology and reporting among randomized trials comparing lumbar fusion with lumbar total disk replacement (TDR) using established AE reporting systems; (2) to compare the AEs and reoperations of lumbar spinal fusion with those from lumbar TDR; (3) to make recommendations on how to report AEs in randomized controlled trials (RCTs) so that surgeons and patients have more-detailed and comprehensive information when making treatment decisions. Methods A systematic search of PubMed, the Cochrane collaboration database, and the National Guideline Clearinghouse through May 2015 was conducted. Randomized controlled trials with at least 2 years of follow-up comparing lumbar artificial disk replacement with lumbar fusion were included. Patients were required to have axial or mechanical low back pain of ≥3 months' duration due to degenerative joint disease defined as degenerative disk disease, facet joint disease, or spondylosis. Outcomes included the quality of AE acquisition methodology and results reporting, and AEs were defined as those secondary to the procedure and reoperations. Individual and pooled relative risks and their 95% confidence intervals comparing lumbar TDR with fusion were calculated. Results RCTs demonstrated a generally poor description of methods for assessing AEs. There was a consistent lack of clear definition or grading for these events. Furthermore, there was a high degree of variation in reporting of surgery-related AEs. Most studies lacked adequate reporting of the timing of AEs, and there were no clear distinctions between acute or chronic AEs. Meta-analysis of the pooled data demonstrated a twofold increased risk of AEs in patients having lumbar fusion compared with patients having lumbar TDR at 2-year follow-up, and this relative risk was maintained at 5 years. Furthermore, the pooled data demonstrated a 1.7 times greater relative risk of

  18. Major geologic events of the Cauvery Basin, India and their correlation with global signatures – A review

    Directory of Open Access Journals (Sweden)

    R. Nagendra

    2017-01-01

    Full Text Available The present review is aimed at correlating major geologic events of the Cauvery Basin with analogous global episodes. The Cauvery Basin came into existence due to Gondwana break up during Late Jurassic–Early Cretaceous by taphrogenic rift process. The first marine transgression close to Aptian/Albian boundary at the western margin of the basin terminates the syn-rift tectonic phase, which is also precise in adjoining Krishna-Godavari (KG Basin. Two regional tectonic episodes are well documented in the basin which have global significance viz. (1 A major basinal uplift during late Turonian caused by Marion hot mantle plume resulted in widespread subaqueous volcanism in the southern part of the Cauvery Basin. This uplift also led to relative sea level (RSL fall of about 100 m in Cauvery and KG Basins and an unconformity of a magnitude of 2.3 Ma. The RSL fall closely correlates with global sea level fall. This volcanic episode also resulted in Madagascar detachment from India. (2 The reunion hot mantle plume that led to Deccan volcanism in central India resulted in E–SE tilt of the Cauvery Basin during upper Maastrichtian (CF1-CF3 zones. This tilt caused a sea level fall of about 80 m and lateral withdrawal of sea by about 50 km developing a major erosional unconformity ranging in magnitude of ∼1.8–30 My. The magnitude of RSL correlates well with global sea level fall. This sea level fall caused widespread development of canyon features in the Cauvery Basin resulting in differential subaqueous erosion. The globally significant ocean anoxic events viz. OAE-1b, OAE-1d, OAE-2 and OAE-3 are fairly discernible in the Cauvery Basin. The new isotopic palaeotemperature data suggests that southern India and Madagascar were located apparently in middle latitudes within the tropical-subtropical climatic zone during Albian and early Maastrichtian. The magnitude of hiatus across K–Pg boundary varying from 0 to 30 Ma is estimated based on planktic

  19. Adverse Events Associated with Immune Checkpoint Blockade in Patients with Cancer: A Systematic Review of Case Reports.

    Directory of Open Access Journals (Sweden)

    Noha Abdel-Wahab

    Full Text Available Three checkpoint inhibitor drugs have been approved by the US Food and Drug Administration for use in specific types of cancers. While the results are promising, severe immunotherapy-related adverse events (irAEs have been reported.To conduct a systematic review of case reports describing the occurrence of irAEs in patients with cancer following checkpoint blockade therapy, primarily to identify potentially unrecognized or unusual clinical findings and toxicity.We searched Medline, EMBASE, Web of Science, PubMed ePubs, and Cochrane CENTRAL with no restriction through August 2015.Studies reporting cases of cancer develop irAEs following treatment with anti CTLA-4 (ipilimumab or anti PD-1 (nivolumab or pembrolizumab antibodies were included.We extracted data on patient characteristics, irAEs characteristics, how irAEs were managed, and their outcomes.191 publications met inclusion criteria, reporting on 251 cases. Most patients had metastatic melanoma (95.6%, and the majority were treated with ipilimumab (93.2%. Autoimmune colitis, hepatitis, endocrinopathies, and cutaneous irAEs were the most frequently reported irAEs in ipilimumab treated patients. A broad spectrum of toxicities were reported for almost every body system. Moreover, well-defined diseases such as sarcoidosis, polyarthritis, polymyalgia rheumatica/arteritis, lupus, celiac disease, dermatomyositis, and Vogt-Koyanagi-like syndrome were reported. The most frequent irAEs reported with anti-PD1 agents were dermatitis for pembrolizumab, and thyroid disease and pneumonitis for nivolumab. Complete resolution of adverse events occurred in most cases. However, persistent irAEs and death were reported, mainly in patients treated with ipilimumab.Our study is limited by information available in the original reports.Evidence from case reports shows that cancer patients develop irAEs following checkpoint blockade therapy, and can occasionally develop clearly defined autoimmune systemic diseases

  20. A description of the "event manager" role in resuscitations: A qualitative study of interviews and focus groups of resuscitation participants.

    Science.gov (United States)

    Taylor, Katherine L; Parshuram, Christopher S; Ferri, Susan; Mema, Briseida

    2017-06-01

    Communication during resuscitation is essential for the provision of coordinated, effective care. Previously, we observed 44% of resuscitation communication originated from participants other than the physician team leader; 65% of which was directed to the team, exclusive of the team leader. We called this outer-loop communication. This institutional review board-approved qualitative study used grounded theory analysis of focus groups and interviews to describe and define outer-loop communication and the role of "event manager" as an additional "leader." Participants were health care staff involved in the medical management of resuscitations in a quaternary pediatric academic hospital. The following 3 domains were identified: the existence and rationale of outer-loop communication; the functions fulfilled by outer-loop communication; and the leadership and learning of event manager skills. The role was recognized by all team members and evolved organically as resuscitation complexity increased. A "good" manager has similar qualities to a "good team leader" with strong nontechnical skills. Event managers were not formally identified and no specific training had occurred. "Outer-loop" communication supports resuscitation activities. An event manager gives direction to the team, coordinates activities, and supports the team leader. We describe a new role in resuscitation in light of structural organizational theory and cognitive load with a view to incorporating this structure into resuscitation training. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Scheduling for production teams

    Directory of Open Access Journals (Sweden)

    Yuri Mauergauz

    2015-09-01

    Full Text Available This paper presents a method of calendar (weekly scheduling for production teams, when the average orders utility function is used as the quality criterion. The method is based on the concept of “production intensity”, which is a dynamic parameter of production process. Applied software package allows scheduling for medium quantity of jobs. The result of software application is the team load on the planning horizon. The computed schedule may be corrected and recalculated in interactive mode. Current load of every team is taken into account at each recalculation. The method may be used for any combination of complex and specialized teams.

  2. The NPD team conflict

    DEFF Research Database (Denmark)

    Ma, Zheng; Lin, Chih-Cheng; Tanev, Stoyan

    2012-01-01

    elaborates on the role of culture diversity and geographical dispersion in NPD team conflict. A simulation is conducted where organizations may be regarded as complex systems to affect the team conflict with a variety of influences. The results firstly indicate that there are two dimensions of NPD team...... conflict: stable and unstable dimensions with four elements: task characteristics, group members’ relationship, cultural diversity and geographical dispersion; secondly, there are two phenomena whereby the geographical dispersion influences the NPD team interaction, and the influence between cultural...

  3. Disagreements between central clinical events committee and site investigator assessments of myocardial infarction endpoints in an international clinical trial: review of the PURSUIT study

    Directory of Open Access Journals (Sweden)

    Lee Kerry L

    2001-07-01

    Full Text Available Abstract Background Limited information has been published regarding how specific processes for event adjudication can affect event rates in trials. We reviewed nonfatal myocardial infarctions (MIs reported by site investigators in the international Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin (Eptifibatide Therapy (PURSUIT trial and those adjudicated by a central clinical events committee (CEC to determine the reasons for differences in event rates. Methods The PURSUIT trial randomised 10,948 patients with acute coronary syndromes to receive eptifibatide or placebo. The primary end-point was death or post-enrolment MI at 30 days as assessed by the CEC; this end-point was also constructed using site-reported events. The CEC identified suspected MIs by systematic review of clinical, cardiac enzyme, and electrocardiographic data. Results The CEC identified 5005 (46% suspected events, of which 1415 (28% were adjudicated as MI. The site investigator and CEC assessments of whether a MI had occurred disagreed in 983 (20% of the 5005 patients with suspected MI, mostly reflecting site misclassification of post-enrolment MIs (as enrolment MIs or underreported periprocedural MIs. Patients for whom the CEC and site investigator agreed that no end-point MI had occurred had the lowest mortality at 30 days and between 30 days and 6 months, and those with agreement that a MI had occurred had the highest mortality. Conclusion CEC adjudication provides a standard, systematic, independent, and unbiased assessment of end-points, particularly for trials that span geographic regions and clinical practice settings. Understanding the review process and reasons for disagreement between CEC and site investigator assessments of MI is important to design future trials and interpret event rates between trials.

  4. Review of serious events in cases of (suspected) child abuse and/or neglect: A RoSE by any other name?

    Science.gov (United States)

    Raman, Shanti; Maiese, Michelle; Vasquez, Viviana; Gordon, Paola; Jones, Jennifer M

    2017-08-01

    Child abuse and neglect (CAN) cases presenting to health-services may be complex; when things go seriously wrong such as a child death or near miss, cases are reviewed and health-services and professionals subject to intense scrutiny. While there are a variety of mechanisms to review critical incidents in health-services no formal process for the review of cases where child protection is the primary concern exists in Australia. We aimed to develop a systematic process to review serious events in cases of suspected CAN across two health districts in Sydney, so that shared learnings could fuel system change. Drawing upon mapping, case review, literature findings and using quality improvement methodology, we developed a model named Review of Serious Events (RoSE), in suspected cases of CAN. The RoSE model has the key features of: being child focused; seeking to examine care over a period of time; using child protection staff as lead reviewers; involving health professionals/services in the review who have been involved with the child; and actioning systems change at local levels. The RoSE model was trialled through 2014-2015. Eight cases were reviewed using RoSE; cases were similar to those reviewed prior to having a model. Participant feedback from RoSE group processes was overwhelmingly positive; outputs were transparent and accessible to key stakeholders, there was mixed progress with implementation. The RoSE model is a serious case review process that is strongly child-focused, is both investigative and reflective, led by child protection experts; and can be adapted to other settings and systems. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  5. Event studies in Turkey

    Directory of Open Access Journals (Sweden)

    Ulkem Basdas

    2014-09-01

    Full Text Available The primary goal of this paper is to review the event studies conducted for Turkey to in order to identify the common components in their designs. This paper contributes to the existing literature by reviewing all event studies for Turkey for the first time, but more importantly; this review leads to the upcoming event studies on Turkey by highlighting main components of a proper design. Based on the review of 75 studies, it is observed that event studies generally choose BIST-100 (formerly, ISE-100 market index and market adjusted returns with the parametric tests. In general, the studies prefer to rely on one type of model to calculate abnormal returns without discussing the selection of the underlying model. Especially for the event studies focusing on the impact of political events or macroeconomic announcements in Turkey, there is a risk of clustering due to the application of same event date for all observations.

  6. Quantifying the role of adverse events in the mortality difference between first and second-generation antipsychotics in older adults: systematic review and meta-synthesis.

    Directory of Open Access Journals (Sweden)

    John W Jackson

    Full Text Available BACKGROUND: Observational studies have reported higher mortality among older adults treated with first-generation antipsychotics (FGAs versus second-generation antipsychotics (SGAs. A few studies examined risk for medical events, including stroke, ventricular arrhythmia, venous thromboembolism, myocardial infarction, pneumonia, and hip fracture. OBJECTIVES: 1 Review robust epidemiologic evidence comparing mortality and medical event risk between FGAs and SGAs in older adults; 2 Quantify how much these medical events explain the observed mortality difference between FGAs and SGAs. DATA SOURCES: Pubmed and Science Citation Index. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS: Studies of antipsychotic users that: 1 evaluated mortality or medical events specified above; 2 restricted to populations with a mean age of 65 years or older 3 compared FGAs to SGAs, or both to a non-user group; (4 employed a "new user" design; (5 adjusted for confounders assessed prior to antipsychotic initiation; (6 and did not require survival after antipsychotic initiation. A separate search was performed for mortality estimates associated with the specified medical events. STUDY APPRAISAL AND SYNTHESIS METHODS: For each medical event, we used a non-parametric model to estimate lower and upper bounds for the proportion of the mortality difference-comparing FGAs to SGAs-mediated by their difference in risk for the medical event. RESULTS: We provide a brief, updated summary of the included studies and the biological plausibility of these mechanisms. Of the 1122 unique citations retrieved, we reviewed 20 observational cohort studies that reported 28 associations. We identified hip fracture, stroke, myocardial infarction, and ventricular arrhythmias as potential intermediaries on the causal pathway from antipsychotic type to death. However, these events did not appear to explain the entire mortality difference. CONCLUSIONS: The current literature suggests that

  7. Quantifying the role of adverse events in the mortality difference between first and second-generation antipsychotics in older adults: systematic review and meta-synthesis.

    Science.gov (United States)

    Jackson, John W; Schneeweiss, Sebastian; VanderWeele, Tyler J; Blacker, Deborah

    2014-01-01

    Observational studies have reported higher mortality among older adults treated with first-generation antipsychotics (FGAs) versus second-generation antipsychotics (SGAs). A few studies examined risk for medical events, including stroke, ventricular arrhythmia, venous thromboembolism, myocardial infarction, pneumonia, and hip fracture. 1) Review robust epidemiologic evidence comparing mortality and medical event risk between FGAs and SGAs in older adults; 2) Quantify how much these medical events explain the observed mortality difference between FGAs and SGAs. Pubmed and Science Citation Index. Studies of antipsychotic users that: 1) evaluated mortality or medical events specified above; 2) restricted to populations with a mean age of 65 years or older 3) compared FGAs to SGAs, or both to a non-user group; (4) employed a "new user" design; (5) adjusted for confounders assessed prior to antipsychotic initiation; (6) and did not require survival after antipsychotic initiation. A separate search was performed for mortality estimates associated with the specified medical events. For each medical event, we used a non-parametric model to estimate lower and upper bounds for the proportion of the mortality difference-comparing FGAs to SGAs-mediated by their difference in risk for the medical event. We pro