Faculty Opinions recommendation of The impact of critical event checklists on medical management and teamwork during simulated crises in a surgical daycare facility.

2017 ◽  
Author(s):  
Craig Webster
Keyword(s):  
Medical Management ◽  
Critical Event ◽  
The Impact

The impact of critical event checklists on medical management and teamwork during simulated crises in a surgical daycare facility

Anaesthesia ◽  
2016 ◽  
Vol 72 (3) ◽  
pp. 350-358 ◽  
Author(s):  
T. C. Everett ◽  
P. J. Morgan ◽  
R. Brydges ◽  
M. Kurrek ◽  
D. Tregunno ◽  
...  
Keyword(s):  
Medical Management ◽  
Critical Event ◽  
The Impact

scholarly journals The impact of EEG in the diagnosis and management of patients with acute impairment of consciousness

2012 ◽  
Vol 70 (1) ◽  
pp. 34-39 ◽  
Author(s):  
João A. G. Ricardo ◽  
Marcondes C. França Jr. ◽  
Fabrício O. Lima ◽  
Clarissa L. Yassuda ◽  
Fernando Cendes
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Emergency Room ◽  
Medical Management ◽  
Clinical Management ◽  
Epileptiform Activity ◽  
Acute Setting ◽  
Diagnosis And Management ◽  
The Impact ◽  
Electroencephalogram Eeg

OBJECTIVES: To assess the frequency of electroencephalogram (EEG) requests in the emergency room (ER) and intensive care unit (ICU) for patients with impairment of consciousness (IC) and its impact in the diagnosis and management. METHODS: We followed patients who underwent routine EEG from ER and ICU with IC until discharge or death. RESULTS: During the study, 1679 EEGs were performed, with 149 (8.9%) from ER and ICU. We included 65 patients and 94 EEGs to analyze. Epileptiform activity was present in 42 (44.7%). EEG results changed clinical management in 72.2% of patients. The main reason for EEG requisition was unexplained IC, representing 36.3% of all EEGs analyzed. Eleven (33%) of these had epileptiform activity. CONCLUSION: EEG is underused in the acute setting. The frequency of epileptiform activity was high in patients with unexplained IC. EEG was helpful in confirming or ruling out the suspected initial diagnosis and changing medical management in 72% of patients.

Accounting for gaming in the time of plague: COVID-19 in Macau

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Carlos Noronha ◽  
Jieqi Guan ◽  
Sandy Hou In Sio
Keyword(s):  
Critical Event ◽  
Gaming Industry ◽  
Content Type ◽  
The Public ◽  
The Social ◽  
Social Account ◽  
The Government ◽  
The Impact ◽  
Practical Implications

Purpose While the COVID-19 virus has been spreading worldwide, some studies have related the pandemic with various aspects of accounting and therefore emphasized the importance of accounting research in understanding the impact of COVID-19 on society as a whole. Recent studies have looked into such an impact on various industries such as retail and agriculture. The current study aims at applying a sociological framework, sociology of worth (SOW), to the gaming industry in Macau, the largest operator of state-allowed gambling and entertainment in China, which will allow for its development during the COVID-19 pandemic to be charted. Design/methodology/approach The study uses the theory of SOW as a framework and collects data from various sources, such as the government, gaming operators and the public, to create timelines and SOW frameworks to analyze the impact of the virus on the gaming industry and the society as a whole. Findings Detailed content analysis and the creation of different SOW matrices determined that the notion of a “lonely economy” during a time of a critical event may be ameliorated in the long term through compromises of the different worlds and actors of the SOW. Practical implications Though largely theory-based, this study offers a thorough account of the COVID-19 incident for both the government and the gaming industry to reflect on and to consider new ways to fight against degrowth caused by disasters or crises. Social implications The SOW framework divides society into different worlds of different worths. The current study shows how the worths of the different worlds are congruent during normal periods, and how cracks appear between them when a sudden crisis, such as COVID-19, occurs. The article serves as a social account of how these cracks are formed and how could they be resolved through compromise and reconstruction. Originality/value This study is a first attempt to apply SOW to a controversial industry (gaming) while the effects of the COVID-19 pandemic are ongoing. It offers a significant contribution to the social accounting literature through its consideration of the combination of unprecedented factors in a well-timed study that pays close attention to analyses and theoretical elaboration.

Abstract 141: Impact of an Aggressive Medical Management Protocol on Early Risk Factor Measures in the Stenting and Aggressive Medical Management for Preventing Recurrent stroke in Intracranial Stenosis (SAMMPRIS) Trial

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Tanya N Turan ◽  
Azhar Nizam ◽  
Michael J Lynn ◽  
Colin P Derdeyn ◽  
David Fiorella ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Medical Management ◽  
Intracranial Stenosis ◽  
Patient Specific ◽  
Early Risk ◽  
Aggressive Medical Management ◽  
The Impact ◽  
Early Risk Factor

Purpose: SAMMPRIS is the first stroke prevention trial to include protocol-driven aggressive management of multiple vascular risk factors. We sought to determine the impact of this protocol on early risk factor control in the trial. Materials and Methods: SAMMPRIS randomized 451 patients with symptomatic 70%-99% intracranial stenosis to aggressive medical management or stenting plus aggressive medical management at 50 USA sites. For the primary risk factor targets (SBP < 140 mm/Hg (<130 if diabetic) and LDL < 70 mg/dL), the study neurologists follow medication titration algorithms and risk factor medications are provided to the patients. Secondary risk factors (diabetes, non-HDL, weight, exercise, and smoking cessation) are managed with assistance from the patient’s primary care physician and a lifestyle modification program (provided). Sites receive patient-specific recommendations and feedback to improve performance. Follow-up continues, but the 30-day data are final. We compared baseline to 30-day risk factor measures using paired t-tests for means and McNemar tests for percentages. Results: The differences in risk factor measures between baseline and 30 days are shown in Table 1. Conclusions: The SAMMPRIS protocol resulted in major improvements in controlling most risk factors within 30 days of enrollment, which may have contributed to the lower than expected 30 day stroke rate in the medical group (5.8%). However, the durability of this approach over time will be determined by additional follow-up.

scholarly journals Analysis of Minimum Cost of Supply Chain Emergencies Based on Diffusion Path Processing

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Yan Cao ◽  
Tian Tian ◽  
Wanyu Wei ◽  
Liang Huang ◽  
Yujia Wu
Keyword(s):  
Supply Chain ◽  
Clustering Algorithm ◽  
Minimum Cost ◽  
Diffusion Path ◽  
Critical Event ◽  
Design Structure ◽  
Perform Cluster Analysis ◽  
The Impact ◽  
The Relationship ◽  
Case Data

In view of the complexity and severity of the impact of supply chain emergencies on enterprise economy, this paper proposes modular processing to improve the design structure matrix (DMS), and the designed clustering algorithm is used to perform cluster analysis of the improved DMS, to predict the possible diffusion path of emergencies, and to establish the critical event diffusion path planning model by designing the critical event diffusion path storage method. As in the case data of a certain type of servo motor of the H Company, after data screening, the diffusion path is classified and stored by analyzing the relationship between each member of the supply chain network. Secondly, the same group of data is put into the method of this paper and other scholars’ to calculate the minimum cost of emergency response in time.

scholarly journals The Impact of Rapid Exome Sequencing on Medical Management of Critically Ill Children

2020 ◽  
Vol 226 ◽  
pp. 202-212.e1 ◽  
Author(s):  
Amanda S. Freed ◽  
Sarah V. Clowes Candadai ◽  
Megan C. Sikes ◽  
Jenny Thies ◽  
Heather M. Byers ◽  
...  
Keyword(s):  
Exome Sequencing ◽  
Critically Ill ◽  
Medical Management ◽  
Critically Ill Children ◽  
The Impact

scholarly journals Next level proctored exam for proficiency testing in Primary Care Education: an observatory study on efficiency and accuracy and on exam outcome. (Preprint)

2020 ◽  
Author(s):  
Birgitte Schoenmakers ◽  
Johan Wens
Keyword(s):  
Background Noise ◽  
Negative Impact ◽  
Cost Benefit ◽  
Critical Event ◽  
Future Research ◽  
Test Accuracy ◽  
Primary Care Education ◽  
Technical Issues ◽  
The Cost ◽  
The Impact

BACKGROUND The COVID19 pandemic affected education and assessment and led to a complex planning. Therefore, we organised the proficiency test for admission to Family Medicine as a proctored exam. To prevent from fraud we developed a virtual supervisor app tracking and tracing candidates’ behaviour. OBJECTIVE To assess efficiency and accuracy of the proctored exam procedure and to test the impact on the exam scores. METHODS The app operates on three levels to register events: recording of actions, analyses of behaviour and live supervision. Each suspicious event is given a score. To assess efficiency we inventoried the technical issues and the interventions. To test accuracy we counted the number of suspicious students and behaviours. To test the impact of the supervising app on students’ exam outcome we compared the scores between the proctored and the on campus group. Candidates were free to register for off or on campus participation. RESULTS 593 candidates subscribed to the exam: 472 (79%) candidates used the supervisor app and 121 (20%) were on campus. Test results of both groups were comparable. We registered 15 technical issues in off campus context. Two candidates experienced a negative impact on the exam due to the technical issue. The app detected 22 candidates with a suspicious level >1, mainly increased due to background noise. All events occurred without fraud purpose. CONCLUSIONS This pilot study demonstrated that a supervisor app with recording and registration behaviour is able to detect suspicious events without an impact on the exam. Background noise was the most critical event. There was no fraud detected. A supervisor app registering and recording behaviour to prevent from fraud during exams is efficient and not affecting the exam outcome. In future research, a controlled design should compare the cost-benefit balance between the complex intervention of the supervisor app and the combination of the candidates’ awareness of being monitored with a safe exam browsing plug in. CLINICALTRIAL Not applicable

scholarly journals Cholesterol Alters Mitophagy by Impairing Optineurin Recruitment and Lysosomal Clearance in Alzheimer’s Disease

2020 ◽  
Author(s):  
Vicente Roca-Agujetas ◽  
Elisabet Barbero-Camps ◽  
Cristina de Dios ◽  
Petar Podlesniy ◽  
Albert Morales ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cholesterol Homeostasis ◽  
Critical Event ◽  
Primary Neurons ◽  
Cholesterol Levels ◽  
Swedish Mutation ◽  
Intracellular Cholesterol ◽  
The Impact

Abstract Background: Emerging evidence indicates that impaired mitophagy-mediated clearance of defective mitochondria is a critical event in Alzheimer’s disease (AD) pathogenesis. Amyloid-beta (A) metabolism and the microtubule-associated protein tau have been reported to regulate key components of the mitophagy machinery. However, the mechanisms that lead to mitophagy dysfunction in AD are not fully deciphered. We have previously shown that intraneuronal cholesterol accumulation can disrupt the autophagy flux, resulting in low A clearance. In this study, we examine the impact of neuronal cholesterol changes on mitochondrial removal by autophagy.Methods: Regulation of PINK1-parkin-mediated mitophagy was investigated in conditions of acute (in vitro) and chronic (in vivo) high cholesterol loading using cholesterol-enriched SH-SY5Y cells, cultured primary neurons from transgenic mice overexpressing active SREBF2 (sterol regulatory element binding factor 2), and mice of increasing age that express the amyloid precursor protein with the familial Alzheimer Swedish mutation (Mo/HuAPP695swe) and mutant presenilin 1 (PS1-dE9) together with active SREBF2.Results: In cholesterol-enriched SH-SY5Y cells and cultured primary neurons, high intracellular cholesterol levels stimulated mitochondrial PINK1 accumulation and mitophagosomes formation triggered by A while impairing lysosomal-mediated clearance. Antioxidant recovery of cholesterol-induced mitochondrial glutathione (GSH) depletion prevented mitophagosomes formation indicating mitochondrial ROS involvement. Interestingly, when brain cholesterol accumulated chronically in aged APP-PSEN1-SREBF2 mice the mitophagy flux was affected at the early steps of the pathway, with defective recruitment of the key autophagy receptor optineurin (OPTN). Sustained cholesterol-induced alterations in APP-PSEN1-SREBF2 mice promoted an age-dependent accumulation of OPTN into HDAC6-positive aggresomes, which disappeared after in vivo treatment with GSH ethyl ester (GSHee). The analyses in post-mortem brain tissues from individuals with AD confirmed these findings, showing OPTN in aggresome-like structures that correlated with high mitochondrial cholesterol levels in late AD stages. Conclusions: Our data demonstrate that accumulation of intracellular cholesterol reduces the clearance of defective mitochondria and suggest recovery of the cholesterol homeostasis and the mitochondrial scavenging of ROS as potential therapeutic targets for AD.

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