Team Activation Research Articles

Case of death from community-acquired pneumonia with an abnormal clinical course

BACKGROUND. Nosocomial infection of the lower respiratory tract ranks fourth among all causes of patient mortality and first among causes of infectious mortality. The relevance of the problem lies in the fact that in old age, atypical pneumonia clinic frequently occurs, often in combination with other diseases, which significantly complicates the diagnostic search and selection of the leading syndrome of the disease. OBJECTIVE. To draw the attention of practicing doctors to the importance of timely establishing a clinical diagnosis of community-acquired pneumonia through adequate communication with patients and their relatives, correct collection of complaints, history and detailed physical examination. CLINICAL CASE. Patient L., born in 1952, did not have typical complaints characteristic of respiratory system damage, only signs of a severe intoxication syndrome that gradually progressed. Community-acquired pneumonia, which was the main cause of the patient’s death, was first diagnosed only after a chest X-ray during hospitalization. The relatives of the deceased patient received a complaint about the actions of the emergency medical team, which did not conduct an examination of the patient and did not explain the possible medical consequences of refusing hospitalization. CONCLUSIONS. Elderly people often have an atypical course of community-acquired pneumonia, which can be combined with various pathologies, that complicates the diagnosis and requires a certain vigilance and a thorough physical examination of the patient. In practical medicine, the problem of frequent complaints and lawsuits from patients and their relatives of medical workers, who expect a professional attitude to their duties, is becoming more and more relevant.

Adherence to national trauma triage criteria in Norway: a cross-sectional study

BackgroundNorwegian hospitals employed individual trauma triage criteria until 2015 when nationwide criteria were implemented. There is a lack of empirical evidence regarding adherence to Norwegian national criteria for activation of the trauma team (NTrC) and the decision-making processes regarding trauma team activation (TTA) within Norwegian trauma hospitals. The objectives of this study were to investigate institutional adherence to the NTrC and to investigate similarities and differences in the decision-making process leading to TTA in Norwegian trauma hospitals.MethodsA digital semi-structured questionnaire regarding adherence to criteria, TTA decision-making and criteria documentation was distributed to all Norwegian trauma hospitals (n = 38) in the spring of 2022. Contact details of trauma coordinators and registrars were provided by the Norwegian Trauma Registry secretariat. Follow-up telephone interviews were conducted at the investigator’s discretion in cases of non-respondents or need to clarify answers.ResultsThirty-eight trauma hospitals were invited to answer the survey, where 35 hospitals responded (92%), making 35 the denominator of the results. Thirty-four (97.1%) hospitals stated that they followed NTrC. Thirty-three (94.3%) of the responding hospitals provided documentation of their criteria in use, of which twenty-eight (80%) of responding hospitals adhered to the NTrC. Three (8.6%) hospitals employed a tiered TTA approach with different sized teams. In addition four hospitals (11.4%) used specialized teams to meet the needs of defined patient groups (e.g. geriatric patients, traumatic brain injury). Twenty-one (60%) of the responding hospitals had written guidelines on who could perform TTA and in 18 hospitals (51.4%) TTA could be performed by pre-hospital personnel. Twenty-three (65.7%) of the hospitals documented which criteria that were used for TTA.ConclusionThere is good adherence to the national criteria for activation of the trauma team among Norwegian trauma hospitals after implementation of national guidelines. Individual hospitals argue the use of certain local criteria and trauma team activation decision-making processes to increase their precision in specific patient populations and demographics. Further steps should be done to reduce the variation in TTA decision-making processes among hospitals and improve documentation quality.

Future‐Making Power: A Study of Competing Imagined Futures in Healthcare

AbstractThis paper presents a conceptual model of strategies of power in future‐making, informed by a case study in the healthcare sector. In zooming out from investigating the future‐making activities of an organizational innovation project team and tracing competing imagined futures enacted by medical professionals and strategic management, this study explains how and why the project struggled to realize its mandate. In this case, we identify three strategies of power, namely mobilization, discipline and discretion, and discuss their potential controversies and combinations. Moreover, we contribute to theories on discretionary power, demonstrating how it is produced by combining interdiscursivity with management control and nondecision. Strategies of discretion are productive in the realm of future‐making, particularly in exploiting forces of discipline and mobilization to enable parallel imagined futures to be created and maintained over time. On the downside, this may keep competing imagined futures hostage, potentially serving non‐transparent agendas.

أثر استخدام استراتيجية دمج الأقران في تنمية المهارات الاجتماعية لدى الأطفال التوحديين: دراسة تجريبية على عينة من طلاب صف التوحد بمدرسة الحد الابتدائية للبنين

This study aimed to investigate the effect of using the peer integration strategy in developing social skills in autistic children, by answering the following main question: What is the effect of using the peer integration strategy in developing social skills in autistic children? To answer the main study question included in the context of this study, the researcher in this study followed the quasi-experimental approach that relies on studying the phenomenon as it exists in reality, and is based in its original construction on experimental application; to obtain data from its primary sources through a questionnaire that was designed according to the scientific steps approved in this regard, as it was applied to the study community consisting of all autism students registered in government schools in the Kingdom of Bahrain in the academic year 2022/2023 AD, numbering (106) male and female students according to official statistics issued by the Ministry of Education in the Kingdom of Bahrain. By selecting (5) autism students registered at Al-Hadd Elementary School for Boys in the academic year 2022/2023, with mild and moderate autism, and selecting (5) normal students to play the role of peers, as they were chosen by classroom teachers and subject teachers based on their personal qualities that qualify them to play the role of peers, their high academic level, their activity in school committees and teams, in addition to their personal desire to support the autism class as a deliberate sample for the study. This school was chosen because the researcher works as an assistant director in it, which made it easy for her to implement the experiment easily and smoothly, as well as bypassing many of the administrative matters required by this type of field applications. After ensuring that the study tools met their psychometric characteristics, they were applied to the target sample, and statistical analysis was conducted to extract the results. The results of the study concluded that the performance of the study individuals on the post-measurement items was better than their performance on the pre-measurement items, as the arithmetic mean of their scores on the post-measurement items was (2.72) with a standard deviation of (0.09), while the mean scores of the study individuals after applying the experiment to them on the pre-measurement items was (2.48) with a standard deviation of (0.06). The results of the study also showed that the calculated value of (z) indicates the presence of statistically significant differences at a significance level (@=0.05) in the average scores of the study members related to the effectiveness of the training program in developing social skills in children on the pre- and post-measurement items, meaning that the applied training program affected the performance of the study members.In light of the results reached by the study, it recommends working on training families of autistic children through workshops and training courses and involving them in the design and implementation of educational programs. As well as training autistic children on social skills at an early age to help them rely on themselves in their daily lives.

Parents’ Perception of the Role of Sports in Supporting Psychological and Social Development in Children with Specific Learning Disorders

Background: This study aims to examine parents’ perceptions of how coach support influences the satisfaction of basic psychological needs (autonomy, competence, and relatedness) and its subsequent impact on the self-esteem and overall well-being of children with Specific Learning Disorders (SLDs) through participation in sports. Methods: The sample consisted of 1146 parents of children and young people diagnosed with SLDs from several European countries. The Coach Support Scale (COS), the Basic Psychological Needs Satisfaction Scale (BPNS), the Rosenberg Self-Esteem Scale (RSES), and the Sport Impact Scale (SIS) were used. Descriptive, reliability, Gaussian distribution, and ANOVA analyses were conducted. Results: The results show that increased sports participation is associated with higher perceptions of coach support, autonomy, competence, psychological need satisfaction, self-esteem, relatedness, and the positive impact of sports on the lives of children and adolescents with SLDs. Children and teenagers who engage in individual and team sports exhibit greater coach support, autonomy, competence, relatedness, BPNS, and self-esteem compared to those who participate in only one type of sport, with p-values ranging from 0.004 to 0.050. Conclusions: In conclusion, participation in sports seems to benefit the self-esteem and well-being of children and young people with SLDs. The practical applications of this study highlight the importance of specialized coach training to address the psychological needs of children with SLDs, the development of balanced sports programs that integrate individual and team activities to optimize benefits, the encouragement of parental involvement to enhance positive experiences, and the implementation of policies that support inclusive and adaptive sports practices.

A IMPORTÂNCIA DA FISIOTERAPIA IMEDIATA NO PÓS-OPERATÓRIO DE LIGAMENTO CRUZADO ANTERIOR: REVISÃO DE LITERATURA

Introduction: Reconstruction of the anterior cruciate ligament (ACLR) has been very prominent in the academic and professional experience of those involved in this process, physiotherapists, trauma-orthopedists, anesthesiologists and surgeons. However, there is still no consensus on the performance of the multidisciplinary team and its techniques, with disagreements regarding the benefits and actions of the multidisciplinary team in the ACLR process. Objective: This study aims to understand the effectiveness of immediate physiotherapy in the postoperative period of anterior cruciate ligament, to evaluate the quality of life after physiotherapy treatment in athletes and men who have undergone this reconstruction. Materials and methods: This is a literature review whose databases were Scielo, Pubmed and Google Scholar, the keywords used were: immediate physiotherapy, anterior cruciate ligament postoperative period, physiotherapy and ACL, in Portuguese and English. Results: 245 articles were found related to the importance of immediate physiotherapy in the postoperative period of anterior cruciate ligament. Conclusion: It is necessary for the physiotherapist to know all phases of ACLR rehabilitation to understand the symptoms that the patient will present and to be prepared, thus having expertise on which technique to use in each phase of rehabilitation. It is necessary for the physiotherapist to set up individualized rehabilitation protocols for each patient. using the greatest diversity of techniques, which prioritize performance for the patient’s greatest gain in function, forgetting rehabilitation time and thus increasing the quality of rehabilitation and safety when returning to sports or daily life.

The current physical activity in persons with disability in Qatar: a cross-sectional study.

The primary objective of this study was to measure and quantify the current level of physical activity among persons with disability in Qatar. The secondary objective was to assess and analyze the duration of sedentary behavior among individuals with disability in Qatar. This was a cross-sectional epidemiological study of persons with disability living in Qatar. The study period was from October 2020 to December 2021. 96 persons with disabilities participated in this study. They included individuals with amputations, spinal cord injuries, cerebral palsy, and other developmental impairments. Of the respondents, 56% were male and 64% were Qataris. Of the respondents, 61.5%said that they felt psychologically and emotionally better when engaging in physical activity, and this difference was statistically significant. 71% of all those who reported feeling physically good after sport, 65% said that they enjoyed the social aspects of sports. This corroborates the beneficial effects of exercise, sports, and physical activity in persons with all types of disabilities. There was a definite impact on the emotional and physical well-being of those who participated in the physical activities. There was less participation in team activities and two-thirds preferred to exercise alone. However, their numbers were not statistically significant because of low enrollment in the study.

Protocol for COACH, an evidence-based intervention for improved head impact safety in youth American football developed using a community-engaged approach.

Subconcussive, repetitive head impacts sustained in collision sports may negatively affect brain health. American football practices are controlled environments amenable to intervention. Engaging community members is essential for successful development, implementation, and sustainability of viable interventions. The objective of this study is to develop and pilot test an evidence-based intervention to reduce head impact exposure in youth American football (i.e., football), using a community-engaged approach. This manuscript describes the co-design of the intervention and associated implementation plan and the study protocol for evaluating the effectiveness and feasibility of the intervention and implementation plan. In the first part of this study, focus groups with parents and coaches, and individual interviews with organizational leaders associated with two teams at the middle school level were conducted. An anonymous survey assessing beliefs and perceptions of non-concussive head impacts was given to parents, coaches, and organizational leaders within the local youth football league. Following the football season, qualitative and quantitative data describing determinants of head acceleration events in football were shared with 12 stakeholders of coaches, league and school administrators, parents, an athletic trainer, and local university player development director. Together, we co-designed COACH (COmmunities Aligned to reduce Concussion and Head impact exposure) and implementation plan using a strategic planning approach. The preliminary effectiveness and feasibility were assessed in the second part of this study. Youth football players participating on the teams in year 1 (control teams) were fitted with mouthpiece-based head kinematic sensors which measure head acceleration events (HAEs). HAEs were collected and quantified during team activities. Preliminary effectiveness of the intervention to reduce HAEs was measured among two new teams pilot testing COACH with mouthpiece-based sensors, while simultaneously monitoring implementation of the intervention. We report our study design and evaluation, and opportunities and challenges with our approach. The results will inform a future full-scale pragmatic trial to assess the implementation and effectiveness of the intervention program. NCT04908930.

팀 기여도 동료평가에서 평가 준거의 구체성에 따른 동료평가에 대한 인식과 동료평가의 효과성

The purpose of this study is to explore learners' perceptions of peer assessment and evaluate its effectiveness based on the specificity of peer assessment criteria in teamᐨbased collaborative learning. The specificity of peer assessment criteria was examined through two independent variables: the use of detailed criteria and the presentation of evaluation grounds. Learners' perceptions were assessed via quantitative surveys and openᐨended questions focused on the usefulness and fairness of peer assessment, while the effectiveness was determined by the extent of equal participation in team activities, measured by actual team contribution scores. A total of 84 undergraduate students participated in the study. The findings revealed that the use of detailed criteria didn't show the statistical significance, but the provision of evaluation grounds significantly influenced learners' perceptions of the usefulness and fairness of peer assessment, though no interaction effect between the two was found. This suggests that regardless the use of specific criteria, evaluation grounds are provided enhances the perceived usefulness and fairness of peer assessment in evaluating team contributions. Moreover, the study found that group D (which used holistic criteria without providing evaluation grounds) demonstrated relatively unequal team contributions compared to other groups, highlighting the impact of specific peer assessment methods on team contribution within collaborative learning settings. To further clarify the quantitative results, openᐨended responses reflecting learners' perceptions of peer assessment were thoroughly reviewed to interpret the findings. The discussion was approached from the perspective of suggesting specific strategies for utilizing peer assessment to enhance learners' contributions in collaborative learning settings.

A IMPORTÂNCIA DA FISIOTERAPIA IMEDIATA NO PÓS-OPERATÓRIO DE LIGAMENTO CRUZADO ANTERIOR: REVISÃO DE LITERATURA

Introduction: Reconstruction of the anterior cruciate ligament (ACLR) has been very prominent in the academic and professional experience of those involved in this process, physiotherapists, trauma-orthopedists, anesthesiologists and surgeons. However, there is still no consensus on the performance of the multidisciplinary team and its techniques, with disagreements regarding the benefits and actions of the multidisciplinary team in the ACLR process. Objective: This study aims to understand the effectiveness of immediate physiotherapy in the postoperative period of anterior cruciate ligament, to evaluate the quality of life after physiotherapy treatment in athletes and men who have undergone this reconstruction. Materials and methods: This is a literature review whose databases were Scielo, Pubmed and Google Scholar, the keywords used were: immediate physiotherapy, anterior cruciate ligament postoperative period, physiotherapy and ACL, in Portuguese and English. Results: 245 articles were found related to the importance of immediate physiotherapy in the postoperative period of anterior cruciate ligament. Conclusion: It is necessary for the physiotherapist to know all phases of ACLR rehabilitation to understand the symptoms that the patient will present and to be prepared, thus having expertise on which technique to use in each phase of rehabilitation. It is necessary for the physiotherapist to set up individualized rehabilitation protocols for each patient. using the greatest diversity of techniques, which prioritize performance for the patient’s greatest gain in function, forgetting rehabilitation time and thus increasing the quality of rehabilitation and safety when returning to sports or daily life.

Methodological Guidelines and Publications of Benefitrisk Assessment for Health Technology Assessment: A Scoping Review

Introduction Benefit-risk assessment (BRA) is an important component in decision-making throughout the lifecycle of a health technology. The BRA of comparative technologies was usually carried out informally, without the use of a systematized process, which can lead to inappropriate decisions. In the last two decades, efforts have been observed to use more structured, objective and transparent approaches, aiming at better communication and decision-making by stakeholders. In this sense, some frameworks have been proposed to guide BRA, and are currently available. Therefore, we conducted a scoping review to: (1) map the available methodological guidelines and documents for conducting and reporting BRA in the different phases of the lifecycle of health technologies; and (2) identify methodological guidelines on methods for BRA, which could be used as the basis for the development of a BRA guideline for the Brazilian Health Technology Assessment (HTA) context. Methods Our searches were conducted between Oct 2022 to Mar 2023 in three main sources: (1) electronic databases (EMBASE and MEDLINE); (2) grey literature (48 HTA and regulatory organizations); and (3) manual search and contacting experts in the field. We included methodological guidelines or publications presenting methods for conducting or reporting BRA of any types of health technologies developed in any context of the health technology’s lifecycle. Selection process and data charting were conducted by pairs of independent reviewers. We provided a narrative synthesis of the findings. Results From the 83 eligible documents, only six stated the HTA context, 30 were produced in the regulatory setting and 35 documents involved guidance for BRA throughout the health technology’s lifecycle. Among the 129 methodological approaches for BRA identified, the most frequently cited descriptive frameworks were the Problem, Objectives, Alternatives, Consequences, Trade-offs, Uncertainty, Risk, and Linked decisions (PrOACT-URL) and the Benefit Risk Action Team (BRAT), reported in 29 (34.9%) of the documents. Multicriteria Decision Analysis was the most common quantitative framework, cited in 52 (62.7%) of the documents. Other frequent quantitative frameworks cited were Markov Decision Process (n=18; 21.7%) and Decision Tree (n=16; 19.3%). We also identified the most cited metric indices which could be used to measure benefits and risks: numbers needed to harm (n=38; 45.8%) and to treat (n=37; 44.6%) as threshold indices, quality-adjusted life-year (n=37; 44.6%) as health index, and incremental net health benefit (n=32; 38.6%) as trade-off index. The documents also report probabilistic simulation method (n=32; 38.6%) and indirect treatment comparison (n=18; 21.7%) as the most common estimation techniques, while discrete choice experiment and conjoint analysis, mentioned in 26 (31.3%) documents, were the most mentioned utility survey techniques to elicit preferences for quantitative BRA. Discussion and conclusion The efforts for using formal structure approaches for BRA in HTA and at population level have been more modest than in the regulatory setting. We will test and explore the potential of the two most cited descriptive and quantitative frameworks in case studies in the context of HTA to evaluate their performance. The case studies using the frameworks identified in this review will support the elaboration of the Brazilian guideline of BRA for HTA.

Prognostic Factors Associated With Survival Distribution of Admission to Delayed Rapid Response Team Activation Among Deteriorating Patients: A Retrospective Study.

To investigate the prevalence of rapid response team delays, survival distribution of admission to rapid response team delay and its prognostic factors. A retrospective single-centre study. Data on rapid response team activations from 1 January 2018 to 31 December 2022 were retrieved from electronic medical records at a tertiary hospital in Hangzhou, China. All patients who met the eligibility criteria were included. Multivariable Cox regression analysis was conducted to analyse the data. Out of 636 patients included, 18.4% (117) experienced a delay, with a median (interquartile range) of 8.5 (12) days from admission to rapid response team activation. Six significant prognostic factors were found to be associated with the higher hazard ratio of rapid response team delay, including call time (05:01 PM and 7:59 AM), emergency admission, a higher Modified Early Warning Score, an admission diagnosis of infection, a comorbidity of respiratory failure/Acute Respiratory Distress Syndrome and the absence of lung infection. The prevalence of rapid response team delays was lower, and the days from admission to rapid response team delay was longer than in previous studies. Healthcare providers are suggested to prioritise the care of high-risk patient groups and provide proactive monitoring to ensure timely identification and management. Implementing artificial intelligence in continuous monitoring systems for high-risk patients is recommended. The findings help nurses anticipate potential delays in rapid response team activation, enabling better preparedness. The study highlights the prevalence of rapid response team delays, timing from admission to rapid response team activation and six prognostic factors influencing delays. It could shape patient care and inform future research. Hospital administrators should review staffing, especially during night shifts, to minimise delays. Further qualitative research is needed to explore why nurses may delay rapid response team activation. The STROBE checklist was adhered to when reporting this study. 'No patient or public contribution'.

The influence of emotional intelligence and peer social support on subjective well-being in early adolescents at SMP Istiqomah Sambas Boarding School Purbalingga

Adolescence is a period of development marked by upheaval and conflict, which can explain the problems experienced by students at Islamic boarding schools. This is related to students' comfort while living in Islamic boarding schools, which can reduce the level of subjective well-being of teenagers. This research examined the influence of emotional intelligence and peer social support on subjective well-being in early adolescents at SMP Istiqomah Samabas Boarding school Purbalingga. This research uses a quantitative approach with multiple linear regression analysis methods. This research used a saturated sampling technique in which the entire population was sampled, a total of 118 students, with 60 male students and 58 female students. The measuring instruments used are the subjective well-being scale (SwLS and SPANE), the emotional intelligence scale (EII), and the peer social support scale (SSSS). This research shows a significant influence between emotional intelligence and peer social support on subjective well-being, with a value of F=18.158, P=0.000, and R Square of 0.240, meaning that emotional intelligence and peer social support contribute 24% to subjective well-being. It is essential to carry out positive activities to develop emotional intelligence and team activities to foster a sense of friendship to increase high subjective well-being.

Effects of a Virtual Trauma Clinic on admissions and length of stay for minor to moderate trauma.

To investigate the feasibility of a Virtual Trauma Clinic (VTC) for patients with minor to moderate trauma, and evaluate patient satisfaction and outcomes. One hundred VTC patients were matched 1:1 with historical patients from the hospital trauma registry who received conventional care. Matching was based on age ± 5 years, sex, mechanism of injury, Injury Severity Score ± 2, trauma team activation and day of week of presentation. VTC patients were sent surveys on experience and outcome measures. VTC was associated with reduced average hospital length of stay for admitted patients by 1.81 days (95% CI = -2.82, -0.79; P = 0.001) and reduced hospital admissions (odds ratio 0.26; 95% CI = 0.14, 0.48; P < 0.001). There was an avoidance of 199 inpatient bed days in total, with no trauma-related readmissions within 30 days post-hospital discharge. 92% of respondents (n = 22) rated the care they received from VTC as excellent or good. Patient-reported outcome surveys showed overall improvement in functional domains but evidence of ongoing disability, with persistent issues of pain and psychological distress at 1 month post-injury. Patients with minor to moderate trauma have ongoing care needs with high rates of pain, psychological distress and disability remaining prevalent long after discharge. VTC provided an innovative strategy for hospital avoidance with high levels of patient satisfaction and no adverse effects on safety. The overall quality of care for these patients was enhanced through the provision of standardised, patient-centred and multidisciplinary follow-up.

Train one and get a crew: a multilevel evaluation of team-centric leadership training for airport security screening crew leaders

PurposeThis study aims to introduce a team-centric leadership training program tailored for leaders of critical action teams. It emphasizes the critical role of effective teamwork in high-stakes environments.Design/methodology/approachThe authors developed a team-centric leadership training program for crew leaders of airport security teams. The training program comprised in-class teaching on the psychological foundations of teamwork and practical simulations. The training program’s effectiveness was assessed at the individual and team levels using Kirkpatrick’s evaluation model to obtain a complete evaluation of its effectiveness. First, a pre- and posttraining questionnaire recorded changes in self-efficacy, knowledge and skills about teamwork at the individual level from 62 leaders. Second, the authors assessed the transfer effects of the team-centric leadership training on self-reported team processes and team performance during a work shift of 37 crews.FindingsResults indicate an improvement in the application of teamwork skills but not in self-efficacy or knowledge among crew leaders who underwent the training. Additional analysis revealed that leaders with initially high self-efficacy in teamwork experienced a reduction posttraining, whereas those with initially low levels reported an increase. Teams led by trained leaders demonstrated a higher engagement in key team processes than those led by untrained leaders. No effect has been found on team performance.Originality/valueThis study offers a cost-effective alternative to conventional teamwork training methods, specifically designed for high-pressure security contexts. The authors advocate for the adoption of this training model by security professionals, aiming to elevate team processes and operational efficacy in critical action teams.

Picture Perfect: A Task Interdependence and Communication Experiential Activity for Teams

Effective communication in interdependent group tasks plays a pivotal role in organizational effectiveness, especially in today’s dynamic and global workplace. As the modern workplace evolves toward more remote work environments and dynamic work teams, the ability to adapt communication strategies across various job designs and work settings becomes increasingly crucial. In this article, we present an experiential learning activity designed for management education that delves into the impact of task design on communication. Drawing from theories of team interdependence, this immersive experience enables students to identify the essential facets of communication and their relationship with various types of task interdependence. It equips them with valuable skills and communication strategies that are vital for various types of teamwork across different types of settings. Suitable for a wide range of educational settings, this experiential activity serves as a valuable resource for management educators.

Leveraging the Fetal and Infant Mortality Review (FIMR) Process to Advance Health Equity.

The fetal and infant mortality review (FIMR) process is a community-oriented strategy focused on improving the health services systems for pregnant persons, infants, and their families. FIMR helps communities to understand and change systems that contribute to racial disparities in birth outcomes. FIMR equally values the medical and social services delivery records and the personal narratives of families who have suffered a fetal or infant loss when creating the de-identified case summaries to be reviewed by teams. A two-tiered process, FIMR uses a multidisciplinary Case Review Team (CRT) as the information processor and the Community Action Team (CAT) as the action arm of the process. Pediatricians are vital to both teams, helping to bring about systems change to improve maternal and child health. This paper examines how the well-established FIMR team serving Indianapolis (Marion County, IN) worked to build the capacity of its CAT to address racial disparities in birth outcomes through 5 distinct steps: focus on the primary causes of local fetal or infant mortality, focus on neighborhoods with the highest stable fetal or infant mortality rates, designation of a CAT leader, creation of a culture of regular CAT meetings inclusive of a health-equity skill building curriculum, and inclusion of Grassroots Maternal and Child Health Leaders on the CAT. This paper demonstrates how the synergy between local organizations and community members can effectively address racial disparities in birth outcomes.

Accuracy of the Norwegian trauma protocol. An observational population study from South-Western Norway.

The Norwegian trauma plan was established in 2007 and renewed in 2017 defining national trauma team activation (TTA) criteria. Norwegian studies validating the performance of previous TTA protocols have found overtriage and undertriage to be out of line with the quality indicators set in the national trauma plan, but studies have not yet been published validating the new TTA protocol. This was a registry study of a prospectively maintained database in the period from 01/01/2018 to 12/31/2020. Data were collected from the Trauma Registry including prehospital documents. A total of 1519 patients were eligible, of which 95 were excluded, yielding a study population of 1424 patients. All patients were evaluated for a total of 29 criteria in four criteria groups: 1 Physiology, 2 Anatomical injury, 3 Mechanism of injury, and 4 Special considerations. Overtriage, undertriage, sensitivity and positive predictive value (PPV) were estimated for the current and alternative TTA protocols, criteria groups, and single criteria. The current Norwegian TTA protocol involving criteria groups 1-3 had a total sensitivity of 84.8 %, hence an undertriage of 15.2 % (95 % confidence interval, 11.1-20.3 %), and PPV of 19.2 % hence an overtriage of 80.8 % (78.3-83.1 %). Patients 60 years and older had an undertriage of 21.6 %, whilst patients under 60 years of age had an undertriage of 11.2 %. A TTA protocol including criteria group 4 as well yielded a lower undertriage (5.6 %) without significantly increasing overtriage (81.7 %), and a TTA protocol with criteria group 4 replacing group 3 yielded an undertriage of 7.4 % and an overtriage of 81.0 %. Criteria group 3 Mechanism of injury was the criteria group with the most overtriage, at 95 %. Patients that did not meet any criteria had a similar overtriage of 94 %. Both overtriage and undertriage are out of line with the goals set in the Norwegian trauma plan. Undertriage is often caused by older patients that do not fulfill the trauma criteria in the current TTA protocol. Mechanism of injury increases overtriage but does not reduce undertriage. The TTA protocol could be improved by changing the composition of criteria groups, removal of single criteria with low PPV, and by better compliance to the existing criteria.

Comparison of facilities with and without additional medical fees for nutrition support team activity during the COVID-19 pandemic

BackgroundThis study aimed to clarify the effectiveness of nutrition support team (NST) facilities for preventing central line-associated bloodstream infection (CLABSI).MethodsWe retrospectively analyzed the incidence of CLABSI as well as the presence or absence of additional medical fees for NST activity between 2019 and 2021, including the period before and after the COVID-19 pandemic. Subsequently, we performed between-group comparisons of the CLABSI incidence. CLABSI rates were compared based on cumulative per 1000 catheter uses during the relevant period.ResultsAmong 47 facilities that were registered for participation, there were 34 and 13 facilities with and without additional medical fees for NST activity (NST and non-NST groups, respectively). The CLABSI incidence rate was significantly lower in the NST group 0.96 [0.28–1.73] than in the non-NST group 1.25 [075–6.10] (p < 0.05). Before the pandemic, the NST group had a lower CLABSI rate per 1000 catheter uses than the non-NST group 2019: 0.70 [0.12–1.26] vs 2.10 [0.62–5.97]. During the pandemic, the CLABSI incidence showed no significant between-group difference 2020: 0.99 [0.51–1.61] vs 1.01 [0.80–4.16]; 2021: 1.24 [0.44–2.35] vs 1.96 [1.23–5.31]; however, the CLABSI rates in the NST group remained low.ConclusionDuring the COVID-19 pandemic, the incidence of CLABSI was lower in the NST group than in the non-NST group, indicating the effectiveness of NST in preventing the occurrence of CLABSI.

The Impact of Team-Based Learning Activities on Learning Satisfaction : Focusing on the Mediating Effects of Learning Engagement and Problem-Solving Skills

This study aims to analyze the structural relationships between the impact of team-based learning activities on learning satisfaction and the mediating effects of learning engagement and problem-solving skills in the common liberal arts course Masterpieces of Wisdom and Compassion Seminar, which was revised and operated using a team-based learning teaching method in the first semester of 2024. A survey was conducted from June 10 to 17, 2024, targeting students who took the Masterpieces of Wisdom and Compassion Seminar, and the analysis was performed using structural equation modeling. The main findings of the study are as follows: First, team-based learning activities showed positive correlations with learning engagement, problem-solving skills, and learning satisfaction. Second, team-based learning activities had significant positive effects on learning engagement, problem-solving skills, and learning satisfaction. These results imply that better adaptation to team-based learning activities, higher learning engagement, and better problem-solving skills lead to higher learning satisfaction among students. Additionally, one of the major changes in the revised course operation was the initial step of learning readiness. This process likely contributed to enhancing learning engagement and problem-solving skills, and increasing learning satisfaction during the team activities of presenting and discussing topics. However, there is a need to address issues such as the lack of time for students to read the masterpieces, the burden of evaluating learning readiness which hampers immersion in understanding the masterpieces, difficulties in communication and cooperation among team members which may lower learning engagement, problem-solving skills, learning satisfaction, and concerns about the reduction of individual competence due to the increased scope and weight of team activity-related tasks.