Assessment Team Research Articles

Immediate outcome assessment of the rapid response team of home health care services at King Abdulaziz Medical City in Riyadh.

Paediatrics rapid response team (RRT) is a newly developed service under paediatrics home health care (HHC) programme which is a standby visiting team that responds to non-critical emergency calls. The current study aimed to compare the total emergency visits and hospital admissions before and after implementation of RRT project. A retrospective chart review was conducted from December 2018 to December 2020. Paediatric patients registered under the home health care (HHC) programme were the target population. The admission and hospitalization rates were assessed before and after the implantation of an RRT. The variables related to patient profile were assessed to explore the association between hospitalization and admission. Data for 117 patients and a total of 114 calls attended under HHC covered by RRT were analysed. In the first year after the implementation of RRT, the mean number of ER visits per patient per year was reduced from 4.78 ± 6.10 to 3.93 ± 4.12 with (P value, 0.06). Also, a slight decrease in the mean number of admissions from 3.74 ± 4.43 to a mean of 3.46 ± 4.1 with (P value, 0.29). Follow-up after receiving an RRT call for an initial complaint was statistically significant in reducing both ER visits and hospital admissions within 7 days with a P value of 0.03 and 0.04, respectively. The RRT was effective in decreasing the ER visits and hospital admissions for a very special group of patients. Additionally, the emplacement of proper triaging code at the time of attending to patients helped in reducing unnecessary ER visit and hospital admission.

Assessment of the Psychosocial Care Center multidisciplinary team from users' and family members' perspective.

to assess the multidisciplinary team of a Psychosocial Care Center I from users' and family members' perspective. an evaluative study, anchored in the fourth generation evaluation theoretical-methodological framework, carried out in a Psychosocial Care Center I, from September 2021 to March 2022. Eleven users and 06 family members participated. Data were collected through non-participant observation, individual interviews and negotiation sessions, and analyzed using the Constant Comparative Method, using the MAXQDA software. the team develops its care based on individual and collective care, with integrated and complementary work by professionals. They seek to facilitate treatment initiation and continuation, considering health needs and offering support, understanding and guidance to users and their families. the multidisciplinary team's work is based on the psychosocial paradigm, which can qualify care and strengthen the service role in the mental health network.

Low-flow, Low-gradient Severe Aortic Stenosis: A Review.

Aortic stenosis (AS) is a common valve pathology experienced by patients worldwide. There are limited population-based studies assessing its prevalence; however, epidemiological studies emphasize that the burden of disease is growing. Recognizing AS relies on accurate clinical assessment and diagnostic investigations. Patients who develop severe AS are often referred to the heart team for assessment of aortic valve intervention. Although echocardiography has traditionally been used to screen and monitor the progression of AS, there can be discordance between measurements in a low-flow state. Such patients may have truly severe AS and potentially derive long-term benefit from aortic valve intervention. Accurately identifying these patients with the use of ancillary testing has been the focus of research for several years. In this article, we discuss the contemporary approaches and challenges in identifying and managing patients with low-flow, low-gradient severe AS.

Information measuring system for training assessors to determine the odour threshold using the dynamic olfactometry method

This article presents the results of training, selection and control of a group of assessors to determine the odour threshold. General recommendations of the European standard EN 13725: 2003 “Air quality － Determination of odour concentration by dynamic olfactometry” for the training, selection and supervision of a group of assessors were used in this work. A trained assessor team or panel is the odour measuring instrument. The dynamic olfactometry method was used to determine the concentration of odour in a gas sample. N-butanol was chosen as the odour sample. The experimental setup for the selection and training of a group of assessors to determine the odour threshold is a information measuring system. This information measuring system provides high accuracy and reliability of measurements. The authors chose the Scentroid SM 100 olfactometer and the Agilent 7800 A gas chromatography-mass spectrometer with a 5975C mass-selective detector as a mean of measuring in information system. The referenced value of odour threshold for n-butanol was set to 38 ppb for a panel of 8 selected n-butanol assessors. The number of steps in the dilution series was 6. The instrumental dilution range was 11 ppb to 145 ppb.

Community and Policy Factors Influencing the Decision to Undergo Screening Mammography amongst Indian Women in the United Arab Emirates.

This study explored the expectations, requirements, and recommendations and identifies the socio-ecological determinants for the informed uptake of screening mammography amongst expatriate women residing in the UAE. A qualitative research approach was adopted using five focus group discussions. The study comprised two populations- those who had undergone screening mammography and those who had not. Thematic analysis- the six-phase model was adopted and modified for data analysis. The factors that influence the rate of uptake of screening mammography by the participants were multifactorial and reciprocal. The community determinants identified are cultural beliefs, medical professionals, breast cancer survivors, community organizations, and media. The health policies in an expatriate's home country and adopted country were found to have a considerable influence on the health behaviors of the participants. A comprehensive approach to change in health behavior is required to increase the informed uptake of screening mammography by expatriate women residing in the UAE. The study identified the need of developing migrant health units with community navigators, international health collaboration, migrant health directory, risk assessment team, automatic invitation system for screening, referral system, migrant cancer registry, and psychological support team in UAE. However, further studies are expected to give a wider perspective.

Lock the Doors: The Myocarditis Disaster and a call for the broad examination of the CDC and FDA

“Lock the doors.” uttered by LeRoy Cain, the flight director of STS-107, meant the complete loss of Space Shuttle Columbia. Locking the doors initiated the protocol to preserve data and logs for the impending investigation. Some hard lessons were learned from the Space Shuttle Challenger disaster 17 years earlier, one of which was that the National Aeronautics and Space Administration (NASA) should not be put in a position to investigate itself. The interagency Columbia Accident Investigation Board (CAIB) was formed to learn what we could from the fate of Columbia. Had NASA been the investigating agency, given the culture, it is possible the concluding cause would have been a random event such as bird strike after takeoff or micrometeoroid in orbit. “We are convinced that the management practices overseeing the Space Shuttle Program were as much a cause of the accident as the foam that struck the left wing.”[1] Those management practices point to lock-stepping, where dissenting opinions are discouraged or suppressed. NASA’s opinion was that foam is safe. When Bob Page, chair of NASA’s Intercenter Photo Working Group, saw foam strike the wing he raised an alarm that the heat shield may be compromised. He and two members of the Debris Assessment Team made a total of three requests to the Department of Defense (DoD) to obtain high-resolution images of Columbia’s left wing. A request that, by all accounts, the DoD was willing and able to fulfill. Those requests were subsequently canceled by the shuttle program managers. The CAIB report went on to say, “[t]he Board was also influenced by discussions with members of Congress, who suggested that this nation needed a broad examination of NASAʼs Human Space Flight Program, rather than just an investigation into what physical fault caused Columbia to break up during re-entry.” There are two vitally important lessons we have learned from NASA. The first is that a government agency should not be able to investigate itself. The second is that lock-stepping is lethal. The most advanced population health surveillance in the United States couldn’t find a single healthy child who died of COVID-19. Zero is a powerful number. Zero is also the number of vaccines that impart superior immunity over that of natural immunity. If we could choose one feature that the emergent 5th endemic cold virus could have, it would unequivocally be a minimal effect on children – safeguarding our future and allowing the progression of natural immunity. There is nothing mild about pediatric myocarditis. Even with the best medical management, 1/3rd of all patients never completely recovers, and will live with dilated cardiomyopathy. If untreated, 80% of children will develop chronic heart disease. These children are subject to a high risk of sudden death and may require an urgent heart transplant[2].

Editorial

Editorial

INTEGRATION-INTERCONNECTION-BASED SCIENCE MODULE DEVELOPMENT IN LIGHT MATERIALS FOR JUNIOR HIGH SCHOOL

This study aims to 1) produce a science module based on integration-interconnection on light material for grade VIII students of Junior High School [SMP/MTs], 2) find out the quality of a science module based on integration-interconnection on light material for class VIII students of Junior High School, 3) find out students' responses to the science module based on integrationinterconnection on light material for grade VIII Junior High School students. This research is an R&D research with a procedural model that adapts development research procedures according to Borg and Gall, which can be carried out more simply according to the Puslitjaknov Team, which involves five main steps, namely (1) analyzing the product to be developed, (2) developing the initial product, (3) validation and revision, (4) small-scale trials and product revisions, and (5) large-scale trials and final products. We conducted this research at the stage of small-scale trials. The research instruments were validation sheets, quality assessment sheets for science modules based on integration-interconnection for material experts, media experts, integration-interconnection experts, and SMP/MTs science teachers using a Likert scale made in the form of a checklist. The student response sheet instrument for SMP/MTs students uses the Guttman scale, which is made in the form of a checklist. The result of the research that has been developed is the integration-interconnection-based science module on light for grade VIII students of SMP/MTs. The quality of the integratedinterconnection-based IPA module developed according to the assessment team is of Very Good quality (SB) with the average score of each assessor being: material expert 3.80 (SB), media expert 3.19 (B), expert integration-interconnection 3.67 (SB), and SMP/MTs Science Teachers 3.44 (SB). Student responses to the integration-interconnection-based science module have the Agree (S) category with a score of 0.96 in a small-scale trial. The results of this study indicate that the developed integration-interconnection-based science module can be used as teaching material for Grade VIII students of SMP/MTs.

Cognitive behaviour therapy (CBT) as a psychological intervention in the treatment of ARFID for children and young people

AbstractAvoidant Restrictive Food Intake Disorder (ARFID) is a condition characterised by a disturbance in eating behaviour that leads to a significant negative impact on physical, social and nutritional health. The diagnosis of ARFID relies on a comprehensive, multi-disciplinary assessment to understand the individual’s history, physical, social and mental health risk, and any co-occurring mental health difficulties. Consensus guidance suggests that psychological treatment, alongside medical and dietetic input is delivered with consideration of any appropriate adaptions to accommodate developmental stage and/or common co-occurring presentations. This paper has been authored by clinicians working in an out-patient setting for children and adolescents with ARFID, and focuses on the presentation and assessment of ARFID and cognitive behavioural therapy (CBT) approaches that can help children, young people and their families. After an introductory section, the paper is split into four sections: assessment of ARFID; drivers of avoidant restrictive eating behaviour; multi-disciplinary formulation and intervention planning; and treatment. The treatment section provides an overview of the available research on CBT for ARFID, and a brief summary of the broader evidence base for CBT in children and young people with anxiety. Following a review of the evidence base, three case descriptions are provided to illustrate the clinical application of CBT where fear-based avoidance is the main driver. The paper concludes with practice points for clinicians to take forward when working with children and young people with ARFID.Key learning aims(1)To be aware of the international consensus for the use of psychological interventions as a component of ARFID treatment alongside medical and dietetic input.(2)To understand that ARFID is characterised as a disturbance of eating behaviour, and as such, psychological intervention should target the drivers of this disturbance to promote behavioural change.(3)To gain an overview of the multi-disciplinary team assessment as an important tool to understand the contribution of each of the three drivers proposed to underpin an ARFID presentation.(4)To recognise when a CBT approach might be indicated, the current best evidence base for CBT for ARFID and how to adapt CBT to accommodate developmental stage and/or common co-occurring presentations.

The needs of patients with noncancer diseases and their families from hospital-based specialized palliative care teams in Japan.

Hospital-based specialized palliative care teams (HSPC) are important for symptom management and ethics support, especially during complex decision-making, but the needs of patients with noncancer diseases and their families from the HSPC are unclear. This study aimed to (I) compare the prevalence of symptom between patients with and without cancer and explore changes in symptom intensity after HSPC consultation in patients with noncancer; (II) determine factors related to ethics support; and (III) compare the percentage of request contents from patients and their families when a certified nurse specialist in gerontological nursing (geriatric care nurse below) is present in the HSPC to that when a certified nurse specialist in palliative care (palliative care nurse below) is present in the HSPC. We utilized a retrospective cohort study to analyze 761 patients (360 with noncancer and 401 with cancer) referred to our HSPC at the National Center for Geriatrics and Gerontology using 10-year data (since 2011) available in an electronic medical record database. (I) Symptom scores of the Support Team Assessment Schedule were compared between noncancer and cancer groups and between initial and 1-week assessments for noncancer patients. (II) Ethics support was compared between noncancer (including dementia) and cancer. The presence or absence of ethics support requests, which was set as the objective variable, was examined using logistic regression analysis. (III) The percentage of request contents selected from nine items defaulted on the electronic medical record when a geriatric care nurse was present in our HSPC were compared to those when a palliative care nurse was present in our HSPC. Compared to those with cancer, patients with noncancer suffered more from dyspnea and sputum accumulation. More than 10% of patients with noncancer had suffered from pain, dyspnea, sputum accumulation, and anorexia that required treatment, with symptom scores showing improvement after 1 week of HSPC involvement, except for the sputum accumulation. Moreover, for anorexia, symptom scores improved, but >10% of these patients continued to suffer. Patients with noncancer diseases, including dementia, received ethics support than those with cancer without dementia. More requests for ethics support were received when a geriatric care nurse was in the HSPC than when a palliative care nurse was in the HSPC. Logistic regression analysis revealed that requests for ethics support were more frequent from patients or families with impaired decision-making capacity or when the patient lacked an advocate. The needs of patients with noncancer diseases and families from the HSPC in Japan included (I) symptom management for intractable conditions, such as sputum accumulation; (II) ethics support for patients with noncancer diseases, including dementia, with impaired decision-making capacity, and without advocates; and (III) advice on ethics issues from a geriatric care nurse.

Pricing Mechanism for Collateral Auctions in Problematic Financing at Bank Syariah Indonesia, Palangka Raya

A Sharia bank is an institution whose main business is to provide credit and other services based on sharia principles. A sharia bank has various products, one of which is financing. However, risks in financial institutions are inevitable and become potential events, both foreseeable and unpredictable. Such as financing customers who end up experiencing defaults and leading to the sale of collateral or collateral through auctions. Therefore, it is necessary to know the mechanism for pricing collateral auctions and constraints on problematic financing at Sharia Bank of Indonesia, Palangka Raya City. This research uses a descriptive qualitative approach. The results of this study are that the pricing mechanism is carried out with the provisions and procedures applicable at Sharia Bank of Indonesia, Palangka Raya City, with price interpretation carried out by the assessment team after the survey is carried out, looking for appeal data based on the prevailing market value in the collateral area, looking at collateral conditions, interpreting until finally the price is determined based on the applicable mechanism in accordance with the Circular Letter of the Board of Directors must use the price reference Central Market, Regional Market Price, and Local Market Price. Pricing carriess out with appropriate assessments and calculations based on the market approach method and cost approach that have been formulated to be used as a guide in the assessment and pricing of collateral auctions in accordance with the fair price or market price that occurred at that time.

Imbalanced dietary patterns, anthropometric, and body composition profiles amongst adults with Down syndrome

ABSTRACT Introduction: We aimed to analyze the anthropometric and body composition profiles of Down syndrome (DS) adults; to describe their dietary habits, nutrient intake, and physical activity patterns; and to identify the related risk factors which may influence their health status and quality of life. Methods: A cross-sectional study was conducted on a cohort of 23 DS adults (45% women) aged 21-44 years. Anthropometry and body composition were assessed by bioelectrical impedance. Dietary nutrient intake was assessed quantitatively using a 72-h recall. A food frequency questionnaire and the prevention with Mediterranean diet-PREDIMED questionnaire were used for qualitative rating. Results: Higher fat mass (FM) and lower lean mass (LM), bone mass (BM), and waist to hip ratio (WHR) were observed in women compared to men. LM and BM decreased, and body mass index (BMI), FM, and WHR increased with aging (all P < 0.05). Vitamin D and iodine intakes were not met by 70% and 60% of the studied participants, respectively. A total of 82% of the participants consumed less than 5 portions of fruits and vegetables per day and overconsumed food groups such as sweets and snacks and red meat (> 2 times per week). Protein intake showed a significant positive correlation with height (r = 0.489, P < 0.05), whereas fat intake was positively correlated with sweets and snacks (r = 0.521, P < 0.05). Conclusion: The present findings support the existence of poor anthropometric and body composition profiles, and diet quality, underscoring the need for an interdisciplinary team assessment to enhance health and quality of life in DS adults.

Approaches to scientometric evaluation of the work of reasearch teams

Abstract. Personality assessments are administered for a variety of purposes among different groups of qualified personnel in a wide range of practice settings, including the educational and scientific fields. There is strong evidence of the usefulness of specific personality tests in these settings, especially using a multiparameter assessment system. However, there are no unified guidelines that form the basis for current personality assessment practice. The absence of these guidelines may contribute to increased inconsistencies in the formation of work teams for research projects by research managers. The aim of the article is to form the main methods for assessing the results of scientific activity of scientific teams, used in Ukraine, with identifying their advantages and disadvantages. Adequate assessment of the effectiveness of scientific teams and individual scientists is a key task for building a rating of both the scientist himself and the scientific institution in which he has affiliation. The methodology of the research is based on the principle of systematicity, a comparative analysis of evaluation criteria has been carried out. Scientific novelty. The article considers the principles, methods and indicators of scientometric evaluation of information processes in science and evaluation of publication activity of individuals and scientific teams; analyzes the main criteria for assessing the prospects of scientific directions, evaluation of the effectiveness of scientific organizations, their departments and individual employees; shows the means of accounting additional information; proposes criteria for evaluating the work of scientific teams and methods of assessing each of the criteria. Conclusions. It has been determined that the transition to specific quantitative assessments will require a clearer formalization of the above criteria, as well as the formation of unambiguous algorithms for their application. A proposal has been made to evaluate the work of a scientific unit as a scientific team, the composition of which can be interdepartmental or international, and possible criteria for evaluating its work have been considered. A proposal has been made to introduce different scales of evaluation for theoretical and applied areas of science. This approach is a generalization of the global and domestic experience of evaluating the work of scientific teams. Keywords: research team, evaluation criteria, scientometrics, citation index, h-index, expertise.

European Burns Association guidelines for the management of burn mass casualty incidents within a European response plan

BackgroundA European response plan to burn mass casualty incidents has been jointly developed by the European Commission and the European Burn Association. Upon request for assistance by an affected country, the plan outlines a mechanism for coordinated international assistance, aiming to alleviate the burden of care in the affected country and to offer adequate specialized care to all patients who can benefit from it. To that aim, Burn Assessment Teams are deployed to assess and triage patients. Their transportation priority recommendations are used to distribute outnumbering burn casualties to foreign burn centers. Following an appropriate medical evacuation, these casualties receive specialized care in those facilities. MethodsThe European Burns Association’s disaster committee developed medical-organizational guidelines to support this European plan. The experts identified fields of interest, defined questions to be addressed, performed relevant literature searches, and added their expertise in burn disaster preparedness and response. Due to the lack of high-level evidence in the available literature, recommendations and specially designed implementation tools were provided from expert opinion. The European Burns Association officially endorsed the draft recommendations in 2019, and the final full text was approved by the EBA executive committee in 2022. RecommendationsThe resulting 46 recommendations address four fields. Field 1 underlines the need for national preparedness plans and the necessary core items within such plans, including coordination and integration with an international response. Field 2 describes Burn Assessment Teams' roles, composition, training requirements, and reporting goals. Field 3 addresses the goals of specialized in-hospital triage, appropriate severity criteria, and their effects on priorities and triage. Finally, field 4 covers medical evacuations, including their timing and organization, the composition of evacuation teams and their assets, preparation, and the principles of en route care.

Assessment of Surgical Teams’ Teamwork Skills in Pediatric Surgery: A Cross-sectional Study

Background: The operating room is a high-risk environment in which practitioners with different educational backgrounds work together to provide safe care for surgical patients. The surgical team needs to use teamwork skills for safe performance and error prevention. Pediatric surgery is a very sensitive surgery type that needs special psychological skills. Objectives: This study aimed to assess surgical teams’ teamwork skills in pediatric surgery. Methods: This cross-sectional study was conducted on 154 surgical teams working in the pediatric operating rooms of two public hospitals in Shiraz, Iran, during the summer of 2021 using convenience sampling. The data were collected by the Mayo High-Performance Teamwork Scale. An operating room technologist collected the data by observing surgeries. Descriptive statistics were used for the analysis of the data. The data were analyzed using SPSS software (version 22). Results: The mean value of the teamwork score was 1.57 ± 0.20 (out of 2). The total teamwork score was 25.20 ± 3.31 (out of 32). The majority of items had a score of more than average. The team members had the highest score in recognizing a leader. The studied surgical teams had low scores in verbalizing their activities and repeating back the instructions. Conclusions: The overall teamwork score in the studied teams in the pediatric operating rooms was at an acceptable level. However, the studied teams did not do well in team communication behaviors. Interventions, such as educating, standardizing communications, and implementing a pediatric surgical safety checklist, can improve team communication skills.

Pediatric Preanesthesia Anxiety and Factors of Family Satisfaction

PurposePediatric patients scheduled for procedures with anesthesia experience stress and feelings of anxiety, but frequently lack the opportunity to report their feelings. Pediatric patient anxiety may be related to internal (patient perceptions/emotions) or external (demographic/family knowledge/satisfaction) factors. The purpose of the study was to explore patient reports of anxiety in young school-age through adolescent ages, and factors of family satisfaction before a scheduled procedure with anesthesia. DesignCross-sectional, descriptive, and correlational. MethodsA voluntary survey including family-report of patient age and past anesthesia, type of procedure, family satisfaction factors (knowledge of anesthesia; perioperative concerns), and patient-report of anxiety with a visual analog scale (0-10) was offered to eligible families at their preanesthesia clinic appointment. FindingsCompleted surveys from 80 families (mean age of patient = 12 years; range 7-17 years) showed legally authorized guardians (LAGs) felt the preanesthesia visit helped them understand anesthesia information, but they also had concerns, such as complications and pain. Patient anxiety ratings ranged from 0 to 10 (M = 3.3, SD = 3.1), and were slightly higher for patients 11 years and younger (M = 3.8; SD = 3.4). Anxiety ratings were not significantly correlated with other factors measured. ConclusionsPediatric patients, ages 7-17, report preanesthesia anxiety levels ranging from “not at all” to “worst imaginable,” unrelated to demographic or family factors. Family members have perioperative concerns that need to be addressed before scheduled procedures. There is an impetus for improvement in psychosocial assessment and health care team collaboration to meet needs in a family-centered preanesthesia care model.

647 COMPLEX PERCUTANEOUS CORONARY INTERVENTION IN HIGHT BLEEDING AND THROMBOTIC RISK PATIENT: WHICH ANTITHROMBOTIC THERAPY?

Abstract Background Antiplatelet therapy is required in patients with atherosclerotic coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES). Current European and American guidelines recommend 6 months of DAPT in CCS and 12 months after ACS. However, a shorter duration of DAPT may be considered in high bleeding risk (HBR) patients, and a longer duration in those at higher thrombotic risk (HTR). To minimize the risk of thrombotic and bleeding events of an individual patient and therefore improve the overall outcomes of PCI, risk stratification is essential. In particular, bleeding and thrombotic characteristics must be weighed on a case-by-case basis to tailor antiplatelet therapy strategies and decisions over a patient's individual risk profile. We describe an illustrative case of complex PCI in patient with ACS in which defining the appropriate duration of DAPT is a clinical challenge. Clinical case A 68-year-old man with ACS-NSTEMI and anemia was hospitalized in intensive care unit. His medical history was notable for hypertension, dyslipidemia, diabetes mellitus, diabetic retinopathy, chronic kidney disease (CKD) and paroxysmal atrial fibrillation. A transthoracic echocardiogram showed left ventricular ejection fraction of 30% with diffuse hypokinesia, without relevant valvular disease. He was conducted to the cath-lab for a diagnostic coronary angiogram which showed a three-vessel critical CAD. After Heart Team evaluation coronary artery bypass surgery (CABG) was indicated. However, during the hospitalization in intensive care unit there was a worsening of clinical conditions with cognitive impairment due to mesencephalic stroke leading to a new Heart Team assessment that indicated PCI after stabilization of clinical scenario. After two weeks patient was conducted to the cath-lab to undergoing an IVUS guided PCI. PCI of the right coronary artery was performed with implantation of 1 DES (3.0/30 mm) on the middle segment and 1 DES (4.0/15 mm) on the ostial segment. PCI of the left main bifurcation was performed with implantation of 2 DES (4.0/28 mm) with culotte technique. Patients have both HBR and HTR, therefore, after procedure, the new trade off model score introduced by the Academic Research Consoritum (ARC) was applied. Based on his risk factor, the predicted 1-y risk of BARC type 3 to 5 bleeding (51.41%) was greater than the predicted 1-y risk of myocardial infarction or stroke (25.00%). Based on this result we decided to prescribe Triple antithrombotic therapy for 1 week, dual antithrombotic therapy for 12 months and after only oral anticoagulation. Conclusion In the context of patient with several risk factor undergoing complex PCI the stratification of bleeding and thrombotic individual risk is mandatory to define the appropriate duration of DAPT. The new trade-off model score is an important useful tool to identify patients who might benefit from individualized DAPT durations depending on the balance between HBR and HTR characteristics.

Findings of a Multidisciplinary Assessment of Children Referred for Possible Neurodevelopmental Disorders: Insights from a Retrospective Chart Review Study.

Children with ASD have a wide spectrum of functional deficits in multiple neurodevelopmental domains. A multidisciplinary team assessment (MDT) is required to assess those deficits to help construct a multimodal intervention plan. This is a retrospective chart review of the assessment for children who were referred for an assessment of potential neurodevelopmental disorders. We reviewed 221 participants' charts from January 2019 to January 2020. The mean age of the children was 7.95 ± 3.69, while the mean age of the fathers and mothers was 37.31 ± 8.57 and 31.95 ± 6.93, respectively. Consanguinity was as high as 37.9% for the referred children with developmental delay who were first-degree related, and 13.2% of the parents were second-degree relatives. Approximately 26.6% of children had a family history of mental illness in first-degree relatives. ASD was the most commonly reported diagnosis post-assessment, and ADHD was the most common reported comorbidity at 64.3% and 88.5%, respectively. The MDT findings showed that 58% of children required moderate or higher assistance with toileting, 79.2% were unable to answer yes/no questions, and 86.8% were unable to understand "wh" questions. Only 26% of the nonverbal children had average IQ testing results, and 31% of verbal children did. In conclusion, the mean age of the children when assessed was above that recommended for early screening and intervention. An increased paternal and maternal age was noticeable. Consanguinity and a family history of mental disorders in first-degree relatives were high, attesting to a possible genetic risk.

Team leadership assessment after advanced life support courses comparing real teams vs. simulated teams.

Effective team leadership is essential during cardiopulmonary resuscitation (CPR) and is taught during international advanced life support (ALS) courses. This study compared the judgement of team leadership during summative assessments after those courses using different validated assessment tools while comparing two different summative assessment methods. After ALS courses, twenty videos of simulated team assessments and 20 videos of real team assessments were evaluated and compared. Simulated team assessment used an instructor miming a whole team, whereas real team assessment used course participants as a team that acted on the team leader's commands. Three examiners individually evaluated each video on four different validated team leadership assessment tools and on the original European Resuscitation Council's (ERC) scenario test assessment form which does not assess leadership. The primary outcome was the average performance summary score between all three examiners for each assessment method. The average performance summary score for each of the four assessment tools was significantly higher for real team assessments compared to simulated team assessments (all p-values < 0.01). The summary score of the ERC's scenario test assessment form was comparable between both assessment methods (p = 0.569), meaning that participants of both assessments performed equally. Team leadership performance is rated significantly higher in real team summative assessments after ALS courses compared to simulated team assessments by four leadership assessment tools but not by the standard ERC's scenario test assessment form. These results suggest that summative assessments in ALS courses should integrate real team assessments, and a new assessment tool including an assessment of leadership skills needs to be developed.

Approaches to Interdisciplinary Care for Infants with Severe Bronchopulmonary Dysplasia: A Survey of the Bronchopulmonary Dysplasia Collaborative.

Bronchopulmonary dysplasia (BPD) remains the most common late morbidity for extremely premature infants. Care of infants with BPD requires a longitudinal approach from the neonatal intensive care unit to ambulatory care though interdisciplinary programs. Current approaches for the development of optimal programs vary among centers. We conducted a survey of 18 academic centers that are members of the BPD Collaborative, a consortium of institutions with an established interdisciplinary BPD program. We aimed to characterize the approach, composition, and current practices of the interdisciplinary teams in inpatient and outpatient domains. Variations exist among centers, including composition of the interdisciplinary team, whether the team is the primary or consult service, timing of the first team assessment of the patient, frequency and nature of rounds during the hospitalization, and the timing of ambulatory visits postdischarge. Further studies to assess long-term outcomes are needed to optimize interdisciplinary care of infants with severe BPD. · Care of infants with BPD requires a longitudinal approach from the NICU to ambulatory care.. · Benefits of interdisciplinary care for children have been observed in other chronic conditions.. · Current approaches for the development of optimal interdisciplinary BPD programs vary among centers..