Team Activation Research Articles

PELATIHAN PEMBUATAN MEDIA INTERAKTIF MENGGUNAKAN APLIKASI CLASSPOINT UNTUK MENGOPTIMALKAN PEMBELAJARAN DI SEKOLAH DASAR

So far, the use of PowerPoint is only for media presentations or teaching materials that are one-way in nature. Presentations using PowerPoint are commonly used, especially by teachers at SDN 14 Cakranegara. This service seeks to further optimize learning with applications that can be integrated with the use of PowerPoint. The application is called Classpoint which is an interactive media that can load learning material in the form of questions, quizzes, or questions. The types of questions provided by Classpoint which can be accessed for free include multiple choice, short answer, word cloud, slide drawing, image upload with competition mode, and other settings. the methods of implementing the service that will be carried out include presentations by the lecturer team, question, and answer activities and discussions, as well as direct assistance in making Classpoint interactive media. The training at SDN 14 Cakranegara was conducive because the 10 participants were guided by 5 service team members and 2 students so that obstacles could be overcome immediately. The presenters were very communicative and guided step by step and ensured that each participant could go through each step before moving on to the next step. In the training of the five types of Classpoint interactive quiz features such as multiple choice, word clouds, short answers, slide drawings, and image uploads, all of them can be applied.

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The article examines the essence of the psychology of interaction in the process of innovative professional activity. The authors define the essence of the "management team" concept, the stages of its formation, and the features of the management team. In addition, the causes of conflicts in management teams, their characteristics, and the consequences for effective teamwork on the project are considered. The study describes the mechanisms of interaction in management teams and the ways to solve their problems. The authors describe the essence of disagreements in management teams, where the group members are both managers with a long history of holding a certain position and also newly appointed managers. The article also examines the essence of conflicts in management teams. The main factors of the appearance of conflicts are determined, where the character is given to such factors as the location of all team members on the same management horizon, the desire for leadership, the presence of experience in some team members compared to others, the relationship of the problematic issue to a certain department, the essence of the project. At the same time, the characteristics of interaction in the team are carried out. The authors characterize such ways of interaction as "shuttle diplomacy," executive influence, pressure from some team members on others, the presence of a common goal, and a motivational component. The study aims to highlight the essence of the psychology of interaction in the process of innovative professional activity in management teams.

Development of the Tiered Onsite Evaluation Tool for Organization-Wide Person-Centered Positive Behavior Support

Positive behavior support (PBS) is an evidence-based framework for improving quality of life and preventing challenging behavior that is often implemented in combination with person-centered practices in the intellectual and developmental disability (IDD) field. Recently, state agencies and organizations supporting people with IDD have adopted a system-wide approach to PBS, much like multi-tiered school-wide PBS for youth in educational settings (e.g., SW-PBIS). Fidelity tools for guiding team implementation and action planning are essential throughout every phase of implementation in any innovation. Although such tools exist for SW-PBIS, no widely used measure currently exists for assessing the implementation of organization-wide PBS in the adult IDD field. This article describes the initial development of a fidelity of implementation tool used to evaluate organization-wide implementation of PBS and person-centered practices in community settings. A Midwestern State Department of Human Services and a University Center on Developmental Disabilities (UCEDD) in the United States partnered to complete this project. The authors discuss the exploratory and descriptive evaluation process involved in the initial development of the tool and share data for 10 provider organizations over a 6-year period of implementation. A descriptive case study using mixed measures is used to provide more details about the implementation of PBS in one agency to show the types of changes captured by the fidelity tool.

Patterns of major trauma admissions to a level 1 trauma centre: A five year database analysis

IntroductionIt is only in recent years that major trauma systems and networks have been operating in the UK. High-quality data is available from the Trauma Audit and Research Network (TARN) database, enabling regional analysis. Our aim was to analyse Trauma Team Activations within the Cheshire and Merseyside major trauma network and discuss the implications of these data on resource allocation, training and trauma prevention. MethodsA retrospective analysis was performed for all patients requiring Trauma Team Activation (TTA) at a category one adult Major Trauma Centre (MTC) who were submitted to the TARN database from the 1st January 2015 to the 1st January 2020.Data collected included the date and time of arrival, location of injury and Injury Severity Score (ISS) in addition to routine demographic data. Dates of major sporting events and school holidays were obtained. Results4811 patients were identified. The median age was 57 years; 65.8 % were male. The mean frequency of TTAs was 18.5 per week. Patterns identified include annual peaks during the summer months, October and December, weekly peaks on Thursdays and Sundays and daily peaks between 16:00 and 23:59 with 45.0 % of TTAs occurring between these hours.There were 5.9 additional TTAs per week during the Isle of Man TT races. The median ISS increased from 14 to 23 for TT race TTAs and from 14 to 36 for Manx Grand Prix TTAs. Those injured during the TT races were twice as likely to require surgery and those injured during the MGP required five additional days in intensive care. School holidays did not independently affect major trauma volumes. ConclusionsMajor trauma in Cheshire and Merseyside did follow distinct patterns according to calendar month, day and time. Major motorsport increased trauma volumes and severity; school holidays did not. Such analysis could enable Major Trauma Centres to tailor the supply of trauma services to meet a predictable local demand for the benefit of our staff and patients.

УСПЕШНОЕ ПРИМЕНЕНИЕ МЕТОДА ПОЛИМИКСИНОВОЙ СОРБЦИИ ЭНДОТОКСИНА В КОМПЛЕКСНОЙ ТЕРАПИИ ПАЦИЕНТКИ С ГРАМОТРИЦАТЕЛЬНЫМ СЕПСИСОМ ПРИ ПОЗДНЕМ ИНФИЦИРОВАННОМ ВЫКИДЫШЕ

Abstract. Introduction. Sepsis is one of the most serious problems of modern obstetrics, accounting for 11% of the overall structure of maternal mortality. One of the main initial causes of sepsis is endotoxin having diverse biological effects. Moreover, during sepsis development, endotoxin directly or indirectly leads to irreversible and often life-incompatible damage to organs. Columns for direct hemoperfusion with polymyxin B are used for extracorporeal endotoxin removal. Aim: Reviewing the literature on using columns with polymyxin B in sepsis treatment and describing our own clinical observation of maternal sepsis. Materials and Methods. Review of publications in electronic resources, such as PubMed, eLibrary, EMBASE, and Google Scholar. This article presents a clinical case of successful sepsis treatment during late infected miscarriage in a young patient. Results and Discussion. Currently published systematic reviews and meta- analyses prove the reduction of mortality in patients with sepsis/septic shock. A 39-year-old patient was admitted with signs of chorioamnionitis and incipient miscarriage at 20-21 weeks of pregnancy. After the delivery of a dead fetus, the picture of sepsis and septic shock developed. Removal of the uterus as the primary source of infection did not improve the woman’s condition. Positive changes were only observed after having applied the polymyxin sorption of endotoxin. This new advanced technology in medicine, thanks to the timely use, correct dose, and duration of hemoperfusion with polymyxin B, made it possible to remove bacterial endotoxins safely and effectively from the blood, which led to the successful sepsis therapy. Conclusions. Thanks to the coordinated actions of a multidisciplinary team of highly qualified specialists and the timely administration of adequate therapy, it was possible to save the patient’s life, thus preventing her from maternal mortality.

Reducing endocrine metabolic disease risk in adults with chronic spinal cord injury: strategic activities conducted by the Ontario-Quebec RIISC team

Purpose The Rehabilitation Interventions for Individuals with a Spinal Cord Injury in the Community (RIISC) team aimed to develop and evaluate innovative rehabilitation interventions to identify endocrine metabolic disease (EMD) risk, intending to reduce the frequency and severity of EMD related morbidity and mortality among adults living with chronic spinal cord injury or disease (SCI/D). Materials and Methods An interprovincial team from Ontario and Quebec reviewed available EMD literature and evidence syntheses and completed an inventory of health services, policies and practices in SCI/D care. The review outcomes were combined with expert opinion to create an EMD risk model to inform health service transformation. Results EMD risk and mortality are highly prevalent among adults with chronic SCI/D. In stark contrast, few rehabilitation interventions target EMD outcomes. The modelled solution proposes: 1) abandoning single-disease paradigms and examining a holistic perspective of the individual’s EMD risk, and 2) developing and disseminating practice-based research approaches in outpatient community settings. Conclusions RIISC model adoption could accelerate EMD care optimization, and ultimately inform the design of large-scale longitudinal pragmatic trials likely to improve health outcomes. Linking the RIISC team activities to economic evaluations and policy deliverables will strengthen the relevance and impact among policymakers, health care providers and patients.

Anti-factor Xa as the preferred assay to monitor heparin for the treatment of pulmonary embolism.

The mainstay of acute pulmonary embolism (PE) treatment is anticoagulation. Timely anticoagulation correlates with decreased PE-associated mortality, but the ability to achieve a therapeutic activated partial thromboplastin time (aPTT) with unfractionated heparin (UFH) remains limited. Although some institutions have switched to a more accurate and reproducible test to assess for heparin's effectiveness, the anti-factor Xa (antiXa) assay, data correlating a timely therapeutic antiXa to PE-associated clinical outcomes remains scarce. We evaluated time to a therapeutic antiXa using intravenous heparin after PE response team (PERT) activation and assessed clinical outcomes including bleeding and recurrent thromboembolic events. This was a retrospective cohort study at NYU Langone Health. All adult patients ≥18 years with a confirmed PE started on IV UFH with >2 antiXa levels were included. Patients were excluded if they received thrombolysis or alternative anticoagulation. The primary endpoint was the time to a therapeutic antiXa level of 0.3-0.7 units/mL. Secondary outcomes included recurrent thromboembolism, bleeding and PE-associated mortality within 3 months. A total of 330 patients with a PERT consult were identified with 192 patients included. The majority of PEs were classified as sub massive (64.6%) with 87% of patients receiving a bolus of 80 units/kg of UFH prior to starting an infusion at 18 units/kg/hour. The median time to the first therapeutic antiXa was 9.13 hours with 93% of the cohort sustaining therapeutic anticoagulation at 48 hours. Recurrent thromboembolism, bleeding and mortality occurred in 1%, 5% and 6.2%, respectively. Upon univariate analysis, a first antiXa <0.3 units/ml was associated with an increased risk of mortality [27.78% (5/18) vs 8.05% (14/174), p = 0.021]. We observed a low incidence of recurrent thromboembolism or PE-associated mortality utilizing an antiXa titrated UFH protocol. The use of an antiXa based heparin assay to guide heparin dosing and monitoring allows for timely and sustained therapeutic anticoagulation for treatment of PE.

Current trauma team activation processes at Canadian trauma centres: A national survey

BackgroundTrauma team activation (TTA) allows the provision of specialized and timely care to improve outcomes for severely injured patients. Limited information is available on the current state of TTA in Canadian trauma centres (TC). Study objectives were to describe TTA processes, data and reports, along with the challenges and successes from a national perspective. MethodsA mixed-methods, cross-sectional survey was undertaken with Canadian trauma leadership, utilizing a total population sampling strategy. The questionnaire, containing 108-items, was administered online between February-April 2022, utilizing a modified Dillman technique. Descriptive statistics and thematic analyses were performed. ResultsTrauma leaders from 9 out of 10 provinces responded for a response rate of 68% (32/47). Two-thirds (67%) of respondents worked in adult TC; 63% in a level I center. A higher proportion of pediatric TC had a two-tiered TT response (60% pediatric; 35% adult). The most common criteria were neurologic compromise (100% one-level TTA) and hypotension (pediatric: 100% one-level, 100% tier 1; adult: 92% one-level, 86% tier 1). All one-level TTA included penetrating trauma criteria. One-third of respondents reported using TTA subgroup criteria for pediatric, pregnant, and/or geriatric patients. There was variability with disciplines responding to TTA, with largest, most comprehensive teams for tier 1. Two-thirds of TC review activation compliance (under/overtriage), while 55% focus on non-compliance and reasons for missed TTA. The most frequent challenges related to TTA practices were reliable data collection (60%) while successes included were the establishment of TTA guidelines to improve team compliance (33%) and RN initiated TTA. ConclusionsSome TTA practices were similar among Canadian TC, while others showed variability. Findings provide opportunities for improvement, including a two-tier system, geriatric-specific criteria, and RN initiated TTA, and could help establish national standards and best practices. Compliance with standards has the potential to improve Canadian TTA practices and patient outcomes.

Development of physical qualities of football players in the training process

In this article, we will look at what is necessary to develop the physical qualities of football players and their further improvement.&#x0D; Football training, if properly organized, is a powerful means of developing physical qualities that shape the general and special physical fitness and performance of young football players.&#x0D; In addition, the game of football requires comprehensive training, due to frequently changing game situations associated with a variety of dynamic individual and collective actions.&#x0D; In Ukraine, despite the great enthusiasm for football, experts point out that the players of the leading Ukrainian clubs lag far behind the best world and European teams in terms of individual technical, tactical and physical fitness. Physical fitness is of particular importance for young football players and the martial law makes it difficult for Ukrainian clubs to hold matches at home, which in turn is another disadvantage, as our players do not feel the proper psychological and moral support that is necessary to fulfill their tasks.&#x0D; The physical fitness of football players is one of the important components on which the activity and effectiveness of team, group and individual technical and tactical actions depend.&#x0D; The development of physical qualities in football players has its own characteristics. Speed - the ability of a football player to perform actions in the minimum time for the given conditions for the minimum period of time. Effective means for the development of physical qualities are physical exercises in pairs, and the rest interval between them should be should be optimal for the recovery of the body. By the same means you can to develop speed endurance, but rest intervals should be limited. Such exercises should be included at the beginning of the main part of the training session, followed by exercises to develop endurance and strength.

The role and significance of mobile games in the process of psychological and psychophysiological development of young football players at the stage of initial training

Organized football increasingly goes against the capabilities and needs of the child. This trend is especially critical at the stage of initial preparation. In addition to the negative effects on the physical development of young football players, forcing training and ignoring their age characteristics has an extremely destructive effect on the mental development of children. The article analyzes the possibilities and advantages of pedagogical means of regulating motivational factors and the process of forming a number of psychological qualities and abilities of young football players aged 6 to 9 years. Suggested methods of personality formation of young football players. The formation of the sports character of young football players should consist of both team actions and individual characteristics.&#x0D; Focusing on raising children begins in the environment that shapes them. The most important component of the formation of a young personality is the psychological aspect. Due to various movements with and without the ball, children can gain game experience. Adapting exercises to the child's needs is a basic condition for preventing traumatic effects and promoting its harmonious development, creating prerequisites for stimulating independent thinking, using the "try to find a solution" principle. The work summarizes data from special literary sources and domestic practical experience, as well as analyzes the key factors that determine the dynamics of training and physical and psychological development of young football players. The mechanisms of the influence of the use of pedagogical tools of a game nature on the process of formation of the motivational, cognitive and psycho- emotional sphere of a child of primary school age playing football are shown.

Caffeine administration to treat oversedation after general anesthesia: A retrospective analysis

Study objectiveOur institution has adopted an informal practice of administering postoperative caffeine to expedite anesthesia recovery for patients with excessive sedation. This study aimed to determine whether caffeine administration was associated with improved sedation recovery and reduced risk of respiratory complications. DesignSingle-center, retrospective, observational study. SettingQuaternary medical center. PatientsWe included adult patients who were admitted to a postanesthesia recovery care unit (PACU) after general anesthesia and had evidence of postoperative sedation (Richmond Agitation Sedation Score [RASS] < 0). Patients were seen from May 5, 2018, through December 31, 2020. InterventionsPatients were categorized according to caffeine administration (0 vs 250 mg). MeasurementsSedation was measured with RASS. To account for potential confounding, binary and ordinal logistic regression with inverse probability of treatment weighting (IPTW) were used to compare RASS and episodes of severe respiratory complications within 48 h after PACU discharge. Main resultsWe identified 47,222 adult surgical patients with evidence of sedation in the PACU, and of these, 1892 (4.0%) were intravenously administered caffeine. Patients who received caffeine had more sedation in the PACU. In the IPTW-adjusted analysis, caffeine administration was associated with improved sedation scores after PACU discharge (ordinal logistic regression odds ratio [OR], 1.13 [95% CI, 1.00–1.28]; P = .04 for the first RASS score after PACU discharge) but increased risk of respiratory complications (OR, 2.99 [95% CI, 1.44–6.24]; P = .003) and emergency response team activation (OR, 7.18 [95% CI, 2.85–18.10]; P < .001). ConclusionsIn this observational study, caffeine administration during anesthesia recovery was associated with improved sedation scores. However, it was also associated with an increased risk of respiratory complications, possibly reflecting selection bias (ie, administering caffeine to higher-risk patients). Patients with signs of excessive sedation during anesthesia recovery may benefit from enhanced postoperative respiratory monitoring.

Evaluating the impact of pre-hospital trauma team activation criteria.

Little evidence exists studying the benefits of pre-hospital trauma team activation. Our study measured the impact of pre-hospital trauma team activation on 24-h survival. Our secondary objectives assessed the effects of pre-hospital trauma team activation on time to emergency procedure, computed tomography, blood transfusion, and critical administration threshold, as well as emergency department length of stay. We conducted a 40-month health records review on all trauma team activations at The Ottawa Hospital, a Level 1 Trauma Center. Outcomes were compared between pre-hospital and in-hospital trauma team activations. We used logistic and linear regression models to assess outcomes, while controlling for injury severity score, age, systolic blood pressure, and anti-coagulation use. A P value < 0.05 was considered statistically significant. A sensitivity analysis was also used to validate the primary outcome results. Of the 1013 trauma team activations occurring during the study period, 762 patients were included. The mean age (41.3 vs. 43.8) and percentage of males (79.4% vs. 77.5%) for pre-hospital activations were similar to their counterparts. Pre-hospital activations did not have a statistically significant effect on 24-h mortality (14.4% vs. 4.5%; P = 0.30). However, pre-hospital activations did demonstrate a statistically significant reduction in time (minutes) to emergency procedure (18.0 vs. 27.0; P < 0.001), computed tomography (37.0 vs 42.0; P = 0.009), and blood transfusion (14.0 vs. 28.0; P < 0.001), as well as emergency department length of stay (101.0 vs. 171.0; P < 0.001). When controlling for key covariates, pre-hospital trauma team activation did not have a significant effect on 24-h mortality, but did result in a significant reduction in time to emergency procedure, computed tomography, and blood transfusion, as well as emergency department length of stay. Our study demonstrates that pre-hospital trauma team activation can expedite patient intervention and disposition.

Abstract 329: Unrecognized Clinical Deterioration Prior to In-Hospital Cardiac Arrest and Associated In-Hospital Mortality

Introduction: Physiologic abnormalities often precede in-hospital cardiac arrest (IHCA). Critical Care Outreach Teams (CCOTs) are designed to respond to patients that meet standardized rapid response team (RRT) activation criteria including vital sign abnormalities, neurologic changes, and nursing concern. However, these systems often rely on clinical staff recognizing signs of clinical deterioration and initiating a rapid response. Research Question: The purpose of this post-hoc analysis was to identify if there was an in-hospital mortality difference between two different adult patient groups: 1) patients who met standardized RRT criteria but did not receive an RRT prior to IHCA and 2) patients who had no evidence of clinical deterioration prior to IHCA. Goals: The primary goal was to explore the association of unrecognized clinical deterioration on patient mortality. A secondary goal was to identify the timing onset of RRT criteria in patients who had an IHCA but did not receive an RRT activation. Methods: All non-ICU IHCAs during a 5-year period (January 1st, 2018, to December 31st, 2022) were reviewed to identify whether: 1) standardized RRT criteria had been met in the 24 hours prior to IHCA, 2) the onset of RRT criteria if present, 3) sustained return of spontaneous circulation (ROSC) occurred during the IHCA, and 4) if the patient died during their hospitalization. Results: There were 271 adult non-ICU IHCAs without a preceding RRT activation. Of those, 203 (79.4%) met RRT criteria prior to IHCA. In patients who had evidence of clinical deterioration, patients displayed at least one RRT criterion an average of 13.1 hours prior to IHCA. Sustained ROSC was higher in the patient group without RRT criteria (79.4%, 54/68 vs 72.9%, 148/203), but this was not significant. In-hospital mortality was significantly higher patients who met RRT criteria without RRT activation compared to patients who did not meet RRT criteria prior to IHCA (67.9%, 65/138 vs 54.4%, 31/37, p&lt;0.05). Conclusions: Most patients who experienced an IHCA demonstrated physiologic abnormalities hours prior to IHCA. Patients who met RRT criteria without RRT activation had a significantly higher mortality rate when compared with patients who did not have evidence of clinical deterioration.

Abstract 14054: Pre-Hospital Predictors of Cardiogenic Shock Among ST-Segment Elevation Myocardial Infarction Patients With and Without Cardiac Arrest: Implications for Shock Teams

Introduction: Cardiogenic shock (CS) develops in up to 8.6% of patients with STEMI and is associated with poor outcomes. Early identification of patients at risk of CS is paramount to enable timely mobilization of shock teams to improve outcomes. Hypothesis: We hypothesized that pre-hospital clinical parameters can predict development of CS in STEMI patients undergoing primary PCI. Using these predictors, we developed a risk score to rapidly identify patients at risk of developing CS. Methods: We performed a retrospective cohort study using prospective data from a centralized STEMI registry of a healthcare system serving 1.25 million people. Patients presenting with STEMI with intent to receive primary PCI between 2012 to 2020 were included. Logistic regression was used to assess the relationship between predictors and the occurrence of CS at any point from first medical contact to hospital discharge. The prediction model was converted to a risk score by scaling of the regression coefficients. The accuracy of the risk score was determined using C-statistic. Results: Among 2736 consecutive STEMI patients, 15.2% (n=415) developed CS. Overall, 10.9% of patients had prehospital cardiac arrest, which was more likely in those with CS (46.5% vs. 4.5%, p&lt;0.001). Patients with CS were more likely to have prolonged first medical contact-to-device time per national guidelines (74.7% vs. 53.3%, p&lt;0.001). Regression analysis identified 8 parameters that predict CS as shown in Table 1. Two models, with and without cardiac arrest, were developed. Both models show C-statistics of 0.80 and above. Conclusions: Among STEMI patients with intent to undergo primary PCI, we identified 8 clinical parameters that strongly predict CS. This has been developed into a scoring system which can be easily used by emergency service providers to rapidly identify patients with CS and enable timely shock team activation.

Abstract 15831: Characterization of Patient-Specific Care Pathways in Cardiogenic Shock

Background: Heterogeneity in patient characteristics and clinical severity may affect treatment goals and associated management in cardiogenic shock (CS). We sought to better describe the development over time of specific care pathways and the associated patient phenotypes informing such decisions in CS. Methods: We consented and prospectively enrolled 60 patients presenting with CS from November 2022 to May 2023. Provider notes were reviewed for language describing 3 distinct care pathways: Advanced Group (AG): urgent evaluation for left ventricular assist device and/or heart transplantation; Recovery Group (RG): eligible for native myocardial recovery only; and Palliation Group (PG): unlikely to recover. Remaining patients were classified as No Decision (ND). Pathway decisions were assessed at days 3 and 7. Results: Median cohort age was 59 years (IQR 42-66), and 67% (n = 40) were men. Initial SCAI stages D and E comprised 63% (n = 38) of cases. By hospital days 3 and 7, care pathways were defined in 11 (18%) and 36 (60%) patients, respectively ( Figure ). There were no ND deaths before day 7. Patient characteristics were similar regardless of whether a pathway was specified by day 7. Across care pathways, recovery options decreased with increased age (AG 45, RG 53, PG 66 years; p = 0.037) and new dialysis requirement (AG 0%, RG 36% [n = 5], PG 56% [n = 5]; p = 0.007). Initial SCAI stage, CS etiology (AMI 20% [n = 12], HF 58% [n = 35]), rate of shock team activation (15% [n = 9]), and mechanical circulatory support use (43% [n = 26]) were numerically similar. Palliative care was involved in 78% (n = 47) of cases overall and in all PG cases. In-hospital mortality was 29% (n = 16) and was highest in PG (88.9% [n = 8], p &lt;0.0001). Conclusion: Even after 7 days in an intensive care unit at an academic medical center, 40% of patients with CS did not have a care pathway defined. These data suggest that structured interventions to expedite such decision-making should be tested to improve care in patients with CS.

Scientific and methodological foundations for the development of motivation of high school hockey players

Relevance. The main task is to analyze psychological and pedagogical approaches to the formation of motivation in game sports (using the example of hockey). The paper considers the problem of motivation development in high school hockey players, examines the structure of motivation and its features, identifies the main components of motivation, and defines terminology. The paper identifies the features of high school age, which play an important role in the formation of professional self-determination.The aim of the work was to study the scientific and methodological foundations for the development of motivation of hockey players of old school age.Organization and methods of research. An important structure in the formation of motivation is the emotional sphere of a person. The peculiarity of this structure consists in its variability of functions depending on the object under consideration, as well as in the heterogeneity of the cause of affect. I think the fact that our emotions are physiologically conditioned is well-established. However, the stimulus that triggers emotional reactions may have different origins.The results of the study and their discussion. The implementation of the first mechanism is based on the creation of conditions in which an athlete independently comes to the formation of motives and goals, from which motivation is subsequently formed, as well as which help to maintain effective sports motivation. To implement such a scheme, using the example of a hockey team, it is possible to organize team activity outside the training program that would bring them together, various options are possible here, for example, joint camping.Conclusions. Various aspects of sports motivation, ways to maintain its optimal state, the formation of new motives using multidirectional methods, as well as the formation of motivation through the satisfaction of multi-level needs are considered.

MO29-1 The present activity and issues of AYA support team for the patients in AYA generation

MO29-1 The present activity and issues of AYA support team for the patients in AYA generation

Association between trauma triage and time-to-vaso-occlusive events in patients with sickle cell disease after traumatic injury: a retrospective study

IntroductionSickle cell disease (SCD) is associated with vaso-occlusive events (VOEs) that can lead to disease complications, including early mortality. Given that similar inflammatory responses characterize VOE and traumatic injury, injured...

Abstract 264: Enhancing Stroke Care: Neurology Residents' Clinical Prediction of Large Vessel Occlusions for Faster Endovascular Activation

Introduction Large vessel occlusions (LVO) account for approximately 15 to 30% of acute ischemic strokes, necessitating rapid clinical recognition to facilitate timely endovascular team activation and reduce door‐to‐reperfusion time for mechanical thrombectomy (MT). Existing clinical LVO scales, such as RACE, FASTED, and VAN, designed for utilization by Emergency Medical Services (EMS), lack reliability and have not been widely adopted for pre‐activation of endovascular teams. Typically, endovascular team activation occurs after LVO confirmation through neuroimaging, highlighting the need for improved methods to identify LVO during early assessments by neurologists. Methods A prospective observational study was conducted at University Hospital, involving all stroke codes activated by the Emergency Department (ED) or EMS. Neurology residents responding to the codes performed initial assessments, encompassing patient history, physical examination, and NIH Stroke Scale (NIHSS) evaluations. Based on the onset and severity of symptoms, presence of cortical signs, and NIHSS scores, patients were classified into four categories: A) probable LVO and stroke, B) possible LVO and stroke, C) not LVO but probable stroke, and D) probable stroke mimic. All assessments were completed before CT scanning. Results Over a ten‐month period, 159 stroke codes were evaluated by neurology residents. Among these, 27 patients were diagnosed with LVO, while 132 patients had no LVO. The neurology residents classified 18 patients into the probable stroke group, demonstrating a sensitivity of 48%, specificity of 96%, a positive predictive value (PPV) of 72%, and a negative predictive value (NPV) of 90%. Combining the probable and possible stroke groups, the residents identified 34 patients with a sensitivity of 74%, specificity of 89%, a PPV of 5%, and an NPV of 94%. Regrettably, seven patients with LVO were misclassified as either stroke mimics or non‐LVO strokes. Among these cases, five patients presented with low NIHSS scores, two had LVO in the posterior circulation, and one developed an in‐stent thrombus. Conclusion Our study revealed that neurology residents' ability to predict LVO was comparable to other LVO prediction scales in terms of sensitivity and specificity, but significantly improved in PPV. With a PPV exceeding 70%, the clinical prediction of LVO by neurology residents proves to be a valuable tool for activating the endovascular team promptly. This approach holds promise for enhancing stroke care in both the emergency department and pre‐hospital ambulance‐based settings. Nevertheless, larger studies are warranted to validate and further refine these findings. Implementing the neurology residents' clinical judgment in LVO identification can potentially optimize patient outcomes and treatment timelines in acute ischemic strokes.

Improving the impact of pharmacy interventions in hospitals

The clinical and pharmaceutical interventions of pharmacy professionals are considered impactful inputs towards optimised patient care and safety, by rationalising prescriptions, enhancing therapeutic choices and reducing and preventing medication errors...