Has anesthesia care become safer and is anesthesia-related mortality decreasing?

In well-resourced areas of the world anesthesia has become safer over the past decades, and anesthesia mortality does seem to be reducing. However, there is a lack of international agreement over definitions of anesthetic mortality and, therefore, difficulty in knowing exactly what the rate of anesthetic mortality is. Avoidable harm from error is still a problem, and sophisticated analysis suggests that more deaths than generally appreciated may be attributable to factors under the control of anesthetists. Mortality rates in low income areas of the world are unacceptably high. There is more to be done if anesthesia is to become truly safe for all patients

Protocol for a randomised controlled trial of a school based cognitive behaviour therapy (CBT) intervention to prevent depression in high risk adolescents (PROMISE)

<p>Abstract</p> <p>Background</p> <p>Depression in adolescents is a significant problem that impairs everyday functioning and increases the risk of severe mental health disorders in adulthood. Relatively few adolescents with depression are identified and referred for treatment indicating the need to investigate alternative preventive approaches.</p> <p>Study Design</p> <p>A pragmatic cluster randomised controlled trial evaluating the effectiveness of a school based prevention programme on symptoms of depression in "high risk" adolescents (aged 12-16). The unit of allocation is year groups (n = 28) which are assigned to one of three conditions: an active intervention based upon cognitive behaviour therapy, attention control or treatment as usual. Assessments will be undertaken at screening, baseline, 6 months and 12 months. The primary outcome measure is change on the Short Mood and Feeling Questionnaire at 12 months. Secondary outcome measures will assess changes in negative thoughts, self esteem, anxiety, school connectedness, peer attachment, alcohol and substance misuse, bullying and self harm.</p> <p>Discussion</p> <p>As of August 2010, all 28 year groups (n = 5023) had been recruited and the assigned interventions delivered. Final 12 month assessments are scheduled to be completed by March 2011.</p> <p>Trial Registration</p> <p>ISRCTN19083628</p

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Human Factors and the Cardiac Surgical Team: A Role for Simulation

Human factors play an important role in determining the outcome of cardiac surgery. The interaction of humans with their equipment, and with each other in teams, is critical to success. Simulation provides a means of teaching and assessing the technical and non-technical skills of clinicians and can facilitate research into interventions to improve safety. Simulation in anesthesia has taken much from aviation and provides a model that could be extended to perfusion. The cost of setting up a simulation center (or even of adding a perfusion simulator to an existing center) is relatively high, but the potential return on this investment is also substantial, particularly at a time when access to patients for teaching and research is becoming harder. Different degrees of complexity and fidelity in simulation lend themselves to different objectives, whether in teaching, assessment, or research. In the longer term, comprehensive simulations of cardiac surgical procedures involving all participants in meaningful simulated roles may be possible