56 research outputs found
Simulationâbased otorhinolaryngology emergencies boot camp: Part 1: Curriculum design and airway skills
Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/107579/1/lary24572.pd
Simulationâbased otorhinolaryngology emergencies boot camp: Part 2: Special skills using task trainers
Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/107500/1/lary24571.pd
ALYREF, a novel factor involved in breast carcinogenesis, acts through transcriptional and post-transcriptional mechanisms selectively regulating the short NEAT1 isoform
Prevalence of Errors in Anaphylaxis in Kids (PEAK): A Multicenter Simulation-Based Study
Background
Multi-institutional, international practice variation of pediatric anaphylaxis management by health care providers has not been reported.
Objective
To characterize variability in epinephrine administration for pediatric anaphylaxis across institutions, including frequency and types of medication errors.
Methods
A prospective, observational, study using a standardized in situ simulated anaphylaxis scenario was performed across 28 health care institutions in 6 countries. The on-duty health care team was called for a child (patient simulator) in anaphylaxis. Real medications and supplies were obtained from their actual locations. Demographic data about team members, institutional protocols for anaphylaxis, timing of epinephrine delivery, medication errors, and systems safety issues discovered during the simulation were collected.
Results
Thirty-seven in situ simulations were performed. Anaphylaxis guidelines existed in 41% (15 of 37) of institutions. Teams used a cognitive aid for medication dosing 41% (15 of 37) of the time and 32% (12 of 37) for preparation. Epinephrine autoinjectors were not available in 54% (20 of 37) of institutions and were used in only 14% (5 of 37) of simulations. Median time to epinephrine administration was 95 seconds (interquartile range, 77-252) for epinephrine autoinjector and 263 seconds (interquartile range, 146-407.5) for manually prepared epinephrine (P = .12). At least 1 medication error occurred in 68% (25 of 37) of simulations. Nursing experience with epinephrine administration for anaphylaxis was associated with fewer preparation (P = .04) and administration (P = .01) errors. Latent safety threats were reported by 30% (11 of 37) of institutions, and more than half of these (6 of 11) involved a cognitive aid.
Conclusions
A multicenter, international study of simulated pediatric anaphylaxis reveals (1) variation in management between institutions in the use of protocols, cognitive aids, and medication formularies, (2) frequent errors involving epinephrine, and (3) latent safety threats related to cognitive aids among multiple sites
Microduplications of 16p11.2 are associated with schizophrenia
Recurrent microdeletions and microduplications of a 600-kb genomic region of chromosome 16p11.2 have been implicated in childhood-onset developmental disorders1,2,3. We report the association of 16p11.2 microduplications with schizophrenia in two large cohorts. The microduplication was detected in 12/1,906 (0.63%) cases and 1/3,971 (0.03%) controls (P = 1.2 Ă 10â5, OR = 25.8) from the initial cohort, and in 9/2,645 (0.34%) cases and 1/2,420 (0.04%) controls (P = 0.022, OR = 8.3) of the replication cohort. The 16p11.2 microduplication was associated with a 14.5-fold increased risk of schizophrenia (95% CI (3.3, 62)) in the combined sample. A meta-analysis of datasets for multiple psychiatric disorders showed a significant association of the microduplication with schizophrenia (P = 4.8 Ă 10â7), bipolar disorder (P = 0.017) and autism (P = 1.9 Ă 10â7). In contrast, the reciprocal microdeletion was associated only with autism and developmental disorders (P = 2.3 Ă 10â13). Head circumference was larger in patients with the microdeletion than in patients with the microduplication (P = 0.0007)
Simulationâbased otorhinolaryngology emergencies boot camp: Part 3: Complex teamwork scenarios and conclusions
Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/107531/1/lary24570.pd
- âŠ