Background and Aims: as conducting the regular trauma team simulation training is expensive and time-consuming, its effects must be explored. the objective was to evaluate the efficacy of a structured 2-h in situ multiprofessional trauma team simulation training course on non-technical skills.Materials and Methods: this prospective study comprised 90 trauma teams with 430 participants. the structured, 2-h course consisted of an introductory lecture and two different simulations with debriefings. Data were collected using a pre-post selfassessment questionnaire. in addition, the expert raters used the t-notechS scale.Results: the following non-technical skills improved significantly among both medical doctors and nurses: knowledge of the trauma resuscitation guidelines, problem identification, decision making, situation awareness/coping with stress, communication and interaction, time management, being under authority, and confidence in one's role in a team. the teams improved significantly in leadership, cooperation and resource management, communication and interaction, assessment and decision making, and situation awareness/coping with stress.Conclusion: a short, structured 2-h in situ trauma team simulation training course is effective in improving non-technical skills.
The influences of joint immobilization and running exercise on the articular cartilage surfaces of the patella and lateral tibial condyle of young rabbits were investigated by the semiquantitative stereomicroscopic and scanning electron microscopic methods during a period of 8 weeks. The smoothness of the articular surfaces was disturbed already 1 week after the onset of immobilization. Leafy, slightly rough and rough surface qualities associated with superficial splits were observed. The changes were of the same nature after a longer period of immobilization. Running exercise on the treadmill (150–300 m twice a day, 12–24 min per turn, 5 times a week) led to an increase of the striated surface quality at 1 to-2-week intervals as compared with the controls. It was apparent that during immobilization remarkable changes of the articular cartilage took place within the first week, while running exercise up to 8 weeks elicited only transient or minor alterations of the articular surface.
BackgroundThe 5-item non-technical skills scale for trauma (T-NOTECHS) with five response categories is developed to assess non-technical skills in trauma team resuscitations. This validated instrument assesses behavioral aspects in teamwork. Outcome instruments should undergo a robust adaptation process followed by psychometric validation to maintain their measurement properties when translated into different languages. The translatability of the T-NOTECHS into a non-Anglo-Saxon language has not been thus far unraveled. The authors aimed to assess whether the T-NOTECHS would be translatable into a non-Anglo-Saxon language and to investigate its psychometric properties for simulated multi-professional trauma team resuscitations.MethodsThe T-NOTECHS (scores: 1 = poor; 5 = excellent) was translated and cross-culturally adapted into Finnish. Data was derived from 61 real hospital trauma team resuscitation simulations with 193 multi-professional participants. Floor-ceiling effects, internal consistency, and inter-rater reliability were analyzed. An exploratory factor analysis was conducted to test construct validity.ResultsAfter pre-testing, minor changes were made to the Finnish translation of the T-NOTECHS. Mean scores of two raters were 3.76 and 4.01, respectively. The T-NOTECHS instrument showed no floor-effect either in single items or in the total score. The total score of the T-NOTECHS instrument showed a percentage of maximum scores of 1.6 and 4.9% by the Raters 1 and 2, respectively. Internal consistency (Cronbach’s alpha) was 0.70 with inter-item correlation of 0.54. The intraclass correlation coefficient was 0.54 and coefficient of repeatability 1.53. The T-NOTECHS loaded on one factor.ConclusionsThe T-NOTECHS translated well into a difficult non-Anglo-Saxon language. The rigorous adaptation process used here can be recommended in the translation of observational performance assessment instruments. The translated version demonstrated fair reliability and good construct validity for assessing team performance in simulated multi-professional trauma team resuscitations. The translated T-NOTECHS instrument can be used to assess the efficacy of simulated in-situ trauma team resuscitations allowing benchmarking and international collaboration.
A681herbs showed various larvicidal and repellent activities. C.longa showed the highest repellent activity against mosquitoes. All 5 of the Thai herbs (A.graveolens, C.aurantifolia, C.longa, O.basilicum, Z.limonella) showed larvicidal activity (LD50) superior to DEET. PHP171 Do PeoPle WitH Private HealtH insurance attacH a HigHer value toHealtH tHan tHose WitHout insurance? results From an eQ-5D-5l valuation stuDy in tHe rePublic oF irelanD
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