Simulation-Based Clinical System Testing of Neonatal Resuscitation Readiness Across a Rural Health System Identifies Common Latent Safety Threats.

Background: Simulation offers an opportunity to practice neonatal resuscitation and test clinical systems to improve safety. The authors used simulation-based clinical systems testing (SbCST) with a Healthcare Failure Mode and Effect Analysis (HFMEA) rubric to categorize and quantify latent safety threats (LSTs) during in situ training in eight rural delivery hospitals. The research team hypothesized that most LSTs would be common across hospitals.

The effects of paced breathing on psychological distress vulnerability and heart rate variability in adults sustaining traumatic injury.

Background: Traumatic physical injuries can lead to psychological distress and increased risk of psychiatric disorders, often reflected in dysregulated autonomic responses measurable through heart rate variability (HRV). Slow-paced breathing has shown potential in enhancing HRV, but its effectiveness in injured survivors remains unexplored. This study investigates the effect of slow-paced breathing on HRV among injured survivors compared to non-injured individuals and explores the influence of psychological distress and spontaneous respiratory rate on this effect.

Identifying Cyclical Patterns of Behavior Using a Moving-Average, Data-Smoothing Manipulation.

For some individuals, rates of destructive behavior change in a predictable manner, irrespective of the contingencies programmed. Identifying such cyclical patterns can lead to better prediction of destructive behavior and may allow for the identification of relevant biological processes. However, identifying cyclical patterns of behavior can be difficult when using traditional methods of visual analysis.

Association of Low Hospital Birth Volume and Adverse Short-Term Outcomes for Neonates Treated with Therapeutic Hypothermia in Rural States.

Objective: We hypothesized that outborn neonates from smaller birth volume hospitals would have more frequent adverse short-term outcomes following therapeutic hypothermia (TH).

Study Design: Multicenter retrospective study comparing outcomes for small (<500 births/year), medium (501-1500 births/year), and large (>1500 births/year) hospitals in Northern New England. Multivariable logistic regression assessed the combined outcome of death/severe gray matter injury on MRI, controlling for encephalopathy severity and time to initiation of TH.

Establishing national diagnostic reference levels in fluoroscopy and fluoroscopically guided interventions in Ireland and comparing these with national diagnostic reference levels in Europe and internationally.

Purpose: The purpose of this work was to establish national Irish diagnostic reference levels (DRLs) for a clinically representative and comprehensive list of clinical indications, anatomical regions, and common procedures for fluoroscopy and fluoroscopically guided interventions and compare these, where possible, to other DRLs established at a national level.

Method: A list of clinical indications, anatomical regions and common procedures was established. A national database of service providers was used to identify all medical radiological facilities providing fluoroscopy and fluoroscopically guided intervention services.