Traffic, training, and turnover: Experiences of research personnel in collecting road safety data in Hyderabad, India.

We describe the experiences of research personnel in collecting road safety data, using a range of quantitative and qualitative methods to collect primary and secondary data, in the course of monitoring and evaluating the impact of road safety interventions under the Bloomberg Philanthropies Global Road Safety Program, in Hyderabad, India. We detail environmental, administrative, and operational barriers encountered, and individual, systemic, and technical enablers pertaining to the conduct of road safety research in Hyderabad, India, but bearing relevance to broader public health research and practice and the implementation and evaluation of projects. From our experiences of the challenges and the solutions developed to address them, we set out recommendations for research teams and for administrators in road safety as well as in various other streams of public health research and practice.

The ethical experiences of trainees on short-term international trips: a systematic qualitative synthesis.

Background: Medical student and resident participation in short-term international trips for trainees (STINTTs) has increased in the past few decades. However, there has been no systematic review of trainees' actual ethical experiences. The authors sought to identify what ethical issues medical trainees encounter during STINTTs, as elicited by and reported in peer-reviewed, quantitative and qualitative research papers.

Value of hospital resources for effective pressure injury prevention: a cost-effectiveness analysis.

Objective: Hospital-acquired pressure injuries are localised skin injuries that cause significant mortality and are costly. Nursing best practices prevent pressure injuries, including time-consuming, complex tasks that lack payment incentives. The Braden Scale is an evidence-based stratification tool nurses use daily to assess pressure-injury risk.

A quality improvement project to reduce door-to-electrocardiogram time: A multicenter study.

Objective: To improve compliance with a target door-to-electrocardiogram (EKG) time of 10 minutes or less in patients presenting with symptoms concerning for acute coronary syndrome.

Methods: A pre-post study was performed between January 2014 and May 2016 at five emergency departments (EDs) in Saudi Arabia. Patients who presented to ED with symptoms concerning for acute coronary syndrome were included in the study.

A quality improvement project decreases incidence of pulmonary embolism following arthroplasty.

Objective: To develop a quality improvement initiative to reduce the incidence of pulmonary embolism (PE) following elective lower extremity joint replacement surgery.

Methods: 866 Patients undergoing a total knee or total or partial hip replacement surgery at a from 2014 to 2016 were included in this prospective pre-post interventional study.

Results: There were 13 PE's before the intervention and 2 after the intervention.

Obtaining a follow-up appointment before discharge protects against readmission for patients with acute coronary syndrome and heart failure: A quality improvement project.

Background: Cardiac patients have a high risk of readmission following hospital discharge. The aim of our project was to examine the factors associated with increased readmission rate, with a view to eventually decrease the rate of readmission for patients admitted to the hospital due to acute coronary syndrome (ACS) or heart failure.

Methods: Patients admitted to the cardiac step-down unit at a single private hospital from 2015 to 2016 were included in our study.

Global Health Career Interest among Medical and Nursing Students: Survey and Analysis.

Background: Global health experiences undertaken in international settings (GHEs) are becoming an increasingly prevalent aspect of health professions education and, as such, merit comprehensive analysis of the impact they have on students and host communities.

Objective: To assess the associations between demographic/experiential factors and the interest of health professions students in careers involving global health.

Methods: A cross-sectional survey was administered online to a convenience sample of medical and nursing students at Johns Hopkins University.

Allocating provider resources to diagnose and treat restless legs syndrome: a cost-utility analysis.

Objectives: Restless legs syndrome (RLS) is a neurological disorder that is frequently misdiagnosed, resulting in delays in proper treatment. The objective of this study was to analyze the cost-utility of training primary care providers (PCP) in early and accurate diagnosis of RLS.

Methods: We used a Markov model to compare two strategies: one where PCPs received training to diagnose RLS (informed care) and one where PCPs did not receive training (standard care).

Relationship between depression and clinical outcome following anterior cervical discectomy and fusion.

Background: Anterior cervical discectomy and fusion (ACDF) is a commonly performed procedure for patients with symptomatic degenerative conditions of the cervical spine. The objective is to assess the impact of preoperative depression and other baseline characteristics on patient reported clinical outcomes following ACDF surgery based on the experience at our institution.

Methods: This was a retrospective cohort study of some patients undergoing ACDF at a single institution from 2012 to 2014.

Improving antibiotic prophylaxis in gastrointestinal surgery patients: A quality improvement project.

Background: A surgical site infection (SSI) is a frequent complication following gastrointestinal surgery, but the careful selection and administration of prophylactic antibiotics can reduce the risk. The aim of this study was to develop a package of interventions that could be used to improve surgical antibiotic prophylaxis (SAP) at our institution.

Methods: A pre-post quality improvement project at a private hospital in Saudi Arabia was conducted between January 2014 until July 2016.

Impact of improving vehicle front design on the burden of pedestrian injuries in Germany, the United States, and India.

Objective: European car design regulations and New Car Assessment Program (NCAP) ratings have led to reductions in pedestrian injuries. The aim of this study was to evaluate the impact of improving vehicle front design on mortality and morbidity due to pedestrian injuries in a European country (Germany) and 2 countries (the United States and India) that do not have pedestrian-focused NCAP testing or design regulations.

Methods: We used data from the International Road Traffic and Accident Database and the Global Burden of Disease project to estimate baseline pedestrian deaths and nonfatal injuries in each country in 2013.

Cost-Benefit Analysis of a Support Program for Nursing Staff.

Objectives: A peer-support program called Resilience In Stressful Events (RISE) was designed to help hospital staff cope with stressful patient-related events. The aim of this study was to evaluate the impact of the RISE program by conducting an economic evaluation of its cost benefit.

Methods: A Markov model with a 1-year time horizon was developed to compare the cost benefit with and without the RISE program from a provider (hospital) perspective.

Cost-Effectiveness of Craniotomy for Epidural Hematomas at a Major Government Hospital in Cambodia.

Background: Epidural hematoma (EDH) is a common and potentially deadly occurrence following a severe traumatic brain injury. Our aim was to determine whether craniotomy is cost-effective when indicated for the treatment of EDH when a trained neurosurgeon is available.

Methods: A decision tree was used to model the cost-effectiveness of craniotomy available versus craniotomy unavailable for the management of traumatic EDH from a Cambodian societal and provider perspective.

A Quality Improvement Intervention Reduces the Time to Administration of Stat Medications.

Introduction: The delivery of urgent ("stat") medications to hospitalized children is important for safe quality care. The goal of this study was to evaluate the effect of a set of interventions on the percentage of stat medications administered within 30 minutes of ordering.

Methods: A pre-post study in 2 pediatric units (36 beds) in a private hospital in Saudi Arabia between January 2015 and September 2016.

Timing of surgical treatment for idiopathic normal pressure hydrocephalus: association between treatment delay and reduced short-term benefit.

OBJECTIVE A growing body of evidence suggests that longer durations of preoperative symptoms may correlate with worse postoperative outcomes following cerebrospinal fluid (CSF) diversion for treatment of idiopathic normal pressure hydrocephalus (iNPH). The aim of this study is to determine whether the duration of preoperative symptoms alters postoperative outcomes in patients treated for iNPH. METHODS The authors conducted a retrospective review of 393 cases of iNPH involving patients treated with ventriculoperitoneal (VP) shunting.

Predictors of Ventriculoperitoneal Shunt Revision in Patients with Idiopathic Normal Pressure Hydrocephalus.

Objective: Few studies have focused on predictive factors of ventriculoperitoneal (VP) shunt revision in patients with idiopathic normal pressure hydrocephalus (iNPH). This study aims to determine whether comorbidities and baseline symptoms are associated with the need for shunt revision.

Methods: A retrospective review of patients with iNPH treated with VP shunts by the senior author from 1993 to 2013 was conducted.

Comparison of outcomes between patients with idiopathic normal pressure hydrocephalus who received a primary versus a salvage shunt.

Placement of a ventriculoperitoneal (VP) shunt is the treatment of choice for communicating hydrocephalus; however, the extent to which VP shunting is able to relieve symptoms in patients who had previously been treated with cerebrospinal fluid diverting therapy at an outside institution remains unclear. A retrospective review of patients with idiopathic normal pressure hydrocephalus treated with VP shunts at a single institution between 1993 and 2013 was conducted. Patients were classified as having received a primary VP shunt if they had not been previously treated with a VP shunt, ventriculoatrial shunt, lumboperitoneal shunt, or endoscopic third ventriculostomy.

Development of global health education at Johns Hopkins University School of Medicine: a student-driven initiative.

Global health is increasingly present in the formal educational curricula of medical schools across North America. In 2008, students at Johns Hopkins University School of Medicine (JHUSOM) perceived a lack of structured global health education in the existing curriculum and began working with the administration to enhance global health learning opportunities, particularly in resource-poor settings. Key events in the development of global health education have included the introduction of a global health intersession mandatory for all first-year students; required pre-departure ethics training for students before all international electives; and the development of a clinical global health elective (Global Health Leadership Program, GHLP).

Does CT wand guidance improve shunt placement in patients with hydrocephalus?

Object: To evaluate the effectiveness of stereotactic navigation in enhancing the accuracy of ventricular shunt placement in patients with hydrocephalus.

Methods: A retrospective cohort study at a single institution by a single surgeon was performed. Consecutive patients who underwent implantation of a ventricular shunt for the management of hydrocephalus between July 2001 and December 2011 were included in the study, totaling 535 patients.

Maintenance of bowel, bladder, and motor functions after sacrectomy.

Background Context: Repeated cohort studies have consistently demonstrated a survival advantage after en bloc resection for locally aggressive primary tumors in the sacrum. A sacrectomy is often required to remove the tumor en bloc, which may necessitate the sacrifice of sacral nerves. This can potentially result in functional complications, including the impairment of gait, bowel function, or bladder function.