Implementation of simulation-based health systems science modules for resident physicians.

Background: Health system science (HSS) encompasses both core and cross-cutting domains that emphasize the complex interplay of care delivery, finances, teamwork, and clinical practice that impact care quality and safety in health care. Although HSS skills are required during residency training for physicians, current HSS didactics have less emphasis on hands-on practice and experiential learning. Medical simulation can allow for experiential participation and reflection in a controlled environment.

An Initiative to Improve Performance on a National Transition of Care Measure and to Reduce Readmissions in an Academic Psychiatric Hospital.

Background: Inpatient psychiatry discharge planning through careful transition documentation may reduce adverse patient outcomes and decrease hospital readmissions. In 2017 a national psychiatry reporting program instituted a quality metric called the Transition Record with Specified Elements Received by Discharged Patients (TR-1). At Yale New Haven Psychiatric Hospital, the TR-1 metric had 0% provider compliance when the quality metric was instituted.

Shifts in inpatient psychiatry utilization patterns at a U.S. Academic Medical Center during the COVID-19 pandemic.

The COVID-19 pandemic has impacted utilization volumes and patterns for inpatient psychiatry, though reports have noted inconsistencies on small populations. We obtained demographic and diagnostic data from a retrospective cohort of admitted psychiatric patients at a single-site from March-July 2020 and the corresponding months in 2019. Despite controlling for the modest decrease in inpatient admissions, no statistically significant changes in demographics or utilization was found, except for an increase in patients with substance use disorder (p<0.

Epidemiology, Infection Prevention, Testing Data, and Clinical Outcomes of COVID-19 on Five Inpatient Psychiatric Units in a large Academic Medical Center.

Inpatient psychiatric facilities can face significant challenges in containing infectious outbreaks during the COVID-19 pandemic. The main objective of this study was to characterize the epidemiology, testing data, and containment protocols of COVID-19 in a large academic medical center during the height of the COVID-19 outbreak. A retrospective cohort analysis was conducted on hospitalized individuals on five inpatient psychiatric units from March 1 to July 8, 2020.

Multiple Shape Coexistence in ^{110,112}Cd.

From detailed spectroscopy of ^{110}Cd and ^{112}Cd following the β^{+}/electron-capture decay of ^{110,112}In and the β^{-} decay of ^{112}Ag, very weak decay branches from nonyrast states are observed. The transition rates determined from the measured branching ratios and level lifetimes obtained with the Doppler-shift attenuation method following inelastic neutron scattering reveal collective enhancements that are suggestive of a series of rotational bands. In ^{110}Cd, a γ band built on the shape-coexisting intruder configuration is suggested.

Simeprevir with pegylated interferon alfa 2a plus ribavirin for treatment of hepatitis C virus genotype 1 in patients with HIV: a meta-analysis and historical comparison.

Background: About one third of patients infected with human immunodeficiency virus (HIV) also have chronic hepatitis due to hepatitis C virus (HCV). HCV therapy with simeprevir, pegylated interferon alfa (PegIFNα) and ribavirin (RBV) have been shown to be superior to PegIFNα + RBV alone in non-HIV patients, but no randomized trials in patients with HCV genotype 1 (HCV-1)/HIV coinfection are available.

Methods: This was a historical comparison of study C212 (simeprevir + PegIFNα-2a + RBV in patients with HCV-1/HIV coinfection) with studies in which HCV-1/HIV coinfected patients were treated with PegIFNα-2a + RBV alone.

New features of shape coexistence in ;{152}Sm.

Excited states in ;{152}Sm have been investigated with the ;{152}Sm(n,n;{'}gamma) reaction. The lowest four negative-parity band structures have been characterized in detail with respect to their absolute decay properties. Specifically, a new K;{pi} = 0;{-} band has been assigned with its 1;{-} band head at 1681 keV.

Health Technology Assessment of laparoscopic compared to conventional surgery with and without mesh for incisional hernia repair regarding safety, efficacy and cost-effectiveness.

Introduction: Incisional hernias are a common complication following abdominal surgery and they represent about 80% of all ventral hernia. In uncomplicated postoperative follow-up they can develop in about eleven percent of cases and up to 23% of cases with wound infections or other forms of wound complications. Localisation and size of the incisional hernia can vary according to the causal abdominal scar.

Hormones for therapy of climacteric afflictions.

Background: In Western countries hormone replacement therapy (HT) is widely used in the treatment of climacteric women who are affected with hot flashes and night sweats. Besides, long-term HT was frequently used to manage the higher risks for osteoporosis and heart attack in postmenopause. Estrogens alone or combined with progestin feature most frequently in HT.

[Health economics and HTA].

For a comprehensive health technology assessment (HTA), health economic studies are analysed as well as medical studies. Significance and effects of HTA are rather different in European countries. In Germany HTA is conducted by two official agencies: DIMDI and IQWiG.

Therapy of atopic eczema.

Objectives: Major objective is the evaluation of the medical effectiveness of different therapeutical approaches and the cost effectiveness with relevance for Germany.

Methods: This health technology assessment (HTA) evaluates systemically randomized controlled studies (RCT) on the therapy of atopic dermatitis which were published between 1999 and 2004. Further it includes some important clinical studies which have been published after 2004 and other updates the English HTA report by Hoare et al.

Platelet aggregation inhibitors in primary and secondary prevention of ischemic stroke.

Background: The ischaemic stroke (IS) is one of the most frequent cause of death in Germany. Besides of non-drug many drug-based interventions are used in primary or secondary prevention of IS, among them the thrombocyte aggregation inhibitors (TAI).

Objectives: The evaluation addresses the questions on medical efficacy and cost-effectiveness of the TAI administration in the prevention of IS as compared to the management of risk factors alone as well as to the use of anticoagulant drugs.

Therapy of moderate and severe psoriasis.

Objective And Methods: This health technology assessment (HTA) report synthesises systematically randomized controlled studies (RCT) on the therapy of moderate and severe psoriasis vulgaris which were published between 1999 and 2004; it includes some important clinical studies which have been published after 2004 and thus updates the English HTA report by Griffiths et al. [1]. The major objective is the evaluation of the medical effectiveness of different therapeutical approaches and the cost effectiveness with relevance for Germany.

Bypass materials in vascular surgery.

Introduction: Arteriosclerotic changes can lead to circulatory disturbances in various areas of the human vascular system. In addition to pharmacological therapy and the management of risk factors (e. g.

Cost-effectiveness of outpatient treatment in depressive patients with escitalopram in Germany.

We investigated the cost-effectiveness of escitalopram (10 mg daily dose) vs. venlafaxine XR (75 mg daily dose) in a German outpatient setting for the treatment of unipolar depression (MADRS score 20-34) over a period of 70 days. To assess the cost effectiveness of the two substances we combined data from physician's surveys and clinical response data; cost-effectiveness was calculated using a Markov model.

Influence of tumor necrosis factor α in rheumatoid arthritis.

Objective: Rheumatoid arthritis (RA) is the most prevalent inflammatory rheumatic disorder. It is a chronic and incurable disease that leads to painful inflammation, often irreversible joint damage, and eventually to functional loss. Conventional treatment is based on unspecific immunosuppressive agents, e.

Sonographic diagnosis of "acute abdomen" in children and adults.

Introduction: The acute abdomen is the main term for an at first unclear emergency situation of the abdominal cavity. The acute abdomen belongs to the three most important reasons for the admission of patients into the emergency room. Further, this illness ranks 40% of all consultations in the ambulant care sector.

Low-energy coexisting band in 154Gd.

A low-energy coexisting band Jpi (Ex keV) 0(+) (1182), 2(+) (1418), 4(+) (1701) is identified in the deformed nucleus, 154Gd. Detailed gamma-ray spectroscopy following the beta decays of 154Eu (J=3), (g,m(1),m(2))154Tb (J=0,3,7) is used to establish this structure. The structure is explained in terms of the pairing and deformation degrees of freedom, a "pairing isomer," which results from the nu[505] upward arrow Nilsson intruder orbital.

Fine structure in proton emission from 145Tm discovered with digital signal processing.

Fine structure in proton emission from the 3.1(3) mus activity of 145Tm was discovered by using a novel technique of digital processing of overlapping recoil implantation and decay signals. Proton transitions to the ground state of 144Er and to its first excited 2(+) state at 0.

[Using the excimer laser in refractive eye surgery. Results of a survey of German ophthalmologists].

Background: Little information about the cost-effectiveness of excimer laser operations is available. As the number and structure of providers of these services in Germany are relatively unknown, only rough estimations can be made about the number of operations.

Purpose: In this study the market for excimer laser operations is defined, structured from an economic view and examined according to medium-term demand and supply trends.