Navigating cardiac arrest together: A survivor and family-led co-design study of family needs and care touchpoints.

Introduction: This study aimed to i) identify the care needs of families experiencing cardiac arrest; and ii) co-identify strategies for meeting the identified care needs. Cardiac arrest survivors and family members (of survivors and non-survivors) were engaged as "experience experts," collaborators and co-researchers in this study.

Methods: A qualitative study using semi-structured interviews of cardiac arrest survivors and family members was conducted.

Challenges simulating the AMOC in climate models.

The latest assessment report from the Intergovernmental Panel on Climate Change concluded that the Atlantic Meridional Overturning Circulation (AMOC) was very likely to decline over the twenty-first century under all emissions scenarios; however, there was low confidence in the magnitude of the decline. Recent research has highlighted that model biases in the mean climate state can affect the AMOC in its mean state, variability and its response to climate change. Hence, understanding and reducing these model biases is critical for reducing uncertainty in the future changes of the AMOC and in its impacts on the wider climate.

What Are the Care Needs of Families Experiencing Sudden Cardiac Arrest? A Survivor- and Family-Performed Systematic Review, Qualitative Meta-Synthesis, and Clinical Practice Recommendations.

Introduction: Cardiac arrest care systems are being designed and implemented to address patients', family members', and survivors' care needs. We conducted a systematic review and a meta-synthesis to understand family experiences and care needs during cardiac arrest care to create treatment recommendations.

Methods: We searched eight electronic databases to identify articles.

The Low-Resolution Version of HadGEM3 GC3.1: Development and Evaluation for Global Climate.

A new climate model, HadGEM3 N96ORCA1, is presented that is part of the GC3.1 configuration of HadGEM3. N96ORCA1 has a horizontal resolution of ~135 km in the atmosphere and 1° in the ocean and requires an order of magnitude less computing power than its medium-resolution counterpart, N216ORCA025, while retaining a high degree of performance traceability.

Implementation of a novel portfolio of structured, curriculum-aligned, simulation-based, cardiothoracic surgery training courses: Evolving the delivery of surgical education.

Objective: The provision of high-quality cardiothoracic surgical training faces many challenges. This has generated an increased interest in simulation-based learning, which can provide a less stressful environment for deliberate practice. We developed a comprehensive, structured program of knowledge and simulation-based learning aligned to the official cardiothoracic surgery curriculum.

Evaluating Surgical Residents Quickly and Easily Against the Milestones Using Electronic Formative Feedback.

Objective: This study was conducted to assess the effectiveness of a newly implemented electronic web-based review system created at our institution for evaluating resident performance relative to established milestones.

Design: Retrospective review of data collected from a survey of general surgery faculty and residents.

Setting: Tertiary care teaching hospital system and independent academic medical center.

Shiga Toxin-Producing Escherichia coli Infection, Antibiotics, and Risk of Developing Hemolytic Uremic Syndrome: A Meta-analysis.

Background: Antibiotic administration to individuals with Shiga toxin-producing Escherichia coli (STEC) infection remains controversial. We assessed if antibiotic administration to individuals with STEC infection is associated with development of hemolytic uremic syndrome (HUS).

Methods: The analysis included studies published up to 29 April 2015, that provided data from patients (1) with STEC infection, (2) who received antibiotics, (3) who developed HUS, and (4) for whom data reported timing of antibiotic administration in relation to HUS.

Alberta Provincial Pediatric EnTeric Infection TEam (APPETITE): epidemiology, emerging organisms, and economics.

Background: Each year in Canada there are 5 million episodes of acute gastroenteritis (AGE) with up to 70% attributed to an unidentified pathogen. Moreover, 90% of individuals with AGE do not seek care when ill, thus, burden of disease estimates are limited by under-diagnosing and under-reporting. Further, little is known about the pathogens causing AGE as the majority of episodes are attributed to an "unidentified" etiology.

Standards for heart valve surgery in a 'Heart Valve Centre of Excellence'.

Surgical centres of excellence should include multidisciplinary teams with specialist expertise in imaging, clinical assessment and surgery for patients with heart valve disease. There should be structured training programmes for the staff involved in the periprocedural care of the patient and these should be overseen by national or international professional societies. Good results are usually associated with high individual and centre volumes, but this relationship is complex.

A comparison of the efficacy of 70% v/v isopropyl alcohol with either 0.5% w/v or 2% w/v chlorhexidine gluconate for skin preparation before harvest of the long saphenous vein used in coronary artery bypass grafting.

Background: Chlorhexidine gluconate (CHG) is often recommended for skin antisepsis; however, the most efficacious concentration is currently unclear. Our objective was to compare the efficacy of 70% isopropyl alcohol (IPA) containing either 0.5% or 2% CHG for antiseptic skin preparation in patients undergoing coronary artery bypass grafting.

Clinical outcomes of Carbomedics Top Hat valve with a robust follow-up system.

Aim: Late failure of bioprosthetic valves may limit their use in patients < 60 years. The superior hemodynamic performance offered by the Carbomedics Top Hat supraannular valve enables greater effective orifice areas to be achieved. The aim of this study was to assess the clinical outcomes of this valve, using a robust follow-up system.

UK specialist cardiothoracic management of thoracic injuries in military casualties sustained in the wars in Iraq and Afghanistan.

Objectives: Outcomes of casualties with thoracic wounding at the deployed UK military field hospital (Role 3(R3)) have been previously described. The level of cardiothoracic specialist input required on repatriation to the UK is less clear. This study aimed to assess the outcomes of casualties with thoracic injuries repatriated to the UK (Role 4 (R4)) and evaluate the impact of specialist cardiothoracic care.

Stab to the chest causing severe great vessel injury.

Penetrating trauma has increased in developed and urban environments. Pulmonary artery injury is rare, but can be associated with significant morbidity. We report a case of delayed cardiac arrest following a stab injury to the chest.

Patient-prosthesis mismatch in patients with aortic stenosis undergoing isolated aortic valve replacement does not affect survival.

Background: Data suggest that patient-prosthesis mismatch (PPM) adversely effects late survival after aortic valve replacement (AVR). This study examined the incidence and implications of PPM in patients undergoing isolated AVR.

Methods: Prospectively collected data on patients undergoing isolated AVR for aortic stenosis between January 1, 1997 and December 31, 2007 were analyzed.

Informatics and knowledge translation.

To ensure that the benefits of knowledge translation synthesis are accessible to care providers at the point of decision-making, fast, efficient, usable clinical information systems are required. Medical informatics appears to hold the greatest promise to be able to create systems with the necessary capacity and functionality. Emergency medicine needs to be actively engaged at all levels of the process.