scholarly journals Transferability of Simulation-Based Training in Laparoscopic Surgeries: A Systematic Review

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Antonios E. Spiliotis ◽  
Panagiotis M. Spiliotis ◽  
Ifaistion M. Palios
Keyword(s):  
Operating Room ◽  
Randomized Clinical Trials ◽  
Operation Time ◽  
Surgical Skills ◽  
Systemic Review ◽  
Trained Group ◽  
The Real ◽  
Camera Navigation ◽  
Simulation Based ◽  
Time Accuracy

Objective. The implementation of simulation-based training in residency programs has been increased, but the transferability of surgical skills in the real operating room is not well documented. In our survey, the role of simulation in surgical training will be evaluated. Study Design. In this systemic review, randomized control trials, which assessed the transferability of acquired skills through simulation in the real operating setting, were included. A systematic search strategy was undertaken using a predetermined protocol. Results. Eighteen randomized clinical trials were included in this survey. Two studies investigated inguinal hernia repair, six laparoscopic cholecystectomy, five gynecologic procedures, two laparoscopic suturing, and two camera navigation during laparoscopic procedures. Simulation-trained participants showed superiority in surgical performance in comparison with untrained surgeons. The operation time, accuracy, incidence of intraoperative errors, and postoperative complications were statistically better in the simulation-trained group in comparison with the conventional-trained group. Conclusion. Simulation provides a safe, effective, and ethical way for residents to acquire surgical skills before entering the operating room.

Abstract P391: Marine N-3 Fatty Acids Reduce Atherosclerosis Cardiovascular Disease: A Systemic Review and Meta-analysis of Clinical Trials

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Akira Sekikawa ◽  
Nobutake Hirooka ◽  
Abhishek Vishnu ◽  
Vashudha Ahuja ◽  
Emmanuel Sampene ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Fatty Acids ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Imaging Techniques ◽  
Meta Analysis ◽  
Quantitative Information ◽  
Systemic Review ◽  
Cochrane Library ◽  
Cardiac Imaging Techniques

Introduction: Although marine n-3 fatty acids are believed to be cardioprotective through their anti-arrhythmic, anti-thrombotic, anti-atherogenic and other effects, results from recent meta-analyses of marine n-3 fatty acids on cardiovascular disease (CVD) are controversial. We performed a meta-analysis of marine n-3 fatty acids on CVD outcomes in randomized clinical trials (RCTs) to test the hypothesis that marine n-3 fatty acids are anti-atherogenic. We also tested the hypothesis that such benefit is dose-dependent. Methods: A systematic review of English language articles using PubMed, EMBASE and Cochrane Library through Aug 2012 was performed selecting RCTs evaluating the effect of marine n-3 fatty acids intake for 2 years or more on cardiovascular diseases, coronary disease, arteriosclerosis, cardiac imaging techniques, and carotid artery ultrasound. Descriptive and quantitative information was extracted. Odds ratios were calculated for cardiac event outcome. Correlation coefficients were obtained from studies of which outcome is intima-media thickness (IMT) and coronary lumen diameter (CD). We converted the estimates into a single effect size; the log odds ratio and its corresponding standard error. Results: Of 14,236 citations retrieved, 13 studies were selected, including studies reporting IMT (n=3) and CD (n=2) and major CVD events (n=8). Overall, marine n-3 fatty acids significantly reduced atherosclerotic CVD (RR 0.94: 95%CI 0.90 to 0.99, p<0.05). There was no evidence of heterogeneity (p=0.65) or publication bias (p=0.37, Begg’s test). A sub-analysis among 8 studies of major CVD events showed the similar results (RR 0.94: 95% CI 0.89 to 0.99, p<0.05). Another sub-analysis among 4 studies excluding sudden cardiac death as an outcome showed RR of 0.91 (95% CI 0.82 to 1.02, p=0.097). A meta-regression analysis shows that dose of marine n-3 fatty acids was inversely associated with CVD outcome, although the association was not statistically significant (p=0.06). Conclusions: The result of our meta-analysis supports a modest anti-atherogenic effect of marine n-3 fatty acids. This benefit may be proportional to the amount of marine n-3 fatty acids consumed.

Measuring Surgical Skills in Simulation-based Training

2018 ◽  
Vol 26 (7) ◽  
pp. e156-e157
Author(s):  
Jan Duedal Rölfing ◽  
Søren Kold ◽  
Donald D. Anderson ◽  
Matthew Douglas Putnam ◽  
Julie Adams ◽  
...  
Keyword(s):  
Surgical Skills ◽  
Simulation Based

Piloting the ISCP Surgical Skills Assessment: The Wales Deanery Experience

2013 ◽  
Vol 95 (1) ◽  
pp. 1-4
Author(s):  
G Shingler ◽  
J Ansell ◽  
S Goddard ◽  
N Warren ◽  
J Torkington
Keyword(s):  
Systematic Review ◽  
Surgical Training ◽  
Surgical Skills ◽  
Operating Theatre ◽  
Skills Assessment ◽  
Surgical Simulators ◽  
Simulation Based

The evidence for using surgical simulators in training and assessment is growing rapidly. A systematic review has demonstrated the validity of different simulators for a range of procedures. Research suggests that skills developed on simulators can be transferred to the operating theatre. The increased interest in simulation comes as a result of the need to streamline surgical training. This is reflected by the numerous simulation-based courses that have become an essential part of modern surgical training.

scholarly journals The safety and efficacy of SDLT-2 (Sodium-glucose co-transporter 2) inhibitor versus placebo in the treatment of heart failure in patients with or without T2DM (Type 2 diabetes mellitus): A Systemic Review and Meta-analysis.

2020 ◽  
Author(s):  
Qian Zhang ◽  
Xiaofei Wang ◽  
Peipei Ge ◽  
Aizhen Hu ◽  
Xuexun Li
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Sglt2 Inhibitor ◽  
Systemic Review ◽  
Cochrane Library ◽  
Volume Depletion ◽  
Patients With Heart Failure ◽  
Safety Outcomes

Abstract Background Sodium-glucose co-transporter 2 (SGLT2) inhibitor which is a type of drug used for the treatment of diabetes mellitus, has been reported by many trials that it could be beneficial for patients with established heart failure. A meta-analysis on this subject could obtain more reliable estimates of the efficacy and safety outcomes. Methods A systematic review and meta-analysis of randomized, placebo-controlled trials of SGLT2 inhibitor in patients with heart failure was conducted. We searched PubMed, Cochrane Library, and Web of Science for trials published from inception to March, 2018. PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was used to conduct the review. For quality assessment of included studies. The methodological quality of the included trials was assessed using the Cochrane tool for assessing randomized clinical trials (RCT). Efficacy outcomes included hospitalization for heart failure and all-cause death. Safety outcomes consisted of serious adverse event (SAE) and volume depletion. Results We included data from 5 identified studies and 8775 patients (aged 64.9, female 29.8%). A total of 3930 (44.8%) patients were known to have diabetes mellitus. Compared with placebo, SGLT2 inhibitor decrease the incidence of hospitalization for heart failure (RR 0.692; 95%CI, 0.611-0.784 P<0.001), and all-cause death (RR 0.824; 95%CI, 0.736-0.922 P=0.001). The incidence of SAE in patients with a treatment of SGLT2 inhibitor was low (RR 0.869; 95%CI, 0.779-0.970 P=0.012). SGLT2 inhibitor didn’t increase the incidence of volume depletion (RR1.165, 95%CI, 0.977-1.390 P=0.089). Conclusion Our results confirm that SGLT2 inhibitor is effective and safe for patients with heart failure regardless of presence of diabetes mellitus.

scholarly journals The Effect of Perinatal Fish Oil Supplement on Perinatal Depression: A Systemic Review and Meta- Analysis of Randomized Clinical Trials

2019 ◽  
pp. 262-271
Author(s):  
Helman S ◽  
Baker RB ◽  
Hassan M ◽  
Nafee T ◽  
Yang J ◽  
...  
Keyword(s):  
Fish Oil ◽  
Odds Ratio ◽  
Randomized Clinical Trials ◽  
Perinatal Depression ◽  
Meta Analysis ◽  
Systemic Review ◽  
Effect Measure ◽  
Central Registry ◽  
Fish Oil Supplementation ◽  
Reduced Risk

Background: Perinatal depression is a common complication of pregnancy and can have severe and long-termadverse effects on both mother and infant. Randomized controlled trials (RCT) assessing the effect of fish oilsupplements on perinatal depression have shown mixed results.Objectives: We performed a systematic review and meta-analysis to assess the effects of fish oil supplementation during pregnancy on perinatal depression.Methods: A comprehensive search of MEDLINE (PubMed), EMBASE, and Cochrane Central Registry were conducted in adherence with the PRISMA guideline. Only RCTs published in English from January 2000 to date were included. The participants were pregnant women receiving fish oil supplementation or placebo. Summary effect measure of each study was converted to a common effect measure (log odds ratio) and its variance was calculated to estimate the pooled odds ratio and its 95% confidence Interval using random Effects model. Heterogeneity was assessed used restricted maximum likelihood method.Results: Nine trials were included in our analysis (2,979 women). Prevention Cohort (n = 5): Fish oil supplementation during pregnancy was associated with reduced risk of developing perinatal depression (OR: 0.87; CI: 0.076 to 0.99; p = 0.03). Treatment Cohort (n = 4) Fish oil supplementation during pregnancy was associated with reduced risk of persistent perinatal depression during postpartum period but did not reach statistical significance.Conclusion: In conclusion, a meta-analysis of included RCTs data shows a significant reduction in incidences of perinatal depression in women who received fish oil supplements during pregnancy. However, there was no evidence for a similar effect among women diagnosed with perinatal depression or women with major depressive disorder.

Examining validity evidence for a simulation-based assessment tool for basic robotic surgical skills

2018 ◽  
Vol 13 (1) ◽  
pp. 99-106 ◽  
Author(s):  
Maria Cecilie Havemann ◽  
Torur Dalsgaard ◽  
Jette Led Sørensen ◽  
Kristin Røssaak ◽  
Steffen Brisling ◽  
...  
Keyword(s):  
Assessment Tool ◽  
Surgical Skills ◽  
Validity Evidence ◽  
Simulation Based

The Timing of Simulation-Based Scenario Implementation in Patient Safety Education: The Example of the Operating Room

2020 ◽  
Vol 48 ◽  
pp. 80-88
Author(s):  
Nermin Ocaktan ◽  
Yasemin Uslu ◽  
Merve Kanıg ◽  
Vesile Unver ◽  
Ukke Karabacak
Keyword(s):  
Patient Safety ◽  
Operating Room ◽  
Safety Education ◽  
Simulation Based ◽  
Patient Safety Education

Monitoring the health of the work environment with a daily assessment tool: the REAL – Relative Environment Assessment Lens – indicator

2015 ◽  
Vol 26 (6) ◽  
pp. 1082-1089 ◽  
Author(s):  
Karen E. Hinsley ◽  
Audrey C. Marshall ◽  
Michelle H. Hurtig ◽  
Jason M. Thornton ◽  
Cheryl A. O’Connell ◽  
...  
Keyword(s):  
Work Environment ◽  
Operating Room ◽  
Assessment Tool ◽  
Time Frame ◽  
Cardiac Catheterisation ◽  
Face Validity ◽  
Great Good ◽  
The Real ◽  
Environment Assessment ◽  
Catheterisation Laboratory

AbstractBackgroundEvidence shows that the health of the work environment impacts staff satisfaction, interdisciplinary communication, and patient outcomes. Utilising the American Association of Critical-Care Nurses’ Healthy Work Environment standards, we developed a daily assessment tool.MethodsThe Relative Environment Assessment Lens (REAL) Indicator was developed using a consensus-based method to evaluate the health of the work environment and to identify opportunities for improvement from the front-line staff. A visual scale using images that resemble emoticons was linked with a written description of feelings about their work environment that day, with the highest number corresponding to the most positive experience. Face validity was established by seeking staff feedback and goals were set.ResultsOver 10 months, results from the REAL Indicator in the cardiac catheterisation laboratory indicated an overall good work environment. The goal of 80% of the respondents reporting their work environment to be “Great”, “Good”, or “Satisfactory” was met each month. During the same time frame, this goal was met four times in the cardiovascular operating room. On average, 72.7% of cardiovascular operating room respondents reported their work environment to be “Satisfactory” or better.ConclusionThe REAL Indicator has become a valuable tool in assessing the specific issues of the clinical area and identifying opportunities for improvement. Given the feasibility of and positive response to this tool in the cardiac catheterisation laboratory, it has been adopted in other patient-care areas where staff and leaders believe that they need to understand the health of the environment in a more specific and frequent time frame.

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