to prevent wrong person, wrong procedure, and wrong site surgery in all surgical and nonsurgical invasive procedures (1). These guidelines have been applied specifically to the practice of interventional radiology (IR) (2); however, a pre-procedure checklist tailored to IR may further improve patient safety and outcomes.Recent interest has evolved in developing a surgical or time-out checklist to reduce morbidity and mortality caused by human errors. For example, Haynes et al (3) demonstrated that implementation of a 19-item surgical checklist adopted from the World Health Organization (4) reduced the rate of death associated with surgery from 1.5% to 0.8% in a global population. Inpatient complications also were reduced from a baseline of 11% to 7%. Corso et al (5) showed that use of a 20-item time-out checklist derived from the Cardiovascular and Interventional Radiological Society of Europe (6) eliminated adverse events associated with IR procedures in the first year of use. Such positive results with the use of checklists have also been confirmed in other studies (7-9). However, other studies have failed to duplicate significant improvements in patient safety following widespread implementation of pre-procedure checklists (10,11). These failures could reflect issues with checklist design or its implementation. A well-designed checklist should include items that effectively address the underlying failure modes for the adverse events that occur in any particular operational environment. In addition, the checklist should be designed to facilitate reliable execution of the control strategy for those failure modes. Creating a checklist that addresses the cause of every conceivable adverse event would result in a checklist so long as to be impractical. Rather, patient safety is better served by allowing local teams to build a checklist from a list of items that matches the operational requirements of their working environment and case mix. A series of potential checklist items is provided along with their rationale.
Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that affects the child and adolescent population. It is characterized by impairment in attention/concentration, hyperactivity, and impulsivity, all of which can impact performance of athletes. ADHD treatment within the athletic population is a unique challenge. The research in this field has been relatively limited. The National Collegiate Athletic Association and International Olympic Committee both regulate the use of psychostimulants for treatment of ADHD due to their performance-enhancing effects. In this article, authors have discussed the screening methods, pharmacological treatment, side effects, and behavioral approaches for the treatment of ADHD in adolescent athletes.
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