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https://www.readbyqxmd.com/read/29786947/does-general-experience-affect-self-assessment
#1
Parisa Rezaiefar, Kelly Forse, Joseph K Burns, Sharon Johnston, Elizabeth Muggah, Claire Kendall, Douglas Archibald
BACKGROUND: The assessment of clinical competence is critical in medical education. Understanding the effect of general experience on a physician's self-assessment would help design more effective curricula and evaluations of procedural skills in postgraduate training and continuing professional development (CPD). In this observational study, we assessed the effect of general experience on the correlation between confidence and competence amongst experienced clinicians (ECs) and postgraduate trainees (PGTs) when learning an office-based procedure in pessary care...
May 22, 2018: Clinical Teacher
https://www.readbyqxmd.com/read/29786861/temporally-feathered-intensity-modulated-radiation-therapy-a-planning-technique-to-reduce-normal-tissue-toxicity
#2
Juan Carlos López Alfonso, Shireen Parsai, Nikhil Joshi, Andrew Godley, Chirag Shah, Shlomo A Koyfman, Jimmy J Caudell, Clifton D Fuller, Heiko Enderling, Jacob G Scott
PURPOSE: Intensity modulated radiation therapy (IMRT) has allowed optimization of three-dimensional spatial radiation dose distributions permitting target coverage while reducing normal tissue toxicity. However, radiation-induced normal tissue toxicity is a major contributor to patients' quality of life and often a dose-limiting factor in the definitive treatment of cancer with radiation therapy. We propose the next logical step in the evolution of IMRT using canonical radiobiological principles, optimizing the temporal dimension through which radiation therapy is delivered to further reduce radiation-induced toxicity by increased time for normal tissue recovery...
May 22, 2018: Medical Physics
https://www.readbyqxmd.com/read/29786776/a-framework-for-image-based-modeling-of-acute-myocardial-ischemia-using-intramurally-recorded-extracellular-potentials
#3
Brett M Burton, Kedar K Aras, Wilson W Good, Jess D Tate, Brian Zenger, Rob S MacLeod
The biophysical basis for electrocardiographic evaluation of myocardial ischemia stems from the notion that ischemic tissues develop, with relative uniformity, along the endocardial aspects of the heart. These injured regions of subendocardial tissue give rise to intramural currents that lead to ST segment deflections within electrocardiogram (ECG) recordings. The concept of subendocardial ischemic regions is often used in clinical practice, providing a simple and intuitive description of ischemic injury; however, such a model grossly oversimplifies the presentation of ischemic disease-inadvertently leading to errors in ECG-based diagnoses...
May 21, 2018: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/29786153/vasa-previa-screening-strategies-a-decision-and-cost-effectiveness-analysis
#4
R G Sinkey, A O Odibo
OBJECTIVE: The aim of this study is to perform a decision and cost-effectiveness analysis comparing four screening strategies for the antenatal diagnosis of vasa previa among singleton pregnancies. METHODS: A decision-analytic model was constructed comparing vasa previa screening strategies. Published probabilities and costs were applied to four transvaginal screening scenarios which occurred at the time of mid-trimester ultrasound: no screening, ultrasound-indicated screening, screening pregnancies conceived by in vitro fertilization (IVF), and universal screening...
May 22, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29786025/resident-perspectives-on-communication-training-that-utilizes-immersive-virtual-reality
#5
Francis J Real, Dominick DeBlasio, Nicholas J Ollberding, David Davis, Bradley Cruse, Daniel Mclinden, Melissa D Klein
Background: Communication skills can be difficult to teach and assess in busy outpatient settings. These skills are important for effective counseling such as in cases of influenza vaccine hesitancy. It is critical to consider novel educational methods to supplement current strategies aimed at teaching relational skills. Methods: An immersive virtual reality (VR) curriculum on addressing influenza vaccine hesitancy was developed using Kern's six-step approach to curriculum design...
September 2017: Education for Health: Change in Training & Practice
https://www.readbyqxmd.com/read/29786021/developing-and-implementing-a-global-emergency-medicine-course-lessons-learned-from-rwanda
#6
Sojung Yi, Olivier Félix Umuhire, Doris Uwamahoro, Mindi Guptill, Giles N Cattermole
Background: There is a growing demand by medical trainees for meaningful, short-term global emergency medicine (EM) experiences. EM programs in high-income countries (HICs) have forged opportunities for their trainees to access this experience in low-and middle-income countries (LMICs). However, few programs in LMICs have created and managed such courses. As more LMICs establish EM programs, these settings are ideal for developing courses beneficial for all participants. We describe our experience of creating and implementing a short-term global EM course in Rwanda...
September 2017: Education for Health: Change in Training & Practice
https://www.readbyqxmd.com/read/29786019/measuring-situation-awareness-in-medical-education-objective-structured-clinical-examination-guides
#7
Margaret Frere, John Tepper, Markus Fischer, Kieran Kennedy, Thomas Kropmans
Background: Medical errors are among the most prevalent and serious adverse events in health care. Lack of situation awareness (SA) is an important factor leading to such errors. SA can be understood using Endsley's three-tier model: level 1 is perception, level 2 is comprehension, and level 3 is projection. While there is extensive literature on the theory of SA, it is difficult to measure and quantify. The purpose of this pilot study was to measure, identify, and characterize SA in some medical objective structured clinical examination (OSCE) guides, including a 1st year National University of Ireland, Galway (NUIG) OSCE...
September 2017: Education for Health: Change in Training & Practice
https://www.readbyqxmd.com/read/29785839/optimization-of-a-secondary-voi-protocol-for-lung-imaging-in-a-clinical-ct-scanner
#8
Thomas C Larsen, Vissagan Gopalakrishnan, Jianhua Yao, Catherine P Nguyen, Marcus Y Chen, Joel Moss, Han Wen
We present a solution to meet an unmet clinical need of an in-situ "close look" at a pulmonary nodule or at the margins of a pulmonary cyst revealed by a primary (screening) chest CT while the patient is still in the scanner. We first evaluated options available on current whole-body CT scanners for high resolution screening scans, including ROI reconstruction of the primary scan data and HRCT, but found them to have insufficient SNR in lung tissue or discontinuous slice coverage. Within the capabilities of current clinical CT systems, we opted for the solution of a secondary, volume-of-interest (VOI) protocol where the radiation dose is focused into a short-beam axial scan at the z position of interest, combined with a small-FOV reconstruction at the xy position of interest...
May 21, 2018: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/29785281/impact-of-the-applied-simulated-and-integrated-learning-approach-on-nursing-assistants-knowledge-and-confidence-caring-for-frail-seniors-in-nursing-homes
#9
Veronique M Boscart, George Heckman, Meaghan Davey, Michelle Heyer, John P Hirdes
Background: Increasing importance is being placed on optimizing the role of Nursing Aides (NAs) in improving quality of care for nursing home (NH) residents. One approach to do so is to have NAs participate in assessments embedded within the Minimum Data Set (MDS). This pilot study aimed to design and evaluate the Applied Simulated and Integrated Learning Approach (ASILA) program, a novel innovative training program for NAs employed in NHs to enhance their ability to assess residents within an inter-professional framework...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29784537/artificial-intelligence-a-joint-narrative-on-potential-use-in-pediatric-stem-and-immune-cell-therapies-and-regenerative-medicine
#10
REVIEW
Irena Sniecinski, Jerard Seghatchian
Artificial Intelligence (AI) reflects the intelligence exhibited by machines and software. It is a highly desirable academic field of many current fields of studies. Leading AI researchers describe the field as "the study and design of intelligent agents". McCarthy invented this term in 1955 and defined it as "the science and engineering of making intelligent machines". The central goals of AI research are reasoning, knowledge, planning, learning, natural language processing (communication), perception and the ability to move and manipulate objects...
May 9, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29784222/psychiatric-patients-and-nurses-opinions-about-limit-setting-technique-in-port-said-city
#11
Sonia M El-Sayad
BACKGROUND: Limit setting facilitates the development of a therapeutic, caring and supportive relationships, it can also decrease patients' feelings of anxiety and uncertainty. It is a two-way process that should be delivered professionally by the nurse and perceived therapeutically by the patient, so patient considered a vital participant of the technique. AIM: The present study aimed at exploring psychiatric patients' and nurses' opinions as well as their information about limit setting...
June 2018: Archives of Psychiatric Nursing
https://www.readbyqxmd.com/read/29783867/virtual-stenting-of-intracranial-aneurysms-a-pilot-study-for-the-prediction-of-treatment-success-based-on-hemodynamic-simulations
#12
Philipp Berg, Sylvia Saalfeld, Gábor Janiga, Olivier Brina, Nicole M Cancelliere, Paolo Machi, Vitor M Pereira
Endovascular treatment of intracranial aneurysms using flow-diverting devices has revolutionized the treatment of large and complex lesions due to its minimally invasive nature and potential clinical outcomes. However, incomplete or delayed occlusion and persistent intracranial aneurysm growth are still an issue for up to one-third of the patients. We evaluated two patients with intracranial aneurysm located at the internal carotid artery who were treated with flow-diverting devices and had opposite outcomes...
May 1, 2018: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29782402/understanding-conflict-management-styles-in-anesthesiology-residents
#13
Terrie Vasilopoulos, Christopher R Giordano, Jack D Hagan, Brenda G Fahy
BACKGROUND: Successful conflict resolution is vital for effective teamwork and is critical for safe patient care in the operating room. Being able to appreciate the differences in training backgrounds, individual knowledge and opinions, and task interdependency necessitates skilled conflict management styles when addressing various clinical and professional scenarios. The goal of this study was to assess conflict styles in anesthesiology residents via self- and counterpart assessment during participation in simulated conflict scenarios...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29782065/foley-catheter-vs-oral-misoprostol-to-induce-labour-among-hypertensive-women-in-india-a-cost-consequence-analysis-alongside-a-clinical-trial
#14
Simon Leigh, Paul Granby, Alan Haycox, Shuchita Mundle, Hillary Bracken, Vaishali Khedikar, Jayashree Mulik, Brian Faragher, Thomas Easterling, Mark A Turner, Zarko Alfirevic, Beverly Winikoff, Andrew D Weeks
OBJECTIVE: To determine the effectiveness and economic impact of two methods for induction of labour in hypertensive women, in low-resource settings. DESIGN: Cost-consequence analysis of a previously reported multi-centre, parallel, open-label randomized trial. SETTING & POPULATION: 602 women with a live fetus, aged>18 years requiring delivery for pre-eclampsia or hypertension, in two public hospitals in Nagpur, India. METHODS: We performed a formal economic evaluation alongside the INFORM clinical trial...
May 21, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29781968/infusing-social-justice-in-undergraduate-nursing-education-fostering-praxis-through-simulation
#15
Robyn Caldwell, Courtney Cochran
SCOPE OF THE PROBLEM: Forensic clinical experiences are often inconsistent in undergraduate nursing education. Nursing students are not included in the process of forensic evidence collection, often because of the sensitive nature of the situation. Unfortunately, nursing students are forced to rely on theoretical knowledge provided by the nurse educator to understand the complexities of forensic nursing care. Nursing students must be able to identify and provide appropriate nursing care for individuals in all forensic situations...
April 2018: Journal of Forensic Nursing
https://www.readbyqxmd.com/read/29781952/optimizing-temperature-and-oxygen-supports-long-term-culture-of-human-islets
#16
Hirotake Komatsu, Jeffrey Rawson, Leonard Medrano, Colin A Cook, Alyssa Barriga, Nelson Gonzalez, Mayra Salgado, Keiko Omori, Fouad Kandeel, Yu-Chong Tai, Yoko Mullen
BACKGROUND: Islet transplantation is a promising treatment for type-1 diabetes; however, donor shortage is a concern. Even when a pancreas is available, low islet yield limits the success of transplantation. Islet culture enables pooling of multiple low-yield isolations into an effective islet mass, but isolated islets rapidly deteriorate under conventional culture conditions. Oxygen depletion in the islet core, which leads to central necrosis and volume loss, is one of the major reasons for this deterioration...
May 16, 2018: Transplantation
https://www.readbyqxmd.com/read/29781237/investigation-of-mixed-model-repeated-measures-analyses-and-non-linear-random-coefficient-models-in-the-context-of-long-term-efficacy-data
#17
Bruno Delafont, Kevin Carroll, Claire Vilain, Emmanuel Pham
The longitudinal data from 2 published clinical trials in adult subjects with upper limb spasticity (a randomized placebo-controlled study [NCT01313299] and its long-term open-label extension [NCT01313312]) were combined. Their study designs involved repeat intramuscular injections of abobotulinumtoxinA (Dysport®), and efficacy endpoints were collected accordingly. With the objective of characterizing the pattern of response across cycles, Mixed Model Repeated Measures analyses and Non-Linear Random Coefficient (NLRC) analyses were performed and their results compared...
May 20, 2018: Pharmaceutical Statistics
https://www.readbyqxmd.com/read/29781037/microrna-485-plays-tumour-suppressive-roles-in-colorectal-cancer-by-directly-targeting-gab2
#18
Jibin Li, Jian Xu, Xiaofei Yan, Keer Jin, Wenya Li, Rui Zhang
Colorectal cancer (CRC) is reported to be the third most common cancer and the fourth leading cause of cancer-related deaths around the world. MicroRNA-485 (miR-485) has been reported to be aberrantly expressed and play important roles in several types of human malignancy. However, the expression level, biological functions and underlying molecular mechanisms of miR-485 in CRC remain unclear. Therefore, the aim of the present study was to determine miR-485 expression levels and their clinical significance in CRC and to explore the functions and underlying mechanisms of miR-485 in this disease...
May 17, 2018: Oncology Reports
https://www.readbyqxmd.com/read/29780789/a-fundamentals-train-the-trainer-approach-to-building-pediatric-critical-care-expertise-in-the-developing-world
#19
Sheri S Crow, Beth A Ballinger, Mariela Rivera, David Tsibadze, Nino Gakhokidze, Nino Zavrashvili, Matthew J Ritter, Grace M Arteaga
Pediatric Fundamental Critical Care Support (PFCCS) is an educational tool for training non-intensivists, nurses, and critical care practitioners in diverse health-care settings to deal with the acute deterioration of pediatric patients. Our objective was to evaluate the PFCCS course as a tool for developing a uniform, reproducible, and sustainable model for educating local health-care workers in the optimal management of critically ill children in the Republic of Georgia. Over a period of 18 months and four visits to the country, we worked with Georgian pediatric critical care leadership to complete the following tasks: (1) survey health-care needs within the Republic of Georgia, (2) present representative PFCCS lectures and simulation scenarios to evaluate interest and obtain "buy-in" from key stakeholders throughout the Georgian educational infrastructure, and (3) identify PFCCS instructor candidates...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29780587/development-of-a-vancomycin-dosing-approach-for-critically-ill-patients-receiving-hybrid-hemodialysis-using-monte-carlo-simulation
#20
Susan J Lewis, Bruce A Mueller
Objectives: Prolonged intermittent renal replacement therapy is an increasingly popular treatment for acute kidney injury in critically ill patients that runs at different flow rates and durations than conventional hemodialysis or continuous renal replacement therapies. Pharmacokinetic studies conducted in patients receiving prolonged intermittent renal replacement therapy are scarce; consequently, clinicians are challenged to dose antibiotics effectively. The purpose of this study was to develop vancomycin dosing recommendations for patients receiving prolonged intermittent renal replacement therapy...
2018: SAGE Open Medicine
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