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https://www.readbyqxmd.com/read/28344722/assessment-of-emergency-medicine-residents-a-systematic-review
#1
REVIEW
Isabelle N Colmers-Gray, Kieran Walsh, Teresa M Chan
BACKGROUND: Competency-based medical education is becoming the new standard for residency programs, including Emergency Medicine (EM). To inform programmatic restructuring, guide resources and identify gaps in publication, we reviewed the published literature on types and frequency of resident assessment. METHODS: We searched MEDLINE, EMBASE, PsycInfo and ERIC from Jan 2005 - June 2014. MeSH terms included "assessment," "residency," and "emergency medicine." We included studies on EM residents reporting either of two primary outcomes: 1) assessment type and 2) assessment frequency per resident...
February 2017: Canadian Medical Education Journal
https://www.readbyqxmd.com/read/28342823/evidence-that-increased-kcnj6-gene-dose-is-necessary-for-deficits-in-behavior-and-dentate-gyrus-synaptic-plasticity-in-the-ts65dn-mouse-model-of-down-syndrome
#2
Alexander M Kleschevnikov, Jessica Yu, Jeesun Kim, Larisa V Lysenko, Zheng Zhen, Y Eugene Yu, William C Mobley
Down syndrome (DS), trisomy 21, is caused by increased dose of genes present on human chromosome 21 (HSA21). The gene-dose hypothesis argues that a change in the dose of individual genes or regulatory sequences on HSA21 is necessary for creating DS-related phenotypes, including cognitive impairment. We focused on a possible role for Kcnj6, the gene encoding Kir3.2 (Girk2) subunits of a G-protein-coupled inwardly-rectifying potassium channel. This gene resides on a segment of mouse Chromosome 16 that is present in one extra copy in the genome of the Ts65Dn mouse, a well-studied genetic model of DS...
March 22, 2017: Neurobiology of Disease
https://www.readbyqxmd.com/read/28330444/incidence-and-time-trends-of-type-2-diabetes-mellitus-in-youth-aged-5-19-years-a-population-based-registry-in-zhejiang-china-2007-to-2013
#3
Haibin Wu, Jieming Zhong, Min Yu, Hao Wang, Weiwei Gong, Jin Pan, Fangrong Fei, Meng Wang, Li Yang, Ruying Hu
BACKGROUND: The incidence of type 2 diabetes mellitus (T2DM) has been increasing globally over the past two decades in children and adolescents. There are currently a dearth of comprehensive population-based estimates of T2DM incidence and time trends in Chinese youth. METHODS: A population-based diabetes registry system in 30 representative districts in Zhejiang has been established for diabetes surveillance. All newly cases diagnosed by physicians in local hospitals and wards were registered using the registry system through web services and direct network report...
March 22, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28320715/experimental-models-of-short-courses-of-liposomal-amphotericin-b-for-induction-therapy-for-cryptococcal-meningitis
#4
Jodi Lestner, Laura McEntee, Adam Johnson, Joanne Livermore, Sarah Whalley, Julie Schwartz, John R Perfect, Thomas Harrison, William Hope
Cryptococcal meningoencephalitis is a rapidly lethal infection in immunocompromised patients. Induction regimens are usually administered for 2-weeks. The shortest effective period of induction therapy with liposomal amphotericin B (LAmB) is unknown. The pharmacodynamics of LAmB were studied in murine and rabbit models of cryptococcal meningoencephalitis. The concentrations of LAmB in plasma and brain of mice were measured using HPLC. Histopathological changes were determined. The penetration of LAmB into the brain was determined by immunohistochemistry using an antibody directed to amphotericin B...
March 20, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28298605/cxcr5-dependent-entry-of-cd8-t-cells-into-rhesus-macaque-b-cell-follicles-achieved-through-t-cell-engineering
#5
Victor I Ayala, Claire Deleage, Matthew T Trivett, Sumiti Jain, Lori V Coren, Matthew W Breed, Joshua A Kramer, James A Thomas, Jacob D Estes, Jeffrey D Lifson, David E Ott
Follicular helper CD4 T cells, TFH, residing in B-cell follicles within secondary lymphoid tissues, are readily infected by AIDS viruses and are a major source of persistent virus despite relative control of viral replication. This persistence is due at least in part to a relative exclusion of effective antiviral CD8 T cells from B-cell follicles. To determine whether CD8 T cells could be engineered to enter B-cell follicles, we genetically modified unselected CD8 T cells to express CXCR5, the chemokine receptor implicated in cellular entry into B-cell follicles...
March 15, 2017: Journal of Virology
https://www.readbyqxmd.com/read/28295885/multi-directional-abundance-shifts-among-north-american-birds-and-the-relative-influence-of-multi-faceted-climate-factors
#6
Qiongyu Huang, John R Sauer, Ralph O Dubayah
Shifts in species distributions are major fingerprint of climate change. Examining changes in species abundance structures at a continental scale enables robust evaluation of climate change influences, but few studies have conducted these evaluations due to limited data and methodological constraints. In this study, we estimate temporal changes in abundance from North American Breeding Bird Survey data at the scale of physiographic strata to examine the relative influence of different components of climatic factors and evaluate the hypothesis that shifting species distributions are multi-directional in resident bird species in North America...
March 12, 2017: Global Change Biology
https://www.readbyqxmd.com/read/28295048/cardiac-repair-in-a-mouse-model-of-acute-myocardial-infarction-with-trophoblast-stem-cells
#7
Guannan Li, Jianzhou Chen, Xinlin Zhang, Guixin He, Wei Tan, Han Wu, Ran Li, Yuhan Chen, Rong Gu, Jun Xie, Biao Xu
Various stem cells have been explored for the purpose of cardiac repair. However, any individual stem cell population has not been considered as the ideal source. Recently, trophoblast stem cells (TSCs), a newly described stem cell type, have demonstrated extensive plasticity. The present study evaluated the therapeutic effect of TSCs transplantation for heart regeneration in a mouse model of myocardial infarction (MI) and made a direct comparison with the most commonly used mesenchymal stem cells (MSCs). Transplantation of TSCs and MSCs led to a remarkably improved cardiac function in contrast with the PBS control, but only the TSCs exhibited the potential of differentiation into cardiomyocytes in vivo...
March 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28286835/role-of-feedback-during-evaluation-in-improving-emergency-medicine-residents-skills-an-experimental-study
#8
Ali Vafaei, Kamran Heidari, Mohammad-Ali Hosseini, Mostafa Alavi-Moghaddam
INTRODUCTION: Evaluation of students' learning in clinical education system is one of the most important and challenging issues that facilities in this field have been facing. The present study aimed to evaluate the role of feedback during evaluation in increasing emergency medicine residents' clinical skills. METHOD: The present experimental study was performed on all second year emergency medicine residents of two educational hospitals, Tehran, Iran, with switching replications design and before-after method...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28283998/anesthesia-residents-preferentially-request-operating-room-case-assignments-with-complex-cases
#9
Peggy Y Kim, Jonathan P Wanderer, David W Allbritton, Matthias Eikermann, Keith Baker
Self-directed learning is associated with knowledge and performance improvements, increased identification and amelioration of knowledge gaps, and heightened critical appraisal of available evidence. We developed and implemented a decision support system that could support self-directed learning for anesthesia residents by soliciting resident input in case selection. We hypothesized that residents would utilize this system to request complex cases, and that more advanced residents would request more complex cases...
April 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28282063/lower-urinary-cotinine-level-is-associated-with-a-trend-toward-more-myopic-refractive-errors-in-korean-adolescents
#10
G E Nam, B E Hwang, Y-C Lee, J-S Paik, S-W Yang, Y-H Chun, K Han, Y G Park, S H Park
PurposeTo investigate the association between urinary cotinine levels as an objective biological marker for exposure to nicotine and refractive status.Patients and methodsThis cross-sectional study analyzed data from the Korea National Health and Nutrition Examination Survey between 2008 and 2011. A total of 1139 Korean adolescents aged 12-18 years were enrolled. Urinary cotinine concentrations and other potential risk factors for myopia were examined. Correlation analyses and multivariate regression analysis were performed to investigate the association between urinary cotinine level and refractive error...
March 10, 2017: Eye
https://www.readbyqxmd.com/read/28281117/game-based-training-improves-the-surgeon-s-situational-awareness-in-the-operation-room-a-randomized-controlled-trial
#11
Maurits Graafland, Willem A Bemelman, Marlies P Schijven
BACKGROUND: Equipment-related malfunctions directly relate to one-fourth of the adverse events in the surgical theater. A serious game trains residents to recognize and respond to equipment problems in minimally invasive surgery (MIS). These include disturbed vision, gas transport, electrocautery, and pathophysiological disturbances. This randomized controlled trial explores whether game-based training improves surgical residents' response to equipment-related problems during surgery...
March 9, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28264090/comparison-of-male-vs-female-resident-milestone-evaluations-by-faculty-during-emergency-medicine-residency-training
#12
Arjun Dayal, Daniel M O'Connor, Usama Qadri, Vineet M Arora
Importance: Although implicit bias in medical training has long been suspected, it has been difficult to study using objective measures, and the influence of sex and gender in the evaluation of medical trainees is unknown. The emergency medicine (EM) milestones provide a standardized framework for longitudinal resident assessment, allowing for analysis of resident performance across all years and programs at a scope and level of detail never previously possible. Objective: To compare faculty-observed training milestone attainment of male vs female residency training...
March 6, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28261405/successful-implementation-of-a-direct-observation-program-in-an-ambulatory-block-rotation
#13
Jeremy Smith, Elizabeth Jacobs, Zhanhai Li, Bennett Vogelman, Yingqi Zhao, David Feldstein
BACKGROUND : Direct observation of clinical skills is a cornerstone of competency-based education and training. Ensuring direct observation in a consistent fashion has been a significant challenge for residency programs. OBJECTIVE : The purpose of this study was to evaluate the effects of a novel evaluation system, designed to achieve ongoing direct observation of residents, examine changes in resident observation practices, and understand faculty attitudes toward direct observation and the evaluation system...
February 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28257399/addressing-the-health-and-wellness-needs-of-vulnerable-rockaway-residents-in-the-wake-of-hurricane-sandy-findings-from-a-health-coaching-and-community-health-worker-program
#14
David Russell, Mia R Oberlink, Shivani Shah, Lauren Evans, Karen Bassuk
OBJECTIVES: To describe the design and participants of a program that employed health coaches and community health workers to address the social, health, and long-term disaster recovery needs of Rockaway residents roughly 2 years after Hurricane Sandy made landfall. DESIGN: Baseline and exit questionnaires, containing demographic, health, and health care utilization measures, were administered to participants at the start and end of the program. Enrollment and encounter information was captured in program administrative records...
March 1, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28257335/serial-procalcitonin-predicts-mortality-in-severe-sepsis-patients-results-from-the-multicenter-procalcitonin-monitoring-sepsis-moses-study
#15
Philipp Schuetz, Robert Birkhahn, Robert Sherwin, Alan E Jones, Adam Singer, Jeffrey A Kline, Michael S Runyon, Wesley H Self, D Mark Courtney, Richard M Nowak, David F Gaieski, Stefan Ebmeyer, Sascha Johannes, Jan C Wiemer, Andrej Schwabe, Nathan I Shapiro
OBJECTIVES: To prospectively validate that the inability to decrease procalcitonin levels by more than 80% between baseline and day 4 is associated with increased 28-day all-cause mortality in a large sepsis patient population recruited across the United States. DESIGN: Blinded, prospective multicenter observational clinical trial following an Food and Drug Administration-approved protocol. SETTING: Thirteen U.S.-based emergency departments and ICUs...
March 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28255084/myocardial-aging-as-a-t-cell-mediated-phenomenon
#16
Gustavo Campos Ramos, Anne van den Berg, Vânia Nunes-Silva, Johannes Weirather, Laura Peters, Matthias Burkard, Mike Friedrich, Jürgen Pinnecker, Marco Abeßer, Katrin G Heinze, Kai Schuh, Niklas Beyersdorf, Thomas Kerkau, Jocelyne Demengeot, Stefan Frantz, Ulrich Hofmann
In recent years, the myocardium has been rediscovered under the lenses of immunology, and lymphocytes have been implicated in the pathogenesis of cardiomyopathies with different etiologies. Aging is an important risk factor for heart diseases, and it also has impact on the immune system. Thus, we sought to determine whether immunological activity would influence myocardial structure and function in elderly mice. Morphological, functional, and molecular analyses revealed that the age-related myocardial impairment occurs in parallel with shifts in the composition of tissue-resident leukocytes and with an accumulation of activated CD4(+) Foxp3(-) (forkhead box P3) IFN-γ(+) T cells in the heart-draining lymph nodes...
March 2, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28250486/developing-competency-in-post-graduate-students-of-anaesthesiology-for-taking-informed-consent-for-elective-caesarean-section
#17
Kamla Harshad Mehta, Vandana Saurin Shah, Kirti Dhirajlal Patel
BACKGROUND AND AIMS: Post-graduate medical students (residents) generally lack effective communication skills required to obtain informed consent. The aim of this study was to assess role play and group discussion as teaching/learning tools for improving residents' knowledge on informed consent and competency in communicating while taking informed consent. METHODS: This prospective, observational study was conducted on 30 anaesthesia residents. They were first observed while obtaining informed consent and their basic knowledge regarding communication skills was checked with a pre-test questionnaire...
February 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28247495/staging-a-performance-learners-perceptions-about-direct-observation-during-residency
#18
Kori A LaDonna, Rose Hatala, Lorelei Lingard, Stephane Voyer, Christopher Watling
CONTEXT: Evidence strongly supports that direct observation is a valid and reliable assessment tool; support for its impact on learning is less compelling, and we know that some learners are ambivalent about being observed. However, learners' perceptions about the impact of direct observation on their learning and professional development remain underexplored. To promote learning, we need to understand what makes direct observation valuable for learners. METHODS: Informed by constructivist grounded theory, we interviewed 22 learners about their observation experiences...
February 28, 2017: Medical Education
https://www.readbyqxmd.com/read/28241785/systematic-pain-assessment-in-nursing-homes-a-cluster-randomized-trial-using-mixed-methods-approach
#19
Anna-Greta Mamhidir, Britt-Marie Sjölund, Birgitta Fläckman, Anders Wimo, Anders Sköldunger, Maria Engström
BACKGROUND: Chronic pain affects nursing home residents' daily life. Pain assessment is central to adequate pain management. The overall aim was to investigate effects of a pain management intervention on nursing homes residents and to describe staffs' experiences of the intervention. METHODS: A cluster-randomized trial and a mixed-methods approach. Randomized nursing home assignment to intervention or comparison group. The intervention group after theoretical and practical training sessions, performed systematic pain assessments using predominately observational scales with external and internal facilitators supporting the implementation...
February 28, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28238704/effectiveness-of-a-perioperative-transthoracic-ultrasound-training-program-for-students-and-residents
#20
Juliet June Ray, Jonathan P Meizoso, Valerie Hart, Davis Horkan, Vicente Behrens, Krishnamurti A Rao, Charles A Karcutskie, Joshua Lenchus, Carl I Schulman, Roman Dudaryk
OBJECTIVE: Focused ultrasound (US) is being incorporated across all levels of medical education. Although many comprehensive US courses exist, their scope is broad, requiring expert instructors, access to simulation, and extensive time commitment by the learner. We aim to compare learning across levels of training and specialties using a goal-directed, web-based course without live skills training. DESIGN: A prospective observational study of students and residents from medicine, surgery, and anesthesiology...
February 23, 2017: Journal of Surgical Education
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