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1
Crowne, Kerri Anne. "It’s Salsa Time! A Team Activity." Management Teaching Review 2, no. 4 (September 23, 2017): 289–98. http://dx.doi.org/10.1177/2379298117733261.
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This article provides information on a team-building activity in which student teams make salsa. I usually use this exercise on the day that I form teams to provide an opportunity for teams to work on something that is not graded prior to completing the graded team assignment. The activity is built on several theories, such as social learning, experiential learning, and constructivist theory. The goal of the activity is to allow team members to get acquainted with each other and quickly go through the team development process. It is a springboard for discussing many aspects of teams, such as tacit knowledge, decision making, creativity, and resource allocation. It has primarily been used in an undergraduate leadership course but may be applicable to other courses.
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Sharma, Ramaswamy, Thomas S. King, Elizabeth R. Hanson, and Kristin Fiebelkorn. "Medical Histopathology Laboratories: Remote Teaching in Response to COVID-19 Pandemic." Academic Pathology 8 (January 1, 2021): 237428952199804. http://dx.doi.org/10.1177/2374289521998049.
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The COVID-19 pandemic required the rapid conversion of medical school curricula to virtual instruction. Prior to the crisis, histopathology teaching laboratories at UT Health San Antonio included completion of an Individual Laboratory Quiz before the laboratory session, a Team Application Exercise released and completed during the laboratory session with guidance from faculty, and a graded Team Laboratory Quiz at the end of the laboratory session. Adaptation of this interactive, in-person activity to a fully online platform included releasing the Team Application Exercise earlier to provide ample time for students to work virtually with their teams, conducting laboratory sessions using Microsoft Teams, with 5 to 6 teams led by a single instructor, and requiring the Team Laboratory Quiz to be taken individually for ensuring quiz security and test integrity. For incentivizing collaboration while completing the Team Application Exercise, the final score was either the student’s individual score on the Team Laboratory Quiz or their team’s average, whichever was higher. Comparison of student scores on the modified Team Laboratory Quiz to Team Laboratory Quiz scores using the earlier laboratory format prior to COVID-19 showed a significant decline; however, scores on other weekly quizzes or examinations were unaffected. Students welcomed the early release of Team Application Exercise and easier access to faculty but indicated that the modified Team Laboratory Quiz decreased peer-teaching and learning experience and increased anxiety. Faculty indicated the loss of personal interaction with students as a major theme. These data suggest that novel pedagogical approaches are required for online histopathology instruction to accommodate differences in learning styles while maintaining the benefits of team collaboration.
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Kjellin, A., L. Hedman, C. Escher, and L. Felländer-Tsai. "Hybrid simulation: bringing motivation to the art of teamwork training in the operating room." Scandinavian Journal of Surgery 103, no. 4 (February 18, 2014): 232–36. http://dx.doi.org/10.1177/1457496913516897.
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Background and Aims: Crew resource management–based operating room team training will be an evident part of future surgical training. Hybrid simulation in the operating room enables the opportunity for trainees to perform higher fidelity training of technical and non-technical skills in a realistic context. We focus on situational motivation and self-efficacy, two important factors for optimal learning in light of a prototype course for teams of residents in surgery and anesthesiology and nurses. Material and Methods: Authentic operating room teams consisting of residents in anesthesia (n = 2), anesthesia nurses (n = 3), residents in surgery (n = 2), and scrub nurses (n = 6) were, during a one-day course, exposed to four different scenarios. Their situational motivation was self-assessed (ranging from 1 = does not correspond at all to 7 = corresponds exactly) immediately after training, and their self-efficacy (graded from 1 to 7) before and after training. Training was performed in a mock-up operating theater equipped with a hybrid patient simulator (SimMan 3G; Laerdal) and a laparoscopic simulator (Lap Mentor Express; Simbionix). The functionality of the systematic hybrid procedure simulation scenario was evaluated by an exit questionnaire (graded from 1 = disagree entirely to 5 = agree completely). Results and Conclusions: The trainees were mostly intrinsically motivated, engaged for their own sake, and had a rather great degree of self-determination toward the training situation. Self-efficacy among the team members improved significantly from 4 to 6 (median). Overall evaluation showed very good result with a median grading of 5. We conclude that hybrid simulation is feasible and has the possibility to train an authentic operating team in order to improve individual motivation and confidence.
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Gevenois, P. A., E. Pichot, F. Dargent, S. Dedeire, R. Vande Weyer, and P. De Vuyst. "Low Grade Coal Worker's Pneumoconiosis." Acta Radiologica 35, no. 4 (July 1994): 351–56. http://dx.doi.org/10.1177/028418519403500408.
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We compared CT with chest radiography (CR) in the assessment of low grade coal worker's pneumoconiosis (CWP) in a population of 83 subjects. All subjects had a high-voltage p.a. CR, graded according to the ILO classification between 0/0 and 1/1, a conventional CT (CCT) using contiguous 1-cm-thick sections on the entire thorax and a set of 10 high-resolution CT (HRCT) images. CR and CT were separately read by consensus by 2 teams of 2 trained readers. CR were coded 0/0 in 9 subjects; 0/1 in 31; 1/0 in 28; 1/1 in 15. Among these groups of patients, micronodules were detected by CT in respectively 2 (22%), 14 (45%), 17 (61%) and 10 (67%) patients. In all groups, micronodules were more often detected by CT when the opacities detected on CR were scored as rounded (p, q) than irregular (s, t). Among the patients graded 0/0 or 0/1, CT showed micronodules in 40%. By contrast, among the patients graded 1/0 or 1/1, CT did not show micronodules in 37%, but revealed in numerous patients that opacities detected on CR were related to bronchiectasis and/or emphysema only. Comparative analysis of HRCT and CCT showed that both techniques are complementary and proved the usefulness of CCT in the detection or confirmation of low profusion of micronodules.
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Moser, Bruno C. "Video and Photography Assignments from Field Trips Build Communication and Teamwork Skills." HortScience 32, no. 3 (June 1997): 432E—432. http://dx.doi.org/10.21273/hortsci.32.3.432e.
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Employers of undergraduates tell us there is a need to turn out students with greater communication and teamwork skills in addition to good horticultural and business training. Field trips are an important tool to expose students to the real world of horticulture. The course “Nursery Crop Production” has adopted a class project that enhances these skills and experiences. Teams of three students each are assigned a production nursery to visit and to bring back documentation to the class in the form of an edited video tape and a written report containing pictures. Their report is presented in class and each student receives a composite video tape and written report of all team efforts. Quality of the reports has been remarkable. Each part of the project (video, written report, and class presentation) is graded independently, with all team members receiving the same final grade. The department has purchased video cameras and editing equipment, which are essential to the success of this educational experience. Student evaluations indicate enthusiasm for this approach and the role of video in the class. Copies of finished projects are returned to each nursery for their information. A collection of these projects is being assembled to provide the Nursery and Landscape Crops Extension Specialist with additional information about the production nursery industry.
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Aiwale, Amit, Pankajkumar Patel, Syed Paspala, and T. Murthy. "Simultaneous Cervical and Lumbar Spine Surgery: Retrospective Analysis of 45 Cases." Indian Journal of Neurosurgery 08, no. 01 (March 2019): 047–52. http://dx.doi.org/10.1055/s-0039-1677962.
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Abstract Background The term ‘tandem spinal stenosis’ (TSS) was first introduced by Dagi et al to describe concurrent symptomatic cervical and lumbar spinal stenosis. A typical clinical picture includes intermittent neurogenic claudication, myelopathy, and polyradiculopathy in both the upper and lower extremities. The incidence of TSS ranges from 0.12 to 28%. Methods We studied patients who presented with tandem canal stenosis and operated cervicolumbar decompression with or without fusion procedures by two separate neurosurgical teams simultaneously from June 2015 to 2017 with follow-up period of minimum 6 months. Results We had 30 (66.66%) male and 15 (33.33%) female patients who underwent simultaneous cervical and lumbar spine surgeries. The average age was 57.8 years (male) and 53.9 years (female). Cervical canal stenosis was graded as per magnetic resonance imaging (MRI) morphological grades of stenosis by Kang et al and lumbar grading, was done as per Schizas et al grading system. The mean duration of complaints in cervical and lumbar compression was 29.54 ± 44.99 months and 30.55 ± 38.11 months, respectively. The mean preoperative Japanese Orthopaedic Association (JOA) score of was 10.46 ± 1.39, whereas the postoperative mean JOA score was 11.93 ± 1.28, and mean preoperative (38.59 ± 16.52) and postoperative (29.22 ± 9.38) Oswestry Disability Index (ODI) scores showed a statistically significant difference (p = 0.0001). Conclusion Patients with TSS are elderly and have associated comorbidities, still simultaneous cervical and lumbar surgery is feasible with the good outcome if you have two neurosurgical teams operating simultaneously and having good other super specialty teams’ support. It can be timesaving and cost effective for patients. Also, it avoids patients from undergoing exposure to two separate surgical and anesthetic stress.
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El Morabit, Nadir. "Graded Readers: An Empirical Study Measuring the Impact on Low-Proficiency EFL Students’ Writing Fluency in Morocco." International Journal of Linguistics, Literature and Translation 4, no. 6 (June 30, 2021): 237–44. http://dx.doi.org/10.32996/ijllt.2021.4.6.28.
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The writing ability of Moroccan students is generally characterized by low language fluency. This article examines the impact of the implementation of graded readers as a syllabus intervention alternative rather than the textbook-based approach regarding teaching writing skill. The research design for this study is a mixed method. The qualitative method was twofold, in-class and online. The first tool was conducted via a series of observations and structured discussions with students. Likewise, the second tool was conducted through online forum interactions between the students one another and students with their instructor so as to measure their perceptions on the use of graded readers as a new method of dealing with the writing skill in preparation for the formative assessment quiz. Microsoft Teams platform, commissioned by the Ministry of Education, was used as a complementary medium to enhance in-class discussions where students are required to answer some open-ended questions. On the other hand, the quantitative method was used to measure the students’ outcomes by using the Rubric Calculator Software issued by Smekenseducation.com. The findings of this study demonstrate that the use of graded readers to improve the writing fluency was encouraging according to the positive results obtained from the analyzed data regardless of the time restrictions. The paper is concluded with several recommendations for more research in the field of study and the requirements needed for the best implementation of this creative method to boost the learners’ writing fluency.
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Belanger, John R. "Learning in the Laboratory: How Group Assignments Affect Motivation and Performance." Journal of Education and Learning 5, no. 1 (February 2, 2016): 210. http://dx.doi.org/10.5539/jel.v5n1p210.
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<p>Team projects can optimize educational resources in a laboratory, but also create the potential for social loafing. Allowing students to choose their own groups could increase their motivation to learn and improve academic performance. To test this hypothesis, final grades and feedback from students were compared for the same course in two different years, one with and one without fixed group arrangements. Seniors of the United States Military Academy at West Point were divided into groups of three or four to complete chemical engineering lab projects during the fall semesters of 2014 and 2015. In the first year, 21 cadets remained in instructor-assigned teams for the duration of the course. The next year, 23 cadets were initially assigned groups, but then allowed to choose their own teammates for the second half of the semester. There was no significant difference in graded performance between the two years, although cadet feedback was interesting. When cadets had the option of choosing groups, 65% of survey respondents strongly agreed that their peers had contributed to their learning, versus 40% when groups were not allowed to change. When asked if their motivation to learn or their critical thinking ability had increased, fewer respondents in the second year strongly agreed with either statement. While these results are not conclusive, a wider implementation of team-focused learning currently underway at West Point will offer a robust dataset and insights on how to get group work to work well in science and engineering education.</p>
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Kim, Hwiyoung, Jiyun Choi, Chul-Young Jang, Jin Woo Lee, Sungjun Kim, and Seung Hwan Han. "Automatic Grading of Ankle Osteoarthritis Based on Takakura Staging System: A Deep Learning- Based Approach." Foot & Ankle Orthopaedics 4, no. 4 (October 1, 2019): 2473011419S0024. http://dx.doi.org/10.1177/2473011419s00246.
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Category: Ankle, Ankle Arthritis Introduction/Purpose: The Takakura staging system has been used for the stratification in ankle osteoarthritis(OA). Patient’s OA stage is determined by visual examination on the status of talar and distal tibia in anteroposterior ankle radiograph. Clinical decisions about whether to treat conservatively or to treat with operation such as supra-malleolar osteotomy or arthroplasty may depend on this grading system. However, this is not completely reproducible between examiners and it makes a debating situation about different treatment method to a same ankle radiograph. If highly reproducible measurement method may be suggested this debating may no longer need. Therefore, the purpose of this study was to suggest a deep learning-based algorithm that automatically grades ankle osteoarthritis and to present feasibility of the provided automatic grading system. Methods: 2529 AP both-ankle radiographs were collected and graded for OA by a radiologist and orthopedic surgeon. We converted Takakura staging system into 3 grades(Grade1: stageI, Grade2: II-IIIa, Grade3: IIIb-IV) according to treatment plan. To confine the region of interest(ROI), a rectangle encompassing ankle portion was automatically generated using an object detection model(YOLOv2). The data oversampling was done to overcome small data and class imbalance. Four pre-trained convolutional networks(One Inception-v3 and three ResNet models) were fine-tuned using augmented data. We tried two different ensemble methods: voting ensemble and gradient boosting. Voting ensemble adjusts the decision through selecting majority votes among trained models. Gradient boosting(XGboost model) trains new classification model to focus on the cases that previous model mis- classified. The evaluation of trained models and ensemble model were performed in terms of average classification accuracy. Gradient-class activation map(CAM) method was utilized to present CAM highlighting the location where highly affected the network for the decision. Results: A total of 3836 original ROIs were obtained and as follows: grade 1, 1382; grade 2, 1927; grade 3, 527. The number of oversampled ROIs was 16398 like follows: grade 1, 5528; grade 2, 7708; grade 3, 3162. The performance of each classifier was ranged 71.0% ˜ 77.3% in terms of average classification accuracy. Ensemble methods yielded average classification accuracies of 78.1% and 79.2% for voting ensemble and XGboost, respectively. Conclusion: Deep learning-based algorithm application for automatic grading of ankle osteoarthritis based on Takakura staging system is feasible. This approach is expected to be applied to various staging system for arthritis assessment through radiographs.
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Kieffer, Emily, P. Gunnar Brolinson, and Steve Rowson. "Elevated In-Season Presentation of Concussion-Like Symptoms in the Absence of Diagnosed Concussion." Neurology 95, no. 20 Supplement 1 (November 16, 2020): S3.1—S3. http://dx.doi.org/10.1212/01.wnl.0000719884.09273.f0.
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ObjectiveThe objective of this study was to quantify elevated in-season presentation of concussion-like symptoms in the absence of diagnosed concussion in a cohort of collegiate rugby players.BackgroundIt is well known that many sports-related concussions are unreported. Athletes that do not immediately report concussion symptoms and continue to participate in activities are at higher risk for longer recoveries and sustain post-concussion symptoms longer. How regularly athletes experience elevated concussion symptoms in-season is unknown.Design/MethodsAthletes from men's and women's rugby teams were recruited and consented in accordance with the Virginia Tech Institutional Review Board. 63 males and 78 females participated over three seasons. Subjects completed a symptom and exposure query (SEQ) weekly throughout their season. The SEQ asked subjects if, in the past week, they experienced the 27 symptoms from the Graded Symptom Checklist for concussion. Subjects graded each symptom on a scale of 0–6, with 0 being no presentation and 6 being the most severe presentation. The graded severities of each symptom were summed to compute the overall Symptom Severity Score (SSS). Surveys that indicated confounding circumstances leading to symptoms were removed from analysis. The 99th percentile of SSS from baseline data was used as a metric of “elevated SSS,” which corresponded to an SSS of 11.Results1,214 SEQs were collected. There were 77 surveys from 43 athletes, 10 (15.8%) men and 33 (42.3%) women, who reported elevated SSS. In a given season, 16.3% of males and 41.7% of females reported elevated symptoms at least once. The surveys identified 11 additional suspected concussions based on symptom scores beyond the 8 that were clinically diagnosed.ConclusionsThis provides some evidence that constellations of concussion symptoms are commonly experienced by collegiate rugby athletes in-season. Some are at severities typically associated with concussion, but most are below current clinical concussion diagnostic thresholds.
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Mendez Lozano, Sergio Manuel, and Felipe Tirado Segura. "Enhancing Historical Reasoning: A Strategy Including Formative Assessment with Systematic Continuous Feedback." International Journal of Educational Psychology 5, no. 2 (June 24, 2016): 187. http://dx.doi.org/10.17583/ijep.2016.1639.
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Learning History promotes students’ reasoning. According to Van Drie & Van Boxtel (2008), historical reasoning involves six elements: substantive concepts, metaconcepts, asking historical questions, using sources, contextualization, and argumentation. Although there are didactic strategies that promote historical reasoning, these do not include systematic continuous feedback using rubrics, which can be useful both in assessing and promoting students’ progress and progression of ideas on metaconcepts. This study described the development of the six historical reasoning elements in a strategy that included formative assessment for K8 students. A case study was carried out in Mexico City: four teams of three students were formed according to their knowledge of history, with a single History teacher providing continuous systematic feedback on metaconcepts by using graded rubrics. Results showed that the six historical reasoning elements were developed in different ways and suggested possible methods for use in future didactics.
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Petit Francis, Lucine, Erin Spaulding, Ruth-Alma Turkson-Ocran, and Jerilyn Allen. "Randomized Trials of Nurse-Delivered Interventions in Weight Management Research: A Systematic Review." Western Journal of Nursing Research 39, no. 8 (January 8, 2017): 1120–50. http://dx.doi.org/10.1177/0193945916686962.
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The purpose of this systematic review was to determine whether nurse-delivered weight management interventions improve weight outcomes across the life span. We conducted a comprehensive search of the PubMed, CINAHL, and PsycINFO electronic databases. We graded the trials using an adapted Jadad approach for methodological quality. The search identified a total of 1,159 citations; 23 articles from 20 studies were eligible for this review. Sixty-five percent of the studies reported significant findings related to body mass index (BMI) or weight reduction. Studies that were particularly successful at helping participants reduce weight and/or BMI involved nurses engaged in health promotion activities, operating within multidisciplinary teams and/or providing consultations, physical activity education, and coaching over the phone. Of the studies that involved long-term follow-up assessments, three out of nine studies showed a significant loss in weight or BMI between the intervention and control groups at follow-up times ranging from 12 months to 2 years.
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Hill, David M., Kate O. Pape, Sarah Zavala, Allison N. Boyd, Rita M. Gayed, Melissa Reger, Beatrice Adams, et al. "A Review of the Most Impactful Published Pharmacotherapy-Pertinent Literature of 2017 and 2018 for Clinicians Caring for Patients with Burn or Inhalation Injuries." Journal of Burn Care & Research 41, no. 1 (August 11, 2019): 167–75. http://dx.doi.org/10.1093/jbcr/irz138.
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Abstract Staying current and evaluating literature related to pharmacotherapy in burn or inhalation injury can be difficult as burn care teams are multidisciplinary and pertinent content can be spread across a plethora of journals. The goal of this review is to critically evaluate recently published pharmacotherapy-pertinent literature, assist practitioners staying current, and better identify potential future research targets. Twelve board-certified clinical pharmacists with experience caring for patients with burn and inhalation injuries reviewed and graded scientific literature published in 2017 and 2018. An MeSH-based search revealed 1158 articles related to burns, which were published during the 2-year period. One-hundred fifty one were determined to be potentially related to pharmacotherapy. After exclusions, only 82 (7%) remained for scoring, and the top 10 comprehensively presented. More than half of the reviewed manuscripts were assessed as lacking a significant impact on pharmacotherapy. There is a need for higher impact literature to support pharmacotherapy-pertinent treatment of such complex patients.
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Drummond, L. M., A. Pillay, P. J. Kolb, S. Benson, R. Fogg, E. Jones-Thomas, and S. Rani. "Community model in treating obsessive–compulsive and body dysmorphic disorders." Psychiatric Bulletin 32, no. 9 (September 2008): 336–40. http://dx.doi.org/10.1192/pb.bp.107.017509.
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Aims and MethodIn November 2005, the National Institute for Health and Clinical Excellence published guidelines for the treatment of obsessive–compulsive disorder (OCD) and body dysmorphic disorder. These guidelines incorporated a stepped care approach with different interventions advised throughout the patient pathway. South West London and St George's Mental Health NHS Trust devised a system of expert clinicians with special expertise in OCD/body dysmorphic disorder to help deliver this model of care. To aid the delivery of service it was decided to operationalise the definitions of severity of OCD/body dysmorphic disorder at each of the stepped-care levels. Examples are given as to how this has been applied in practice. Outcome is presented in terms of clinical hours in the first year of operation.ResultsIn total, 108 patients were referred to the service in the first year. Many of these patients were treated by offering advice and support and joint working with the community mental health team and psychotherapy in primary care teams who had referred. Sixty-eight patients were treated by a member of the specialist service alone and 57 of these suffered from severe OCD. Outcome data from these 57 patients is presented using an intention-to-treat paradigm. They showed a clinically and statistically significant reduction in OCD symptoms after 24 weeks of cognitive–behavioural therapy comprising graded exposure and self-imposed response prevention. the mean Yale–Brown Obsessive Compulsive Scale score dropped from 28 (severe OCD) to 19 (considerable OCD). Depressive symptoms on the Beck Depression Inventory also decreased by an average 24% over the same period.Clinical ImplicationsThe feasibility of extending this model of service organisation to other areas and other diagnoses is discussed.
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Rocha, Hugo André da, Alaneir de Fátima dos Santos, Ilka Afonso Reis, Marcos Antônio da Cunha Santos, and Mariângela Leal Cherchiglia. "Mental health in primary care: an evaluation using the Item Response Theory." Revista de Saúde Pública 52 (February 26, 2018): 17. http://dx.doi.org/10.11606/s1518-8787.2018052000051.
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OBJECTIVE: To determine the items of the Brazilian National Program for Improving Access and Quality of Primary Care that better evaluate the capacity to provide mental health care. METHODS: This is a cross-sectional study carried out using the Graded Response Model of the Item Response Theory using secondary data from the second cycle of the National Program for Improving Access and Quality of Primary Care, which evaluates 30,523 primary care teams in the period from 2013 to 2014 in Brazil. The internal consistency, correlation between items, and correlation between items and the total score were tested using the Cronbach’s alpha, Spearman’s correlation, and point biserial coefficients, respectively. The assumptions of unidimensionality and local independence of the items were tested. Word clouds were used as one way to present the results. RESULTS: The items with the greatest ability to discriminate were scheduling of the agenda according to risk stratification, keeping of records of the most serious cases of users in psychological distress, and provision of group care. The items that required a higher level of mental health care in the parameter of location were the provision of any type of group care and the provision of educational and mental health promotion activities. Total Cronbach’s alpha coefficient was 0.87. The items that obtained the highest correlation with total score were the recording of the most serious cases of users in psychological distress and scheduling of the agenda according to risk stratification. The final scores obtained oscillated between -2.07 (minimum) and 1.95 (maximum). CONCLUSIONS: There are important aspects in the discrimination of the capacity to provide mental health care by primary health care teams: risk stratification for care management, follow-up of the most serious cases, group care, and preventive and health promotion actions.
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Stockwell, David W., Richard Blalock, Kenneth Podell, and Rex A. W. Marco. "At-Risk Tackling Techniques in American Football." Orthopaedic Journal of Sports Medicine 8, no. 2 (February 1, 2020): 232596712090271. http://dx.doi.org/10.1177/2325967120902714.
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Background: In American football, fewer fatalities and severe injuries have been seen annually since 1976, after data from 1971 through 1975 were retrospectively reviewed to better understand the mechanisms involved in catastrophic cervical spine injury and rules were enacted to prohibit certain types of aggressive tackling. The National Football Head and Neck Injury Registry was established in 1975. Purpose: To assess (1) tackling techniques that coaches were teaching at 3 levels—youth level (YL; 4th to 5th grades), middle school (MS; 6th to 8th grades), and high school (HS; 9th to 12th grades); (2) tackling techniques used during games; and (3) the successful tackle rates of these techniques. Study Design: Descriptive epidemiology study. Methods: Surveys were distributed via email to 500 coaches of YL, MS, and HS football teams in Texas. Coaches provided video recordings of football games, and all tackle attempts were graded by a single reviewer who watched game videos; 1000 consecutive tackles were observed for each group. Survey data included how coaches instructed their players to tackle, the types of tackles, the number of tackles versus missed tackles, the head position, and the initial contact. Data were analyzed with the chi-square test. A subset of 100 consecutive tackles at each level of play was reviewed by 2 blinded reviewers to assess intra- and interrater reliabilities. Results: In all groups, coaches responded that they preferred to teach the at-risk “head across the bow” tackling technique (83% YL, 81% MS, 75% HS). Coaches stated that they instructed players to “keep your head up,” as currently recommended, 89% in YL, 100% in MS, and 81% in HS. During games, players used head-up, inside-shoulder tackles more successfully across all groups (97.5% YL, 99.5% MS, 98.8% HS). While intra- and interrater reliabilities were in the good range, these scores were lower in the youth group. Conclusion: Our study supports the effectiveness of tackling with the head up and making the initial contact with the inside shoulder. Lower reliability ratings for the youth group were likely due to lower video quality and the lack of players’ tackling experience.
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Alsina, Angel E., Daniel Wind, Ambuj Kumar, Ebonie Rogers, Jacentha Buggs, Raviender Bukkapatnam, and Wade J. Sexton. "Outcomes in Renal Cell Carcinoma With IVC Thrombectomy: A Multiteam Analysis Between an NCI-Designated Cancer Center and a Quaternary Care Teaching Hospital." American Surgeon 86, no. 8 (August 2020): 1005–9. http://dx.doi.org/10.1177/0003134820942172.
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Introduction Interteam performance and Clavien-Dindo (C-D) complications in renal cell carcinoma with inferior vena cava thrombectomy (RCC-IVCT) have not been reported. We aimed to describe complications by the degree of complexity and surgical teams in a collaborative effort between a National Cancer Institute-designated Comprehensive Cancer Center and a Quaternary Care Teaching Hospital. Methods Between January 2011 and May 2019, 73 consecutive RCC-IVCT were included. C-D grades III or higher were captured. Teams involved were urologic-oncology, vascular, hepatobiliary/transplant, and cardiothoracic. The Mayo Clinic tumor thrombus classification was used. Results Overall complication rate was 42% (n = 31). Nineteen percent had grade III, 18% had grade IV, and 6% had grade V complications. Patients with level IV thrombus had the highest in-hospital mortality rate (75%). Thrombus level did not show a correlation to complication rates (14% level I, 45% level II, 32% level III, 42% level IV). A positive correlation found between the number of teams involved and complication rates (35% with 2-team, 59% with 3-team, P = .059). Thromboembolic events (6% vs 24%, P = .02) and disposition other than home (22% vs 48%, P = .01) were statistically lower for the 2-team groups. Two-team in-hospital mortality was 1/51 (2%) versus 3-team (3/22,14%, ( P = .07). No statistical differences were found in infections, thromboembolic events, and grades of complications between surgical teams. Conclusions Despite similar interteam performance, the consistency of surgeons in high complexity cases could improve outcomes further. Complexity was higher for hepatobiliary/transplant and cardiothoracic teams. A combination of intraoperative events and patient selection (comorbidities and age) contributed to death. Overall, in-hospital mortality was lower than in most reported series.
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Cox, Jocelyn, Marion McGregor, Dominic Giuliano, and Loretta Howard. "Impact of providing case-specific knowledge in simulation: a theory based study of learning." BMJ Simulation and Technology Enhanced Learning 3, no. 1 (October 28, 2016): 1–4. http://dx.doi.org/10.1136/bmjstel-2016-000131.
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BackgroundSimulation-based education (SBE) has been lauded for its ability to help students recognise and react appropriately to common and rare circumstances. While healthcare professions have started to implement SBE into their curriculum, there is no evidence to suggest which educational theory is best for implementation. This study explores the usage of cognitive load theory (CLT) and the unified theory of emotional learning (UTEL).Study designA mixed methods ordered-allocation cohort study.Methods23 patient management teams were allocated into 2 groups. The first group received prior information about the simulation scenario; the second group did not. Each team had 1 student assigned to the role of doctor. The scenarios were filmed at time 1 (T1), time 2 (T2) and follow-up (F/U). The ‘doctor’ role was then graded with a validated checklist by a three-judge panel. The scores were evaluated to determine if prior information enabled better performance. Secondary analysis evaluated the role of gender on performance and also evaluated anxiety at the onset of the simulation.Results23 doctors were evaluated. There was no difference between groups in performance (t=1.54, p=0.13). Secondary analysis indicated that gender did not play a role. There was no difference in anxiety between groups at baseline (t=0.67, p=0.51).ConclusionsTrends were observed, suggesting that when students enter a simulation environment with prior knowledge of the event they will encounter, their performance may be higher. No differences were observed in performance at T2 or F/U. Withholding information appeared to be an inappropriate proxy for emotional learning as no difference in anxiety was observed between groups at baseline. All trends require confirmation with a larger sample size.
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Norton, Ryan, Christopher Honstad, Rajat Joshi, Matthew Silvis, Vernon Chinchilli, and Aman Dhawan. "Risk Factors for Elbow and Shoulder Injuries in Adolescent Baseball Players: A Systematic Review." American Journal of Sports Medicine 47, no. 4 (April 9, 2018): 982–90. http://dx.doi.org/10.1177/0363546518760573.
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Background: The incidence of shoulder and elbow injuries among adolescent baseball players is on the rise. These injuries may lead to surgery or retirement at a young age. Purpose: To identify independent risk factors for elbow and shoulder injuries in adolescent baseball players. A secondary aim was to determine whether the literature supports the Major League Baseball and USA Baseball Pitch Smart guidelines. Study Design: Systematic review. Methods: A systematic review was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines utilizing MEDLINE, SPORTDiscus, and Web of Science. Because of study heterogeneity, a quantitative synthesis was not performed. A qualitative review was performed on 19 independent risk factors for elbow and shoulder injuries in adolescent baseball players. Level of evidence was assigned per the Oxford Centre for Evidence-Based Medicine Working Group, and risk of bias was graded per the Newcastle-Ottawa Scale. Results: Twenty-two articles met criteria for inclusion. Of the 19 independent variables that were analyzed, age, height, playing for multiple teams, pitch velocity, and arm fatigue were found to be independent risk factors for throwing arm injuries. Pitches per game appears to be a risk factor for shoulder injuries. Seven independent variables (innings pitched per game, showcase participation, games per year, training days per week, pitch type, shoulder external rotation, and shoulder total range of motion) do not appear to be significant risk factors. The data were inconclusive for the remaining 6 variables (weight, months of pitching per year, innings or pitches per year, catching, shoulder horizontal adduction, and glenohumeral internal rotation deficit). Conclusion: The results from this study demonstrate that age, height, playing for multiple teams, pitch velocity, and arm fatigue are clear risk factors for throwing arm injuries in adolescent baseball players. Pitches per game appears to be a risk factor for shoulder injuries. Other variables are either inconclusive or do not appear to be specific risk factors for injuries.
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Preddie, Martha Ingrid. "The Utilization of Wireless Handheld Computers with MEDLINE is an Effective Mechanism for Answering Clinical Questions at the Point of Care." Evidence Based Library and Information Practice 3, no. 3 (September 3, 2008): 64. http://dx.doi.org/10.18438/b8t31m.
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A Review of:
Hauser, Susan E., Dina Demner-Fushman, Joshua L. Jacobs, Susanne M. Humphrey, Glenn Ford, and George R. Thoma. “Using Wireless Handheld Computers to Seek Information at the Point of Care: An Evaluation by Clinicians.” Journal of the American Medical Informatics Association 14.6 (Nov./Dec. 2007): 807-15.
Abstract
Objective – To assess the effectiveness of wireless handheld computers (HHCs) for information retrieval in clinical environments and the role of MEDLINE in answering clinical questions at the point of care.
Design – A prospective single-cohort study.
Setting – Teaching rounds in the intensive care units and general medicine wards in two hospitals associated with a university’s school of medicine in the United States.
Subjects – Five internal medicine residents with training in evidence-based practice.
Methods – While accompanying medical teams on teaching rounds for approximately four consecutive weeks, each resident used MD on Tap (an application for handheld computers) on a TreoTM 650 PDA/cell phone to find answers in real time, to questions that were raised by members of the medical teams. Using a special version of MD on Tap, each resident initialized a UserID. Serving as evaluators, the residents described and categorized clinical scenarios and recognized questions. They also formulated search terms, searched MEDLINE and identified citations determined to be useful for answering the questions. An intermediate server collected details of all MEDLINE search query transactions, including system response time, the user (based on UserIDs), citations selected for viewing, the saving of citations to HHC memory, as well as use of the Linkout and Notes features. In addition evaluators submitted daily summaries. These summaries included information on the scenarios, clinical questions, evidence-based methodology (EBM) category, the team member who was the source of the question, the PubMed Identifiers (PMIDs) of relevant citations, and comments. At the end of the data collection period, each evaluator submitted a summary report consisting of a qualitative and quantitative evaluation of his experience using MEDLINE via the handheld device to find relevant evidence based information at the point of care. The report also focused on the usefulness of MD on Tap features, along with suggestions for additional features.
Data analysis encompassed matching the text of daily summaries to transaction records in order to identify sessions (containing a scenario, clinical question, one or more search queries, citation fetches and selected PMIDs). A senior medical librarian/expert indexer reviewed all the citations selected by evaluators and graded each citation as A (useful for answering the question), B (provided a partial answer) or C (not useful for answering the question). Only those graded A were regarded as “relevant.” For the purpose of analysis a session was deemed to be successful “if at least one of the citations selected by the evaluator as relevant was also classified as Relevant” (810) by the expert indexer. Similarly, an individual query was successful “if at least one of the citations among the results of the query was Relevant, that citation was viewed by the evaluator during rounds, and it addressed the clinical question as recorded in the daily summary” (810). Various types of relationships were analyzed including the characteristics of clinical questions vis-a-vis successful sessions, search strategies in relation to successful queries, and the association between MD on Tap features and successful queries. SAS/SUDAAN version 9.1 was used for statistical analysis.
Main Results – Evaluators answered 68% (246 of 363) clinical questions during rounding sessions. They identified 478 “relevant” citations, an average of 1.9 per successful session and 1.3 for each successful question. Session lengths averaged 3 minutes and 41 seconds. Characteristics of the evaluator (training, interest, experience and expertise) were a significant predictor of a session’s success. The significant determinants of query success were “the number of search terms that could be mapped to Medical Subject Headings (MeSH)” (812), the number of citations that were found for a query, and the use of MD on Tap’s auto-spellcheck feature. Narrative comments from the evaluators indicated that using MEDLINE on a HHC at the point of care contributed positively to the practice of evidence -based medicine.
Conclusion – Wireless handheld computers are useful for retrieving information in clinical environments. The application of several MeSH terms in a query facilitates the retrieval of MEDLINE citations that provide answers to clinical questions. The MD on Tap program is a valuable interface to MEDLINE at the point of care.
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Root, Hayley J., R. Curtis Bay, and Lindsay J. DiStefano. "INFLUENCE OF PREVENTIVE TRAINING PROGRAM FEEDBACK COMPLEXITY ON ATHLETE INJURY RISK." Orthopaedic Journal of Sports Medicine 8, no. 4_suppl3 (April 1, 2020): 2325967120S0027. http://dx.doi.org/10.1177/2325967120s00272.
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Background: Preventive training programs (PTPs) reduce injury risk in youth athletes. Corrective verbal feedback is an integral component of PTP implementation; however, too many cues delivered at once may be too complicated for youth athletes. PTPs with simplified cues may be more effective as traditional PTPs to improve athlete injury risk. Hypothesis/Purpose: The purpose of this study was to evaluate changes in movements associated with injury risk youth athletes participating in a season-long PTP: with simplified feedback cues, with traditional feedback cues, or in a warm-up of the coaches’ choosing. Methods: A cluster-randomized controlled trial was utilized. Youth soccer teams were randomized into: simplified or traditional PTP, or the control group. Simplified and traditional PTPs were the same duration (10-15 minutes) with the same exercises, but the simplified PTP only provided sagittal plane feedback cues (e.g., “get low”) and the traditional PTP provided feedback in all planes of motion (e.g., “don’t let your knees cave inward”). Teams in the control group performed their coach’s warm-up. Participants completed two test sessions (PRE-season, POST-season) with three trials of a jump-landing task evaluated using the Landing Error Scoring System (LESS). The LESS is a valid and reliable clinical movement assessment. Participants jumped off a 30-cm high box to a distance half their height and immediately rebounded straight in the air for maximum vertical height. A single, reliable rater graded all trials. Three trials were averaged together for one composite LESS score at each time point. A generalized linear model was used to evaluate differences in composite LESS score between warm-up (Simplified, Traditional, Control) over time (PRE, POST) while controlling for team. All data were analyzed using SPSS Version 21.0 (p<0.05). Results: There were no significant differences between Simplified and Traditional PTPs (P>0.05) so the PTPs were combined into a single group (Intervention) and compared to Control from PRE to POST. Four-hundred and twenty athletes (Intervention n=291 athletes, Control n=129 athletes) participated. The Intervention group improved LESS scores ((Mean±SE [95% CI]) Intervention PRE:6.32±0.17 [5.99,6.67], Intervention POST: 5.36±0.16 [5.05,5.69], Control PRE: 6.58±0.35 [5.94,7.30], Control POST: 6.09±0.34 [5.47,6.79])(P=.04). Conclusion: Regardless of PTP, athletes improved movement technique. These findings suggest that simplified corrective feedback is as effective as more complex feedback. Future studies should look to train coaches to focus on simplified cues and evaluate impact on PTP implementation.
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Orbay, L., J. A. McLean, B. J. Sauder, and P. L. Cottell. "Economic losses resulting from ambrosia beetle infestation of sawlogs in coastal British Columbia, Canada." Canadian Journal of Forest Research 24, no. 6 (June 1, 1994): 1266–76. http://dx.doi.org/10.1139/x94-166.
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Estimates of ambrosia beetle damage on 10 log grades, commonly used in sawmills of coastal British Columbia, were determined by the sawmill team of an Ambrosia Beetle Task Force during 1990–1992. A total of 417 ambrosia beetle attacked logs were evaluated in eight cooperating sawmills. Test logs were processed into lumber products, graded, and valued. Estimates of dollar loss per cubic metre for various log diameter classes were made. The average losses for the 10 log grades with respect to grade of lumber, with and without pinholes, ranged from $3.27 to $77.40/m3 of log. Changes in sawing patterns as a result of ambrosia beetle infestation were also assessed. The loss of deep clear potential on high-grade logs increased value losses by 57%. One third of large pulp logs were sawn for lumber. Ambrosia beetle infestation of sawn large pulp logs resulted in $19.20/m3 degrade loss.
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Tahir, Mohammad, Tehreem Atif, Summaya Sohail, Arfa Nawazish, and Huma Mushtaq. "The Expression of Progesterone Receptors in Meningiomas of Different Grades." Journal of Islamabad Medical & Dental College 8, no. 2 (June 27, 2019): 65–69. http://dx.doi.org/10.35787/jimdc.v8i2.357.
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Background: Meningiomas are slow growing intracranial and intraspinal neoplasms with a tendency to recur locally. WHO grades them as I (benign), II (atypical) and III (anaplastic) in order of their increasing aggressiveness, based on histological parameters and brain parenchymal invasion. Progesterone receptors (PR) are more prevalent amongst the lower grade meningiomas. The objective of this study was to determine the immunohistochemical expression of progesterone receptors in meningiomas of different grades.Material and Methods: A total of 100 cases were selected over a period of 2.5 years. Three to five microns’ thick sections stained with Hematoxylin and Eosin were examined microscopically by a team of two Histopathologists and graded into grades I, II and III, according to 2016 WHO classification criteria. Another section of the original tumor was stained with progesterone receptor antibody using the conventional immunoperoxidase method. Stained slides were than examined by the same team of Histopathologists and declared positive (if nuclear staining was observed in more than 10% of tumor cells) or negative. Statistical analysis was done using SPSS version 21.Results: Out of a total of 100 cases of meningioma, there were 79 cases of benign/typical WHO grade I, 15 cases of atypical/ WHO grade II and 6 cases of anaplastic/ WHO grade III tumor. PR status was positive in 89.8 % (71/79) of grade I meningiomas and 46.6 % (7/15) of grade II/Atypical meningiomas. The 06 cases of Anaplastic/WHO grade III tumors were negative for PR. There was a higher prevalence of Progesterone receptors in female patients (89.8%; 53/59) as compared to male meningioma patients (60.9%; 25/41).Conclusion: We observed a decreased expression of progesterone receptor in higher grades of meningioma in this study. It is an effort to explore conservative treatment options for inoperable lesions, as anti-progesterone therapy may hold a promise as a new treatment option in the near future.
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Godwin, John E., Bassam Ibrahim Mattar, Michael B. Maris, Carlos R. Bachier, Don A. Stevens, Daanish Hoda, Juan Carlos Varela, et al. "Outreach: Preliminary safety and efficacy results from a phase 2 study of lisocabtagene maraleucel (liso-cel) in the nonuniversity setting." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): e19513-e19513. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e19513.
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e19513 Background: Concerns about adverse events (AEs) related to CAR T cell therapy have resulted in administration of this therapy largely in an inpatient setting. OUTREACH (NCT03744676) evaluates safety and efficacy of liso-cel in patients (pts) with R/R large B-cell lymphoma (LBCL) across inpatient and outpatient settings at nonuniversity medical centers (NMCs). Methods: NMCs, including centers naïve to CAR T cell therapy, enrolled adults with R/R LBCL in this open-label, multicenter study. Eligible pts had R/R PET-positive disease after ≥2 lines of prior systemic therapy, ECOG PS ≤1, and adequate organ function. Prior autologous HSCT was allowed. Pts received sequential infusions of equal target doses of CD8+ and CD4+ cells at a total target dose of 100 × 106 CAR+ T cells. Primary endpoint was incidence of grade (G) ≥3 cytokine release syndrome (CRS) graded per 2014 Lee criteria, neurological events (NEs), prolonged cytopenias (Day 29 G ≥3 lab values), and infections. Secondary endpoints were safety and overall response rate (ORR). Outpatient AE monitoring/management was managed by a multidisciplinary CAR T cell therapy team following standard operating procedures (SOPs). Results: At data cutoff, 46 pts (inpatients n = 16, outpatients n = 30) were treated with liso-cel. Inpatients and outpatients had similar demographics and baseline disease characteristics; median age was 63 y (range, 34–83), 63% had diffuse LBCL not otherwise specified, and 91% were refractory to last therapy. Safety data were similar across inpatients and outpatients (Table). Early (study Day ≤4) and overall hospitalization in outpatients was reported in 27% and 63%, respectively; median time to hospitalization was 5 (2–61) days and median length of stay was 6 (1–28) days. For efficacy-evaluable pts (n = 44), ORR was 75% for inpatients and 79% for outpatients; CR rates were 50% and 61%, respectively. Conclusions: Liso-cel was successfully administered to pts with R/R LBCL in the outpatient setting and pts were monitored for CAR T cell therapy–related toxicities by multidisciplinary teams using SOPs. The incidences of severe CRS and NEs and use of tocilizumab and/or corticosteroids were similar in inpatients and outpatients, and consistent with the pivotal study observations (Abramson, The Lancet 2020). Updated data with longer follow-up will be presented. Clinical trial information: NCT03744676. [Table: see text]
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Lee, Il Hwan, Do Hyun Kim, Jae-Sung Park, Sin-Soo Jeun, Yong-Kil Hong, and Sung Won Kim. "Cerebrospinal fluid leakage repair of various grades developing during endoscopic transnasal transsphenoidal surgery." PLOS ONE 16, no. 3 (March 26, 2021): e0248229. http://dx.doi.org/10.1371/journal.pone.0248229.
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Objectives We describe the strategy used to repair intraoperative leaks of various grades and define factors for preventing postoperative cerebrospinal fluid leakage (CSF) after surgery via the endoscopic endonasal transsphenoidal approach (EETA). Study design Retrospective chart review at a tertiary referral center. Methods Patients who underwent surgery via EETA from January 2009 to May 2020 were retrospectively reviewed. Intraoperative CSF leakage was graded 0–3 in terms of the dural defect size; various repairs were used depending on the grade. Results A total of 777 patients underwent 869 operations via EETA; 609 (70.1%) experienced no intraoperative CSF leakage (grade 0) but 260 (29.9%) did. Leakage was of grade 1 in 135 cases (15.5%), grade 2 in 83 (9.6%), and grade 3 in 42 (4.8%). In 260 patients with intraoperative CSF leakage, a buttress was wedged into the sellar defect site in 178 cases (68.5%) and a pedicled flap was placed in 105 cases (40.4%). Autologous fat (108 cases, 41.5%) and a synthetic dural substitute (91 cases, 35%) were used to fill the dead space of the sellar resection cavity. Postoperative CSF leakage developed in 21 patients: 6 of grade 1, 7 of grade 2, and 8 of grade 3. Buttress placement significantly decreased postoperative leakage in grade 1 patients (p = 0.041). In patients of perioperative leakage grades 2 and 3, postoperative CSF leakage was significantly reduced only when both fat and a buttress were applied (p = 0.042 and p = 0.043, respectively). Conclusion A buttress prevented postoperative CSF leakage in grade 1 patients; both fat and buttress were required by patients with intraoperative leakage of grades 2 and 3.
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Suryana, Agus, Agus Sugianto, and Ayu Bahari. "Pengaruh Metode Pembelajaran Student Teams Achivement Divisions (STAD) terhadap Hasil Belajar Matematika Siswa Madrasah Ibtidaiyah." Jurnal Dirosah Islamiyah 3, no. 2 (April 17, 2021): 166–79. http://dx.doi.org/10.47467/jdi.v3i2.351.
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This study aims to examine the effect of the Student Teams Achievement Division (STAD) method on the mathematics learning outcomes of grade V students at MIS Yapis Al Falah, Bojonggede District. This study used a pre-experimental method with a pre-post test design, while the sample of this study consisted of 15 grade V students. The results showed that there was an effect of the Student Teams Achievement Division (STAD) method on the Mathematics learning outcomes of class V students as seen from the results of the grades. sig 0.000 <0.05 so also obtained tcount = 7.897 while t table = 2.14. Then t count> ttable (-7,897> 2.14) and it can be concluded that there is an influence between the STAD method on the Mathematics learning outcomes of class V students at MIS Yapis Al Falah.
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Sun, Min, Susanna Loeb, and Jason A. Grissom. "Building Teacher Teams." Educational Evaluation and Policy Analysis 39, no. 1 (September 20, 2016): 104–25. http://dx.doi.org/10.3102/0162373716665698.
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Student peer effects are well documented; however, we know far less about peer effects among teachers. We hypothesize that a relatively effective teacher can positively affect the performance of his or her peers, whereas a relatively ineffective teacher may negatively affect the performance of other teachers with whom he or she works closely. Utilizing a decade of data on teacher transfers between schools that result in changes of peers when transfer teachers enter grade-level team in the new school, we find evidence of strong positive spillover effects associated with the introduction of peers who are more effective than the incumbent teacher himself or herself. However, the incumbent teacher’s students are not meaningfully disadvantaged by the entry of relatively ineffective peers. This finding provides initial evidence that mixing teachers with diverse performance levels can increase student achievement in the aggregate. These results are robust to several student sorting and teacher selection issues.
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Prakash, Ashutosh, Tom Entwisle, Michal Schneider, Peter Brukner, and David Connell. "Connective tissue injury in calf muscle tears and return to play: MRI correlation." British Journal of Sports Medicine 52, no. 14 (October 26, 2017): 929–33. http://dx.doi.org/10.1136/bjsports-2017-098362.
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ObjectiveThe aim of our study was to assess a group of patients with calf muscle tears and evaluate the integrity of the connective tissue boundaries and interfaces. Further, we propose a novel MRI grading system based on integrity of the connective tissue and assess any correlation between the grading score and time to return to play. We have also reviewed the anatomy of the calf muscles.Materials and methodsWe retrospectively evaluated 100 consecutive patients with clinical suspicion and MRI confirmation of calf muscle injury. We evaluated each calf muscle tear with MRI for the particular muscle injured, location of injury within the muscle and integrity of the connective tissue structure at the interface. The muscle tears were graded 0–3 depending on the degree of muscle and connective tissue injury. The time to return to play for each patient and each injury was found from the injury records and respective sports doctors.ResultsIn 100 patients, 114 injuries were detected. Connective tissue involvement was observed in 63 out of 100 patients and failure (grade 3 injury) in 18. Mean time to return to play with grade 0 injuries was 8 days, grade 1 tears was 17 days, grade 2 tears was 25 days and grade 3 tears was 48 days (p<0.001).ConclusionThe integrity of the connective tissue can be used to estimate and guide the time to return to play in calf muscle tears.
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Bepari, Asmatanzeem, Shaik Kalimulla Niazi, and Amal Al-Otaibi. "The Efficiency of Multi-Faceted Educational Intervention on Knowledge, Perceived Behavior, and Practice Skills towards Pharmacovigilance among Undergraduate Pharmacy Students of India." Open Access Macedonian Journal of Medical Sciences 7, no. 23 (December 10, 2019): 4155–62. http://dx.doi.org/10.3889/oamjms.2019.845.
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BACKGROUND: The primary reason for poor adverse drug reaction (ADR) signal detection worldwide is the under-reporting of ADRs by healthcare professionals. Multidisciplinary teams, including pharmacists, may play an essential role in targeting this issue.
AIM: The purpose of the study was to evaluate the impact of a multi-faceted educational intervention (MEI) on the knowledge, perception, and practice skills of pharmacovigilance among undergraduate pharmacy students.
METHODS: A longitudinal, prospective study using a single group before-and-after intervention design was conducted among 100 undergraduate pharmacy students at Togari Veeramallappa Memorial College of Pharmacy, Ballari, India (TVMCP), affiliated to Vijayanagara Institute of Medical Sciences (VIMS), Ballari, India. The questionnaire was structured using previous studies and standardized. It had three groups of questions. Group 1 questions evaluated the knowledge (K1-K8), group 2 tested perceptions (A1-A6), and group 3 tested the practice skills of pharmacovigilance (P1-P5) of the participant. The participants were graded in 3 categories as poor, unsatisfactory, and satisfactory, depending upon the mean score. Matched pairs student t-test and The Wilcoxon Signed rank statistical test was used to assess the impact of the MEI on the participants' knowledge, perception, and practice skills score, along with recording different factors preventing them from being actively involved in the pharmacovigilance program.
RESULTS: The educational intervention improved the pharmacovigilance knowledge, perception, and practice skills scores of our pharmacy students.
CONCLUSION: Our study showed that knowledge, perception, and practice skills scores increased after MEI highlighting the need for regular educational campaigns to healthcare professions.
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Boers, Anna MM, Ivo GH Jansen, Olvert A. Berkhemer, Albert J. Yoo, Hester F. Lingsma, Cornelis H. Slump, Yvo BWEM Roos, et al. "Collateral status and tissue outcome after intra-arterial therapy for patients with acute ischemic stroke." Journal of Cerebral Blood Flow & Metabolism 37, no. 11 (November 19, 2016): 3589–98. http://dx.doi.org/10.1177/0271678x16678874.
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Intra-arterial therapy (IAT) for ischemic stroke aims to save brain tissue. Collaterals are thought to contribute to prolonged penumbra sustenance. In this study, we investigate the effect of collateral status on brain tissue salvage with IAT. In 500 patients randomized between IAT and standard care, collateral status was graded from 0 (absent) to 3 (good). Final infarct volumes (FIV) were calculated on post-treatment CT. FIVs were compared between treatment groups per collateral grade. Multivariable linear regression with interaction terms was performed to study whether collaterals modified IAT effect on FIV. Four-hundred-forty-nine patients were included in the analysis. Median FIV for the IAT group was significantly lower with 54.5 mL (95% IQR: 21.8–145.0) than for the controls with 81.8 mL (95% IQR: 40.0–154.0) ( p = 0.020). Treatment effect differed across collateral grades, although there was no significant interaction (unadjusted p = 0.054; adjusted p = 0.105). For grade 3, IAT resulted in a FIV reduction of 30.1 mL ( p = 0.024). For grade 2 and 1, this difference was, respectively, 28.4 mL ( p = 0.028) and 28.4 mL ( p = 0.29). For grade 0, this was 88.6 mL ( p = 0.28) in favour of controls. IAT saves substantially more brain tissue as compared to standard care. We observed a trend of increasing effect of IAT with higher collateral grades.
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Lima, Alba Regina de Abreu, Júlio César André, Marina Kamimura, Ana Carolina dos Reis, Juanita Justina Ferreira da Silva, Loiane Letícia dos Santos, Emerson Roberto dos Santos, and Sérgio Luíz Aparecido Brienze. "Peer Assessment in the Context of Team-Based Learning in Undergraduate Education: How Far Can We Go?" Journal of Education and Training Studies 8, no. 3 (February 27, 2020): 90. http://dx.doi.org/10.11114/jets.v8i3.4737.
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In medical education, the team-based learning method (TBL) is a teaching strategy used to intensify interactive learning in small groups, in which the student is given the role of evaluating his/her peers - peer assessment (PA). To investigate the interference of the students' interpersonal relationships in awarding their peers grades (''halo effect''). A qualitative and quantitative retrospective study. The study participants were 78 first-year medical students, divided into 17 teams for the TBL. The final grade of the PA for each member was calculated by the average of the grades received from their peers. Results: The comparison between the average of the evaluations in the TBL method (MTBLs) and the PA showed that 17.64% of the teams showed a significant difference between the grades, thus having the “halo effect”. In the qualitative analysis, the “halo effect” was evidenced in only one of these teams. Although many studies corroborate the idea that using PA in the formative assessment is appropriate, advancing in the use of PA in the summative assessment is necessary, integrating it into the institution's evaluation system. Data presented here can help in continuing its use and in increasing its reliability.
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Uys, Hendrik D., and Arie M. Rijke. "Clinical Association of Acute Lateral Ankle Sprain with Syndesmotic Involvement." American Journal of Sports Medicine 30, no. 6 (November 2002): 816–22. http://dx.doi.org/10.1177/03635465020300061101.
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Background Information concerning the clinical association between syndesmosis injury and grade of lateral ankle ligament damage would aid in the diagnosis and treatment of ankle sprains. Hypothesis Evaluation of lateral ligament injury in terms of percentage tear of both the anterior talofibular and calcaneofibular ligaments can provide information on the extent of syndesmotic involvement. Study Design Prospective cohort study. Methods Twenty-five patients volunteered to have magnetic resonance imaging examinations performed and 21 volunteered to undergo graded stress radiographs. Talar tilt angles were measured from radiographs taken with 0, 6, 9, 12, and 15 daN of force applied medially just above the ankle joint, and the percentage of ligament tear and grade of injury were determined. Scans were obtained with the foot in neutral and plantar flexion to image the anterior talofibular and calcaneofibular ligaments. Results Grades of lateral ligament injury determined by magnetic resonance imaging and graded stress radiography were the same. The extent of syndesmotic injury could be assessed for all patients. Conclusions Intact tibiofibular ligaments were found equally frequently among patients with normal or any grade of lateral ligament damage, but the more severe injuries to the syndesmotic ligaments were associated with normal or minimally traumatized lateral ligaments. The inverse correlation can be explained on the basis of the difference between the mechanisms that precipitate these injuries.
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Shah, Sarav S., Eric Ferkel, and Kai Mithoefer. "High Prevalence of Superior Labral Anterior-Posterior Tears Associated With Acute Acromioclavicular Joint Separation of All Injury Grades." Orthopaedic Journal of Sports Medicine 8, no. 8 (August 1, 2020): 232596712094185. http://dx.doi.org/10.1177/2325967120941850.
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Background: Despite the relatively high number of cases of acromioclavicular joint (AC) separation in the athletic population, optimal clinical outcomes are not achieved in every case. Limited data exist regarding the prevalence of intra-articular glenohumeral pathologies (IAPs) associated with acute AC separation of all injury grades. Purpose: To determine the prevalence of IAPs associated with AC separation, regardless of severity. Study Design: Case series; Level of evidence, 4. Methods: A total of 62 patients (mean age, 37.6 years) with acute AC separation were included in this study; 41 were nonoverhead recreational athletes. All patients underwent magnetic resonance arthrography (MRA) to evaluate for IAPs. Arthroscopic data from patients undergoing surgical treatment were correlated with MRA results. Results: Patients sustained acute AC separation of Rockwood grade 1 (16.1%), grade 2 (46.8%), grade 3 (25.8%), and grade 4 (11.3%). A concomitant IAP was present in 48 of 62 (77.4%) patients and included superior labral anterior-posterior tears (72.6%), anterior labral tears (24.2%), posterior labral tears (4.8%), supraspinatus tears (3.2%), and inferior glenohumeral ligament ruptures (1.6%). There were 18 (29.0%) patients who had a concomitant pathology in >1 intra-articular structure (combined IAPs). Additionally, 71.8% of patients with grade 1 and 2 AC separation had associated IAPs, and 23.1% had combined IAPs. Furthermore, in patients younger than 40 years, 64.0% of those with grade 1 to 3 AC separation demonstrated associated labral pathologies. There was no difference when comparing age or severity of AC separation and the prevalence of concomitant labral tears ( P = .36 and .22, respectively). Conclusion: There was a high prevalence of IAPs among patients undergoing MRA after AC separation. While an IAP has been described in association with high-grade AC separation previously, the high prevalence of IAPs in low-grade separation in our study was unexpected and suggests that a thorough evaluation and clinical follow-up for patients with all grades of AC separation may be beneficial.
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Hartweg, Kim, and Marlys Heisler. "No Tears Here! Third-Grade Problem Solvers." Teaching Children Mathematics 13, no. 7 (March 2007): 362–68. http://dx.doi.org/10.5951/tcm.13.7.0362.
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Description of a year–long professional development project involving the integration of problem solving into the third–grade mathematics curriculum and implications for learning and teaching elementary mathematics.
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Lindo, Jason M., Isaac D. Swensen, and Glen R. Waddell. "Are Big-Time Sports a Threat to Student Achievement?" American Economic Journal: Applied Economics 4, no. 4 (October 1, 2012): 254–74. http://dx.doi.org/10.1257/app.4.4.254.
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We consider the relationship between collegiate football success and non-athlete student performance. We find that the team's success significantly reduces male grades relative to female grades, and only in fall quarters, which coincides with the football season. Using survey data, we find that males are more likely than females to increase alcohol consumption, decrease studying, and increase partying in response to the success of the team. Yet, females also report that their behavior is affected by athletic success, suggesting that their performance is likely impaired but that this effect is masked by the practice of grade curving. (JEL I21, L83)
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Kommer, David. "Is it Time to Revisit Multiage Teams in the Middle Grades?" Middle School Journal 30, no. 3 (January 1999): 28–32. http://dx.doi.org/10.1080/00940771.1999.11494584.
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Godwin, John E., Cesar O. Freytes, Michael Maris, Don A. Stevens, Daanish Hoda, Bassam Mattar, Juan C. Varela, et al. "Outcomes of Treatment with the Chimeric Antigen Receptor (CAR) T Cell Therapy Lisocabtagene Maraleucel (liso-cel) in the Nonuniversity Setting: Initial Results from the Outreach Study." Blood 136, Supplement 1 (November 5, 2020): 50–52. http://dx.doi.org/10.1182/blood-2020-136640.
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Background: Currently approved CAR T cell therapies are generally administered as inpatient treatment at university medical centers due to concerns about the frequency, onset, severity, and management of AEs, including cytokine release syndrome (CRS) and neurological events (NEs). Infusion and monitoring of patients who receive CAR T cell therapy at nonuniversity medical centers and in outpatient settings have not been specifically studied. Liso-cel is an investigational, CD19-directed, defined composition, 4-1BB CAR T cell product administered at equal target doses of CD8+ and CD4+ CAR+ T cells. The liso-cel clinical program allows outpatient treatment per investigator discretion, with standardized guidelines for safety monitoring and AE management. Here we present preliminary safety and efficacy outcomes of liso-cel in relapsed/refractory (R/R) aggressive large B-cell lymphoma (LBCL) across inpatient and outpatient settings at nonuniversity medical centers in the OUTREACH study (NCT03744676). Methods: This open-label, multicenter, phase 2 study enrolled adult patients with R/R LBCL at nonuniversity medical centers, including those with university affiliations and centers naïve to CAR T cell therapy. Inclusion criteria included ECOG PS of 0-1, PET-positive disease, adequate organ function, and R/R disease after ≥2 lines of prior systemic therapy including chemoimmunotherapy. Prior autologous HSCT was permitted, but prior allogeneic HSCT was prohibited. After leukapheresis and 3 days of lymphodepleting chemotherapy, patients received liso-cel infusion at a dose of 100 × 106 CAR+ T cells. The primary endpoint was incidence of grade ≥3 CRS, NEs, prolonged cytopenias through day 29, and infections. Secondary endpoints included safety and overall response rate (ORR). All study sites had a multidisciplinary CAR T cell therapy team and standard operating procedures for toxicity monitoring/management of patients treated and/or monitored as outpatients. CRS was graded as per 2014 Lee criteria; NEs were defined as liso-cel-related investigator-assessed events and graded as per NCI CTCAE v4.03. Results: At data cutoff, 34 patients were treated with liso-cel (inpatients, n = 12; outpatients, n = 22); 5 patients were treated at non-Foundation for the Accreditation of Cellular Therapy (FACT)-accredited sites. Demographics and baseline disease characteristics were similar between inpatients and outpatients (Table); overall, median age was 66 years (range, 34-83), 68% had diffuse LBCL not otherwise specified, and 88% were refractory to last therapy. CRS was reported in 4 inpatients (33%) and 9 outpatients (41%), with no grade ≥3 events. NEs were reported in 3 inpatients (25%) and 6 outpatients (27%), with 1 grade 3 event in the outpatient group. Median (range) time to onset of CRS and NEs, respectively, was 2.5 (1-3) and 10 (5-16) days for inpatients and 6 (2-9) and 8.5 (6-13) days for outpatients. Tocilizumab and/or corticosteroid use for CRS and/or NE management was generally low (inpatients, n = 2 [17%]; outpatients, n = 5 [23%]). Overall, the most common (≥45%) treatment-emergent AEs (TEAEs) were neutropenia (76%), leukopenia (50%), and anemia (47%). Prolonged cytopenias (grade ≥3 lab values at Day 29) were reported for 7 (21%) patients. No grade 5 TEAEs were reported. Early (≤ study Day 4) and overall hospitalization in outpatients was 18% and 50%, respectively; median time to hospitalization was 5 (2-9) days and median length of stay was 6 (1-18) days. Among efficacy-evaluable patients (n = 31), ORR was 75% for inpatients and 84% for outpatients; CR rate was 50% and 68%, respectively. Of the 5 patients treated at non-FACT-accredited sites (inpatients, n = 1; outpatients, n = 4), 2 had CRS and/or NEs, but none were grade ≥3 events; none of these patients received tocilizumab or corticosteroids. Of these 5 patients, 1 achieved CR and 1 achieved PR; 2 had stable disease and 1 had progressive disease. Conclusions: Patients with R/R aggressive LBCL were successfully treated with liso-cel and monitored for CAR T cell therapy-related toxicities at nonuniversity medical centers in inpatient and outpatient settings using standard operating procedures and multidisciplinary teams. Incidences of severe CRS and NEs were low, as was tocilizumab and/or corticosteroid use. Liso-cel showed encouraging preliminary efficacy in both inpatients and outpatients. This trial is ongoing and actively recruiting. Disclosures Freytes: Sanofi: Speakers Bureau. Stevens:Amgen, MorphoSys: Consultancy. Varela:Neximmune: Consultancy, Current equity holder in private company. Cherry:Kite: Other: Ad Board; Bristol Myers Squibb: Membership on an entity's Board of Directors or advisory committees, Other: Ad Board; Epizyme: Other: Ad Board . Essell:Kite: Speakers Bureau; Bristol Myers Squibb: Speakers Bureau. Courtright:AbbVie: Other: Investigator in AbbVie-sponsored clinical trials.. Fanning:Takeda: Consultancy, Speakers Bureau; Abbvie: Consultancy; Sanofi Aventis: Speakers Bureau; TG Therapeautics: Consultancy; Bristol Myers Squibb: Consultancy, Speakers Bureau; Prisma Health: Current Employment. Yimer:Sanofi: Speakers Bureau; AstraZeneca: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: TRAVEL, ACCOMMODATIONS, EXPENSES (paid by any for-profit health care company), Speakers Bureau; Janssen: Other: TRAVEL, ACCOMMODATIONS, EXPENSES (paid by any for-profit health care company), Research Funding, Speakers Bureau; BeiGene: Other: TRAVEL, ACCOMODATIONS, EXPENSES (paid by any for-profit health care company), Research Funding, Speakers Bureau; Epizyme: Consultancy, Divested equity in a private or publicly-traded company in the past 24 months; Karyopharm: Consultancy, Divested equity in a private or publicly-traded company in the past 24 months, Membership on an entity's Board of Directors or advisory committees, Other: TRAVEL, ACCOMMODATIONS, EXPENSES (paid by any for-profit health care company), Speakers Bureau; Amgen: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: TRAVEL, ACCOMMODATIONS, EXPENSES (paid by any for-profit health care company), Speakers Bureau; Celgene, a Bristol-Myers Squibb Company: Consultancy, Membership on an entity's Board of Directors or advisory committees; Takeda: Speakers Bureau; TG Therapeutics: Consultancy; Texas Oncology: Current Employment. Trede:Juno Therapeutics, a Bristol-Myers Squibb Company: Current Employment; Bristol-Myers Squibb Company: Current equity holder in publicly-traded company. Youssef:Bristol-Myers Squibb Company: Current Employment, Current equity holder in publicly-traded company. Lymp:Juno Therapeutics, a Bristol-Myers Squibb Company: Current Employment; Bristol-Myers Squibb Company: Current equity holder in publicly-traded company. Bachier:Juno Therapeutics, a Bristol-Myers Squibb Company: Honoraria; CRISPR: Honoraria; AlloVir: Honoraria; Sanofi: Speakers Bureau.
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Bloomfield, David J., Amy Arbon, Jane Cox, Berkin Hack, Julia Hall, Catherine Harper-Wynne, Sebastian Hinde, et al. "Patient/oncologist decisions about adjuvant chemotherapy in ER+ve, HER2-ve early breast cancer following endopredict testing." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e12002-e12002. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e12002.
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e12002 Background: Endopredict is a multigene test including tumor size and nodal status; it predicts low or high risk of distant recurrence in patients (pts) with ER+ve, HER2–ve breast cancer treated with adjuvant endocrine therapy alone. We compared adj chemotherapy decisions pre and post Endopredict test results, pts’ anxiety, decisional conflict and oncologists’ (oncs) confidence about decisions made. Methods: 14 oncs in 8 UK hospitals saw 149 pts judged by clinical teams to have equivocal indications for chemotherapy. Pts and oncs discussed provisional treatment decisions based on conventional prognostic factors. Initial decisions were reconsidered when Endopredict results were available. Pre and post-test pts completed Spielberger’s State/Trait Anxiety inventory (STAI) and a decision conflict scale (DCS). Oncs answered questionnaires probing:- basic demographic,/clinical details, agreement with, and confidence about treatment decisions (endocrine (E) therapy +/- chemotherapy(C)) Results: 66.7% pts with an initial E alone decision and a high risk result upgraded to E+C. 9.4% pts with initial E+C decisions and high risk results down-graded to E. None of 46 pts initially favouring E alone who were low risk changed decisions. 82.8% who initially wanted E+C and had low risk scores downgraded to E alone. Endopredict results increased oncs’ confidence (8% ‘strongly agreed’ pre-test, 50% post-test). Oncs neither agreeing nor disagreeing with decisions fell (24% to 5%). Anxiety was stable in pts with unchanged decisions. Pts whose therapy was downgraded had significantly lower anxiety scores (p<0.01); those whose treatment was upgraded had increased scores (p<0.001). Likewise overall uncertainty on DCS fell post-test (p<0.023) Conclusions: Endopredict results increased oncs’ and pts’ decision-making confidence, improved matching of risk with therapy decisions and thus a potential for improved outcomes. Clinical trial information: ISRCTN69220108. [Table: see text]
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Levinson, Edward M., Melanee Vogt, William F. Barker, Mary Renck Jalongo, and Pat Van Zandt. "Effects of Reading with Adult Tutor/Therapy Dog Teams on Elementary Students’ Reading Achievement and Attitudes." Society & Animals 25, no. 1 (April 18, 2017): 38–56. http://dx.doi.org/10.1163/15685306-12341427.
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This study assessed the effect of reading aloud to handler/therapy dog teams on children’s oral reading fluency using a post-test control group design with repeated measures. Forty-five children in grades 2-5 were assigned to one of two groups using a stratified random assignment designed to equate groups based on grade and sex. Both groups read aloud for 30 minutes per week for 5 weeks; Group One read with a handler/therapy dog and Group Two read to peers. After 5 weeks, the groups were reversed. Between-group and within-group differences were analyzed. Several statistically significant and large effect sizes were found. Findings generally suggested that reading aloud to an adult/therapy dog team tended to increase children’s scores on a test of oral reading fluency much more than reading aloud to peers. No significant effects were identified on a survey of general attitudes toward reading administered to the children.
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KARAKOC ALATLI, Betul, Cansu AYAN, Betul POLATDEMIR, and Gulcin UZUN. "Examination of the TIMSS 2011 Fourth Grade Mathematics Test in Terms of Cross-Cultural Measurement Invariance." Eurasian Journal of Educational Research 16, no. 66 (January 3, 2017): 1–30. http://dx.doi.org/10.14689/ejer.2016.66.22.
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James, OP, CR Bowman, J. Parker, O. Luton, DBT Robinson, L. Hopkins, AGMT Powell, RJ Egan, and WG Lewis. "Teams, performance and trust: a perspective from the vanguard." Bulletin of the Royal College of Surgeons of England 103, no. 4 (June 2021): 186–91. http://dx.doi.org/10.1308/rcsbull.2021.73.
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Introduction The aim of this study was to determine surgical trainees’ perspectives on team environment, function, performance and trust. Methods A 44-point anonymous survey was distributed to all doctors working in surgery in a single UK statutory education body. Responses were received from 116 doctors (17 foundation year 1 [F1] doctors, 50 senior house officers [SHOs], 49 specialist registrars [SpRs]). Results Psychological safety was associated with trainee grade, with SHOs showing the lowest results relating to perception of support (F1 88%, SHO 60%, SpR 82%, p=0.016) and ability to ask for help (F1 100%, SHO 71%, SpR 92%, p=0.043). Dependability among colleagues was perceived to be poorer by women than by men (70% vs 88%, p=0.009). Clarity of team structure was associated with grade and perceived to be poor by SHOs (F1 94%, SHO 60%, SpR 78%, p=0.014). Meaningfulness and impact of team achievement was also associated with grade (F1 77%, SHO 69%, SpR 94%, p=0.005). Inverse correlations were observed between the prevalence of harassment/bullying and markers of psychological safety (rs=-0.382, p<0.001), dependability (rs=-0.270, p=0.003) and clarity of team structure (rs=0.355, p<0.001). Conclusions Important deficiencies in psychological safety had an adverse effect on two in five SHOs. Countermeasures (enhanced stress resilience training) are needed to protect morale, patient safety and clinical out
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Lieber, Bryan A., Geoffrey Appelboom, Blake E. S. Taylor, Hani Malone, Nitin Agarwal, and E. Sander Connolly. "Assessment of the “July Effect”: outcomes after early resident transition in adult neurosurgery." Journal of Neurosurgery 125, no. 1 (July 2016): 213–21. http://dx.doi.org/10.3171/2015.4.jns142149.
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OBJECT Each July, 4th-year medical students become 1st-year resident physicians and have much greater responsibility in making management decisions. In addition, incumbent residents and fellows advance to their next postgraduate year and face greater challenges. It has been suggested that among patients who have resident physicians as members of their neurosurgical team, this transition may be associated with increased rates of morbidity and mortality, a phenomenon known as the “July Effect.” In this study, the authors compared morbidity and mortality rates between the initial and later months of the academic year to determine whether there is truly a July Effect that has an impact on this patient population. METHODS The authors compared 30-day postoperative outcomes of neurosurgery performed by surgical teams that included resident physicians in training during the first academic quarter (Q1, July through September) with outcomes of neurosurgery performed with resident participation during the final academic quarter (Q4, April through June), using 2006–2012 data from the prospectively collected American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. Regression analyses were performed on outcome data that included mortality, surgical complications, and medical complications, which were graded as mild or severe. To determine whether a July Effect was present in subgroups, secondary analyses were performed to analyze the association of outcomes with each major neurosurgical subspecialty, the postgraduate year of the operating resident, and the academic quarter during which the surgery was performed. To control for possible seasonal trends in certain diseases, the authors compared patient outcomes at academic medical centers to those at community-based hospitals, where procedures were not performed by residents. In addition, the efficiency of academic centers was compared to that of community centers in terms of operative duration and total length of hospital stay. RESULTS Overall, there were no statistically significant differences in mortality, morbidity, or efficiency between the earlier and later quarters of the academic year, a finding that also held true among neurosurgical subspecialties and among postgraduate levels of training. There was, however, a slight increase in intraoperative transfusions associated with the transitional period in July (6.41% of procedures in Q4 compared to 7.99% in Q1 of the prior calendar year; p = 0.0005), which primarily occurred in cases involving junior (2nd- to 4th-year) residents. In addition, there was an increased rate of reoperation (1.73% in Q4 to 2.19% in Q1; p < 0.0001) observed mainly among senior (5th- to 7th-year) residents in the early academic months and not paralleled in our community cohort. CONCLUSIONS There is minimal evidence for a significant July Effect in adult neurosurgery. Our results suggest that, overall, the current resident training system provides enough guidance and support during this challenging transition period.
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Paya, Noemi Serra, Assumpta Ensenyat, Jordi Gatius Real, and Alfonso Blanco. "Energy Expenditure in Low Active Overweight and Obese Children at Varying Treadmill Grades." Pediatric Exercise Science 27, no. 1 (February 2015): 57–66. http://dx.doi.org/10.1123/pes.2013-0111.
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This study aimed to evaluate differences between low active overweight and obese children in terms of energy expenditure (EE), ventilation (VE), and cardiac response during graded submaximal treadmill testing at constant speed.Methods:We categorized 20 children into two weight groups according to the International Obesity Task Force criteria: overweight (n = 10; age = 9.7 ±1.34 years) and obese (n = 10; age = 10.4 ± 1.4 years). Children performed treadmill testing at a constant speed (1.53 ms1) and increasing grade (0%, 4%, and 8%). every 3 min.Results:The EE across all grades was significantly higher (p < .001) in obese than in overweight children. Differences at each grade disappeared when EE was adjusted by body mass; however, several differences remained when the EE was adjusted by fat-free mass or body surface area. The increase in EE with increasing grade was greater in obese children (effect size between 0% and 8% for EE was 1.17). BMI z-score and fat mass (kg) were the main predictors of EE (Kcal·min1) and contributed to explaining 66%, 70%, and 83.4% of the variance in EE at 0%, 4% and 8% gradients respectively.Conclusion:We suggest that when assessing EE response to exercise, the degree of obesity should be taken into consideration.
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Afiah, Yayah. "MENINGKATKAN HASIL BELAJAR DENGAN MODEL PEMBELAJARAN TEAMS GAMES TOURNAMENTS." Perspektif Ilmu Pendidikan 26, no. XVII (October 31, 2012): 103–7. http://dx.doi.org/10.21009/pip.262.2.
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The Grade X-7 students’ understanding of writing argumentative paragraph is still low as the students do not listen to the teacher’s explaination attentively, do not care the use of correct spelling, diction, effective sentence, paragraph coherence, and integerated passage. To overcome these problems, the researcher performed classroom action research aiming at imroving the students’ competence in writing argumentative paragraph. The research was conducted in Grade X-7 of State High School, No. 7, in Jakarta as from January through February 2012 employing Teams Games Tournaments (TGT) Model. After the second cycle of the research, the students’ learning achievement indicated the average of 72 with the learning mastery of 75 % showing the significant improvement. It was concluded that TGT Model can be used to improve the students’ learning achievement in argumentative paragraph writing. Besides, the research recommended a set of steps how to use the model.
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Aivaloglou, Efthimia, and Anna van der Meulen. "An Empirical Study of Students’ Perceptions on the Setup and Grading of Group Programming Assignments." ACM Transactions on Computing Education 21, no. 3 (March 2021): 1–22. http://dx.doi.org/10.1145/3440994.
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Courses in computer science curricula often involve group programming assignments. Instructors are required to take several decisions on assignment setup and monitoring, team formation policies, and grading systems. Group programming projects provide unique monitoring opportunities due to the availability of both product and process data, as well as challenges in team composition, with students of varying levels of prior programming experience. To gain insights into the experiences and perceptions of students about the assignment setup and grading policies in group programming projects, we interviewed 20 computer science students from four universities. The thematic analysis highlighted factors in group composition that are considered important, as well as advantages and disadvantages of the self-selection of the teams. It also indicated three grading strategies experienced by the students, namely, being assigned the same group grade, individual grades distributed by the instructor, and grade distribution determined by the team, with perceptions about them varying greatly. Several practices for monitoring team contributions were identified. Checking the source code repositories was considered useful in recognizing slacking members, but automated metrics are not always representative of the work distribution. The analysis also uncovered student perceptions on the grading factors for programming assignments, including coding efficiency and skill.
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Root, Hayley J., Eleanor M. Beltz, and Lindsay J. DiStefano. "INFLUENCE OF A PRE-SEASON COACHES’ EDUCATION WORKSHOP STRATEGY ON ATHLETE INJURY RISK ASSESSMENT." Orthopaedic Journal of Sports Medicine 7, no. 3_suppl (March 1, 2019): 2325967119S0002. http://dx.doi.org/10.1177/2325967119s00027.
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Background: Evidence-based preventive training programs (PTPs) used as a pre-participation warm-up for sport have been shown to reduce injury risk in youth athletes; however, injury risk improvements depend on PTP dosage and fidelity, where increased levels of PTP compliance facilitate and sustain greater reductions in injury risk. While coaches represent the best option to facilitate PTPs long term, it is unknown how to best train coaches to ensure effective PTP implementation behavior. In other areas of health behavior research, education strategies tailored specifically to an individual’s needs and interests increase the likelihood of adopting a given behavior. To encourage youth sport coaches to implement PTPs, it may be beneficial to tailor workshops. One way to gauge the impact of an education strategy is to look at end-user outcomes. Therefore, the purpose of this study was to evaluate changes in athlete injury risk, as measured by the Landing Error Scoring System (LESS), between adolescent basketball and soccer athletes whose coach attended a General pre-season education workshop on PTP implementation compared to a Tailored pre-season education workshop. Methods: A cluster randomized control trial was utilized. Youth soccer and basketball organizations were contacted to participate in a pre-season coaches’ education workshop on PTP implementation. Organizations were randomized into either a General or Tailored workshop. All participating coaches within a given organization attended the same workshop. General workshops contained standardized content including: youth sport injury epidemiology, injury rate and risk reduction benefits of PTPs, and hands-on instruction on how to implement a PTP. Coaches in Tailored workshops completed pre-workshop surveys. The pre-workshop survey contained Likert-style questions on knowledge of and experience with implementing PTPs. Researchers used the results to prioritize and inform content emphasis within the Tailored workshop. For example, if an organization had a high frequency of coaches who reported that they were particularly interested in the sport performance benefits of PTPs, the research team would devote increased time to discussing that particular component. Both the General and Tailored workshop were approximately 1-hour in length but varied in the amount of time spent on different topic areas. Athletes completed a PRE and POST season baseline assessment of injury risk. The injury risk assessment included three trials of a jump-landing task that was evaluated using the Landing Error Scoring System (LESS). The LESS is a valid and reliable clinical movement assessment used to identify high-risk movement patterns during a jump-landing task. LESS scores are based on observable errors, where a higher score indicates a greater number of movement errors and an increased risk of sustaining a lower extremity injury. To complete the task, participants jumped off a 30-cm high box to a distance half of their height and immediately rebounded straight in the air for maximum vertical height. A single, reliable rater graded all trials for PRE and POST. All three trials were averaged together for one composite LESS score at each time point. A mixed model analysis of variance (ANOVA) was used to evaluate differences in composite LESS score over time (PRE, POST) between educational workshops (General, Tailored). All data were analyzed using SPSS Version 21.0 with an a priori alpha level of p<0.05. Results: Seventy-seven athletes on 9 teams across 6 different organizations (Coaches’ Workshops: General=5 teams from 4 organizations; Tailored=4 teams from 2 organizations) completed both PRE and POST testing sessions. There were no significant differences between workshop (General, Tailored) and LESS scores at POST (P>0.05). Regardless of workshop LESS scores improved over time ((Mean±SD [95%CI]) Generalized PRE: 5.46±0.10 [4.84, 6.08], Generalized POST: 4.62±0.10 [4.00, 5.25], Tailored PRE: 5.99±0.09[5.40, 6.59], Tailored POST: 5.66±0.09[5.06, 6.25])(P=0.03). Conclusions: Regardless of coaches’ educational workshop strategy, athletes improved movement technique from PRE to POST across a single sport season. These findings suggest that any level of exposure to PTP-related content could have beneficial downstream effects for the end user, or in this case reduced injury risk for youth athletes. Future studies should look to evaluate the content of pre-season coach education workshops in conjunction with tracking fidelity of program delivery in order to optimize efforts to disseminate and implement PTPs for youth sport coaches. [Figure: see text]
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Wang, Jing, Xiaohua Wu, Jianqing Zhu, Rutie Yin, Jiaxin Yang, Qidan Huang, Lingying Wu, et al. "Safety assessment of niraparib individualized starting dose in patients with platinum-sensitive recurrent ovarian cancer: A randomized, double-blind, placebo-controlled, phase III NORA trial." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): 5535. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.5535.
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5535 Background: To present the safety profile of niraparib maintenance therapy in patients with platinum-sensitive recurrent ovarian cancer (PSROC) included in the NORA trial. Methods: The double-blind, randomized, placebo-controlled, multicenter, phase III NORA trial (NCT03705156) included adult (≥18 years) Chinese women with PSROC who received ≥2 prior lines of platinum-based chemotherapy. Post ≤8 weeks of the last chemotherapy, patients were randomized (2:1) to receive oral niraparib (300 mg/day or 200 mg/day for patients with bodyweight <77 kg or platelet count <150 × 103/µL) or matched placebo. The primary endpoint was progression free survival, reported previously. Safety was assessed in terms of treatment emergent adverse events (TEAEs) related to hematologic toxicity (anemia/platelet count decreased and neutrophil count decreased) and non-hematologic toxicity (nausea/vomiting/constipation/insomnia/palpitations/hypertension). Adverse events (AEs) were graded using the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) v4.03. The data cutoff was February 1, 2020. Results: Of 265 patients included, the first 16 patients were given oral niraparib or matched placebo at a fixed starting dose of 300mg while 249 patients received individualized starting dose of niraparib (n = 166) or matched placebo (n = 83) based on baseline bodyweight and platelet count. The incidence of any TEAEs and grade ≥3 TEAEs was 100% and 50.8%, respectively in niraparib group, while 95.5% and 19.3%, respectively in placebo. Incidence of all grades of hematologic toxicity, gastrointestinal adverse events (nausea, constipation and vomiting), insomnia, palpitation and hypertension were highest in the first month after treatment with a gradual decrease in the further months. The median time to onset of grade ≥3 anemia, decreased neutrophil count and decreased platelet count were 87, 28, and 22 days, respectively, in the niraparib group. In niraparib group, any TEAEs that lead to dose reduction was observed in 59.9% of patients. Only 2 (1.1%) patients discontinued the treatment due to platelet count decreased and no patients discontinued niraparib treatment due to anemia or neutrophil count decreased. Overall, only 4% of patients in the niraparib group and 5.7% in the placebo group discontinued the treatment due to TEAEs. Conclusions: The lower incidence of TEAEs and the discontinuation rates indicate improved safety profile of niraparib with individualized starting dose in PSROC. Clinical trial information: NCT03705156.
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Kong, Bong Young, Minjoon Cho, Hwa Ryeong Lee, Young Eun Choi, and Sae Hoon Kim. "Structural Evolution of Nonoperatively Treated High-Grade Partial-Thickness Tears of the Supraspinatus Tendon." American Journal of Sports Medicine 46, no. 1 (September 26, 2017): 79–86. http://dx.doi.org/10.1177/0363546517729164.
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Background: High-grade partial-thickness rotator cuff tears (hPTRCTs) are frequently encountered in the shoulder. However, little information is available on the prevalence or timing of tear progression. Purpose/Hypothesis: The purpose was to prospectively evaluate the structural progression of hPTRCTs with a minimum follow-up of 1 year using magnetic resonance imaging (MRI). The hypothesis was that a substantial portion of hPTRCT patients would experience tear progression or evolution to a full-thickness rotator cuff tear. Study Design: Case series; Level of evidence, 4. Methods: Between May 2010 and December 2015, 362 patients were diagnosed with hPTRCT (tear involvement >50% of the mediolateral length of the footprint) of the supraspinatus and were treated nonoperatively. Among these patients, 81 underwent follow-up MRI at least 1 year after initial presentation, and these patients were included in the final analysis. Initial and follow-up MRIs were used to determine whether tears had improved, had not changed, or had progressed. A change in tear involvement of >20% was defined as a significant change. Patients were categorized as follows: (1) a decrease in tear involvement of >20% (improved), (2) an increase or decrease of ≤20% (no change), or (3) an increase in tear involvement of >20% (progressed). Demographic data and morphologic data were analyzed to identify variables related to tear progression. Among them, severity of tendinosis was graded using MRIs: grade 1 (mild tendinosis), mild focal increase in tendon signal; grade 2 (moderate tendinosis), moderate focal increase in tendon signal; and grade 3 (marked tendinosis), marked generalized increase in tendon signal. Results: At initial diagnosis, 23 were articular-side (28%) and 58 were bursal-side (72%) hPTRCTs. The study cohort was composed of 51 women and 30 men, and the mean patient age was 62.3 years (range, 41-77 years). Follow-up MRI was performed at a mean 19.9 ± 10.9 months (range, 12-52 months). A significant change in tear involvement was observed at follow-up. In 13 patients (16%, 2 articular-side and 11 bursal-side tears), tears were classified as progressed (the progressed group); in 48 patients (59%), tears exhibited no change (the unchanged group); and in 20 patients (25%, 9 articular-side and 11 bursal-side tears), tears were improved (the improved group). Univariate analysis showed initial tendinosis grade was significantly different in the 3 groups (grade 1, 2, and 3: 5, 4, and 4 in progressed; 36, 11, and 1 in unchanged; 10, 8, and 2 in improved group, respectively, P = .007). Conclusion: Although progression of hPTRCT in the long term is uncertain, after 1-year follow-up with MRI, tears progressed in 16% of the tears in this study. Furthermore, some tears were healed or reduced in size, which indicates that decisions to undertake surgical repair at time of presentation may be excessive.
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Setiyawati, Heni Rina. "Peningkatan Minat dan Prestasi Belajar IPS teams Achievement Divisions Di SMP." Jurnal VARIDIKA 27, no. 2 (May 24, 2016): 200–207. http://dx.doi.org/10.23917/varidika.v27i2.1733.
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This aimed of the researceh is to descript: (1) The implementation of cooperative learning model STAD in IPS learning can improve learning increase of the students in grade VII B SMP Negeri 1 Kedawung on the second semester of academic year 2014/2015, (2) The implementation of cooperative learning model STAD in IPS learning can improve learning Achievement of student in grade VII B SMP Negeri 1 Kedawung on the second semester of academic year 2014/2015. This research use classroom action research method. Subjects of this research are the students of grade VII B SMP Negeri 1 Kedawung Sragen. Data collection technique in this research are interviews, tests, observations, and questionnaires. Mechanical checks the validity of the data by the method triangulation techniques. Technical analysis has done by means of data collection, data reduction, data presentation, and drawing conclusions. The process of research carried out three cycles, in each cycle includes four stages of action planning, action, observation and reflection. The results showed that: (1) The implementation of cooperative learning model STAD in IPS learning can improve learning increase student of the students in grade VII B SMP Negeri 1 Kedawung on the second semester of academic year 2014/2015, (2) The implementation of cooperative learning model STAD in IPS learning can improve learning Achievement of the students in grade VII B SMP Negeri 1 Kedawung on the second semester of academic year 2014/2015. The increase students learning interest can be seen from the results of student interest questionnaire after implementation of the action, in the first cycle reaches 50%, the second cycle increased to 68.75%, and the third cycle increased to 87.50 %. While student achievement on initial conditions shows that the average value of 68.28 with classsical completeness of 53.12%, after the action on the first cycle increased the average value becomes 74.53 with classical completeness of 65.62%, second cycle increased with an average value of 76.56 with classical completeness of 78%, and the third cycle has increased again, with an average value of 81.56 reached with classical completeness reached 87.5
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Lamichhane, Somraj, Sujata Panta, and Devendra Acharya. "The Functional outcome following anterior cervical discectomy and fusion for single level cervical degenerative disc disease: a prospective single institutional study." Nepal Journal of Neuroscience 17, no. 2 (July 20, 2020): 42–47. http://dx.doi.org/10.3126/njn.v17i2.30164.
Full textAbstract:
Introduction: Cervical degenerative disc diseases leading to cervical spondylotic myelopathy (CSM) is one the most common cause of disability in elderly population that progresses with age with continuation of degree of degeneration.
Objective: To assess the functional outcome following ACDF in single-level cervical degenerative disc disease in terms of improvement in the mJOA scoring system and postoperative complications.
Materials and methods: Eighteen patients with single level cervical degenerative disc diseases who presented at the college of medical sciences from May 2018 to October 2019 fulfilling the inclusion criteria (single-level cervical degenerative disc disease with age between 40 to 70 years with progressive neurological deficits, features of cervical spondylotic myelopathy and patients with mild grade who failed four weeks of conservative treatment and progressed to moderate or severe grades) were included in the study. All patients underwent Anterior Cervical Discectomy and Fusion (ACDF); with tricortical iliac crest graft with cervical plate and screws in 13 patients and polyether ether ketone (PEEK) cage placement in five patients. Patients were assessed using mJOA scoring system and graded into mild, moderate and severe myelopathy. Post-operatively patients were assessed for improvement in terms of mJOA scores at four weeks and three months follow-up. They were also assessed for development of any post-operative complications and documented accordingly. Statistical analysis was done using the Statistical Package for the Social Sciences version 20 software.
Results: Out of 18 patients, at the time of presentation 12 were in moderate grade and six were in severe grade. During subsequent follow up at four weeks and three months, patients showed progressive improvement. 15 patients improved to mild grade while two remained in moderate grade and one in severe grade during three months postoperative assessment. One patient each developed dysphagia, hoarseness and superficial wound infection that were managed conservatively.
Conclusion: Anterior cervical discectomy and fusion is one of the effective and safe treatments for single-level degenerative cervical disc disease associated with cervical spondylotic myelopathy with minimal complications.