Multisource feedback to assess pediatric practice: a systematic review

Introduction: The assessment and maintenance of competence for pediatricians has recently received increased attention. The aim of the present study was to investigate further the use of multisource feedback for assessing pediatricians in practice. Methods: A systematic literature review was conducted using the electronic databases EMBASE, PsycINFO, MEDLINE, PUBMED, and CINAHL for English-language articles. Results: 762 articles were identified with the initial search and 756 articles were excluded for a total of six studies that met the inclusion criteria for this systematic review. Internal consistency reliability was reported in five studies with α > 0.95 for both subscales and full scales. Generalizability was also reported in two studies with Ep2 generally > 0.78. These adequate Ep2 coefficients were achieved with different numbers of raters. Evidence for content, criterion-related (e.g., Pearson’s r) and construct validity (e.g., principal component factor analysis) was reported in all 6 studies. Conclusion: Multisource feedback is a feasible, reliable, and valid method to assess pediatricians in practice. The results indicate that multisource feedback system can be used to assess key competencies such as communication skills, interpersonal skills, collegiality, and medical expertise. Further implementation of multisource feedback is desirable

Question mark ear deformity: a case study and surgical technique

Clefts of the ear are rare and typically develop within the earlobe. They were first described by Vincent et al. in association with urogenital anomalies. Subsequently, Cosman reported them in 1970, referring to the condition as “question mark ear,” which led to its naming. This deformity is infrequently reported and is not well-documented in the literature. In this paper, we present the first reported case in the Omani population of bilateral Cosman ear, associated with a mild cranial deformity. We also discuss the social impact of this condition and introduce our corrective technique for moderate forms of deformity

Cranioplasty in Oman: Retrospective review of cases from the National Craniofacial Center 2012–2022

Objectives: Cranioplasty is a complex craniofacial and neurosurgical procedure that aims to reinstate the architecture of the cranial vault and elevate both its aesthetic and neurological function. Several reconstructive materials have been thoroughly explored in the search for the optimal solution for cranioplasty. This study aimed to evaluate different material used for cranial reconstruction in Oman. Methods: This retrospective study included all patients who had had cranioplasty procedures performed at Khoula Hospital, Muscat, Oman, from 2012 to 2022. Demographic information, the characteristics of the cranial defect and any complications that occurred post-operatively were analysed. Results: A total of 47 patients were included in this study. The most common cause of cranial defects was craniectomy following traumatic head injury (70.2%) along with excision of fibrous dysplasia (10.6%). The most frequently utilised material for cranial repair was autologous bone grafts (n = 28), followed by polyetheretherketone (PEEK; n = 14). Interestingly, the replacement of bone grafts from previous craniectomy showed a notably high resorption rate (71.4%), in contrast to split calvarial grafts (0%) and other types of bone grafts (14.3%). Additionally, delayed graft infection was observed in 3.6% of the bone graft group and 7.1% of the PEEK group. Conclusion: Patient-specific alloplastic implants such as PEEK have gained popularity for large and complex cranioplasty, as they provide excellent aesthetic outcomes and leave no donor site morbidity. In contrast, bone grafts remain the gold standard for small to medium-sized cranial defects. Keywords: Bone Grafting; PEEK; Oman

Validation of Multisource Feedback in Assessing Medical Performance: A Systematic Review

Introduction Over the past ten years, a number of systematic reviews have evaluated the validity of multisource feedback (MSF) to assess and quality assure medical practice. The purpose of this study is to synthesise the results from existing reviews to provide a holistic overview of the validity evidence. Methods This review identified eight systematic reviews evaluating the validity of MSF published between January 2006 and October 2016. Using a standardised data extraction form, two independent reviewers extracted study characteristics. A framework of validation developed by the American Psychological Association (APA) was used to appraise the validity evidence within each systematic review. Results In terms of validity evidence, each of the eight reviews demonstrated evidence across at least one domain of the APA validity framework. Evidence of assessment validity within the domains of ‘internal structure’ and ‘relationship to other variables’ has been well established. However, the domains of content validity (i.e. ensuring MSF tools measure what they are intended to measure); consequential validity (i.e. evidence of the intended or unintended consequences MSF assessments may have on participants or wider society) and response process validity (i.e. the process of standardisation and quality control in the delivery and completion of assessments) remain limited. Discussion Evidence for the validity of MSF has, across a number of domains, been well-established. However, the size and quality of the existing evidence remains variable. In order to determine the extent to which MSF is considered a valid instrument to assess medical performance, future research is required to determine: 1) how best to design and deliver MSF assessments that address the identified limitations of existing tools, and 2) how to ensure involvement within MSF supports positive changes in practice. Such research is integral if MSF is to continue to inform medical performance and subsequent improvements in the quality and safety of patient care

Oman and the Islamic caliphate 11-447/632-1055 : the military struggle

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Model Based Development of Torque Control Drive for Induction Motors for Micro Electric Vehicles

Electric vehicles are attaining significant attention recently and the current legislation is forcing the automotive industry to electrify the productions. Regardless of electric energy accumulation technology, drive technology is one of the vital components of EVs. The motor drive technology has been mainly developed based on the application which required position/velocity control. In automotive application, however, torque control is an important aspect since the drivers have already used to drive the vehicle based on torque control approach in traditional powertrain system. In this article, a model-based approach is employed to develop a controller which can guarantee the precise control of the induction motors torque for a micro electric vehicle (EV) application regardless of operating conditions. The implementation of the control drive was conducted in MATLAB/Simulink environment, followed by Model In the Loop simulation and testing at various test conditions to confirm the robustness of the developed drive. Direct Torque Control (DTC) with optimum voltage vector selection method is employed to control the motor torque that requires fewer power electronics to process its operation and hence lowers the cost of implementation. The result shows the practicality of the designed control system and its ability to track reference torque commands. Vitally, the controlled approach shows fair abilities to control IMs to produce torque at both the motoring and regenerative modes which is a highly important requirement in electrical propulsion powertrains. Furthermore, the controller’s response time was within the industrial standard range which confirms its suitability for industrial implementation at low cost

The association between dental and periodontal diseases and sickle cell disease. A pilot case-control study

Objective: This is a pilot case-control study conducted to investigate the prevalence of dental caries and periodontal disease and examine the possible association between oral health deterioration and SCD severity in a sample of Saudi SCD patients residing in the city of Al-Qatif, Eastern Province, Saudi Arabia. Materials and methods: Dental examination to determine the Decayed, Missing and Filled Teeth index (DMFT), Community Periodontal Index (CPI), and plaque index system were recorded for 33 SCD patients and 33 age and sex-matched controls in the Al-Qatif Central Hospital, Qatif, Saudi Arabia. Self-administered surveys used to assess socio-economic status; oral health behaviors for both SCD patients and controls were recorded. In addition, the disease severity index was established for all patients with SCD. SPSS data analysis software package version 18.0 was used for statistical analysis. Numerical variables were described as mean with a standard deviation. Results: Decayed teeth were significantly more in individuals with ages ranging from 18 to 38 years with SCD compared to the control group (p = 0.036) due to oral hygiene negligence. The mean number of filled teeth was significantly lower in individuals with SCD when compared to the control group (p = 0.015) due to the lack of appropriate and timely treatment reflected in the survey responses of SCD patients as 15.2% only taking oral care during hospitalization. There were differences between the cases and controls in the known caries risk factors such as income level, flossing, and brushing habit. The DMFT, CPI, and plaque index systems did not differ significantly between the SCD patients and the control group. Conclusion: Data suggest that patients with SCD have increased susceptibility to dental caries, with a higher prevalence of tooth decay and lower prevalence of filled teeth. Known caries risk factors influenced oral health more markedly than did factors related to SCD. Keywords: Sickle cell disease, Dental caries, Periodonta

Synthesis and Characterization of Fe-TiO₂ Nanomaterial: Performance Evaluation for RB5 Decolorization and In Vitro Antibacterial Studies

A photocatalytic system for decolorization of double azo reactive black 5 (RB5) dye and water disinfection of E. coli was developed. Sol gel method was employed for the synthesis of Fe-TiO2 photocatalysts and were characterized using thermogravimetric analysis (TGA), Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), scanning electron microscopy (SEM) coupled with energy dispersive X-ray analysis (EDX), transmission electron microscopy (TEM), diffuse reflectance spectroscopy (DRS) and Brunauer–Emmett–Teller (BET) analysis. Results showed that photocatalytic efficiency was greatly influenced by 0.1 weight percent iron loading and 300 °C calcination temperature. The optimized reaction parameters were found to be the ambient temperature, working solution pH 6.2 and 1 mg g−1 dose to completely decolorize RB5. The isotherm studies showed that RB5 adsorption by Fe-TiO2 followed the Langmuir isotherm with maximum adsorption capacity of 42.7 mg g−1 and Kads 0.0079 L mg−1. Under illumination, the modified photocatalytic material had higher decolorization efficiency as compared to unmodified photocatalyst. Kinetic studies of the modified material under visible light irradiation indicated the reaction followed the pseudo-first-order kinetics. The illumination reaction followed the Langmuir-Hinshelwood (L-H) model as the rate of dye decolorization increased with an incremental increase in dye concentration. The L-H constant Kc was 1.5542 mg L–1∙h–1 while Kads was found 0.1317 L mg–1. The best photocatalyst showed prominent percent reduction of E. coli in 120 min. Finally, 0.1Fe-TiO2-300 could be an efficient photocatalyst and can provide a composite solution for RB5 decolorization and bacterial strain inhibition

HIV viral suppression in Oman: Encouraging progress toward achieving the United Nations ‘third 90’

Objective: To assess the impact of capacity-building interventions introduced by the Oman National AIDS Programme on the quality of HIV care in the country. Methods: HIV viral load (VL) suppression and loss to follow-up (LTFU) rates were calculated for the period before (in December 2015; n = 1098) and after (in June 2017; n = 1185) the introduction of the interventions: training, support, and care pathway development. Three HIV VL cuts-offs at last measurement in the year of interest were used to define VL suppression. Results: In the intention-to-treat (ITT) analysis, rates of VL <200 copies/ml and <1000 copies/ml increased from 51.9% in 2015 to 65.5% in 2017 (relative risk (RR) 1.26, 95% confidence interval (CI) 1.17–1.36) and from 58.1% in 2015 to 70.9% in 2017 (RR 1.22, 95% CI 1.14–1.30), respectively; p < 0.0001 for both. Similarly, in the on-treatment analysis, rates of VL <200 copies/ml and <1000 copies/ml increased from 64.2% in 2015 to 76.9% in 2017 (RR 1.20, 95% CI 1.12–1.28) and from 71.9% in 2015 to 83.2% in 2017 (RR 1.16, 95% CI 1.10–1.22), respectively. Fewer patients were LTFU in 2017 than in 2015 (14.7% (157/1061) vs. 19.2% (188/981); RR 0.77, 95% CI 0.64–0.94). Conclusions: Achieving the UNAIDS target of 90% of HIV patients on treatment having VL suppression by 2020 is feasible in Oman