An appraisal of students' awareness of "self-reflection" in a first-year pathology course of undergraduate medical/dental education

<p>Abstract</p> <p>Background</p> <p>Self-reflection and reflective practice are increasingly considered as essential attributes of competent professionals functioning in complex and ever-changing healthcare systems of the 21^stcentury. The aim of this study was to determine the extent of students' awareness and understanding of the reflective process and the meaning of 'self-reflection' within the contextual framework of their learning environment in the first-year of their medical/dental education. We endorse that the introduction of such explicit educational tasks at this early stage enhances and promotes students' awareness, understanding, and proficiency of this skill in their continuing life-long health professional learning.</p> <p>Methods</p> <p>Over two years, students registered in first-year pathology at the University of Saskatchewan were introduced to a self-reflection assignment which comprised in the submission of a one-page reflective document to a template of reflective questions provided in the given context of their learning environment. This was a mandatory but ungraded component at the midterm and final examinations. These documents were individually analyzed and thematically categorized to a "5 levels-of-reflection-awareness" scale using a specially-designed rubric based on the accepted major theories of reflection that included students' identification of: 1) personal abilities, 2) personal learning styles 3) relationships between course material and student history 4) emotional responses and 5) future applications.</p> <p>Results</p> <p>410 self-reflection documents were analyzed. The student self-awareness on personal learning style (72.7% level 3+) and course content (55.2% level 3+) were well-reflected. Reflections at a level 1 awareness included identification of a) specific teaching strategies utilized to enhance learning (58.4%), b) personal strengths/weaknesses (53%), and c) emotional responses, values, and beliefs (71.5%). Students' abilities to connect information to life experiences and to future events with understanding were more evenly distributed across all 5 levels of reflection-awareness.</p> <p>Conclusions</p> <p>Exposure to self-reflection assignments in the early years of undergraduate medical education increases student awareness and promotes the creation of personal meaning of one's reactions, values, and premises in the context of student learning environments. Early introduction with repetition to such cognitive processes as practice tools increases engagement in reflection that may facilitate proficiency in mastering this competency leading to the creation of future reflective health professionals.</p

Keratin 8 expression in colon cancer associates with low faecal butyrate levels

<p>Abstract</p> <p>Background</p> <p>Butyrate has been implicated in the mechanistic basis of the prevention of colorectal cancer by dietary fibre. Numerous in vitro studies have shown that butyrate regulates cell cycle and cell death. More recently we have shown that butyrate also regulates the integrity of the intermediate filament (IF) cytoskeleton <it>in vitro</it>. These and other data suggest a link between the role of diet and the implication of a central role for the keratin 8 (K8) as guardian of the colorectal epithelium.</p> <p>Methods</p> <p>In this cross-sectional study possible links between butyrate levels, field effects and keratin expression in cancer were addressed directly by analysing how levels of expression of the IF protein K8 in tumours, in adjacent fields and at a distant landmark site may be affected by the level of butyrate in the colon microenvironment. An immunohistochemical scoring protocol for K8 was developed and applied to samples, findings were further tested by immunoblotting.</p> <p>Results</p> <p>Levels of K8 in colorectal tumours are lower in subjects with higher levels of faecal butyrate. Immunoblotting supported this finding.Although there were no significant relationships with butyrate on the non-tumour tissues, there was a consistent trend in all measures of extent or intensity of staining towards a reduction in expression with elevated butyrate, consistent with the inverse association in tumours.</p> <p>Conclusions</p> <p>The data suggest that butyrate may associate with down-regulation of the expression of K8 in the cancerized colon. If further validated these findings may suggest the chemopreventive value of butyrate is limited to early stage carcinogenesis as low K8 expression is associated with a poor prognosis.</p

Trends in parameterization, economics and host behaviour in influenza pandemic modelling: a review and reporting protocol.

BACKGROUND: The volume of influenza pandemic modelling studies has increased dramatically in the last decade. Many models incorporate now sophisticated parameterization and validation techniques, economic analyses and the behaviour of individuals. METHODS: We reviewed trends in these aspects in models for influenza pandemic preparedness that aimed to generate policy insights for epidemic management and were published from 2000 to September 2011, i.e. before and after the 2009 pandemic. RESULTS: We find that many influenza pandemics models rely on parameters from previous modelling studies, models are rarely validated using observed data and are seldom applied to low-income countries. Mechanisms for international data sharing would be necessary to facilitate a wider adoption of model validation. The variety of modelling decisions makes it difficult to compare and evaluate models systematically. CONCLUSIONS: We propose a model Characteristics, Construction, Parameterization and Validation aspects protocol (CCPV protocol) to contribute to the systematisation of the reporting of models with an emphasis on the incorporation of economic aspects and host behaviour. Model reporting, as already exists in many other fields of modelling, would increase confidence in model results, and transparency in their assessment and comparison

Nurse assessment of nutritional status to identify patients at risk for complications after pancreatic resection

Purpose/Objectives: To determine if serum prealbumin (PAB) levels can be used by nurses to predict patients who may be at higher risk for postoperative complications after pancreatic surgeries. Design: A quantitative, retrospective study. Setting: One cancer center at an urban medical center in Detroit, Michigan. Sample: A convenience sample of 41 patients with resectable pancreatic neoplasms. Methods: Descriptive study with cross-sectional data using chart review to obtain preoperative PAB levels and perioperative data. Main Research Variables: Pancreatic leak, chyle leak, gastroparesis, sepsis, heart attack, length of hospital stay, and readmissions. Findings: There was a higher incidence of pancreatic leak reported after a distal pancreatectomy; however, this complication was not associated with a low PAB of ≤20 mg/dl. Patients with a diagnosis of adenocarcinoma or who underwent a pancreaticoduodenectomy experienced a longer hospital stay. Conclusions: Results did not reinforce the relationship between preoperative nutritional status and outcomes in pancreatic surgery. Implications for Nursing: Surgical oncology nurses should be aware of the importance of presurgical risk assessment and optimization. Tailored implementation of nutritional prehabilitation to improve patient outcomes after resection of pancreatic neoplasms should be studied more comprehensively

Comparative Analysis of Two Musical Genres Within a Multisensory Environmental Intervention

PURPOSE: The purpose of this study was to determine if there were any differences in the behavioral responses of persons with dementia while listening to nonreligious and religious music within a multisensory environment. RESEARCH DESIGN: A within-subjects, repeated measures design was used. METHOD: Participants were exposed to both musical genres during multiple sessions over a 4-week period. Neuropsychiatric symptoms were recorded before and after the musical intervention. Behavioral responses to the music were recorded while listening to the music. FINDINGS: No significant difference was found between the numbers of neuropsychiatric behaviors observed before and after the participants listened to the nonreligious and religious music. A significant difference was found between the musical interventions as a whole and the number of agitated behaviors before and after intervention. No significant difference was found in the observed behavioral responses with the nonreligious and religious music. CONCLUSIONS: Music can be a useful intervention to reduce neuropsychiatric symptoms in persons with dementia