87 research outputs found

    Assessment for Simulation Training for Prehospital EMS Providers in Bermuda

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    Introduction The island of Bermuda is 21 sq miles and located approximately 650 miles east of North Carolina, US. [1] There is only one hospital to serve the population of approximately 65,000. There are approximately 95 registered EMTs (Emergency Medical Technician) and AEMTs (Advanced Emergency Medical Technician) currently serving the island. [2] It is hypothesized that due to the remote/isolated nature of the island, low ratio of 911 call volume to population, and limited access to continuing education, there is difficulties for EMTs and AEMTs to maintain their skill and knowledge base. [3, 4, 5, 6] The Goal of this needs assessment is to identify key areas where education modules utilizing simulation-based training can be designed to meet the needs of the prehospital providers of Bermuda, ultimately strengthening the knowledge base and skill sets of the EMTs and AEMTs serving the island. Method A recruitment letter with the needs assessment survey link will be sent to employees of Bermuda Fire and Rescue Service (BFRS) and King Edward Memorial Hospital (KEMH). The survey will consist of questions utilizing the Likert scale and open-ended format. This will allow the subjects to self-report their confidence in various areas of their knowledge base, skill set, and training. The survey will be administered via Qualtrics. Once the survey is sent out the subjects will have 1 month to complete it. After the surveys have been submitted the data will be gathered and analyzed utilizing Qualtrics software. Results will be reported using standard statistical methodology. The survey platform is deidentified and will not record any identifying personal information. Next Steps The needs assessment survey has been granted exemption through the Institutional Review Board of the Office of Human Research at Thomas Jefferson University. An application for Research Proposal Approval from the Bermuda Hospital Board Ethics Committee has been submitted. The approval from the Bermuda Hospital Board Ethics Committee is required in order to conduct research in Bermuda. Following approval, the recruitment letter with the survey link will be sent out to BFRS and KEMH to be disseminated to employees. Following completion of the survey, the data will be gathered, analyzed and reported. Impact This needs assessment is meant to help maximize the skill set and knowledge base of prehospital providers in Bermuda. By allowing the subjects to self-report areas in which they are less confident, it provides an opportunity to tailor specific learning modules to the EMTs and AEMTs of Bermuda. This needs assessment provides an opportunity to strengthen the providers but also ensure that the Bermudian public is receiving the highest level of prehospital medical care possible

    Establishing a core outcome set for peritoneal dialysis : report of the SONG-PD (standardized outcomes in nephrology-peritoneal dialysis) consensus workshop

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    Outcomes reported in randomized controlled trials in peritoneal dialysis (PD) are diverse, are measured inconsistently, and may not be important to patients, families, and clinicians. The Standardized Outcomes in Nephrology-Peritoneal Dialysis (SONG-PD) initiative aims to establish a core outcome set for trials in PD based on the shared priorities of all stakeholders. We convened an international SONG-PD stakeholder consensus workshop in May 2018 in Vancouver, Canada. Nineteen patients/caregivers and 51 health professionals attended. Participants discussed core outcome domains and implementation in trials in PD. Four themes relating to the formation of core outcome domains were identified: life participation as a main goal of PD, impact of fatigue, empowerment for preparation and planning, and separation of contributing factors from core factors. Considerations for implementation were identified: standardizing patient-reported outcomes, requiring a validated and feasible measure, simplicity of binary outcomes, responsiveness to interventions, and using positive terminology. All stakeholders supported inclusion of PD-related infection, cardiovascular disease, mortality, technique survival, and life participation as the core outcome domains for PD

    The complex genetics of gait speed:Genome-wide meta-analysis approach

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    Emerging evidence suggests that the basis for variation in late-life mobility is attributable, in part, to genetic factors, which may become increasingly important with age. Our objective was to systematically assess the contribution of genetic variation to gait speed in older individuals. We conducted a meta-analysis of gait speed GWASs in 31,478 older adults from 17 cohorts of the CHARGE consortium, and validated our results in 2,588 older adults from 4 independent studies. We followed our initial discoveries with network and eQTL analysis of candidate signals in tissues. The meta-analysis resulted in a list of 536 suggestive genome wide significant SNPs in or near 69 genes. Further interrogation with Pathway Analysis placed gait speed as a polygenic complex trait in five major networks. Subsequent eQTL analysis revealed several SNPs significantly associated with the expression of PRSS16, WDSUB1 and PTPRT, which in addition to the meta-analysis and pathway suggested that genetic effects on gait speed may occur through synaptic function and neuronal development pathways. No genome-wide significant signals for gait speed were identified from this moderately large sample of older adults, suggesting that more refined physical function phenotypes will be needed to identify the genetic basis of gait speed in aging

    Comprehensive and Integrated Genomic Characterization of Adult Soft Tissue Sarcomas

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    Sarcomas are a broad family of mesenchymal malignancies exhibiting remarkable histologic diversity. We describe the multi-platform molecular landscape of 206 adult soft tissue sarcomas representing 6 major types. Along with novel insights into the biology of individual sarcoma types, we report three overarching findings: (1) unlike most epithelial malignancies, these sarcomas (excepting synovial sarcoma) are characterized predominantly by copy-number changes, with low mutational loads and only a few genes (, , ) highly recurrently mutated across sarcoma types; (2) within sarcoma types, genomic and regulomic diversity of driver pathways defines molecular subtypes associated with patient outcome; and (3) the immune microenvironment, inferred from DNA methylation and mRNA profiles, associates with outcome and may inform clinical trials of immune checkpoint inhibitors. Overall, this large-scale analysis reveals previously unappreciated sarcoma-type-specific changes in copy number, methylation, RNA, and protein, providing insights into refining sarcoma therapy and relationships to other cancer types

    The Science Performance of JWST as Characterized in Commissioning

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    This paper characterizes the actual science performance of the James Webb Space Telescope (JWST), as determined from the six month commissioning period. We summarize the performance of the spacecraft, telescope, science instruments, and ground system, with an emphasis on differences from pre-launch expectations. Commissioning has made clear that JWST is fully capable of achieving the discoveries for which it was built. Moreover, almost across the board, the science performance of JWST is better than expected; in most cases, JWST will go deeper faster than expected. The telescope and instrument suite have demonstrated the sensitivity, stability, image quality, and spectral range that are necessary to transform our understanding of the cosmos through observations spanning from near-earth asteroids to the most distant galaxies.Comment: 5th version as accepted to PASP; 31 pages, 18 figures; https://iopscience.iop.org/article/10.1088/1538-3873/acb29

    The James Webb Space Telescope Mission

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    Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least 4m4m. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the 6.5m6.5m James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

    Summary of cognitive, affective and behavioural outcomes of consuming prestigious sports events

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    In this paper, the authors explore the range of cognitive, affective, and behavioural outcomes of consuming prestigious sports event experiences. The authors obtained means-end chains from 19 individuals from across a range of ages and both genders. A total of 39 examples of events were discussed by participants encompassing 25 unique events and 11 different sports. Outcomes were multi-dimensional. At the cognitive level, consumers developed outer- and inner-directed outcomes. At the affective level, prestigious sports events made consumers feel positive emotions, while at the same time energising them to attend in order to avoid negative emotional states. At the behavioural level, four types of outcomes served as a consequence of attending prestigious events: patronage, financial, communication and experiential. By recognising the multiple outcomes associated with the consumption of prestigious sports event experiences, managers will be better equipped to design experiences that satisfy consumer requirements

    Multiculturalism, reseñado por José Merino

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