168 research outputs found

    COVID‑19 pneumonia imaging follow‑up: when and how? A proposition from ESTI and ESR

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    Abstract This document from the European Society of Thoracic Imaging (ESTI) and the European Society of Radiology (ESR) discusses the role of imaging in the long-term follow-up of COVID-19 patients, to define which patients may benefit from imaging, and what imaging modalities and protocols should be used. Insights into imaging features encountered on computed tomography (CT) scans and potential pitfalls are discussed and possible areas for future review and research are also included. Key Points • Post-COVID-19 pneumonia changes are mainly consistent with prior organizing pneumonia and are likely to disappear within 12 months of recovery from the acute infection in the majority of patients. • At present, with the longest series of follow-up examinations reported not exceeding 12 months, the development of persistent or progressive fibrosis in at least some individuals cannot yet be excluded. • Residual ground glass opacification may be associated with persisting bronchial dilatation and distortion, and might be termed “fibrotic-like changes” probably consistent with prior organizing pneumonia.publishedVersio

    Framework, principles and recommendations for utilising participatory methodologies in the co-creation and evaluation of public health interventions

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    Background: Due to the chronic disease burden on society, there is a need for preventive public health interventions to stimulate society towards a healthier lifestyle. To deal with the complex variability between individual lifestyles and settings, collaborating with end-users to develop interventions tailored to their unique circumstances has been suggested as a potential way to improve effectiveness and adherence. Co-creation of public health interventions using participatory methodologies has shown promise but lacks a framework to make this process systematic. The aim of this paper was to identify and set key principles and recommendations for systematically applying participatory methodologies to co-create and evaluate public health interventions. Methods: These principles and recommendations were derived using an iterative reflection process, combining key learning from published literature in addition to critical reflection on three case studies conducted by research groups in three European institutions, all of whom have expertise in co-creating public health interventions using different participatory methodologies. Results: Key principles and recommendations for using participatory methodologies in public health intervention co-creation are presented for the stages of: Planning (framing the aim of the study and identifying the appropriate sampling strategy); Conducting (defining the procedure, in addition to manifesting ownership); Evaluating (the process and the effectiveness) and Reporting (providing guidelines to report the findings). Three scaling models are proposed to demonstrate how to scale locally developed interventions to a population level. Conclusions: These recommendations aim to facilitate public health intervention co-creation and evaluation utilising participatory methodologies by ensuring the process is systematic and reproducible

    Computer-assisted detection of pulmonary embolism: evaluation of pulmonary CT angiograms performed in an on-call setting

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    Item does not contain fulltextPURPOSE: The purpose of the study was to assess the stand-alone performance of computer-assisted detection (CAD) for evaluation of pulmonary CT angiograms (CTPA) performed in an on-call setting. METHODS: In this institutional review board-approved study, we retrospectively included 292 consecutive CTPA performed during night shifts and weekends over a period of 16 months. Original reports were compared with a dedicated CAD system for pulmonary emboli (PE). A reference standard for the presence of PE was established using independent evaluation by two readers and consultation of a third experienced radiologist in discordant cases. RESULTS: Original reports had described 225 negative studies and 67 positive studies for PE. CAD found PE in seven patients originally reported as negative but identified by independent evaluation: emboli were located in segmental (n = 2) and subsegmental arteries (n = 5). The negative predictive value (NPV) of the CAD algorithm was 92% (44/48). On average there were 4.7 false positives (FP) per examination (median 2, range 0-42). In 72% of studies or=10 FP. CONCLUSION: CAD identified small emboli originally missed under clinical conditions and found 93% of the isolated subsegmental emboli. On average there were 4.7 FP per examination.1 april 201

    Cardiothoracic CT: one-stop-shop procedure? Impact on the management of acute pulmonary embolism

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    In the treatment of pulmonary embolism (PE) two groups of patients are traditionally identified, namely the hemodynamically stable and instable groups. However, in the large group of normotensive patients with PE, there seems to be a subgroup of patients with an increased risk of an adverse outcome, which might benefit from more aggressive therapy than the current standard therapy with anticoagulants. Risk stratification is a commonly used method to define subgroups of patients with either a high or low risk of an adverse outcome. In this review the clinical parameters and biomarkers of myocardial injury and right ventricular dysfunction (RVD) that have been suggested to play an important role in the risk stratification of PE are described first. Secondly, the use of more direct imaging techniques like echocardiography and CT in the assessment of RVD are discussed, followed by a brief outline of new imaging techniques. Finally, two risk stratification models are proposed, combining the markers of RVD with cardiac biomarkers of ischemia to define whether patients should be admitted to the intensive care unit (ICU) and/or be given thrombolysis, admitted to the medical ward, or be safely treated at home with anticoagulant therapy

    Reflective teaching, inclusive teaching and the teacher's tasks in the inclusive classroom:a literary investigation

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    This article has three aims: to continue the process of giving credence to reflective teaching, which is integral to effective teaching and learning; to make explicit the connections between reflective teaching and inclusive teaching; and to identify key tasks for teachers in the inclusive classroom. Relevant articles were selected for inclusion in this review by searching online databases for key words and phrases. Findings reveal that the following features of reflective teaching connect with and are fundamental to inclusive teaching: giving careful consideration or thought; questioning personal assumptions, values, and beliefs; taking initiatives; using intuition; taking part in development and change; and the use of journalling. Teachers' tasks in the inclusive classroom include giving careful consideration to what is to be taught and how it is to be taught (rather than who is to learn); considering the learning needs of all students (not just those with additional needs); questioning beliefs and rejecting deterministic and associated ideas; reflecting on the classroom situation; constantly seeking out and trying new things to support all learners; discussing new initiatives with colleagues in order to receive feedback; examining, framing and attempting to solve dilemmas of the classroom; using journals to track students' learning; and taking responsibility for their own professional growth and understanding

    ‘It’s quite weird to write … you feel like a nut job’: the practical and emotional consequences of writing personal reflections for assessment in psychology

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    Setting the tone for reflective writing – should the first person, populated approach that currently dominates be ethically questioned? An active voice is recommended to enhance ‘power’ and emotional investment in reflection, but often presents practical difficulties for students conditioned in ‘scientific’ depopulated ways. Beyond the practical, being instructed to employ a personal tone could exacerbate the emotional risks involved for vulnerable students. Ethical questioning is an area of reflection and teaching that has been largely neglected. The current paper responds to this gap, discursively considering the impact of requiring students to reflect using the first person and how this could intersect with emotionality components, located within the experiences of MSc Forensic Psychology students. Six students that had recently undertaken a reflective practice assignment volunteered to take part in a semi-structured interview about their experiences. For some students the themes of personal pronoun use and emotionality intersected, whereby at deeper levels of analysis the emotional impact was compounded by first person usage. Assessing the risk of enhanced vulnerability to psychological discomfort, implementing practical strategies to mediate this and the support procedures followed when requiring students to reflect are reviewed
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