244 research outputs found
LâintĂ©gration des Ă©valuations de lâapprentissage autorĂ©gulĂ© dans les activitĂ©s dâĂ©valuation dans les professions de la santĂ© : un appel Ă lâaction
How well have healthcare professionals and trainees been prepared for the inevitable demands for new learning that will arise in their future? Given the rapidity with which âcore healthcare knowledgeâ changes, medical educators have a responsibility to audit whether trainees have developed the capacity to effectively self-regulate their learning. Trainees who engage in effective self-regulated learning (SRL) skilfully monitor and control their cognition, motivation, behaviour, and environment to adaptively meet demands for new learning. However, medical curricula rarely assess traineesâ capacity to engage in this strategic process. In this position paper, we argue for a paradigm shift toward assessing SRL more deliberately in undergraduate and postgraduate programs, as well as in associated licensing activities. Specifically, we explore evidence supporting an innovative blend of principles from the science on SRL, and on preparation for future learning (PFL) assessments. We propose recommendations for how program designers, curriculum developers, and assessment leads in undergraduate and postgraduate training programs, and in licensing bodies can work together to develop integrated assessments that measure how and how well trainees engage in SRL. Claims about lifelong learning in health professions education have gone unmatched by responsive curricular changes for far too long. Further neglecting these important competencies represents a disservice to medical trainees and a potential risk to the future patients they will care for.Dans quelle mesure les professionnels de la santĂ© et les Ă©tudiants ont-ils Ă©tĂ© prĂ©parĂ©s aux exigences inĂ©vitables de nouveaux apprentissages qui se prĂ©senteront Ă eux Ă lâavenir? Ătant donnĂ© la rapiditĂ© avec laquelle les «âconnaissances de base en matiĂšre de soins de santĂ©â» Ă©voluent, les enseignants en mĂ©decine ont la responsabilitĂ© de vĂ©rifier si les Ă©tudiants ont dĂ©veloppĂ© la capacitĂ© dâautorĂ©guler adĂ©quatement leurs apprentissages. Ceux qui pratiquent efficacement lâapprentissage autorĂ©gulĂ© (AAR) surveillent et contrĂŽlent habilement leur cognition, leur motivation, leur comportement et leur environnement pour sâadapter Ă la nĂ©cessitĂ© de nouveaux apprentissages. Cependant, les programmes dâĂ©tudes mĂ©dicales Ă©valuent rarement la capacitĂ© des Ă©tudiants Ă sâengager dans ce processus stratĂ©gique. Dans cet exposĂ© de position, nous plaidons en faveur dâun changement de paradigme vers une Ă©valuation plus ciblĂ©e de lâAAR dans les formations doctorale et postdoctorale, ainsi que pour les activitĂ©s dâĂ©valuation. Plus prĂ©cisĂ©ment, nous explorons les rĂ©sultats convaincants de lâemploi dâun mĂ©lange innovant de principes issus de la recherche en matiĂšre dâAAR et dâĂ©valuations de la prĂ©paration Ă lâapprentissage futur. Nous proposons des recommandations pour une collaboration entre les responsables de la conception de programmes dâĂ©tudes, ceux de lâĂ©laboration du cursus, ceux chargĂ©s de lâĂ©valuation dans les programmes dâĂ©tudes prĂ©doctorales et postdoctorales et les organismes responsables de lâoctroi dâun titre de compĂ©tence en vue de crĂ©er des Ă©valuations intĂ©grĂ©es qui mesurent la mĂ©thode et la qualitĂ© de lâAAR chez les Ă©tudiants. Les programmes dâĂ©tudes tardent encore Ă traduire dans la pratique la reconnaissance de lâimportance de lâapprentissage tout au long de la vie dans lâĂ©ducation mĂ©dicale. Continuer Ă nĂ©gliger ces compĂ©tences importantes ne ferait que nuire aux Ă©tudiants en mĂ©decine et potentiellement Ă leurs futurs patients
Enhancing peer acceptance of children with learning difficulties: classroom goal orientation and effects of a storytelling programme with drama techniques
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Psychometric assessment of the Chinese version of the Supportive Care Needs Survey short-form (SCNS-SF34-C) among Hong Kong and Taiwanese Chinese colorectal cancer patients
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Efficacy of Postoperative Pain Management Using Continuous Local Anesthetic Infusion at the Iliac Crest Bone Graft Site in Patients with Adolescent Idiopathic Scoliosis: A Parallel, Double-Blinded, Randomized Controlled Pilot Trial
Study DesignâRandomized controlled trial. ObjectiveâAdolescent idiopathic scoliosis (AIS) is a common spinal deformity that affects every population. In severe deformity, surgical intervention is performed. Autogenous iliac crest bone graft (ICBG) harvesting remains a common procedure worldwide for scoliosis surgery. Postoperative pain at the ICBG donor site is a major concern in patients undergoing spine surgery that affects postoperative functional outcome and consumes health care resources. Previous studies have noted a decrease in pain and postoperative analgesic use with the application of continuous infusion of anesthetic at the ICBG site in comparison with placebo. However, there is lack of evidence addressing the efficacy of continuous anesthetic infusion at the ICBG site in young patients and in particular those with spinal deformity, such as AIS. As such, this parallel, double-blinded, randomized controlled trial addressed the pain management efficacy of continuous anesthetic infusion versus saline at the ICBG site in patients with AIS during the immediate postoperative period. MethodsâParticipants were randomized into two groups. Group A (control subjects) received 3 mL per hour of saline locally at the ICBG site, and group B (treatment subjects) received a constant rate of infusion of 3 mL per hour of 0.25% levobupivacaine. Both groups received their postoperative intervention for 47 hours. All subjects and outcome assessors were blinded to the type of intervention. Utilizing the visual analog pain scale, pain was assessed at the primary spine surgical site, ICBG site, and contralateral ICBG site. Overall physical pain was assessed by the McGill Pain Questionnaire. The degree of analgesic use and complications were also evaluated. All outcomes were assessed up until the fourth day of the patients' hospitalization following surgery. ResultsâTwelve subjects were recruited (five in group A; seven in group B). No difference was noted at baseline regarding age, weight, height, arm span, sex, curve type, instrumented and fused levels, length of hospitalization, and pain scores between groups. Postoperatively, no difference was noted in surgical site pain between groups (pâ>â0.05). However, decreased ICBG and contralateral ICBG pain decreased twofold in group B patients in comparison with group A. Similarly, group B subjects had notably decreased postoperative overall pain scores (group A, mean 15.3; group B, mean 3.8). No significant differences were noted for the pain scores due to the small sample size. ConclusionsâThis study is the first with a robust level I study design to assess the efficacy of continuous infusion of analgesia into the ICBG site in young patients with AIS. This pilot study noted a trend that continuous anesthetic infusion reduces pain at the ICBG site and may further decrease overall physical bodily pain. This study further established a sample size calculation to facilitate large-scale studies addressing these parameters. This study provides further support of postoperative pain management options for children with spinal deformities.published_or_final_versio
A meta-analysis on the clinical outcomes of bridge to surgery stenting versus emergency surgery in malignant left-sided colonic obstruction
Poster PresentationINTRODUCTION: Left-sided malignant colonic obstruction was conventionally managed by emergency operation until the introduction of bridge to surgery stenting (BTS stenting). Despite evidence showing superior short-term outcome, the long-term oncological safety for BTS stenting is still questionable. Large-scale comparative studies on the long-term outcomes were scarce. The aim of this meta-analysis was to compare the short-term and long-term outcomes of BTS stenting and emergency surgery for ...postprin
PubMed-supported clinical term weighting approach for improving inter-patient similarity measure in diagnosis prediction
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Neuropsychiatric Events Associated with Leukotriene-Modifying Agents: A Systematic Review.
INTRODUCTION: Leukotriene-modifying agents (LTMAs) including montelukast, zafirlukast, and zileuton are approved by the US Food and Drug Administration (FDA) for the treatment of asthma and allergic rhinitis. Various neuropsychiatric events (NEs) have been reported; however, the evidence of the association is conflicting. This systematic review investigates the association between NEs and LTMAs by assessing the relevant published literature. METHODS: PubMed, EMBASE, MEDLINE, and Cochrane Library were searched using keywords. Studies designed to investigate the association were eligible for inclusion without restriction to any study design or language. The primary outcome was defined as suicidal conditions, while secondary outcomes included all other NEs. RESULTS: Thirty-three studies were included for a narrative review. Four observational studies did not find a significant association, while ten pharmacovigilance studies using different global databases detected the signals. Notably, some studies suggest that the FDA warning issued in 2008 might have influenced the reporting rate of NEs as a result of increased awareness. LIMITATIONS: The risk of NEs was not quantified, because of the lack of randomized controlled trials and observational studies investigating the association. CONCLUSION: Many pharmacovigilance studies have been conducted to determine the association between NEs and LTMAs, but there is limited evidence from observational studies. High-quality epidemiological studies should be conducted to evaluate the association and quantify the risk, not only in children, but also in adults
Metastasis-suppressing <i>NID2</i>, an epigenetically-silenced gene, in the pathogenesis of nasopharyngeal carcinoma and esophageal squamous cell carcinoma
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Prevalence and factors associated with anxiety during the COVID-19 pandemic among Malaysians: a cross-sectional study
The COVID-19 pandemic is a significant public health threat with wide-reaching psychological implications. The drastic changes in lifestyle due to the implementation of the movement control order (MCO) were associated with adverse effects on mental health. This study aimed to examine the prevalence of anxiety among Malaysians during the COVID-19 pandemic and its associated factors. The following questionnaires were self-administered online through google form which included: (i) Generalised Anxiety Disorder-7; (ii) Short Boredom Proneness Scale; (iii) Short Scale for Measuring Loneliness in Large Surveys; and (iv) The World Health Organisation (WHO) well-being index. Higher scores denoted higher levels of anxiety, boredom, loneliness, and well-being. Out of the 543 participants, more than half (55.2%) reported mild (25.6%), moderate (13.8%) to severe (19.8%) anxiety. Multiple logistic regression showed higher odds of moderate to severe anxiety were reported among those divorced/separated/widowed (aOR 6.778, 95% CI [1.200, 38.296]), adults aged 25 to 34 years (aOR 2.038, 95% CI [1.049, 3.958]), 35 to 44 years (aOR 2.279, 95% CI [1.064, 4.882]), and with higher boredom levels (aOR 1.063, 95% CI [1.035, 1.092]). One in five Malaysians surveyed experienced severe anxiety. Adults within the working age range (between 25 and 44 years old) were at higher odds of having anxiety. Boredom increased the odds of anxiety compared to loneliness, well-being and coping. Thus, addressing the risk factors through public health messages is deemed important
Improving corporate governance in state-owned corporations in China: which way forward?
This article discusses corporate governance in China. It outlines the basic agency problem in Chinese listed companies and questions the effectiveness of the current mechanisms employed to improve their standards of governance. Importantly, it considers alternative means through which corporate practice in China can be brought into line with international expectations and stresses the urgency with which this task must be tackled. It concludes that regulators in China must construct a corporate governance model which is compatible with its domestic setting and not rush to adopt governance initiatives modelled on those in cultures which are fundamentally different in the hope of also reproducing their success
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