555 research outputs found
A systematic review of educational resources for teaching patient handover skills to residents
Background: As physicians reduce their work hours, transfer of patient care becomes more common; this is a time of heightened risk to patients. Training in patient handover skills may reduce this risk. The objective of this study was to systematically review the literature regarding education models available to teach handovers skills to healthcare professionals. Methods: A systematic review was conducted to identify published educational resources on patient handover skills. Two investigators independently reviewed publications for inclusion/exclusion. A third reviewer resolved any disagreement. Included papers contained an educational resource for teaching handover skills to any health profession in any patient population. Papers were rated on a previously described 4 point scale for quality. Results: 1746 papers were identified, of which twelve met the inclusion criteria These studies presented information on educational curricula, simulation technologies and didactic sessions. The most common educational method was simulation or role-playing, which is better received by learners than didactic sessions. Teaching handover practices makes residents feel more confident in their handover, and residents receiving adequate handover are more comfortable with their duties.Conclusions: Although data are limited, effective training models for handover skills have been described in the literature. Residents and other healthcare practitioners should receive training in handover to improve practitioner comfort and patient care.
HelexKids:a word frequency database for Greek and Cypriot primary school children
In this article, we introduce HelexKids, an online written-word database for Greek-speaking children in primary education (Grades 1 to 6). The database is organized on a grade-by-grade basis, and on a cumulative basis by combining Grade 1 with Grades 2 to 6. It provides values for Zipf, frequency per million, dispersion, estimated word frequency per million, standard word frequency, contextual diversity, orthographic Levenshtein distance, and lemma frequency. These values are derived from 116 textbooks used in primary education in Greece and Cyprus, producing a total of 68,692 different word types. HelexKids was developed to assist researchers in studying language development, educators in selecting age-appropriate items for teaching, as well as writers and authors of educational books for Greek/Cypriot children. The database is open access and can be searched online at www.helexkids.org
HMG-CoA reductase inhibitors in kidney transplant recipients receiving tacrolimus: statins not associated with improved patient or graft survival
Stress activated protein kinase (SAPK) regulation of renal epithelial apoptosis following cold storage
Bibliography: p. 128-141Some pages are in colour
Resident duty hours in Canada: a survey and national statement
Abstract
Physicians in general, and residents in particular, are adapting to duty schedules in which they have fewer continuous work hours; however, there are no Canadian guidelines on duty hours restrictions. To better inform resident duty hour policy in Canada, we set out to prepare a set of recommendations that would draw upon evidence reported in the literature and reflect the experiences of resident members of the Canadian Association of Internes and Residents (CAIR). A survey was prepared and distributed electronically to all resident members of CAIR. A total of 1796 eligible residents participated in the survey. Of those who responded, 38% (601) reported that they felt they could safely provide care for up to 16 continuous hours, and 20% (315) said that 12 continuous hours was the maximum period during which they could safely provide care (n = 1592). Eighty-two percent (1316) reported their perception that the quality of care they had provided suffered because of the number of consecutive hours worked (n = 1598). Only 52% (830) had received training in handover (n = 1594); those who had received such training reported that it was commonly provided through informal modelling. On the basis of these data and the existing literature, CAIR recommends that resident duty hours be managed in a way that does not endanger the health of residents or patients; does not impair education; is flexible; and does not violate ethical or legal standards. Further, residents should be formally trained in handover skills and alternative duty hour models
Clinical Implications of Pediatric Colonic Eosinophilia
Objective: Pediatric colonic eosinophilia represents a confounding finding with a wide differential. It is often difficult to determine which children may progress to inflammatory bowel disease (IBD), which have an eosinophilic colitis (EC), and which may have no underlying pathology. There is little guidance for the practitioner on the approach to these patients. To define the clinical presentations of colonic eosinophilia and identify factors which may aid in diagnosis we reviewed patients with colonic eosinophilia and the clinicopathologic factors associated with their diagnoses.
Mehtods: An 8-year retrospective chart review of children whose histopathology identified colonic eosinophilia (N = 72) compared to controls with normal biopsies (N = 35).
Results: Patients with colonic eosinophilia had increased eosinophils/high-power field compared to controls (P 1 colonoscopy and 68% of these had change from initial diagnoses.
Conclusions: There are 3 main phenotypes of children with colonic eosinophilia. Signs of chronic systemic inflammation raise suspicion for IBD. Peripheral eosinophilia and male sex are associated with EC. A significant percent of children with colonic eosinophilia do not have colonic disease. Eosinophils/high-power field is not reliable to differentiate etiologies. Repeat colonoscopies may be required to reach final diagnoses
SMAD Signaling in the Airways of Healthy Rhesus Macaques versus Rhesus Macaques with Asthma Highlights a Relationship Between Inflammation and Bone Morphogenetic Proteins
Bone morphogenetic protein (BMP) signaling is important for
correct lung morphogenesis, and there is evidence of BMP signaling
reactivation in lung diseases. However, little is known about BMP
signaling patterns in healthy airway homeostasis and inflammatory
airway disease and during epithelial repair. In this study, a rhesus
macaque (Macaca mulatta) model of allergic airway disease was used
to investigate BMP signaling throughout the airways in health,
disease, and regeneration. Stereologic quantification of
immunofluorescent images was used to determine the expression of
BMP receptor (BMPR) Ia and phosphorylated SMAD (pSMAD)
1/5/8 in the airway epithelium. A pSMAD 1/5/8 expression gradient
was found along the airways of healthy juvenile rhesus macaques
(n = 3, P , 0.005). Membrane-localized BMPRIa expression was also
present in the epithelium of the healthy animals. After exposure to
house dust mite allergen and ozone, significant down-regulation of
nuclear pSMAD 1/5/8 occurs in the epithelium. When the animals
were provided with a recovery period in filtered air, proliferating cell
nuclear antigen, pSMAD 1/5/8, and membrane-localized BMPRIa
expression were significantly increased in the epithelium of
conducting airways (P , 0.005). Furthermore, in the asthmatic
airways, altered BMPRIa localization was evident. Because of the
elevated eosinophil presence in these airways, we investigated the
effect of eosinophil-derived proteins on BMPRIa trafficking in
epithelial cells. Eosinophil-derived proteins (eosinophil-derived
neurotoxin, eosinophil peroxidase, and major basic protein) induced
transient nuclear translocation of membrane-bound BMPRIa. This
work mapping SMAD signaling in the airways of nonhuman
primates highlights a potential mechanistic relationship between
inflammatory mediators and BMP signaling and provides evidence
that basal expression of the BMP signaling pathway may be
important for maintaining healthy airways
Calibration and Performance of the REgolith X-Ray Imaging Spectrometer (REXIS) Aboard NASA’s OSIRIS-REx Mission to Bennu
Abstract
The REgolith X-ray Imaging Spectrometer (REXIS) instrument on board NASA’s OSIRIS-REx mission to the asteroid Bennu is a Class-D student collaboration experiment designed to detect fluoresced X-rays from the asteroid’s surface to measure elemental abundances. In July and November 2019 REXIS collected ∼615 hours of integrated exposure time of Bennu’s sun-illuminated surface from terminator orbits. As reported in Hoak et al. (Results from the REgolith X-ray Imaging Spectrometer (REXIS) at Bennu, 2021) the REXIS data do not contain a clear signal of X-ray fluorescence from the asteroid, in part due to the low incident solar X-ray flux during periods of observation. To support the evaluation of the upper limits on the detectable X-ray signal that may provide insights for the properties of Bennu’s regolith, we present an overview of the REXIS instrument, its operation, and details of its in-flight calibration on astrophysical X-ray sources. This calibration includes the serendipitous detection of the transient X-ray binary MAXI J0637-430 during Bennu observations, demonstrating the operational success of REXIS at the asteroid. We convey some lessons learned for future X-ray spectroscopy imaging investigations of asteroid surfaces
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