Development of an Archive at Monmouth Medical Center

Monmouth Medical Center, founded in 1887, was the first hospital at the Jersey Shore. Over the past thirty years there was a limited effort to develop archival and historical collections that document this rich history. In conjunction with the medical center\u27s 125th anniversary in 2012, a consultant was retained to evaluate the archives, develop operational policies and prepare exhibits. Public programs and exhibits about the medical center have been presented to state and local organizations, and a schedule of historical programs is offered in-house during National Hospital Week. The archival collections were actively used to celebrate the medical center\u27s anniversary and continue to be utilized for promotional activities and special events

Learners’ confusion: faulty prior knowledge or a metacognitive monitoring error?

Research often treats confusion as a turning point of the learners’ cognitive-affective dynamics in digital environments (e.g. D’Mello, Grasser and colleagues). The origin of confusion, however, is a topic of a debate. Could inaccurate prior knowledge serve as a source of confusion, or does confusion relate to metacognitive processes? In this paper we are attempting to address this question by employing case study analysis with fourteen participants who worked through simulated learning problems with feedback in a digital environment. Physiological and self-reported data were combined to examine problem-solving patterns. Preliminary findings highlighted the role of metacognitive monitoring in confusion development and its interrelation with inaccurate prior knowledge.5 page(s

Regulation of the Frequency of Part-Word Repetitions Using Electromyographic Feedback

This study investigated the use of electromyographic feedback in regulating the frequency of part-word repetitions. Two adult stutterers, one female (Subject A) and one male (Subject B) were employed. The frequency of part-word repetitions during baserate, EMG uV raising, and EMG uV lowering conditions was assessed for Subject B. As hypothesized, results indicate that there was a notable decline in the frequency of part-word repetitions during the EMG uV lowering sessions. However, contrary to the second hypothesis, (i.e. that an increase in EMG uV would correspond with an increase in part-word repetitions) there was also a decline in the frequency of part-word repetitions during the EMG raising sessions

Contemplative medicine: A practical approach to “Well-Being 2.0” in medicine

Objective: To examine the relationship between Contemplative Medicine training and clinician burnout. Methods: Clinicians underwent a 12 month training program in Contemplative Medicine, which addresses several of the “Well-being 2.0” framework elements. An uncontrolled pre and post test study design was used with the validated Maslach Burnout Inventory (MBI) as the study tool to evaluate efficacy of the program. Results: Participants demonstrated improvement in burnout levels after the intervention. There were significant differences at the 0.05 significance level or better on all three scales of the MBI instrument when comparing baseline to follow-up responses, including emotional exhaustion, depersonalization, and sense of personal accomplishment. Particular improvement was noted in the “personal accomplishment” domain, with p \u3c 0.01 when comparing baseline and follow-up responses. Conclusion: The results of this study suggest that Contemplative Medicine training is a viable approach for improving clinician burnout and concretely implementing the “Well-being 2.0” framework

A national registry for juvenile dermatomyositis and other paediatric idiopathic inflammatory myopathies: 10 years' experience; the Juvenile Dermatomyositis National (UK and Ireland) Cohort Biomarker Study and Repository for Idiopathic Inflammatory Myopathies

Objectives: The paediatric idiopathic inflammatory myopathies (IIMs) are a group of rare chronic inflammatory disorders of childhood, affecting muscle, skin and other organs. There is a severe lack of evidence base for current treatment protocols in juvenile myositis. The rarity of these conditions means that multicentre collaboration is vital to facilitate studies of pathogenesis, treatment and disease outcomes. We have established a national registry and repository for childhood IIM, which aims to improve knowledge, facilitate research and clinical trials, and ultimately to improve outcomes for these patients. Methods: A UK-wide network of centres and research group was established to contribute to the study. Standardized patient assessment, data collection forms and sample protocols were agreed. The Biobank includes collection of peripheral blood mononuclear cells, serum, genomic DNA and biopsy material. An independent steering committee was established to oversee the use of data/samples. Centre training was provided for patient assessment, data collection and entry. Results: Ten years after inception, the study has recruited 285 children, of which 258 have JDM or juvenile PM; 86% of the cases have contributed the biological samples. Serial sampling linked directly to the clinical database makes this a highly valuable resource. The study has been a platform for 20 sub-studies and attracted considerable funding support. Assessment of children with myositis in contributing centres has changed through participation in this study. Conclusions: This establishment of a multicentre registry and Biobank has facilitated research and contributed to progress in the management of a complex group of rare muscloskeletal conditions

Efficacy of thalidomide in a girl with inflammatory calcinosis, a severe complication of juvenile dermatomyositis

We report a 14-year-old girl with juvenile dermatomyositis (JDM) complicated by severe inflammatory calcinosis successfully treated with thalidomide. She was diagnosed as JDM when she was 4 years old after a few months of increasing lethargy, muscle pain, muscle weakness, and rash. During three months, clinical manifestations and abnormal laboratory findings were effectively treated with oral prednisolone. However, calcinosis was recognized 18 months after disease onset. Generalized calcinosis rapidly progressed with high fever, multiple skin/subcutaneous inflammatory lesions, and increased level of CRP. Fifty mg/day (1.3 mg/kg day) of oral thalidomide was given for the first four weeks, and then the dose was increased to 75 mg/day. Clinical manifestations subsided, and inflammatory markers had clearly improved. Frequent high fever and local severe pain with calcinosis were suppressed. The levels of FDP-E, IgG, and tryglyceride, which were all elevated before the thalidomide treatment, were gradually returned to the normal range. Over the 18 months of observation up to the present, she has had no inflammatory calcinosis, or needed any hospitalization, although established calcium deposits still remain. Her condition became painless, less extensive and less inflammatory with the CRP level below 3.08 mg/dL. Recent examination by whole-body 18F-FDG-PET-CT over the 15 months of thalidomide treatment demonstrated fewer hot spots around the subcutaneous calcified lesions

Virtual Delivery of Stress Management and Resiliency Training (SMART) During the COVID-19 Pandemic to Hematology/Oncology Fellows: A Pilot Study

Introduction: Medical trainees experience a high degree of stress that predisposes them to burnout. This pilot study tested a scalable approach to deliver a validated resilience program (Stress Management and Resiliency Training (SMART)) among Hematology/Oncology fellows at an academic medical center. Methods: This was a mixed-methods, prospective, single-arm clinical trial involving Hematology/Oncology fellows at Mayo Clinic in Rochester, MN, USA. Four one-hour training sessions were conducted virtually with 26 fellows. Stress, burnout, and emotional resilience were measured at baseline, three months, and six months post-intervention using the Perceived Stress Scale (PSS-10), Maslach Burnout Inventory (MBI-HSS), and Connor-Davidson Resilience Scale (CD-RISC2). Changes in mean scores were assessed using paired t-tests. Feasibility and acceptability data were obtained during a virtual focus group. Results: Statistically significant improvements in mean stress (p = 0.004) and professional achievement (p \u3c 0.001) were seen at three months post-intervention. At six months post-intervention, mean stress (p \u3c 0.001) and professional achievement (p = 0.032) continued to improve, while improvements in emotional exhaustion (p = 0.001) and depersonalization (p \u3c 0.001) also became significant. Focus group participants found the program beneficial and reported improved stress and work performance as a result of participation. Conclusion: Virtual implementation of the SMART program is feasible and resulted in improvements in stress and burnout. Focus group participants found the training beneficial, reporting lower stress and improved work performance