Assessment and analysis of H.pylori infection treatment strategies of St. Vincent Hospital\u27s family and internal medicine clinics

Helicobacter pylori is a gram-negative bacteria that is responsible for causing chronic gastritis, ulcers in the stomach and intestine, and eventually even gastric lymphoma or cancer. Multiple treatment options have been recommended for treating an H. pylori infection based on kidney function, previous antibiotic exposure, and whether or not the infection is recurrent. The most common regimens used at St. Vincent\u27s primary care centers closely mimic the American College of Gastroenterology\u27s clinical guidelines. However, these medications (clarithromycin and levofloxacin) have been associated with high rates of resistance in other countries. The United States has very limited data on H. pylori\u27s resistance rates to these medications and there is not sufficient data to prove the efficacy of these regimens. This project aims to identify what percentage of H. pylori infections diagnosed at St. Vincent\u27s Family Medicine and Internal Medicine clinics are being successfully treated with current, guideline-directed therapy. It also aims to obtain a general understanding of H. pylori resistance rates to clarithromycin and levofloxacin in the Indianapolis area based on treatment failure rates

Do coursework summative assessments predict clinical performance? A systematic review

BACKGROUND: Two goals of summative assessment in health profession education programs are to ensure the robustness of high stakes decisions such as progression and licensing, and predict future performance. This systematic and critical review aims to investigate the ability of specific modes of summative assessment to predict the clinical performance of health profession education students. METHODS: PubMed, CINAHL, SPORTDiscus, ERIC and EMBASE databases were searched using key terms with articles collected subjected to dedicated inclusion criteria. Rigorous exclusion criteria were applied to ensure a consistent interpretation of ‘summative assessment’ and ‘clinical performance’. Data were extracted using a pre-determined format and papers were critically appraised by two independent reviewers using a modified Downs and Black checklist with level of agreement between reviewers determined through a Kappa analysis. RESULTS: Of the 4783 studies retrieved from the search strategy, 18 studies were included in the final review. Twelve were from the medical profession and there was one from each of physiotherapy, pharmacy, dietetics, speech pathology, dentistry and dental hygiene. Objective Structured Clinical Examinations featured in 15 papers, written assessments in four and problem based learning evaluations, case based learning evaluations and student portfolios each featured in one paper. Sixteen different measures of clinical performance were used. Two papers were identified as ‘poor’ quality and the remainder categorised as ‘fair’ with an almost perfect (k = 0.852) level of agreement between raters. Objective Structured Clinical Examination scores accounted for 1.4–39.7% of the variance in student performance; multiple choice/extended matching questions and short answer written examinations accounted for 3.2–29.2%; problem based or case based learning evaluations accounted for 4.4–16.6%; and student portfolios accounted for 12.1%. CONCLUSIONS: Objective structured clinical examinations and written examinations consisting of multiple choice/extended matching questions and short answer questions do have significant relationships with the clinical performance of health professional students. However, caution should be applied if using these assessments as predictive measures for clinical performance due to a small body of evidence and large variations in the predictive strength of the relationships identified. Based on the current evidence, the Objective Structured Clinical Examination may be the most appropriate summative assessment for educators to use to identify students that may be at risk of poor performance in a clinical workplace environment. Further research on this topic is needed to improve the strength of the predictive relationship. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12909-017-0878-3) contains supplementary material, which is available to authorized users

Velocity map imaging of the dynamics of the CH3 + HCl -> CH4 + Cl reaction using a dual molecular beam method

International audienceThe reactions CH3 + HCl → CH4 + Cl(²P_3/2) and CD₃ + HCl → CD₃H + Cl(²P_3/2) have been studied by photo-initiation (by CH₃I or CD₃I photolysis at 266 nm) in a dual molecular beam apparatus. Product Cl(²P</sub>3/2</sub>) atoms were detected using resonance enhanced multi-photon ionisation and velocity map imaging, revealing product translational energy and angular scattering distributions in the centre-of-mass frame. Image analysis is complicated by the bimodal speed distribution of CH₃ (and CD₃) radicals formed in coincidence with I(²P_3/2) and I(²P_1/2) atoms from CH₃I (CD₃I) photodissociation, giving overlapping Newton diagrams with displaced centre of mass velocities. The relative reactivities to form Cl atoms are greater for the slower CH₃ speed group than the faster group by factors of ~1.5 for the reaction of CH₃ and ~2.5 for the reaction of CD₃, consistent with the greater propensity of the faster methyl radicals to undergo electronically adiabatic reactions to form Cl(²P_1/2). The average fraction of the available energy becoming product translational energy is = 0.48 ± 0.05 and 0.50 ± 0.03 for reaction of the faster and slower sets of CH₃ radicals, respectively. The Cl atoms are deduced to be preferentially forward scattered with respect to the HCl reagents, but the angular distributions from the dual beam imaging experiments require correction for under-detection of forward scattered Cl products