654 research outputs found
Strategies for Improving Learner Metacognition in Health Professional Education
Metacognition is an essential skill in critical thinking and self-regulated, lifelong learning. It is important for learners to have skills in metacognition because they are used to monitor and regulate reasoning, comprehension, and problem-solving, which are fundamental components/outcomes of pharmacy curricula. Instructors can help learners develop metacognitive skills within the classroom and experiential setting by carefully designing learning activities within courses and the curriculum. These skills are developed through intentional questioning, modeling techniques, and reflection. This article discusses key background literature on metacognition and identifies specific methods and strategies to develop learnersā metacognitive skills in both the classroom and experiential settings
Management of Gastroduodenal Artery Pseudoaneurysm Rupture With Duodenal Ulcer Complicated by Coil Migration.
Rupture of visceral artery aneurysms or visceral artery pseudoaneurysms is an unusual cause of upper gastrointestinal bleeding. Although most visceral artery aneurysms and visceral artery pseudoaneurysms occur in the splenic artery or hepatic artery, they can rarely occur in the gastroduodenal artery. These are at high risk for rupture, with a 40%-70% mortality. We report a case of recurrent upper gastrointestinal bleeding due to gastroduodenal artery pseudoaneurysm despite endoscopic treatment and endovascular embolization complicated by coil migration into the duodenum
Cluster Dynamics for Randomly Frustrated Systems with Finite Connectivity
In simulations of some infinite range spin glass systems with finite
connectivity, it is found that for any resonable computational time, the
saturatedenergy per spin that is achieved by a cluster algorithm is lowered in
comparison to that achieved by Metropolis dynamics.The gap between the average
energies obtained from these two dynamics is robust with respect to variations
of the annealing schedule. For some probability distribution of the
interactions the ground state energy is calculated analytically within the
replica symmetry assumptionand is found to be saturated by a cluster algorithm.Comment: Revtex, 4 pages with 3 figure
Mean Field Behavior of Cluster Dynamics
The dynamic behavior of cluster algorithms is analyzed in the classical mean
field limit. Rigorous analytical results below establish that the dynamic
exponent has the value for the Swendsen-Wang algorithm and
for the Wolff algorithm.
An efficient Monte Carlo implementation is introduced, adapted for using
these algorithms for fully connected graphs. Extensive simulations both above
and below demonstrate scaling and evaluate the finite-size scaling
function by means of a rather impressive collapse of the data.Comment: Revtex, 9 pages with 7 figure
The development, usability, and reliability of the Electronic Patient Visit Assessment (ePVA) for head and neck cancer
Background: Annually, over 65,000 persons are diagnosed with head and neck cancer in the United States. During treatment, up to 50% of patients become severely symptomatic with pain, fatigue, mouth sores, and inability to eat. Long term complications are lymphedema, fibrosis, dysphagia, and musculoskeletal impairment. Patientsā ability to perform daily activities and to interact socially may be impaired, resulting in poor quality of life. A pragmatic, clinically useful assessment is needed to ensure early detection and intervention for patients to report symptoms and functional limitations over time. We developed the Electronic Patient Visit Assessment (ePVA) that enables patients to report 42 symptoms related to head and neck cancer and 17 limitations of functional status. This manuscript reports (I) the development of the ePVA, (II) the content validity of the ePVA, and (III) the usability and reliability of the ePVA. Methods: Usability was evaluated using the āThink Aloudā technique to guide the iterative process to refine the ePVA based on participantsā evaluations. After signing the informed consent, 30 participants with head and neck cancer completed the ePVA using digital tablet devices while thinking aloud about ease of use. All patient conversations were recorded and professionally transcribed. Reliability of the ePVA symptom and functional limitation measures was estimated using the Kuder-Richardson test. Convergent validity of the ePVA was evaluated using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 global QoL/health scale. Transcribed qualitative data were analyzed using directed content analysis approach. Quantitative analyses consisted of descriptive statistics and correlation analyses. Results: Among participants, 90% strongly agreed or agreed that the ePVA system was easy to use and 80% were very satisfied. Only minor usability problems were reported due to formatting and software ābugsā. Reporting of usability problems decreased in frequency over the study period and no usability problems were reported by the last 3 participants who completed the ePVA. Based on participantsā suggestions during the iterative process, refinement of the ePVA included increased touch sensitivity of the touch screen technology and customized error messages to improve ease of use. The ePVA also recorded patient reported symptoms (mouth symptoms: 93%, fibrosis: 60%, fatigue: 60%). The ePVA demonstrated acceptable reliability (alpha =0.82ā0.85) and convergent validity (ePVA total number of reported symptoms and function limitations was negatively correlated with EORTC QLQ-C30 global QOL/health scale: r=ā0.55038, P<0.01). Conclusions: The ePVA was rigorously developed, accepted by patients with satisfaction, and demonstrated acceptable reliability and convergent validity. Future research will use data generated by the ePVA to determine the impact of symptom trajectories on functional status, treatment interruptions and terminations, and health resource use in head and neck cancer
The usefulness of the electronic patient visit assessment (ePVA) as a clinical support tool for real-time interventions in head and neck cancer
Background: Patients with head and neck cancer (HNC) experience painful, debilitating symptoms and functional limitations that can interrupt cancer treatment, and decrease their health-related quality of life (HRQoL). The Electronic Patient Visit Assessment (ePVA) for head and neck is a web-based mHealth patient-reported measure that asks questions about 21 categories of symptoms and functional limitations common to HNC. This article presents the development and usefulness of the ePVA as a clinical support tool for real-time interventions for patient-reported symptoms and functional limitations in HNC. Methods: Between January 2018 and August 2019, 75 participants were enrolled in a clinical usefulness study of the ePVA. Upon signing informed consent, participants completed the ePVA and the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) general (C30) questionnaire v3.0 (scores range from 0 to 100 with 100 representing best HRQoL). Clinical usefulness of the ePVA was defined as demonstration of reliability, convergent validity with HRQoL, and acceptability of the ePVA (i.e., >70% of eligible participants complete the ePVA at two or more visits and >70% of ePVA reports are read by providers). Formal focus group discussions with the interdisciplinary teamthat cared for patients with HNC guided the development of the ePVA as a clinical support tool. Qualitative and quantitative methods were used throughout the study. Descriptive statistics consisting of means and frequencies, Pearson correlation coefficient, and Studentās t-tests were calculated using SAS 9.4 and STATA. Results: The participants were primarily male (71%), White (76%), diagnosed with oropharyngeal or oralcavity cancers (53%), and undergoing treatment for HNC (69%). Data analyses supported the reliability (alpha =0.85), convergent validity with HRQoL scores, and acceptability of the ePVA. Participants with the highest number of symptoms and functional limitations reported significantly worse HRQoL (sumof symptoms: r=ā0.50, P<0.0001; sum of function limitations: r=ā0.56, P<0.0001). Ninety-two percent of participants (59 of 64) who had follow-up visits within the 6-month study period completed the ePVA at twoor more visits and providers read 89% (169 of 189) of automated ePVA reports. The use of the ePVA as aclinical support tool for real-time interventions for symptoms and functional limitations reported by patients is described in a clinical exemplar. Conclusions: This research indicates that the ePVA may be a useful mHealth tool as a clinical support tool for real-time interventions for patient-reported symptoms and functional limitations in HNC. The study findings support future translational research to enhance the usefulness of the ePVA in real world settings for early interventions that decrease symptom burden and improve the QoL of patients with HNC
Dynamical Scaling from Multi-Scale Measurements
We present a new measure of the Dynamical Critical behavior: the "Multi-scale
Dynamical Exponent (MDE)"Comment: 9 pages,Latex, Request figures from [email protected]
Drivers of overweight mothers' food choice behaviors depend on child gender
National data suggest a higher prevalence of obesity among boys. One possible cause could be the food choices made by parents on behalf of their children
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