A mixed-methods evaluation of a multidisciplinary point of care ultrasound program

<p><b>Background:</b> Point of Care Ultrasound (PoCUS) is well established within emergency medicine, however, the availability of formal training for other clinical disciplines is limited. Memorial University has established a cost-efficient, multidisciplinary PoCUS training program focusing on training residents’ discipline-specific ultrasound skills. This study evaluates the skills, knowledge, and attitudes of residents who participated in the program.</p> <p><b>Methods:</b> Analysis was conducted using a mixed-methods, sequential exploratory approach. Initially, a focus group of seven first year residents was conducted to generate themes that were used to guide development of a survey administered to residents over a two-year period.</p> <p><b>Results:</b> Thirty residents responded to the survey (response rate 63.8%) with 53.3% meeting the training requirements for focused assessment using sonography in trauma, 43.3% for pleural effusion, 40.0% for aortic aneurysms, and 40.0% for cardiac scans. Early pregnancy assessment was the skill of least interest with 46.6% not interested. Over half the residents (53.6%) agreed or strongly agreed that a multidisciplinary program met their needs while 21.4% disagreed. The focus group found the multidisciplinary approach adequate.</p> <p><b>Conclusions:</b> A single PoCUS curriculum has been shown to meet the needs and expectations of a majority of residents from multiple disciplines. It can enhance collaboration and bridge gaps between increasingly compartmentalized practices of medicine.</p

pdam_2f

VCF data file for unique genotypes only, ie excluding clone mate

pdam_wclon_2f

VCF data file for all samples, including clone mate

Relationship between transmission intensity and population genetic parameters for <i>Plasmodium vivax</i> populations of the Southwest Pacific.

<p>Diversity of parasite populations based on (A) mean gene diversity (<i>H</i>_s), (B) Allelic richness (<i>R</i>_s), (C) the proportion of closely related haplotype pairs (<i>P</i>s>0.50) and (D) multilocus linkage disequilibrium (<i>I</i>_A^S) was plotted against the proportion of polyclonal infections for each defined population (see <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0006146#pntd.0006146.t001" target="_blank">Table 1</a> and <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0006146#pntd.0006146.s003" target="_blank">S1 Table</a>).</p

Map of the study areas and transmission intensity.

<p>(A) Southwest Pacific sampling locations showing Papua New Guinea in blue, Solomon Islands in green and Vanuatu in red, (B) central Solomon Islands, (C) Ngella, showing 19 villages and five distinct geographical/ecological regions. Anchor villages are indicated in yellow, Bay in blue, South Coast in green, Channel in red and North Coast in purple). Maps were produced using an open source map with shape files downloaded from <a href="http://diva-gis.org/" target="_blank">diva-gis.org</a> using the open source software QGIS release 2.18. (D) The distribution of multiplicity of infection values in each defined population, shown as an indicator of <i>P</i>. <i>vivax</i> transmission intensity.</p

Genetic diversity of <i>Plasmodium vivax</i> populations of the Southwest Pacific.

<p>Genetic diversity of <i>Plasmodium vivax</i> populations of the Southwest Pacific.</p

Estimates of Multilocus Linkage Disequilibrium (LD) in <i>Plasmodium vivax</i> populations of the Southwest Pacific.

<p>Estimates of Multilocus Linkage Disequilibrium (LD) in <i>Plasmodium vivax</i> populations of the Southwest Pacific.</p

Phylogenetic analysis of <i>Plasmodium vivax</i> isolates of the Southwest Pacific.

<p>For the lower transmission regions of (A) Ngella and (B) Vanuatu, relatedness amongst haplotypes was defined by calculating the pairwise distance and visualized by drawing unrooted phylogenetic trees using the APE package in R software. Colours indicate the geographic origin of each sample as indicated in the key.</p

Genetic differentiation of <i>Plasmodium vivax</i> populations across the Southwest Pacific.

<p>(A) Average genetic differentiation among subpopulations. Average F statistics (<i>F</i>_ST) was measured over all loci for all regions with at least two sub-populations of 20 or more samples, with the exception of Vanuatu, which had three populations of 7–10 samples. (B) Pairwise genetic differentiation between subpopulations. Pairwise differentiation was measured using Jost’s D, which accounts for the high diversity of microsatellite markers [<a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0006146#pntd.0006146.ref058" target="_blank">58</a>]. Values are shown for populations at different spatial scales. Darker shading indicates higher values.</p

Prevalence of Trachoma after Implementation of Trachoma Elimination Interventions in Oromia Regional State, Ethiopia: Results of Impact Surveys in 131 Evaluation Units Covering 139 Districts

To determine the prevalence of trachomatous inflammation—follicular (TF), trachomatous trichiasis (TT), water, sanitation, and hygiene (WASH) access in 131 evaluation units (EUs) after implementation of trachoma elimination interventions in Oromia Region, Ethiopia. A population-based cross-sectional survey was conducted in each EU using the World Health Organization-recommended two-stage cluster-sampling methodology. Twenty-six clusters, each with a mean of 30 households were enumerated in each EU. All residents aged ≥1 year in selected households were examined for TF and TT. Information on WASH access in surveyed households was also collected through questioning the household head and direct observation. A total of 419,858 individuals were enumerated in 131 EUs, of whom 396,134 (94%) were examined, 54% being female. Age-adjusted EU-level prevalence of TF in children aged 1–9 years ranged from 0.15% (95% confidence interval [CI]: 0.0–0.4) to 37.5% (95% CI: 31.1–43.7). The TF prevalence was Oromia is on the path towards elimination of trachoma as a public health problem.</p