A novel way to present flood hazards using 3D-printing with transparent layers of return period isolines

This paper examines the 3D printed results of a floodplain analysis usually used for hydrological studies to calculate the probabilities in high water stage features. The analysis was performed using probability distributions, including Pearson type III distribution, Log-Pearson type III distribution, Gaussian (normal) distribution, Gumbel distribution, and Log-normal distribution. The maximum theoretical stages of best fitting distribution for different return periods were mapped to the Vardar and Boshava rivers in the Tikvesh Valley. Data to create the model were extracted from digital elevation models of the Vardar river target area. The extracted 3D surface model was covered with a map showing all the flooded areas in the relevant territory for different return periods as transparent layers. The data were converted into a physical model (relief map) using 3D printing methods for visualisation

Experienced Practitioners\u27 Views on Interpersonal Skills in Telehealth Delivery

Background. As telehealth becomes a larger part of the health care landscape, clinicians are becoming prepared to operate technology-based­ systems for conducting routine care and exchanging information. Less defined are interpersonal skills for telehealth care delivery such as communication and therapeutic relationships that can influence clinical outcomes. Examples include clinician adaptability to the communication process via telehealth, clinician congeniality in communications, and striving to achieve telepresence. The purpose of this study was to describe interpersonal skills for telehealth delivery to assist in the preparation of health professionals. Methods. Aqualitative methods approached was used to build on results from our previously published systematic review. Semi-structured, in-depth interviews were conducted with experienced practitioners or educators (n=6) at multiple regional telehealth centers. Video/audio-recorded sessions were transcribed verbatim and researchers conducted thematic analysis of data until achieving saturation of data. Results. Participants provided their perspectives about interpersonal skills important for quality telehealth delivery based on professional experiences. Analysis of responses across interviews showed strong alignment with the six themes identified previously as non-technical clinician attributes: Preinteractional, Verbal Communication, Non-Verbal Communication, Relational, and Environmental. Also, an additional theme of Management/Operations emerged. Suggested training topics crossed clinical disciplines and ranged from telemedicine etiquette and verbal skills to equipment operation and billing and coding. Each study participant commented on benefits from preparation of telehealth clinicians related to the clinician-patient interaction such as: patient engagement, patient-centered care, patient satisfaction, patient implementation of care plans, effective communication with patients, and quality assessment of telehealth sessions. Conclusions. This study identified interpersonal skills that may be applied in professional education for telehealth delivery from the perspective of experienced practitioners. Further research could explore outcomes from professional preparation for interpersonal skills and patient perspectives

Procedural Competency Training during Diagnostic Radiology Residency: Time to Go beyond “See One, Do One, Teach One”!

Objectives: Achieving procedural competency during diagnostic radiology residency can impact the radiologist\u27s future independent practice after graduation, especially in a private practice setting. However, standardized procedure competency training within most radiology residency programs is lacking, and overall procedural skills are still mainly acquired by the traditional “see one, do one, teach one” methodology. We report the development of a simple standardized procedural training protocol that can easily be adopted by residency programs currently lacking any form of structured procedural training. Materials and Methods: An ad hoc resident procedural competency committee was created in our radiology residency program. A procedural certification protocol was developed by the committee which was composed of attending radiologists from the involved divisions and two chief residents. A road map to achieve procedural competency certification status was finalized. The protocol was then implemented through online commercial software. Results: Our procedural certification protocol took effect in September 2014. We reviewed all resident records from September 2014 to December 2016. Eighteen residents of various levels of training participated in our training protocol. About 72% became certified in paracentesis, 11% in thoracentesis, 83% in feeding tube placement, 55% in lumbar puncture/myelogram, and 77% in tunneled catheter removal. Conclusions: Our single-center experience demonstrates that a simple to adopt structured approach to procedural competency training is feasible and effective. Our “certified” radiology residents were deemed capable of performing those procedures under indirect supervision. The following core competencies are addressed in this article: Patient care, Medical knowledge, and Systems-based practice

Evaluating a Second Life PBL Demonstrator Project: What Can We Learn?

This article reports the findings of a demonstrator project to evaluate how effectively Immersive Virtual Worlds (IVWs) could support Problem-based Learning. The project designed, created and evaluated eight scenarios within Second Life (SL) for undergraduate courses in health care management and paramedic training. Evaluation was primarily qualitative, using illuminative evaluation which provided multiple perspectives through interviews, focus groups and questionnaires with designers, facilitators, learning technologists and students. Results showed that SL provided a rich, engaging environment which enhanced authenticity of the scenarios, though there were issues of access and usability. The article concludes by drawing together the lessons learned which will inform educators who seek to design and develop learning scenarios in this medium

Shiga toxin 2-induced intestinal pathology in infant rabbits is A-subunit dependent and responsive to the tyrosine kinase and potential ZAK inhibitor imatinib

Shiga toxin producing Escherichia coli (STEC) are a major cause of food-borne illness worldwide. However, a consensus regarding the role Shiga toxins play in the onset of diarrhea and hemorrhagic colitis (HC) is lacking. One of the obstacles to understanding the role of Shiga toxins to STEC-mediated intestinal pathology is a deficit in small animal models that perfectly mimic human disease. Infant rabbits have been previously used to study STEC and/or Shiga toxin-mediated intestinal inflammation and diarrhea. We demonstrate using infant rabbits that Shiga toxin-mediated intestinal damage requires A-subunit activity, and like the human colon, that of the infant rabbit expresses the Shiga toxin receptor Gb3. We also demonstrate that Shiga toxin treatment of the infant rabbit results in apoptosis and activation of p38 within colonic tissues. Finally we demonstrate that the infant rabbit model may be used to test candidate therapeutics against Shiga toxin-mediated intestinal damage. While the p38 inhibitor SB203580 and the ZAK inhibitor DHP-2 were ineffective at preventing Shiga toxin-mediated damage to the colon, pretreatment of infant rabbits with the drug imatinib resulted in a decrease of Shiga toxin-mediated heterophil infiltration of the colon. Therefore, we propose that this model may be useful in elucidating mechanisms by which Shiga toxins could contribute to intestinal damage in the human

The Effectiveness of Medical Simulation in Teaching Medical Students Critical Care Medicine: A Systematic Review and Meta-analysis

We aimed to assess effectiveness of simulation for teaching medical students critical care medicine and to assess which simulation methods were most useful. We searched AMED, EMBASE, MEDLINE, ERIC, BEI, AEI, plus bibliographies and citations, to July 2013. Randomised controlled trials comparing effectiveness of simulation with another educational intervention, or no teaching, for teaching medical students critical care medicine were included. Assessments for inclusion, quality and data extraction were duplicated and results synthesised using meta-analysis. We included 22 RCTs (n=1325). Fifteen studies comparing simulation with other teaching found simulation to be more effective (SMD 0.84, 95% CI 0.43 to 1.24; p<0.001; I2 89%). High-fidelity simulation was more effective than low-fidelity and subgrouping supported high-fidelity simulation being more effective than other methods. Simulation improved skill acquisition (SMD 1.01, 95% CI 0.49 to 1.53) but was no better than other teaching in knowledge acquisition (SMD 0.41, 95% CI -0.09 to 0.91)

Open access takes on the U.S. government

The open access movement in the United States is slowly expanding into the government arena. (While at least eight other countries are working to open up government-funded research results, this paper will focus on work within the United States.) Bills to ensure that taxpayer-funded research is made freely and openly available to the public have recently been introduced into the 111th Congress. This paper will look specifically at those bills which cover eleven governmental agencies and the Congressional Research Service and view them in light of the successful Public Access Policy at The National Institute of Health (NIH). This paper will also consider some of those players in the foreground and background of the movement to make the electronic products of government-funded research open to all