Engaging patients and clinicians through simulation: rebalancing the dynamics of care

This paper proposes simulation-based enactment of care as an innovative and fruitful means of engaging patients and clinicians to create collaborative solutions to healthcare issues. This use of simulation is a radical departure from traditional transmission models of education and training. Instead, we frame simulation as co-development, through which professionals, patients and publics share their equally (though differently) expert perspectives. The paper argues that a process of participatory design can bring about new insights and that simulation offers understandings that cannot easily be expressed in words. Drawing on more than a decade of our group’s research on simulation and engagement, the paper summarises findings from studies relating to clinician-patient collaboration and proposes a novel approach to address the current need. The paper outlines a mechanism whereby pathways of care are jointly created, shaped, tested and refined by professionals, patients, carers and others who are affected and concerned by clinical care

The effects of dietary fish oil on hepatic high density and low density lipoprotein receptor activities in the rat

AbstractRats were fed either a standard ration diet or that diet supplemented with 8% by wt of a marine fish oil or safflower oil. After 10 days, plasma triacylglycerols, total cholesterol, high density lipoprotein (HDL) cholesterol, hepatic cholesterol and fatty acid synthesis and hepatic low density lipoprotein (LDL) receptor activity were significantly depressed while HDL receptor activity was significantly increased in rats fed fish oil. Fish oil-induced effects on cholesterol metabolism in the rat therefore include reciprocal changes in the activities of hepatic LDL and HDL receptors

Key challenges in simulated patient programs: An international comparative case study

<p>Abstract</p> <p>Background</p> <p>The literature on simulated or standardized patient (SP) methodology is expanding. However, at the level of the program, there are several gaps in the literature. We seek to fill this gap through documenting experiences from four programs in Australia, Canada, Switzerland and the United Kingdom. We focused on challenges in SP methodology, faculty, organisational structure and quality assurance.</p> <p>Methods</p> <p>We used a multiple case study method with cross-case synthesis. Over eighteen months during a series of informal and formal interactions (focused meetings and conference presentations) we documented key characteristics of programs and drew on secondary document sources.</p> <p>Results</p> <p>Although programs shared challenges in SP methodology they also experienced differences. Key challenges common to programs included systematic quality assurance and the opportunity for research. There were differences in the terminology used to describe SPs, in their recruitment and training. Other differences reflected local conditions and demands in organisational structure, funding relationships with the host institution and national trends, especially in assessments.</p> <p>Conclusion</p> <p>This international case study reveals similarities and differences in SP methodology. Programs were highly contextualised and have emerged in response to local, institutional, profession/discipline and national conditions. Broader trends in healthcare education have also influenced development. Each of the programs experienced challenges in the same themes but the nature of the challenges often varied widely.</p

Potential impacts of iron biofortification in India

Iron deficiency is a widespread nutritional problem in developing countries, causing impaired physical activity and cognitive development, as well as maternal mortality. Although food fortification and supplementation programmes have been effective in some countries, their overall success remains limited. Biofortification, that is, breeding crops for higher micronutrient content, is a relatively new approach. We propose a methodology for ex-ante impact assessment of iron biofortification, which builds on disability-adjusted life years (DALYs) and a large household data set. Our analysis of iron-rich rice and wheat in India indicates sizeable potential health benefits. The cost-effectiveness of iron biofortification compares favourably with other interventions

Optimization of Brewer's Yeast Quantity in Liquid and Gel Larval Diets for the Mediterranean Fruit Fly.

Several artificial larval diets have been developed, evaluated and used for mass-rearing of the Mediterranean fruit fly (medfly), Ceratitis capitata (Wiedemann) (Diptera: Teprhitidae). There are several efforts to reduce the cost of rearing and optimize the quality of the produced sterile males that are destined for release in sterile insect release programs. Survival, growth, longevity and reproductive capacity of sterile males are strongly connected with the most expensive ingredient, the brewer's yeast (protein), in the larval diet. The current study focused on settling the optimal content of brewer's yeast in a liquid diet and a gel diet. Egg hatch rates, developmental duration of immatures, pupation rate, pupae and adult survival were recorded as indicators of quantity and quality of the produced adults. Egg hatch was higher and larval developmental duration longer in the gel diet. In contrast to the liquid diet, an increase in brewer's yeast concentration was correlated with increased pupation rate and pupae survival in the gel diet. Reducing brewer's yeast up to 50% of its initial quantity had no significant effect on the survival of the emerging adults regardless of the diet type. Our findings may contribute to the production of low-cost and effective diets for use in mass-rearing facilities of medflies

Role-play for medical students learning about communication: Guidelines for maximising benefits

BACKGROUND: Role-play is widely used as an educational method for learning about communication in medical education. Although educational theory provides a sound rationale for using this form of simulation, there is little published evidence for its effectiveness. Students' prior experiences of role-play may influence the way in which they engage in this method. This paper explores students' experiences with the aim of producing guidelines for maximising the benefits of role-play within this learning context. METHODS: First-year undergraduate medical students participated in a role-play session as part of their communication programme. Before and after the session, students completed questionnaires. In the pre-session questionnaire, students were asked about their experiences of role-play and asked to identify helpful and unhelpful elements. Immediately after the session, students answered similar questions in relation to the role-play activity they had just completed. Descriptive statistics were used to analyse quantitative data and qualitative data was thematically analysed. RESULTS: 284 students completed evaluation forms. Although 63 (22.2%) had prior unhelpful experiences, most students (n = 274; 96.5%) found this experience helpful. Summary findings were that students reported the key aspects of helpful role-play were opportunities for observation, rehearsal and discussion, realistic roles and alignment of roles with other aspects of the curriculum. Unhelpful aspects were those that evoked strong negative emotional responses and factors that contributed to a lack of realism. CONCLUSION: Role-play was valued by students in the acquisition of communication skills even though some had prior unhelpful experiences. Guidelines for effective role-play include adequate preparation, alignment of roles and tasks with level of practice, structured feedback guidelines and acknowledgment of the importance of social interactions for learning

Classification des potentiels évoqués par corrélation de Pearson dans une interface cerveau-ordinateur

National audienceDans cette communication, nous décrivons et évaluons les performances d'une technique d'apprentissage des coefficients d'un classifieur linéaire utilisé dans une interface cerveau-ordinateur. Les signaux de l'électroencéphalogramme d'un individu sont analysés au moyen de cette technique afin de mettre en évidence les réponses de ce dernier à des stimuli visuels. Le traitement et la classification des signaux sont utilisés afin d'implanter un système de communication palliative permettant à l'individu d'épeler des mots. Les performances de la méthode de classification ont été évaluées par une expérimentation sur huit personnes

Dose-Dependent Effect of Rosuvastatin on VLDL–Apolipoprotein C-III Kinetics in the Metabolic Syndrome

OBJECTIVE—Dysregulated apolipoprotein (apo)C-III metabolism may account for hypertriglyceridemia and increased cardiovascular risk in the metabolic syndrome. This study investigated the dose-dependent effect of rosuvastatin on VLDL apoC-III transport in men with the metabolic syndrome

Evaluation of an inter-professional workshop to develop a psychosocial assessment and child-centred communication training programme for paediatricians in training

BACKGROUND: The quality of psychosocial assessment of children in consultations varies widely. One reason for this difference is the variability in effective mental health and communication training at undergraduate and post-qualification levels. In recognition of this problem, the Royal College of Paediatrics and Child Health in the United Kingdom have developed the Child in Mind Project that aims to meet this deficit in medical training. This paper describes the evaluation of a workshop that explored the experiences and expectations of health care professionals in the development of a training programme for doctors. METHODS: The one-day inter-professional workshop was attended by 63 participants who were invited to complete evaluation forms before and immediately after the workshop. RESULTS: The results showed that the workshop was partially successful in providing an opportunity for an inter-professional group to exchange ideas and influence the development of a significant project. Exploring the content and process of the proposed training programme and the opportunity for participants to share experiences of effective practice were valued. Participants identified that the current culture within many health care settings would be an obstacle to successful implementation of a training programme. Working within existing training structures will be essential. Areas for improvement in the workshop included clearer statement of goals at the outset and a more suitable environment for the numbers of participants. CONCLUSIONS: The participants made a valuable contribution to the development of the training programme identifying specific challenges. Inter-professional collaborations are likely to result in more deliverable and relevant training programmes. Continued consultation with potential users of the programme – both trainers and trainees will be essential