Faculty Development for the Use of High-Fidelity Patient Simulation: A Systematic Review

This is a systematic review of the research data between 1995 and June 2013 concerning faculty development in the use of high-fidelity patient simulation for health professionals and students with a search of the following databases: CINAHL, Nursing and Allied Health Collection: Comprehensive, OVID Medline, ScienceDirect, PubMed, Scopus, and ProQuest Dissertation/Theses Database. The primary search terms were high-fidelity patient simulation and faculty development. Reference lists from relevant articles were also reviewed. Twenty-five studies were included for this review. The majority of the studies were surveys with a few quasi-experimental designs. The themes were similar to those found in the non-research literature: strengths, incentives, barriers, use of faculty champions/simulation coordinator, and faculty development. The validity and reliability differed by study. There are numerous incentives and barriers to the use of high-fidelity patient simulation by faculty. Several examples of faculty development programs have been described in the literature but little evaluation has taken place beyond the end of the program. The goal of the use of high-fidelity patient simulation is to enhance the student’s knowledge, skills, and critical thinking in the care of patients. It is essential that the faculty are competent to provide instruction with high-fidelity patient simulation and therefore, the efficacy of these developmental programs need closer attention

Acceptance and commitment therapy processes and their association with distress in cancer: a systematic review and meta-analysis

Around 42% of individuals with cancer experience distress. Acceptance and Commitment Therapy (ACT) can reduce distress, but effects are small, and mechanisms unclear. This review aimed to identify associations between ACT processes and distress in cancer. Search terms included cancer, ACT processes, self-compassion, and distress. Six online databases and grey literature were searched to March 2022. Of 6555 papers screened, 108 studies were included with a total of 17195 participants. Five meta-analyses of seventy-seven studies were conducted. Random effects meta-analyses of correlations revealed higher scores on flexible processes (acceptance, present moment awareness, self-compassion) were associated with lower distress (rpooled = -0.24, -0.39, -0.48, respectively); whilst higher scores on inflexible processes (experiential avoidance, cognitive fusion) were associated with higher distress (rpooled = 0.58, 0.57, respectively). Meta-analyses displayed moderate-to-high heterogeneity with most studies assessed as low risk of bias. Meta-regressions revealed no significant moderators (stage, time since diagnosis, gender and age). This review provides a theoretically aligned evidence base for associations between ACT processes and distress in cancer, supporting elements of ACT theory and providing targeted directions for intervention development. Due to limited evidence, future research should focus on the under-investigated processes (self-as-context, values, committed action) and conducting mediation analysis of ACT processes on distress in cancer in controlled trials

Wainwright’s West Yorkshire: affect and landscape in the television drama of Sally Wainwright

Over the past two decades RED Production Company's key presence in British television drama has been grounded in its regional focus on the North of England. It shares this commitment with Sally Wainwright, whose work with and outside of RED is built around a strong affective engagement with its characters’ experiences. These stories offer intimate explorations of family dynamics and female relationships, situated within and interwoven with the spaces and places of West Yorkshire. From her adaptation of Wuthering Heights in Sparkhouse (BBC, 2002) to her 2016 Christmas biopic of the Brontë sisters To Walk Invisible (BBC, 2016), through Last Tango in Halifax (BBC, 2012–16) and Happy Valley (BBC, 2014–) these are distinctly regional narratives whose female-led familial melodrama, psychodrama and romance are embedded within and return to the landscapes of the region, spaces which blend the stolid and torrid. Wide and spectacular aerial shots follow cars that track through the green and brown expanses between the Harrogate and Halifax families of the elderly couple in Last Tango, the beauty of the Calder Valley pens in the stark bleakness that is foundational to Happy Valley, and the Brontë sisters stride across heathered hills and are silhouetted against grey skies in To Walk Invisible. This article explores the visual dynamics of Wainwright's work and her engagement with the landscapes of the region in both her writing and direction, evoking their numerous literary and cultural connotations in her interweaving of West Yorkshire's stark, dynamic beauty with her stories of intimate female affect

Cost analysis and outcomes of endoscopic, minimal access and open pancreatic necrosectomy.

To assess both individual patient and institutional costs as well as outcomes in patients with pancreatic necrosis who underwent either endoscopic, minimal access or open pancreatic necrosectomy. These data can be used to evaluate clinical effectiveness with a view to informing local health care providers. Intervention for infected pancreatic necrosis is associated with a high morbidity, mortality and long hospital stays. Minimal access surgical step-up approaches have been the gold standard of care, however endoscopic approaches are now offered preferentially. All patients undergoing endoscopic (EN), minimal access retroperitoneal (MARPN) and open (OPN) necrosectomy at a single institution from April 2015-March 2017 were included. Patients were selected for intervention based on morphology and position of the necrosis and on clinical factors. Patient level costing systems were used to determine inpatient and outpatient costs. 86 patients were included: 38 underwent EN, 35 MARPN and 13 OPN. Pre-operative APACHEII was 6 vs 9 vs 9 (p=0.017) and CRP 107 vs 204 vs 278, (p=0.012), respectively. Post-operative stay was 19 days for EN vs. 41 for MARPN vs. 42 for OPN (p=0.007). Complications occurred in 68.4%, 68.6% and 46.2% (p=0.298) while mortality was 10.5%, 22.9% and 15.4% (p=0.379) respectively. Mean total cost was £31,364 for EN, £52,770 for MARPN (p=0.008) and £60,346 for OPN. Ward and critical care costs for EN were lower than for MARPN (ward: £9,430 vs. £14,033, p=0.024; critical care: £5,317 vs. £16,648, p=0.056)

Discovery of mating in the major African livestock pathogen Trypanosoma congolense

The protozoan parasite, Trypanosoma congolense, is one of the most economically important pathogens of livestock in Africa and, through its impact on cattle health and productivity, has a significant effect on human health and well being. Despite the importance of this parasite our knowledge of some of the fundamental biological processes is limited. For example, it is unknown whether mating takes place. In this paper we have taken a population genetics based approach to address this question. The availability of genome sequence of the parasite allowed us to identify polymorphic microsatellite markers, which were used to genotype T. congolense isolates from livestock in a discrete geographical area of The Gambia. The data showed a high level of diversity with a large number of distinct genotypes, but a deficit in heterozygotes. Further analysis identified cryptic genetic subdivision into four sub-populations. In one of these, parasite genotypic diversity could only be explained by the occurrence of frequent mating in T. congolense. These data are completely inconsistent with previous suggestions that the parasite expands asexually in the absence of mating. The discovery of mating in this species of trypanosome has significant consequences for the spread of critical traits, such as drug resistance, as well as for fundamental aspects of the biology and epidemiology of this neglected but economically important pathogen

Canonical Formulation of Spin in General Relativity

The present thesis aims at an extension of the canonical formalism of Arnowitt, Deser, and Misner from self-gravitating point-masses to objects with spin. This would allow interesting applications, e.g., within the post-Newtonian (PN) approximation. The extension succeeded via an action approach to linear order in the single spins of the objects without restriction to any further approximation. An order-by-order construction within the PN approximation is possible and performed to the formal 3.5PN order as a verification. In principle both approaches are applicable to higher orders in spin. The PN next-to-leading order spin(1)-spin(1) level was tackled, modeling the spin-induced quadrupole deformation by a single parameter. All spin-dependent Hamiltonians for rapidly rotating bodies up to and including 3PN are calculated.Comment: 59 pages. Dissertation, Friedrich-Schiller-Universit\"at, Jena, 2010. This thesis was submitted in June 2010. Cite as Ann. Phys. (Berlin) 523:296 (2011

In vitro functional effects of XPC gene rare variants from bladder cancer patients

The XPC gene is involved in repair of bulky DNA adducts formed by carcinogenic metabolites and oxidative DNA damage, both known bladder cancer risk factors. Single nucleotide polymorphisms (SNPs) in XPC have been associated with increased bladder cancer risk. Recently, rarer genetic variants have been identified but it is difficult to ascertain which are of functional importance. During a mutation screen of XPC in DNA from 33 bladder tumour samples and matched blood samples, we identified five novel variants in the patients’ germ line DNA. In a case–control study of 771 bladder cancer cases and 800 controls, c.905T>C (Phe302Ser), c.1177C>T (Arg393Trp), c.*156G>A [3′ untranslated region (UTR)] and c.2251-37C>A (in an intronic C>G SNP site) were found to be rare variants, with a combined odds ratio of 3.1 (95% confidence interval 1.0–9.8, P = 0.048) for carriage of one variant. The fifth variant was a 2% minor allele frequency SNP not associated with bladder cancer. The two non-synonymous coding variants were predicted to have functional effects using analytical algorithms; a reduced recruitment of GFP-tagged XPC plasmids containing either c.905T>C or c.1177C>T to sites of 408 nm wavelength laser-induced oxidative DNA damage was found in vitro. c.*156G>A appeared to be associated with reduced messenger RNA stability in an in vitro plasmid-based assay. Although the laser microbeam assay is relevant to a range of DNA repair genes, our 3′ UTR assay based on Green fluorescent protein(GFP) has widespread applicability and could be used to assess any gene. These assays may be useful in determining which rare variants are functional, prior to large genotyping efforts

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Efficacy of therapist-delivered transdiagnostic CBT for patients with persistent physical symptoms in secondary care: a randomised controlled trial

Background: Medically unexplained symptoms otherwise referred to as persistent physical symptoms (PPS) are debilitating to patients. As many specific PPS syndromes share common behavioural, cognitive, and affective influences, transdiagnostic treatments might be effective for this patient group. We evaluated the clinical efficacy and cost-effectiveness of a therapist-delivered, transdiagnostic cognitive behavioural intervention (TDT-CBT) plus (+) standard medical care (SMC) v. SMC alone for the treatment of patients with PPS in secondary medical care. Methods: A two-arm randomised controlled trial, with measurements taken at baseline and at 9, 20, 40- and 52-weeks post randomisation. The primary outcome measure was the Work and Social Adjustment Scale (WSAS) at 52 weeks. Secondary outcomes included mood (PHQ-9 and GAD-7), symptom severity (PHQ-15), global measure of change (CGI), and the Persistent Physical Symptoms Questionnaire (PPSQ). Results: We randomised 324 patients and 74% were followed up at 52 weeks. The difference between groups was not statistically significant for the primary outcome (WSAS at 52 weeks: estimated difference -1.48 points, 95% confidence interval from -3.44 to 0.48, p = 0.139). However, the results indicated that some secondary outcomes had a treatment effect in favour of TDT-CBT + SMC with three outcomes showing a statistically significant difference between groups. These were WSAS at 20 weeks (p = 0.016) at the end of treatment and the PHQ-15 (p = 0.013) and CGI at 52 weeks (p = 0.011). Conclusion: We have preliminary evidence that TDT-CBT + SMC may be helpful for people with a range of PPS. However, further study is required to maximise or maintain effects seen at end of treatment

Introduction

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67161/2/10.1177_0308275X9301300401.pd