Comparing the da Vinci Si Single Console and Dual Console in Teaching Novice Surgeons Suturing Techniques

Background and Objectives:

Robot-assisted laparoscopic surgery is often taught with the surgical mentor at the surgeon console and the trainee at the patient''s bedside. The da Vinci dual console (Intuitive Surgical, Sunnyvale, California) allows a surgical mentor to teach with both the mentor and the trainee working at a surgeon console simultaneously. The purpose of this study is to evaluate the effectiveness of the dual console versus the single console for teaching medical students robotic tasks.

Methods:

Forty novice medical students were randomized to either the da Vinci single-console or dual-console group and were taught 4 knot-tying techniques by a surgical mentor. The students were timed while performing the tasks.

Results:

No statistically significant differences in mean task times were observed between the single- and dual-console groups: interrupted stitch with a 2-handed knot (300 seconds for single vs 294 seconds for dual, P = .59), interrupted stitch with a 1-handed knot (198 seconds for single vs 212 seconds for dual, P = .88), figure-of-8 stitch with a 2-handed knot (261 seconds for single vs 219 seconds for dual, P = .20), and figure-of-8 stitch with a 1-handed knot (200 seconds for single vs 199 seconds for dual, P = .53).

Conclusion:

No significant difference was observed in performance time when teaching knot-tying techniques to medical students using the da Vinci dual console compared with the single console. More research needs to be performed on the utility of the da Vinci dual console in surgical training.     

Cortisol Level Modulated by Integrative Meditation in a Dose‐dependent Fashion

Prior research has shown that an additional training session immediately after acute stress decreases release of salivary cortisol in a college student group trained with 5‐day integrative body–mind training (IBMT) in comparison with a control group given the same amount of relaxation training. However, 5 days of training does not influence the basal secretion of cortisol. The current study seeks to extend this finding and determine whether increasing amounts of IBMT will decrease the basal cortisol level, suggesting reduced stress to daily activities. Thirty‐four Chinese undergraduates were randomly assigned either to 4 weeks of IBMT or a relaxation control. Salivary cortisol levels at baseline before training and the three stages of a stress intervention test (i.e. rest, stress and additional 20‐min practice) after 2 and 4 weeks of training were assessed. The basal cortisol level decreased significantly in the IBMT but not in relaxation group after 2 and 4 weeks of training. An additional IBMT practice session immediately after acute stress produced significantly lower cortisol release for the IBMT group in comparison with relaxation at weeks 2 and 4. The results indicate that IBMT produces a change in the basal endocrine system and larger acute effects as the dose of training increases. Copyright © 2013 John Wiley & Sons, Ltd.     

RCT of a promising vocational/employment program for high-risk juvenile offenders

Juvenile offenders with substance use problems are at high risk for deleterious long-term outcomes. This study evaluated the capacity of a promising vocational and employment training program in the building sector (i.e., Community Restitution Apprenticeship-Focused Training, CRAFT) to mitigate such outcomes through enhanced employment and education. Participants were 97 high-risk juvenile offenders (mean age = 15.8 years) randomized to CRAFT versus education as usual (EAU) intervention conditions. Multi-method procedures measured employment, education, substance use, mental health, and criminal outcomes through a 30-month post-baseline follow-up. CRAFT was significantly more effective than EAU at increasing rates of youth employment and GED attendance. Intervention effects were not observed, however, for months employed, hours worked, or hourly wage. Measures of youth substance use, mental health symptoms, and criminal activity showed no favorable or iatrogenic effects. The potential of CRAFT was modestly supported, and suggestions were made for future research.     

A Nontraditional Faculty Development Initiative Using a Social Media Platform

Objective. To assess the outcomes from an 11-year nontraditional professional development activity implemented by female faculty members at several colleges and schools of pharmacy.Design. Within the context of an online fantasy football league, faculty members practiced community-based faculty development strategies, including peer mentoring, skills development, constructive feedback and other supportive behaviors.Assessment. Data were extracted from curriculum vitae to characterize the academic progress of participants and to quantify scholarly work collaborations among league members. Analyses were limited to members who had participated in the league for 10 or more consecutive years. Seventy-one collaborative scholarly works occurred among team managers, including presentation of 20 posters and 2 oral presentations at national or international meetings, publication of 29 peer-reviewed articles and 15 book chapters, and funding of 5 research projects.Conclusion. Social media platforms can foster nontraditional faculty development and mentoring by enhancing connectivity between pharmacy educators who share similar interests.     

Modafinil combined with cognitive training is associated with improved learning in healthy volunteers – A randomised controlled trial

Improving cognition in people with neuropsychiatric disorders remains a major clinical target. By themselves pharmacological and non-pharmacological approaches have shown only modest effects in improving cognition. In the present study we tested a recently-proposed methodology to combine CT with a ‘cognitive-enhancing’ drug to improve cognitive test scores and expanded on previous approaches by delivering combination drug and CT, over a long intervention of repeated sessions, and used multiple tasks to reveal the cognitive processes being enhanced. We also aimed to determine whether gains from this combination approach generalised to untrained tests. In this proof of principle randomised-controlled trial thirty-three healthy volunteers were randomised to receive either modafinil or placebo combined with daily cognitive training over two weeks. Volunteers were trained on tasks of new-language learning, working memory and verbal learning following 200 mg modafinil or placebo for ten days. Improvements in trained and untrained tasks were measured. Rate of new-language learning was significantly enhanced with modafinil, and effects were greatest over the first five sessions. Modafinil improved within-day learning rather than between-day retention. No enhancement of gains with modafinil was observed in working memory nor rate of verbal learning. Gains in all tasks were retained post drug-administration, but transfer effects to broad cognitive abilities were not seen. This study shows that combining CT with modafinil specifically elevates learning over early training sessions compared to CT with placebo and provides a proof of principle experimental paradigm for pharmacological enhancement of cognitive remediation.     

试论基层药学服务的高职药学专业课程体系改革

目的 探讨高职药学专业课程体系改革,使学生具备在基层开展药学服务的能力.方法 分析现有高职药学专业课程体系存在的问题,研究基层药学服务的基本需求,有针对性地进行高职药学专业课程体系的改革.结果 长期以来,我国高职药学教育沿袭“化学—药学教育模式”,培养出来的学生化学知识丰富,生物医学知识贫乏,与药学服务工作相关的能力比较薄弱.结论 通过理论教学体系和实践教学体系两个方面的改革,强化医学类课程教学,加强专业课程的优化整合,注重交叉学科课程的开设,新增人文学科知识,践行情景式的实验教学,探索“双元制”的教学模式,培养出来的学生能基本满足在基层开展药学服务的需要.     

基于职业岗位的高职药学人才培养方案的课程构建

目的通过调研药学专业毕业生的职业岗位任务,探索高职药学人才培养方案。方法调研高职药学生的就业岗位,分析执行工作任务时所必须具备的专业知识、能力和素质,制定以职业岗位导向的人才培养方案。结果结合职业岗位制定实用性人才培养方案。结论制定切合职业岗位的人才培养方案,更好地提高高职药学专业人才培养质量。     

盆底肌锻炼对老年前列腺电切术后暂时性尿失禁的影响

目的探讨盆底肌锻炼对老年前列腺汽化电切术后暂时性尿失禁的影响。方法将60例老年前列腺汽化电切患者随机分为实验组和对照组各30例,两组按老年前列腺汽化电切术后护理常规进行护理,实验组在此基础上实施盆底肌锻练,术后3个月评价患者排尿功能情况,比较两组术后尿频、尿急、尿失禁发生率。结果实验组术后发生尿频1例（4％）,尿急2例（7％）,尿失禁Ⅰ度4例（14％）、Ⅱ度2例（7％）;对照组术后发生尿频6例（20％）,尿急5例（17％）,尿失禁Ⅰ度9例（30％）、Ⅱ度4例（14％）、Ⅲ度1例（4％）;两组比较,差异有统计学意义（P〈0．05）。结论盆底肌锻炼是一种简单、易行、有效的方法,能有效预防和降低术后尿失禁的发生,对缩短术后尿失禁的持续时间有积极的作用。