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91.
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Victor M. Neira MD M. Dylan Bould MBChB Amy Nakajima MD Sylvain Boet MD Nicholas Barrowman PhD Philipp Mossdorf MD PhD Devin Sydor MD Amy Roeske MD Stephen Noseworthy MD Viren Naik MD Dermot Doherty MD Hilary Writer MD Stanley J. Hamstra PhD 《Journal canadien d'anesthésie》2013,60(3):280-289
Purpose
Our objective was to develop and evaluate a Generic Integrated Objective Structured Assessment Tool (GIOSAT) to integrate Medical Expert and intrinsic (non-medical expert) CanMEDS competencies with non-technical skills for crisis simulation.Methods
An assessment tool was designed and piloted using two pediatric anesthesia scenarios (laryngospasm and hyperkalemia). Following revision of the tool, we used previously recorded videos of anesthesia residents (n = 50) who managed one of two intraoperative advanced cardiac life support (ACLS) scenarios (ventricular tachycardia or ventricular fibrillation). Four independent trained raters, blinded to the residents’ level of training, analyzed the video recordings using the GIOSAT scale. Inter-rater reliability was calculated using intraclass correlations (ICCs) for single raters (single measure) and the average of the four raters (average measure), and construct validity was investigated by correlating GIOSAT scores with postgraduate year of residency (PGY).Results
Total GIOSAT scores for the ACLS scenarios had single measure ICCs of 0.62 and average measure ICCs of 0.85. Inter-rater reliability was substantial for both Medical Expert and intrinsic competencies (single measure ICCs 0.69 and 0.62, respectively; average measure ICCs 0.90 and 0.82, respectively). We found significant correlations between PGY level and total GIOSAT score (r = 0.36; P = 0.011) and between PGY level and Medical Expert competencies (r = 0.42; P = 0.003); however, correlations were not found between PGY level and intrinsic CanMEDS competencies (r = 0.24; P = 0.09).Conclusion
Inter-rater reliability of the total GIOSAT scores using four trained raters was substantial. Significant correlation between PGY and (i) total GIOSAT score and (ii) Medical Expert competencies supports construct validity. Evidence of validity was not obtained for intrinsic CanMEDS competencies. 相似文献94.
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Jennifer S. Beighley Johnny L. Matson Robert D. Rieske Hilary L. Adams 《Research in developmental disabilities》2013,34(10):3497-3503
Feeding problems are common in children with autism spectrum disorders (ASDs), with food selectivity being the most frequently reported. Selectivity based on type and/or texture of food is of concern in those with ASD. Variations in symptom presentation of food selectivity in children with different autism spectrum diagnoses across childhood have not often been investigated. Parent-report of food selectivity was examined in 525 children age 2–18 years diagnosed with autistic disorder, PDD-NOS, Asperger's disorder, atypical development, and typical development using information garnered from the Autism Spectrum Disorder-Comorbidity for Children (ASD-CC), a tool to assess emotional issues and comorbid psychopathology. Individuals with an ASD were reported to have significantly more food selectivity than both the atypically developing group and the typically developing group. In addition, the ASD groups, when looked at together, showed a decrease in food selectivity across childhood with significant decrease in the Asperger's disorder group. 相似文献
97.
Richard Hall Scott Beattie Hilary P. Grocott C. David Mazer Alexis F. Turgeon André Denault Homer Yang Manoj M. Lalu Ronald B. George Sonia Sampson Heather McDonald members of the Canadian Perioperative Anesthesiology Clinical Trials Group Steering Committee 《Journal canadien d'anesthésie》2016,63(11):1215-1222
98.
Hilary C. McCrary MPH Erynne A. Faucett MD Audrey B. Erman MD 《The Laryngoscope》2016,126(10):2242-2245
Immunoglobulin G4–related sclerosing disease (IgG4‐RSD) is a fibroinflammatory condition that has the potential to affect nearly every organ system. Classic histological findings include storiform fibrosis and lymphoplasmacytic infiltrates of immunoglobulin G4 (IgG4)–positive plasma cells. The clinical features of IgG4‐RSD may be an under‐recognized disease process that can mimic other autoimmune disorders, including Sjogren's syndrome. We describe a rare case of IgG4‐RSD involving the salivary glands, initially misdiagnosed as Sjogren's syndrome. Clinical features of IgG4‐RSD can mimic those of other autoimmune disorders affecting the head and neck. Therefore, otolaryngologists should have IgG4‐RSD on their differential when evaluating patients with diffuse salivary gland swelling. Laryngoscope, 126:2242–2245, 2016 相似文献
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Cappelletti M Barth H Fregni F Spelke ES Pascual-Leone A 《Experimental brain research. Experimentelle Hirnforschung. Expérimentation cérébrale》2007,179(4):631-642
It has been widely argued that the intraparietal sulcus (IPS) is involved in tasks that evoke representations of numerical
magnitude, among other cognitive functions. However, the causal role of this parietal region in processing symbolic and non-symbolic
numerosity has not been established. The current study used repetitive Transcranial Magnetic Stimulation (rTMS) to the left
and right IPS to investigate the effects of temporary deactivations of these regions on the capacity to represent symbolic
(Arabic numbers) and non-symbolic (arrays of dots) numerosities. We found that comparisons of both symbolic and non-symbolic
numerosities were impaired after rTMS to the left IPS but enhanced by rTMS to the right IPS. A signature effect of numerical
distance was also found: greater impairment (or lesser facilitation) when comparing numerosities of similar magnitude. The
reverse pattern of impairment and enhancement was found in a control task that required judging an analogue stimulus property
(ellipse orientation) but no numerosity judgements. No rTMS effects for the numerosity tasks were found when stimulating an
area adjacent but distinct from the IPS, the left and right angular gyrus. These data suggest that left IPS is critical for
processing symbolic and non-symbolic numerosity; this processing may thus depend on common neural mechanisms, which are distinct
from mechanisms supporting the processing of analogue stimulus properties.
H. Barth and F. Fregni contributed equally to this study. 相似文献