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Stuart J. Dilley Tracey J. Weiland Robert O’Brien Neil J. Cunningham Julian E. Van Dijk Rosie M. Mahoney 《Teaching and learning in medicine》2015,27(1):71-79
Theory: Immersive simulation is a common mode of education for medical students. Observation of clinical simulations prior to participation is believed to be beneficial, though this is often a passive process. Active observation may be more beneficial. Hypotheses: The hypothesis tested in this study was that the active use of a simple checklist during observation of an immersive simulation would result in better participant performance in a subsequent scenario compared with passive observation alone. Methods: Medical students were randomized to either passive or active (with checklist) observation of an immersive simulation involving cardiac arrest prior to participating in their own simulation. Performance measures included time to cardiopulmonary resuscitation (CPR) and time to defibrillation and were compared between first and second scenarios as well as between passive and active observers. Results: Seventy-nine simulations involving 232 students were conducted. Mean time to CPR was 18 seconds (SD = 11.6) for those using the checklist and 24 seconds (SD = 15.8) for those who observed passively (M difference = 6 seconds), t(35) = 1.46, p =.153. Time to defibrillation was 94 seconds (SD = 26.4) for those using the checklist and 92 seconds (SD = 23.8) for those who observed passively (M difference = –2 seconds), t(38) =.21, p =.837. Time to CPR was 24 seconds (SD = 15.8) for passive observers and 31 seconds (SD = 21.0; M difference = 7 seconds), t(35) = 1.13, p =.265, for their first scenario counterparts. Time to CPR was 18 seconds (SD = 11.6) for active observers and 36 seconds (SD = 26.2; M difference = 18 seconds), t(24) = 2.81, p =.010, for their first scenario counterparts. Time to defibrillation was 92 seconds (SD = 23.8) for passive observers and 125 seconds (SD = 32.2; M difference = 33 seconds), t(33) = 3.63, p =.001, for their first scenario counterparts. Time to defibrillation was 94 seconds (SD = 26.4) for the active observers and 132 seconds (SD = 52.9; M difference = 38 seconds), t(28) =.46, p =.008, for their first scenario counterparts. Conclusions: Observation alone leads to improved performance in the management of a simulated cardiac arrest. The active use of a simple skills-based checklist during observation did not appear to improve performance over passive observation alone. 相似文献
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Oliver Sartor MD Daniel Heinrich MD Neil Mariados MD Maria José Méndez Vidal MD Daniel Keizman MD Camilla Thellenberg Karlsson MD Avivit Peer MD Giuseppe Procopio MD Stephen J. Frank MD Kalevi Pulkkanen MD Eli Rosenbaum MD Stefano Severi MD José Trigo MD Lucia Trandafir MD Volker Wagner MD Rui Li MS Luke T. Nordquist MD 《The Prostate》2019,79(14):1683-1691
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Dinesh Singhal Nandini Vasdev Arvinder Soin Subash Gupta Samiran Nundy 《Indian journal of gastroenterology》2006,25(4):206-207
It is difficult to distinguish between carcinoid tumors of the pancreatic head and periampullary region and carcinomas preoperatively. Between 1996 and 2002, 125 consecutive pancreaticoduodenectomies done by us for periampullary tumors (14 carcinoids, 111 carcinomas) were analyzed. Patients with carcinoid tumors had significantly younger mean age (48 vs. 54 years), longer history (32 vs. 8 weeks), lower serum total bilirubin levels (1.4 vs. 6.3 mg/dL) and on CT scan, had larger, well-localized tumors (5 cm vs. 2 cm). Their postoperative course was better with no mortality or major morbidity, whereas after resection for carcinoma 7 (6.3%) patients died and 30 (27%) had major postoperative complications. Thus, a tumor of this region in a young patient with indolent history, low bilirubin level and with CT scan depicting a large expansile lesion suggests a carcinoid. Such tumors may be safely resected with low postoperative morbidity and mortality and good long-term prognosis. 相似文献
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Caroline A. Harrison BMedSci MRCS ; Martin J. Heaton MD FRCS ; Christopher M. Layton PhD ; Sheila Mac Neil PhD 《Wound repair and regeneration》2006,14(2):203-209
To produce a stable epidermis, keratinocytes need to be firmly attached to the basement membrane. However, following wounding, keratinocytes are required to develop a migratory phenotype in order to reepithelialize the wound. To investigate some of the issues underlying reepithelialization, we have developed a three-dimensional in vitro model of tissue-engineered skin, comprising sterilized human dermis seeded with human keratinocytes and dermal fibroblasts. Using this model, we have shown that the inclusion of fibroblasts within the model increases the stability of keratinocyte attachment. We have also demonstrated that keratinocyte migration occurs most effectively in the absence of a basement membrane and following the inclusion of fibroblasts in the model. In addition, subjecting the keratinocyte layer to mechanical trauma induces a migratory phenotype. We conclude that this three-dimensional in vitro wound model can be used to increase our understanding of the factors that enhance keratinocyte migration and hence wound healing in vivo. 相似文献
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Neil Harrington 《Cognitive therapy and research》2006,30(6):699-709
Beliefs regarding the toleration of frustration and discomfort are often described as underlying psychological disturbance, and represent a fundamental concept in Rational Emotive Behavior Therapy (REBT). Nevertheless, there has been little systematic analysis of the content of these beliefs, which are often treated as a unidimensional construct. This paper investigates the relationship between a multidimensional Frustration Discomfort Scale (FDS) and measures of depressed mood, anxiety, and anger, in a clinical population. Results indicated that FDS sub-scales were differentially related to specific emotions, independent of self-esteem and negative affect. The entitlement sub-scale was uniquely associated with anger, discomfort intolerance with depressed mood, and emotional intolerance with anxiety. These results supported the validity of the FDS, the importance of distinguishing between frustration intolerance dimensions, and of separating these beliefs from those related to self-worth.Copies of the Frustration Discomfort Scale are available from the author on request 相似文献
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A wound, in the broadest sense, is a disruption of normal anatomic structure and function. Acute wounds progress through a timely and orderly sequence of repair that leads to the restoration of functional integrity. In chronic wounds, this timely and orderly sequence goes awry. As a result, people with chronic wounds often face not only physiological difficulties but emotional ones as well. The study of body image and its damage as a result of a chronic wound fits well with Selder's transition theory. This article describes interviews with seven patients with chronic wounds. The themes that emerged from those interviews were compared with Selder's theory to describe patients' experience with chronic wounds as a transition process that can be identified and better understood by healthcare providers. 相似文献
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Timothy Threlfall Neil Kent Peter Garcia-Webb Elizabeth Byrnes Paul Psaila-Savona 《Australian and New Zealand journal of public health》1993,17(4):379-381
Abstract: This study reports on an analysis of the lead concentrations in 123 venous blood samples collected from Perth children aged between two months and 17 years attending Princess Margaret Hospital. The overall geometric mean was 6.9 μg lead per 100 ml whole blood, with 95 per cent of results lying between 3.2 and 14.8 μg/100 ml. Among children under five years of age, those aged between 18 months and two years had the highest geometric mean blood lead (11.1 μg/100 ml). There were no consistent associations between geometric mean blood lead and area of residence, age group or sex. In this sample of Perth children, the mean blood lead concentration was lower than those reported in other studies. Less than 0.1 per cent of children of the age range studied would have been expected to have lead levels exceeding the NHMRC ‘level of concern’ (25 μg/100 ml) current at the time of the study. However, the recent adoption of goal of less than 10 μg/100 ml could mean that lead levels in up to 21 per cent of Perth children would now be regarded as excessive. 相似文献