scholarly journals The Role of Simulation in Teaching Sinus Surgery in Otolaryngology Residency: A Survey of Rhinologists

2016 ◽  
Vol 7 (4) ◽  
pp. ar.2016.7.0180 ◽  
Author(s):  
Philip G. Chen ◽  
Daniel R. Chang ◽  
Erik K. Weitzel ◽  
Jennifer Peel ◽  
Rakesh K. Chandra ◽  
...  
Keyword(s):  
Simulation Training ◽  
The United States ◽  
Sinus Surgery ◽  
Training Curriculum ◽  
Training Tool ◽  
Standardized Curriculum ◽  
Common Barriers ◽  
Question Survey

Background Simulation is currently recognized as an effective surgical training tool. However, no standardized curriculum exists for endoscopic sinus surgery (ESS) simulation training. The goal of this study was to obtain an understanding of current ESS simulation use to aid the future development of an ESS training curriculum. Methods A 14-question survey regarding sinus simulation in residency training was developed through the education committee of the American Rhinologic Society. The survey was administered to academic American Rhinologic Society members in the United States, Canada, and Puerto Rico. The participants provided information regarding the type, amount, and effectiveness of simulation use in their residency program. Results Responses were received from 67 training programs; 45% of the programs endorsed using simulation training, although only 23.9% used ESS simulation, and all the programs used cadavers. Only 12.5% of respondent programs required ESS simulation training before operating on live patients, and trainees had an average of <6 hours of simulation training before live operations. A majority of respondents observed subjective improvement in residents' endoscope handling, dexterity, and understanding of anatomy after ESS simulation. The greatest obstacles identified were associated cost and lack of realistic simulators. Conclusion A majority of responders observed improved surgical technique and knowledge in residents after simulation training. However, <25% of the survey responders used ESS simulation and cited cost and limited availability as the most common barriers. A curriculum of validated simulators has potential to improve the quality of ESS training during residency.

Biopsychosocial Patterning of Multimorbidity and Its Consequences

2018 ◽  
pp. 220-236
Author(s):  
Elliot Friedman ◽  
Beth LeBreton ◽  
Lindsay Fuzzell ◽  
Elizabeth Wehrpsann
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Functional Outcomes ◽  
The United States ◽  
Chronic Medical Conditions ◽  
Quality Of Life Research ◽  
Increased Risk ◽  
Over Time

By many estimates the majority of adults over age 65 have two or more chronic medical conditions (multimorbidity) and are consequently at increased risk of adverse functional outcomes. Nonetheless, many older adults with multimorbidity are able to maintain high levels of function and retain good quality of life. Research presented here is designed to understand the influences that help ensure better functional outcomes in these older adults. This chapter presents findings that draw on data from the Midlife in the United States study. The independent and interactive contributions of diverse factors to multimorbidity and changes in multimorbidity over time are reviewed. The degree that multimorbidity increases risk of cognitive impairment and disability is examined. The role of inflammation as a mediator is considered. Multimorbidity is increasingly the norm for older adults, so better understanding of factors contributing to variability in multimorbidity-related outcomes can lead to improved quality of life.

scholarly journals The Value of Citizen Science in Increasing Our Knowledge of Under-Sampled Biodiversity: An Overview of Public Documentation of Auchenorrhyncha and the Hoppers of North Carolina

2021 ◽  
Vol 9 ◽  
Author(s):  
Kyle D. Kittelberger ◽  
Solomon V. Hendrix ◽  
Çağan Hakkı Şekercioğlu
Keyword(s):  
North Carolina ◽  
Citizen Science ◽  
Spatial Scales ◽  
The United States ◽  
Undescribed Species ◽  
The Past ◽  
Global Biodiversity ◽  
Temporal And Spatial

Due to the increasing popularity of websites specializing in nature documentation, there has been a surge in the number of people enthusiastic about observing and documenting nature over the past 2 decades. These citizen scientists are recording biodiversity on unprecedented temporal and spatial scales, rendering data of tremendous value to the scientific community. In this study, we investigate the role of citizen science in increasing knowledge of global biodiversity through the examination of notable contributions to the understanding of the insect suborder Auchenorrhyncha, also known as true hoppers, in North America. We have compiled a comprehensive summary of citizen science contributions—published and unpublished—to the understanding of hopper diversity, finding over fifty previously unpublished country and state records as well as dozens of undescribed and potentially undescribed species. We compare citizen science contributions to those published in the literature as well as specimen records in collections in the United States and Canada, illuminating the fact that the copious data afforded by citizen science contributions are underutilized. We also introduce the website Hoppers of North Carolina, a revolutionary new benchmark for tracking hopper diversity, disseminating knowledge from the literature, and incorporating citizen science. Finally, we provide a series of recommendations for both the entomological community and citizen science platforms on how best to approach, utilize, and increase the quality of sightings from the general public.

scholarly journals Deregulation and the Assault on Science and the Environment

2020 ◽  
Vol 41 (1) ◽  
pp. 347-361 ◽  
Author(s):  
Jonathan M. Samet ◽  
Thomas A. Burke
Keyword(s):  
Public Health ◽  
Environmental Pollution ◽  
Reasoned Action ◽  
Scientific Evidence ◽  
Well Being ◽  
The United States ◽  
Research To Policy ◽  
Health And Well Being

The quality of the environment is a major determinant of the health and well-being of a population. The role of scientific evidence is central in the network of laws addressing environmental pollution in the United States and has been critical in addressing the myriad sources of environmental pollution and the burden of disease attributable to environmental factors. We address the shift away from reasoned action and science to a reliance on belief and document the efforts to separate regulation from science and to remove science-based regulations and policies intended to protect public health. We outline the general steps for moving from research to policy, show how each has been undermined, offer specific examples, and point to resources that document the enormity of the current efforts to set aside scientific evidence.

College Campus Sexual Assault: The Contribution of Peers’ Proabuse Informational Support and Attachments to Abusive Peers

2017 ◽  
Vol 24 (8) ◽  
pp. 922-935 ◽  
Author(s):  
Walter S. DeKeseredy ◽  
Amanda Hall-Sanchez ◽  
James Nolan
Keyword(s):  
United States ◽  
Sexual Assault ◽  
Peer Support ◽  
The United States ◽  
Female College Students ◽  
Campus Sexual Assault ◽  
Community Needs ◽  
And Control

Since the mid-1980s, researchers across the United States have uncovered high rates of sexual assault among female college students. However, to advance a better understanding of this gendered type of victimization, and to both prevent and control this problem, the research community needs to identify its major correlates. One that is consistently uncovered in North American campus survey work is negative peer support, especially that provided by male peers. Yet, some earlier studies have found that mixed-sex negative peer support, too, contributes to campus sexual assault. Using recent data from the Campus Quality of Life Survey conducted at a large residential school in the South Atlantic region of the United States, the main objectives of this article are to examine the role of mixed-sex negative peer support in campus sexual assault and to identify the groups of women most at risk of having friends who offer such support.

scholarly journals Can simulators be applied to improve cataract surgery training: a systematic review

2020 ◽  
Vol 5 (1) ◽  
pp. e000488
Author(s):  
Taha Muneer Ahmed ◽  
Badrul Hussain ◽  
M A Rehman Siddiqui
Keyword(s):  
Systematic Review ◽  
Cataract Surgery ◽  
Simulation Training ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Training Tool ◽  
Surgery Training ◽  
Simulation Based ◽  
Effective Training

ObjectiveThe purpose of this paper was to conduct a systematic review of existing literature on simulation-based training of cataract surgery. Available literature was evaluated and projections on how current findings could be applied to cataract surgery training were summarised. The quality of included literature was also assessed.Methods and analysisThe PubMed, Embase and Cochrane Library databases were searched for articles pertaining to simulation training in cataract surgery on 18 November 2019. Selected articles were qualitatively analysed.ResultsA total of 165 articles were identified out of which 10 met inclusion criteria. Four studies reported construct validity of the EyeSi simulator. Six studies demonstrated improved surgical outcomes corresponding to training on the simulator. Quality assessment of included studies was satisfactory.ConclusionCurrent studies on simulation training in cataract surgery all point towards it being an effective training tool with low risk of study biases confounding this conclusion. As technology improves, surgical training must embrace and incorporate simulation technology in training.

The need to strengthen the educative role of parents: Some implications drawn from educational productivity research

1995 ◽  
Vol 20 (4) ◽  
pp. 15-19
Author(s):  
Jeff Dorman
Keyword(s):  
United States ◽  
Learning Environment ◽  
Television Viewing ◽  
The United States ◽  
Home Learning Environment ◽  
Educational Productivity ◽  
Home Learning ◽  
Role Of Parents

This article considers the empirical results of educational productivity research conducted by a team of researchers from Australia and the United States in the mid 1980s. Based on nine factors identified by this research, three issues that highlight the important educative role of parents, namely, the quality of the home learning environment, homework support and monitoring television viewing are discussed.

scholarly journals SIMULATION TRAINING IN THE FORMATION OF FUTURE DOCTORS AS A WAY OF DEVELOPING THEIR PRACTICAL EXPERIENCE

2021 ◽  
pp. 92-105
Author(s):  
Liudmyla Dushyk ◽  
Valentina Mykhaylychenko ◽  
Olexii Tsivenko
Keyword(s):  
Simulation Training ◽  
Standardized Patients ◽  
Practical Experience ◽  
Standardized Patient ◽  
Advantages And Disadvantages ◽  
Sequence Of Events ◽  
Quality Of Medical Care ◽  
Role Of Teachers

It is shown that the use of simulation technologies in the learning process allows medical students to gain practical experience and qualitatively increase the level of their professionalism against the background of the appropriate level of theoretical knowledge. The content of simulation training as an art to imitate reality, the sequence of events and actions or the mental process of training in the quality of medical care to patients is considered. Its advantages and disadvantages are revealed. An analysis of the effectiveness of simulation training with the involvement of a standardized “patient” during the internship by students of the Department of Surgical Diseases. The role of teachers of the department is shown, who observed the behavior of the “standardized patient” and evaluated the results of students’ work according to the scoring system, according to the criteria. A detailed analysis of the training results, a joint discussion of measures aimed at improving treatment and diagnostic tactics and errors were conducted. Methodical recommendations for training have been developed. It is concluded that the method of “standardized patients” is an effective way to gain practical experience of clinical competence and its evaluation. The worldwide spread of this method indicates the need for its intensive implementation in Ukraine.

scholarly journals Endoscopic sinus surgery in patients with cystic fibrosis: a systematic review and meta-analysis of pulmonary function

2012 ◽  
Vol 50 (4) ◽  
pp. 360-369
Author(s):  
K.I. Macdonald ◽  
A. Gipsman ◽  
A. Magit ◽  
M. Fandino ◽  
E. Massoud ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cystic Fibrosis ◽  
Pulmonary Function ◽  
Endoscopic Sinus Surgery ◽  
Meta Analysis ◽  
Pulmonary Function Tests ◽  
Sinus Surgery ◽  
Intravenous Antibiotics

Introduction: The role of endoscopic sinus surgery (ESS) in patients with cystic fibrosis (CF) is not clearly defined. Objective: TO perform a systematic review of subjective and objective outcomes of ESS in CF. Methods: A systematic review was performed using the keywords 'sinusitis,' 'sinus surgery,' 'nasal polyps' and 'cystic fibrosis.' The quality of papers was assessed using the NICE scoring scale. Outcomes included safety, subjective symptoms, objective endoscopy scores, days spent in hospital, courses of antibiotics, and pulmonary function tests (PFTs). Results: Nineteen studies involving 586 patients were included in the review. There were four prospective cohort trials, and three were rated as good quality. There were no major complications attributable to ESS. There was consistent evidence in four cohort studies of improved sinonasal symptoms, including nasal obstruction, facial pain, headaches, rhinorrhea and olfaction. Three studies reported conflicting results in post-operative endoscopy scores. Three studies showed a decrease in days spent in hospital, and two showed a significant decrease in courses of intravenous antibiotics. A recent study, however, did not show a difference in either days spent in hospital or courses of antibiotics. Pulmonary function tests were not improved by ESS in six cohort trials, and one small study found significant improvement. A meta-analysis of FEV1 scores confirmed no significant difference. Conclusion: THE most consistent findings of this review were that ESS in patients with CF is safe, produces symptomatic benefit, and does not consistently improve PFTs. There were more conflicting results with regards to endoscopy scores, days spent in hospital, and courses of intravenous antibiotics. Future prospective studies, utilizing validated quality of life, symptom and endoscopy scales, are needed to further elucidate the role of ESS in the management of chronic rhinosinusitis in CF patients.

scholarly journals Governance in Imperial County and Mexicali at the U.S.–Mexico Border during the COVID-19 Pandemic

2020 ◽  
Vol 2 (1) ◽  
pp. 38-41
Author(s):  
Kimberly Collins
Keyword(s):  
Public Management ◽  
The United States ◽  
Border Region ◽  
Imperial Valley ◽  
Mexico Border ◽  
United States Mexico ◽  
Border Population ◽  
The U.S

The COVID-19 pandemic has greatly impacted the lives of those living in the United States–Mexico border. From the Imperial Valley–Mexicali region, along the California– Baja California border, we find two interesting cases in public management that were impacted by the border population—medical care and informal importation of consumer goods. A lack of federal policy and guidance to improve the quality of life for people in the region leads us to rethink the role of governments and governance in the border region. 

Disparities among GU cancer patients referred to palliative care.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 114-114
Author(s):  
Saad Omar Atiq ◽  
James Helzberg ◽  
Nathan Hirshman ◽  
Zainab Atiq ◽  
Daniel J. George ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Palliative Care ◽  
Cancer Patients ◽  
The United States ◽  
Quality Data ◽  
Black Patients ◽  
Quality Of Life Scale

114 Background: The role of palliative care in genitourinary (GU) malignancies has been understudied. Despite representing nearly 25% of new cancer diagnoses, with over 350,000 new cases diagnosed each year, few GU patients have been included in palliative care trials under the theory that symptoms are less severe for GU patients than other solid tumors. Early involvement of palliative care services improves the patient care experience, decreases healthcare utilization, is associated with survival benefit, and results in improved quality of life and mood. To further elucidate the role of palliative care in oncology, we must study its utility in subsets of malignancy like GU cancers, as needs for patients may differ by malignancy type. Methods: A retrospective cross-sectional analysis of initial outpatient palliative care visits was performed using data from the Quality Data Collection Tool for Palliative Care (QDACT-PC) database from 2014-2020. QDACT-PC is a web-based, point-of-care registry used by physicians across the United States to track quality metrics associated with patient consultations. Data was collected and analyzed from patients' initial visits including pain scale, dyspnea scale, feeling of well-being (Quality of Life scale), fatigue scale, constipation scale, palliative performance status (PPS), and preference for resuscitation status. Scales for these variables were 0-10, with the exception of a scale of 0-100% for PPS. Patients less than 18 and greater than 90 years old were excluded. Chi-squared and Student’s t-tests were used to compare categorical and continuous variables, respectively. Results: 824 GU oncology patients (358 prostate cancer patients, 251 bladder cancer patients, 215 renal cancer patients) were compared against all patients with non-GU cancers (7807 patients). Notably, non-GU patients reported higher rates of fatigue (4.50 vs. 4.13, p = 0.0013) and dyspnea (1.63 vs. 1.11, p < 0.0001) than GU patients. GU malignancies had non-significant higher reported pain (3.73 vs. 3.60, p = 0.3109) and constipation (1.96 vs. 1.83, p = 0.2319) and lower PPS (4.95 vs. 4.96, p = 0.8555) and QOL (4.55 vs. 4.73, p = 0.0962). Preference for resuscitation at the time of referral was similar between the two groups (p = 0.6339). Only 16.5% of prostate cancer patients referred to palliative care in this database were black, while black patients are often estimated to represent 30% of new prostate cancer diagnoses each year. Conclusions: GU patients represent 9.54% of cancer patients seen by palliative care while the incidence is nearly 25%. Traditionally, GU patients were underrepresented in palliative care trials under the notion of less severe symptoms; however, this study demonstrates that GU patients have as severe symptoms as non-GU patients, highlighting a disparity in referral to palliative care. Furthermore, the lack of representation of black patients suggests potential inequity and warrants further investigation.

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