scholarly journals Simulation and practice: a repeated measurements perspective

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Jimmie Leppink ◽  
José Maria Maestre ◽  
Elena Rojo Santos ◽  
Ignacio Del Moral

La simulación puede brindar oportunidades poderosas para el desarrollo de habilidades esenciales en un entorno seguro que no tiene consecuencias para los pacientes. Sin embargo, para comprender los efectos de la simulación en la práctica clínica, necesitamos un diseño que nos permita medir sistemáticamente una o más variables de interés repetidamente durante y después de la simulación y, cuando sea posible, también antes de la simulación. Aunque este tipo de investigación a menudo se asocia con muestras más grandes de participantes, a través de un ejemplo simulado este artículo demuestra que este tipo de diseño se puede utilizar incluso en entornos donde solo hay un participante. Un uso más frecuente de este tipo de diseño puede ayudarnos a comprender los efectos de la simulación en la práctica a corto y largo plazo y cómo estos efectos dependen del contexto en el que se lleva a cabo la simulación. Simulation can provide powerful opportunities for the development of essential skills in a safe environment that has no consequences for patients. However, to understand the effects of simulation on clinical practice, we need a design that allows us to systematically measure one or more variables of interest repeatedly during and after the simulation and where possible also before the simulation. Although this kind of research is often associated with larger samples of participants, through a simulated example this article demonstrates that this type of design can be used even in settings where there is only one participant. An increased use of this kind of design may help us to understand the effects of simulation on practice on the short and long term and how these effects may depend on the context in which simulation takes place.

2011 ◽  
Vol 5 (6) ◽  
pp. 1472-1479 ◽  
Author(s):  
Jenny Anderson ◽  
Stig Attvall ◽  
Lennart Sternemalm ◽  
Aldina Pivodic ◽  
Martin Fahlén ◽  
...  

2012 ◽  
Vol 16 (1) ◽  
pp. 62-70 ◽  
Author(s):  
Elizabeth Soliday ◽  

Following decades of maltreatment of women in obstetric care, professional respect for maternal autonomy in obstetric decision making and care have become codified in global and national professional ethical guidelines. Yet, using the example of birth after cesarean, identifiable threats to maternal autonomy in obstetrics continue. This paper focuses on how current scientific knowledge and obstetric practice patterns factor into restricted maternal autonomy as evidenced in three representative maternal accounts obtained prior and subsequent to birth after cesarean. Short- and long-term remedies to improve the current state of restricted maternal autonomy in clinical practice surrounding decision making on birth after cesarean are provided.


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 5042-5042 ◽  
Author(s):  
Celestia S. Higano ◽  
Shawn H. Zimberg ◽  
Sabina Dizdarevic ◽  
Lauren Christine Harshman ◽  
John Logue ◽  
...  

5042 Background: Ra-223, a targeted alpha therapy, prolonged survival with good safety in metastatic castration-resistant prostate cancer (mCRPC) in the phase 3 ALSYMPCA trial. REASSURE will evaluate Ra-223 short- and long-term safety in routine clinical practice settings. This is the first planned interim analysis (median 7 mo observation). Methods: This global, prospective, single-arm, observational study enrolled pts with mCRPC with bone metastases (mets) for whom Ra-223 therapy was planned. Follow-up will continue up to 7 years after last Ra-223 dose. Results: 1106 pts (437 N. America, 665 Europe, 4 not recorded) enrolled from 2 Sep 2014 to 22 Sep 2016. Baseline data are available from 583 pts receiving 1st- (1L), 2nd- (2L), or ≥3rd-line (≥3L) Ra-223 for mCRPC(Table). The majority of pts (n=369, 63%) completed 5–6 doses (1L, 70%; 2L, 64%; ≥3L, 49%); median 6 doses (1L,6; 2L, 6; ≥3L, 4). Treatment-emergent drug-related AEs occurred in 215 pts (37%). Post-treatment grade 3/4 thrombocytopenia occurred in 14 pts (2.4%) and anemia in 45 (7.7%). Conclusions: In routine clinical practice, Ra-223 was associated with no short-term safety concerns and appeared to be used in pts with less advanced mCRPC than in ALSYMPCA. The majority of pts on 1L/2L Ra-223 therapy received 5–6 doses. Ra-223 was often used with abiraterone or enzalutamide, but not chemotherapy. The next interim analysis in 2019 will report long-term safety and outcomes on all pts. Clinical trial information: NCT02141438. [Table: see text]


2021 ◽  
Vol 17 (1) ◽  
pp. 417-438
Author(s):  
W. Stewart Agras ◽  
Cara Bohon

Research findings strongly suggest that cognitive behavioral therapy for the eating disorders (CBT-ED) is more effective than other treatments for bulimia nervosa (BN) and for binge eating disorder (BED), although interpersonal psychotherapy appears to be equally effective for BED. Evidence for the effectiveness of CBT-ED for the persistent (adult) form of anorexia nervosa (AN) is insufficient at present and is essentially absent for AN in adolescents except for some evidence from uncontrolled trials. This article begins with an overview of the early studies in the development of CBT-ED that showed a similar effectiveness of other symptom-focused psychotherapies—a finding that was neglected at the time. Later developments are then considered, including comparisons of CBT-ED with other psychotherapies, efforts to develop Internet-based training and treatment, and electronic applications for treatment. Finally, implications of the findings for future short- and long-term research and for clinical practice are considered.


1988 ◽  
Vol 35 (7) ◽  
pp. 19-24
Author(s):  
Alan Barson ◽  
Lois Barson

Ideas this month uses newspapers as a source of data from which students design, read, and use tables, charts, and graphs. Proficiency in interpreting data is one of the essential skills necessary for successful problem solving. The following activities provide teachers with both short- and long-term projects.


2019 ◽  
Vol 12 (6) ◽  
pp. e230371 ◽  
Author(s):  
Christina DiMaria ◽  
Wael Hanna ◽  
Julie Murone ◽  
James Reichart

Direct oral anticoagulants (DOACs)—dabigatran, rivaroxaban, apixaban and edoxaban—are changing the landscape of clinical practice for patients requiring short and long-term anticoagulation. We report a patient with no history of kidney disease developing acute interstitial nephritis (AIN) after starting a DOAC, apixaban. To date, this is the first biopsy proven case of apixaban-induced AIN.


2013 ◽  
Vol 103 (5) ◽  
pp. 418-429 ◽  
Author(s):  
Paul Kirkland ◽  
Paul Beeson

Plantar fasciopathy (PF) is characterized by degeneration of the fascia at the calcaneal enthesis. It is a common cause of foot pain, accounting for 90% of clinical presentations of heel pathology. In 2009–2010, 9.3 million working days were lost in England due to musculoskeletal disorders, with 2.4 million of those attributable to lower-limb disorders, averaging 16.3 lost working days per case. Numerous studies have attempted to establish the short- and long-term clinical efficacy of corticosteroid injections in the management of PF. Earlier studies have not informed clinical practice. As the research base has developed, evidence has emerged supporting clinical efficacy. With diverse opinions surrounding the etiology and efficacy debate, there does not seem to be a consensus of opinion on a common treatment pathway. For example, in England, the National Institute for Clinical Health and Excellence does not publish strategic guidance for clinical practice. Herein, we review and evaluate core literature that examines the clinical efficacy of corticosteroid injection as a treatment for PF. Outcome measures were wide ranging but largely yielded results supportive of the short- and long-term benefits of this modality. The analysis also looked to establish, where possible, “proof of concept.” This article provides evidence supporting the clinical efficacy of corticosteroid injections, in particular those guided by imaging technology. The evidence challenges existing orthodoxy, which marginalizes this treatment as a secondary option. This challenge is supported by recently revised guidelines published by the American College of Foot and Ankle Surgeons advocating corticosteroid injection as a primary treatment option. (J Am Podiatr Med Assoc 103(5): 418–429, 2013)


2021 ◽  
Vol 51 (1) ◽  
Author(s):  
Larissa Ayane do Nascimento Braz ◽  
Suellen Rodrigues Maia ◽  
Luciano Alves Faria ◽  
Alef Winter Oliveira Alvarenga ◽  
André Luiz Sampaio Fernandes ◽  
...  

ABSTRACT: Transplants for cats with naturally occurring renal disease have been introduced into clinical practice, but canine renal transplantation represents a greater challenge because of the lack of a balanced immunosuppressive protocol, difficulty in selecting compatible canine kidney donors, and absence of transplantation monitoring protocols. This and other important factors will be discussed in this review to help improve short- and long-term outcomes for renal transplantation in dogs.


Author(s):  
Joaquín Rodríguez Sánchez ◽  
Hugo Uchima Koecklin ◽  
Lucía González López ◽  
Miriam Cuatrecasas ◽  
Eva de la Santa Belda ◽  
...  

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