Development of an Interprofessional Education Experiential Learning Curriculum.

Today's healthcare system is facing many challenges, such as changes in the population, a shift from acute to chronic degenerative conditions, and disparities in access and outcomes. An integrative health approach, in combination with interprofessional collaborative practice, is viewed as an effective response to these changing demands. Curricular strategies must be developed and implemented that help prepare health professions students for these ongoing changes in the health delivery system.

Diagnostic Ureteroscopy in CT Urography-Diagnosed Upper Tract Urothelial Carcinoma: Delay in Definitive Treatment and Increased Intravesical Recurrence.

Purpose To investigate the effect of diagnostic ureteroscopy (URS) on the delay to surgical treatment of upper tract urothelial carcinoma (UTUC) detected by imaging and the risk of intravesical recurrence. Materials and methods We undertook a retrospective case-note analysis of all patients who underwent radical nephroureterectomy (NUU) from November 2012 to July 2019. We identified those who underwent diagnostic ureteroscopy prior to NUU as Group 1 and those who did not undergo diagnostic URS as Group 2.

Enhancing the Enhanced Recovery Program in Colorectal Surgery - Use of Extended-Release Epidural Morphine (DepoDur®).

Purpose: DepoDur® is a single-dose extended-release morphine injection into the epidural space. It is not commonly used, but has many advantages over traditional analgesic regimens. We analyzed a number of these advantages in our case series in the context of the colorectal enhanced recovery program (ERP) and aimed to show that the ERP could be further enhanced by using DepoDur®.

Visual control strategies of surgeons: a novel method of establishing the construct validity of a transurethral resection of the prostate surgical simulator.

Objective: To examine novice and expert differences in visual control strategies while performing a virtual reality transurethral resection of the prostate (TURP) task and to determine if these differences could provide a novel method for assessing construct validity of the simulator.

Subjects And Methods: A total of 11 novices (no TURP experience) and 7 experts (>200 TURPs) completed a virtual reality prostate resection task on the TURPsim (Simbionix USA Corp, Cleveland, OH) while wearing an eye tracker (ASL, Bedford, MA). Performance parameters and the surgeon's visual control strategy were measured and compared between the 2 groups.

Developing and validating the International Consultation on Incontinence Questionnaire bladder diary.

Background: Despite the common use of urinary diaries to assess lower urinary tract symptoms (LUTS), a standardised validated diary does not exist.

Objective: To develop a validated urinary diary, using the psychometric validation protocol used in previous International Consultation on Incontinence Questionnaire (ICIQ) modules.

Design, Setting, And Participants: We invited 400 consecutive patients attending the urology department for assessment of LUTS to complete a urinary diary (developed and validated for content in a previous study), and the ICIQ Male or Female LUTS questionnaire.

Assessing visual control during simulated and live operations: gathering evidence for the content validity of simulation using eye movement metrics.

Background: Although virtual reality (VR) simulators serve an important role in the training and assessment of surgeons, they need to be evaluated for evidence of validity. Eye-tracking technology and measures of visual control have been used as an adjunct to the performance parameters produced by VR simulators to help in objectively establishing the construct validity (experts vs. novices) of VR simulators.

Cheating experience: Guiding novices to adopt the gaze strategies of experts expedites the learning of technical laparoscopic skills.

Background: Previous research has demonstrated that trainees can be taught (via explicit verbal instruction) to adopt the gaze strategies of expert laparoscopic surgeons. The current study examined a software template designed to guide trainees to adopt expert gaze control strategies passively, without being provided with explicit instructions.

Methods: We examined 27 novices (who had no laparoscopic training) performing 50 learning trials of a laparoscopic training task in either a discovery-learning (DL) group or a gaze-training (GT) group while wearing an eye tracker to assess gaze control.

Face validity, construct validity and training benefits of a virtual reality TURP simulator.

Objective: To assess face validity, construct validity and the training benefits of a virtual reality TURP simulator.

Method: 11 novices (no TURP experience) and 7 experts (>200 TURP's) completed a virtual reality median lobe prostate resection task on the TURPsim™ (Simbionix USA Corp., Cleveland, OH).

Developing a validated urinary diary: phase 1.

Aims: To develop and validate a urinary diary, using the psychometric validation protocol applied to all International Consultation on Incontinence Questionnaire (ICIQ) modules.

Methods: Patient and clinician opinion was sought on diary content, format, and duration using interviews and questionnaires. Content deemed essential for inclusion were incorporated into four draft diary formats (Phase 1a).

Increased patient information does not reduce patient anxiety regarding urodynamic studies.

Objective: To establish if patient anxiety pre-urodynamic investigation can be reduced by providing more information within the patient information sheet (PIS).

Patients And Methods: Two prospective cohorts of consecutive patients (round 1, n = 98 and round 2, n = 94) were asked to complete a visual analogue scale (VAS) quantifying their anxiety prior to urodynamics (UDS) and again after UDS quantifying their anxiety of potentially repeating UDS. Patients in round 1 received the standard hospital PIS.

Automatic evaluation of ultrasonography-estimated bladder weight and bladder wall thickness in community-dwelling men with presumably normal bladder function.

Objective: To identify measurements of ultrasonography (US)-derived bladder wall thickness (BWT) and bladder weight in community-dwelling men with presumably normal bladder function.

Subjects And Methods: A total of 100 male volunteers underwent transabdominal US measurements of BWT and bladder weight, using the BVM 9500 bladder scanner (Verathon Medical, Bothell, WA, USA), at a variety of bladder filling volumes. The data were explored for any correlation between measurements of BWT and US-estimated bladder weight (UEBW) with subject age, height, weight, body mass index (BMI), International Consultation on Incontinence Questionnaire-Male Lower Urinary Tract Symptoms (ICIQ M-LUTS) score, International Prostate Symptom Score (IPSS) and IPSS Quality of Life index (IPSS QoL).

Development and validation of a surgical workload measure: the surgery task load index (SURG-TLX).

Background: The purpose of the present study was to develop and validate a multidimensional, surgery-specific workload measure (the SURG-TLX), and to determine its utility in providing diagnostic information about the impact of various sources of stress on the perceived demands of trained surgical operators. As a wide range of stressors have been identified for surgeons in the operating room, the current approach of considering stress as a unidimensional construct may not only limit the degree to which underlying mechanisms may be understood but also the degree to which training interventions may be successfully matched to particular sources of stress.

Methods: The dimensions of the SURG-TLX were based on two current multidimensional workload measures and developed via focus group discussion.

Ultrasound estimated bladder weight in men attending the uroflowmetry clinic.

Aims: To determine if measurements of ultrasound estimated bladder weight (UEBW) provide an additional diagnostic tool when assessing men with lower urinary tract symptoms (LUTS) in the uroflowmetry clinic.

Methods: One hundred men with LUTS attending the uroflowmetry clinic underwent transabdominal ultrasound measurement of bladder weight, using the BVM 9500 bladder scanner (Verathon Medical, Bothell, WA). These data were explored for any correlation between measurements of maximum flow rate (Q(max)) with UEBW, age, height, weight, body mass index (BMI), ICIQ M-LUTS score, M-LUTS voiding score, M-LUTS incontinence score, IPSS, IPSS quality of life score, voided volume, and post-void residual urine.

Urinary diaries: evidence for the development and validation of diary content, format, and duration.

Aims: To review the published literature for evidence of urinary diary development and validation, in terms of diary format, content, and duration. To identify a fully validated urinary diary.

Methods: MEDLINE search to identify all published English literature to date regarding urinary diaries.

Ultrasound estimated bladder weight and measurement of bladder wall thickness--useful noninvasive methods for assessing the lower urinary tract?

Purpose: In the last decade interest has arisen in the use of ultrasound derived measurements of bladder wall thickness, detrusor wall thickness and ultrasound estimated bladder weight as potential diagnostic tools for conditions known to induce detrusor hypertrophy. However, to date such measurements have not been adopted into clinical practice. We performed a comprehensive review of the literature to assess the potential clinical usefulness of these measurements.

Incidence and variables predicting Gleason score up-grading between trans-rectal ultrasound-guided prostate biopsies and radical prostatectomy.

Objective: To determine whether Gleason score up-grading is still occurring in men diagnosed with adenocarcinoma of the prostate via extended biopsy regimens, and factors that might predict this.

Patients And Methods: Between September 1999 and February 2007, 211 men (age: 42-70 years; mean: 60 years) underwent trans-rectal ultrasound-guided prostate biopsies confirming clinically localized adenocarcinoma followed by radical prostatectomy (RP), within our department. Univariate and multivariate logistic regression (LR) analyses using age, serum PSA, prostate volume, clinical stage and total length of cores taken were performed to determine whether Gleason score up-grading could be predicted.

The incidence and success of treatment for severe chronic groin pain after open, transabdominal preperitoneal, and totally extraperitoneal hernia repair.

Background: Chronic groin pain (CGP) is a significant cause of postoperative morbidity after inguinal hernia repair. Open, transabdominal preperitoneal (TAPP), and totally extraperitoneal (TEP) repair are all commonly performed methods of herniorrhaphy. The aim of this study was to compare the frequency of attendance at a chronic pain clinic (CPC) for CGP after open, TAPP or TEP repair.

The role of invasive and non-invasive urodynamics in male voiding lower urinary tract symptoms.

Introduction: Troublesome voiding lower urinary tract symptoms (LUTS) are a common problem in men, particularly with ageing. Implicitly, management of voiding LUTS can be guided by accurate determination of underlying mechanisms, distinguishing men with voiding symptoms caused by outlet obstruction from those with reduced bladder contractility.

Methods: A PubMed search of the published literature on invasive and non-invasive methods used to assess lower urinary tract function was carried out.

The incidence of epidural abscess following epidural analgesia in open abdominal aortic aneurysm repair.

Introduction: Complications of epidural catheterisation can cause significant morbidity. Epidural abscess following epidural catheterisation is rare and the reported incidence is variable. The purpose of this study was to review the incidence of epidural abscess in patients undergoing open abdominal aortic aneurysm (AAA) repair.

Incidence and factors predicting the detection of prostate cancer after transurethral resection of the prostate for clinically benign disease.

Introduction: Transurethral resection of the prostate (TURP) is commonly performed as the surgical management of lower urinary tract symptoms due to clinically benign disease. However, prostate cancer is not uncommonly diagnosed after such a procedure. We, therefore, determined in a retrospective study the incidence and factors that might predict the detection of prostate cancer after TURP.

An unusual case of concurrent insulinoma and nesidioblastosis.

Context: Endogenous hyperinsulinaemic hypoglycaemia in adults is most commonly caused by an insulinoma. Adult nesidioblastosis is rarely reported. To the best of our knowledge the presence of both insulinoma and nesidioblastosis has not been reported before.