Real-time patients' perspectives about participating in teaching consultations in primary care: A questionnaire study.

Introduction: Patients presenting with undifferentiated illnesses provide valuable learning opportunities for medical students. Evidence detailing the factors that affect patient participation in undergraduate medical education is limited. This study examines how patients regard their participation in teaching consultations in primary care.

Neurally Adjusted Ventilatory Assist Is Associated with Greater Initial Extubation Success in Postoperative Congenital Heart Disease Patients when Compared to Conventional Mechanical Ventilation.

Extubation failure is associated with considerable morbidity and mortality in postoperative patients with congenital heart disease (CHD). The study purpose was to investigate initial extubation success utilizing neurally adjusted ventilatory assist (NAVA) compared with pressure-regulated volume controlled, synchronized intermittent mandatory ventilation with pressure support (SIMV-PRVC + PS) for ventilatory weaning in patients who required prolonged mechanical ventilation (MV). Also, total days on MV, inotropes, sedation, analgesia, and pediatric intensive care unit (PICU) length of stay (LOS) between both groups were compared.

The Management of Post Analytical Correction Factors.

Clinical laboratories may systematically apply factors to assay results after analysis, but before reporting, in order to facilitate comparison of data from different methods. This may be done to align with other patient results, reference intervals or clinical decision points. These factors, which we term Post Analytical Correction Factors (PACF), may be applied to all types of results derived from the method, i.

Use of polyvalent equine anti-viper serum to treat delayed coagulopathy due to suspected Sistrurus miliarius streckeri envenomation in two children.

Background: Western Pygmy Rattlesnake (WPR) envenomation reportedly causes refractory and persistent coagulopathy when treated with CroFab (Crotalidae Polyvalent Immune Fab). We report two cases where polyvalent equine anti-viper serum (AntivipmynTRI) was used to treat recurrent coagulopathy in children.

Case Details: The first patient was a 16-month-old male who was bitten by a confirmed WPR.

Surgical endoscopy training: the Joint Advisory Group on gastrointestinal endoscopy national review.

Background And Aims: Endoscopy performance is dependent on the technical ability and experience of the operator. There is anxiety among surgical trainees that certification to perform independent endoscopy to agreed national standards by the date of award of certificate of completion of training is not achievable. The aim of this study was to evaluate the delivery of endoscopy training to UK-based general surgery trainees.

Becoming an effective learner.

The teaching of medicine and the expectations of trainees has changed enormously over the past two decades in parallel to changes in medical technology, advances in information technology and the provision of healthcare. With a shortened time in medical training efficient learning is ever more crucial and the skills with which to optimise and enhance our learning opportunities are discussed.

Lean people … abundant food: memories of whānau health and food in mid-20th Century everyday life.

Issue Addressed: This article reports the first phase of a project to develop, in participation with a Māori community, a model of health promotion to combat the impact of metabolic syndrome.

Methods: A series of hui (meetings and focus groups) were conducted with community elders to learn about the food they gathered, prepared and consumed in the mid-20th Century before diabetes became endemic. A participatory research approach was used.

Trainees in gastroenterology views on teaching in clinical gastroenterology and endoscopy.

Background: Concerns exist amongst gastroenterology trainees regarding the quality of teaching, training and supervision. Gastroenterology Specialist Registrars were surveyed to obtain a wider perspective from the trainee body.

Aims: To gather data on the extent and quality of teaching, training and supervision in outpatient clinics, on ward rounds and in endoscopy.

Laparoscopic surgical skills assessment: can simulators replace experts?

Introduction: Global Rating Scales (GRS) quantify and structure subjective expert assessment of skill. Hybrid simulators measure performance during physical laparoscopic tasks through instrument motion analysis. We assessed whether motion analysis metrics were as accurate as structured expert opinion by using GRS.

Construct validity of the ProMIS laparoscopic simulator.

Background: Laparoscopic surgery challenges both the surgical novice and experienced open surgeon with unique psychomotor adaptations. Surgical skills assessment has historically relied on subjective opinion and case experience. Objective performance metrics have stimulated much interest in surgical education over the last decade and proficiency-based simulation has been proposed as a paradigm shift in surgical skills training.

Anemia, blood loss, and blood transfusions in North American children in the intensive care unit.

Rationale: Minimizing exposure of children to blood products is desirable.

Objectives: We aimed to understand anemia development, blood loss, and red blood cell (RBC) transfusions in the pediatric intensive care unit (PICU).

Methods: Prospective, multicenter, 6-month observational study in 30 PICUs.

What can we expect of clinical teachers? Establishing consensus on applicable skills, attitudes and practices.

Context: Despite myriad advances in medical education, we have not yet established a universally accepted set of attributes we can reasonably expect from our teachers.

Methods: A modified Delphi technique established the skills, attitudes and practices thought to be core for clinical teachers within our region. We identified relevant statements from the literature.

The identification of topics for research that are important to people with ulcerative colitis.

Objectives: To identify topics for research that are important to people with ulcerative colitis, and to provide a framework by which their research priorities can be analysed.

Methods: This is a qualitative study using focus groups and interviews. Forty people with ulcerative colitis participated.

ENHANCE: results of a global open-label trial of drotrecogin alfa (activated) in children with severe sepsis.

Objective: To gather additional 28-day all-cause mortality data and safety information for pediatric patients with severe sepsis who received drotrecogin alfa (activated) (DrotAA).

Design And Setting: Single-arm, open-label, multicentered study conducted in 59 study sites in 15 countries.

Patients: One-hundred eighty-eight children (term newborn to <18 yrs old) with severe sepsis were consecutively enrolled in the study.

Effects of changes in hemoglobin level on quality of life and cognitive function in inflammatory bowel disease patients.

Background: Anemia commonly complicates inflammatory bowel disease (IBD). In patients with chronic renal failure, the treatment of anemia with iron+/-erythropoietin improves both quality of life (QOL) and cognitive function (CF). The same drugs are effective in treating severe anemia in IBD, but there is no evidence to direct the treatment of mild anemia.

Factors associated with the development of post-infectious functional gastrointestinal diseases: does smoking play a role?

Objectives: Irritable bowel syndrome (IBS) is associated with psychological stress, alterations in gut motor function and/or visceral perception. Previous studies suggest 7-32% of people develop IBS after bacterial gastroenteritis but the exact mechanisms underlying post-infectious IBS are not clear. The present study's aim was to examine the role of possible causative factors in the development of post-infectious functional gastro-intestinal disorders (FGIDs), including IBS.

Dietary beliefs of people with ulcerative colitis and their effect on relapse and nutrient intake.

Background & Aims: Ulcerative colitis usually follows a relapsing and remitting course. Patients believe that dietary factors are important. We wished to determine the nature of and reasons for patients' dietary beliefs and their effect on relapse and nutrient intake.

Illness perceptions in people with acute bacterial gastro-enteritis.

Functional gastro-intestinal disorders (FGID) like irritable bowel syndrome (IBS) are common and can develop after gastro-enteritis. Illness representations may be important influences on the development of post-infectious FGIDs. Here, we studied both the relationship between prior chronic symptoms (FGIDs) and illness perception during an acute illness (bacterial gastro-enteritis) as well as the relationship between illness perception during an acute illness (bacterial gastro-enteritis) and the subsequent development of chronic abdominal symptoms.

Does bacterial gastroenteritis predispose people to functional gastrointestinal disorders? A prospective, community-based, case-control study.

Objectives: Irritable bowel syndrome (IBS) might develop after gastroenteritis. Most previous studies of this relationship have been uncontrolled, and little is known regarding other functional gastrointestinal disorders (FGIDs) after gastroenteritis. The primary aim of this study was to determine the frequency of IBS, functional dyspepsia, or functional diarrhea 6 months after bacterial gastroenteritis.

Is irritable bowel syndrome more common in patients presenting with bacterial gastroenteritis? A community-based, case-control study.

Objective: Irritable bowel syndrome (IBS) has been reported to follow infectious diarrhea. Food-borne infections affect 76 million people in the United States and 9.4 million in England per year; of these, only a small percentage of patients see their doctor, and even fewer will have stool culture confirmation.

Is lactose intolerance implicated in the development of post-infectious irritable bowel syndrome or functional diarrhoea in previously asymptomatic people?

Objective: The relationship between lactose intolerance and post-infectious irritable bowel syndrome (IBS) in adults is uncertain. Bowel symptoms may persist after bacterial gastroenteritis and as post-infectious IBS. Acquired lactose intolerance may follow viral enteric infections in children.

Effect of alcohol on the lactate/pyruvate ratio of recently injured adults.

Objective: To compare the ability of plasma (lactate) and the plasma lactate/pyruvate (L/P) ratio to predict shock-related outcome after injury and also to examine the influence of plasma ethanol on any relationships found.

Design: Prospective observational study.

Setting: Emergency departments in the UK and the Republic of South Africa.