Self-Debriefing vs Instructor Debriefing in a Pre-Internship Simulation Curriculum: Night on Call.

This study sought to determine if learner self-performance assessment (SPA) and team-performance assessment (TPA) were different when simulation based education (SBE) was supported by self-debriefing (S-DB), compared to traditional facilitator-led debriefing (F-DB). "One-Night-On-Call," an internship preparation curriculum, was selected to provide SBE. Participants worked as team members in 4 sequential bedside acute care problem-solving scenarios.

Health Information Exchange in Emergency Medicine.

Emergency physicians often must make critical, time-sensitive decisions with a paucity of information with the realization that additional unavailable health information may exist. Health information exchange enables clinician access to patient health information from multiple sources across the spectrum of care. This can provide a more complete longitudinal record, which more accurately reflects the way most patients obtain care: across multiple providers and provider organizations.

Methamphetamine-associated cardiomyopathy.

Methamphetamine and related compounds are now the second most commonly used illicit substance worldwide, after cannabis. Reports of methamphetamine-associated cardiomyopathy (MAC) are increasing, but MAC has not been well reviewed. This analysis of MAC will provide an overview of the pharmacology of methamphetamine, historical perspective and epidemiology, a review of case and clinical studies, and a summary of the proposed mechanisms for MAC.

Does eccentric training of hamstring muscles reduce acute injuries in soccer?

Objective: To investigate the effectiveness of a 10-week hamstring exercise training program in reducing the incidence and severity of new and recurrent hamstring injuries among male soccer players.

Design: Cluster-randomized (by team)controlled trial, stratified by level of play and geographic location. Sample size was calculated with 80% power to show a relative risk reduction for injury of 50% at P ≤ 0.

Attaining meaningful use of health information technology in a residency program: challenges and rewards.

The US Federal Government has offered financial incentives to physicians and hospitals for using health care technology in ways that may improve the quality of patient care, via the use of an electronic health record. Although many barriers exist to achieving the health care technology requirements necessary to capture these incentives, several strategies were employed by the University of Hawai'i Family Medicine Residency Program at the Physician Center at Mililani to overcome these barriers, in order to register and attest for these financial rewards. The rewards are substantial, and may total up to $44,000/eligible provider over 5 years, and $63,750/eligible provider over 6 years, for Medicare and Medicaid respectively.

Changes in fasting plasma glucose levels with ribavirin and pegylated interferon treatment in normal and impaired glucose tolerant patients with chronic hepatitis C.

Background: Patients with Hepatitis C Virus (HCV) infection have increased rates of glucose intolerance, and studies have shown the improvement of fasting plasma glucose (FPG) levels after clearance of HCV infection with standard ribavirin plus pegylated interferon treatment. The purpose of this study was to examine glycemic changes with standard HCV treatment in patients with impaired fasting glucose (IFG) and normal fasting glucose (NFG).

Methods: A retrospective study of FPG changes in HCV patients with IFG and NFG treated with standard HCV therapy was conducted.

A survey of injuries and medical conditions affecting competitive adult outrigger canoe paddlers on O'ahu.

Unlabelled: Outrigger canoe paddling is a very popular competitive sport in the Hawaiian Islands and Polynesia. The sport is growing rapidly in Australia and the mainland US.

Purpose: To assess the types and severity of musculoskeletal injuries and medical conditions that affect adult outrigger canoe paddlers on O'ahu, Hawai'i.

Clinical experience with exenatide in predominantly Asian and Pacific Islander patients with type 2 diabetes.

Exenatide is a new injectable medication for the treatment of hyperglycemia in type 2 diabetes. Due to limited information of exenatide use in Asians and Pacific Islanders (API), we retrospectively reviewed API patients' responses to exenatide treatment and compared the efficacy and safety of treatment to Caucasian patients. A total of 92 patients (70 API, 21 Caucasians, and 1 Hispanic) with type 2 diabetes were treated with exenatide.

Complex humanitarian emergencies: a review of epidemiological and response models.

Complex emergencies (CEs) have been the most common human-generated disaster of the past two decades. These internal conflicts and associated acts of genocide have been poorly understood and poorly managed. This article provides an epidemiological background and understanding of developing and developed countries, and chronic or smoldering countries' CEs, and explains in detail the prevailing models of response seen by the international community.

Single-incision suture anchor repair of distal biceps tendon rupture.

Distal rupture of the biceps tendon can be disabling to active individuals. Many methods have been described to address acute and chronic ruptures surgically. Successful surgical management of these ruptures requires attention to the possible complications of nerve injury and heterotopic bone formation.

Sun protection policy in elementary schools in Hawaii.

Introduction: Childhood sun exposure is a major risk factor for skin cancer, the most common form of cancer in the United States. Schools in locations that receive high amounts of ultraviolet radiation have been identified as important sites for reducing excessive sun exposure.

Methods: The objective of this study was to determine the prevalence of sun protection policies, environmental features, and attitudes in public elementary schools in Hawaii.

Polymorphisms in the interleukin-4 receptor alpha chain: association with traits of allergy and asthma in an admixed population in Hawaii.

Single nucleotide polymorphisms (SNPs) in the gene encoding the interleukin-4 receptor alpha chain (IL-4R alpha) have been associated with IgE levels or clinical atopy in some populations. Two SNPs that encode S503P and Q576R in the intracytoplasmic domain of the receptor are associated with loss or gain of function, respectively. We investigated the frequency of these SNPs and their association with traits of allergic asthma in 36 unrelated subjects selected from a racially admixed, clinically ascertained study population with family histories of asthma.

Tear trough implants for correction of tear trough deformity.

This essay describes the tear trough deformity and its extension into the cheek. It is an extremely common and consistently deforming characteristic of the lower orbital region. The article focuses on cause and correction.

Diagnosing photographic distortion. Decoding true postoperative contour after eyelid surgery.

A method of "decoding" deceptive blepharoplasty photographs resulting from head postural changes (or changes in camera planes) between pre- and postoperative photographs is now available. One need only measure changes in the intercanthal axis relative to the horizontal plane of the face. Each degree of alteration of the axis represents 1 mm of true postural change in the margin of the lower lid--disguised by head tilt or downward gaze.

Canthopexy as a routine blepharoplasty component.

Canthopexy should be a routine companion or alternative to lower lid blepharoplasty. It restores tone and youthful contour to the deteriorating eye, and it reduces or eliminates the need to resect skin that in truth is not excessive, but appears so owing to dropped lid posture from lid atonicity. Canthopexy with fat reduction and enhancement of the deficient suborbital portion of the malar complex should be the principal thrust of lower lid surgery.

The biomechanics of brow and frontalis function and its effect on blepharoplasty.

Understanding the biomechanics and dynamics of eyebrow and frontalis function is essential to controlling the outcome of blepharoplasty. Ignoring the forehead in the pursuit of blepharoplasty excellence dooms to failure any eventual outcome. If, however, the principles laid out in this article become the basis for planning and execution, the final result, measured in the quality of aesthetic repair, will surely improve immensely.

The East Asian eyelid-open technique.

Creation of a dynamic levator aponeurosis fold or double eye adds to the beauty of the East Asian. The eyes are larger and less puffy, and the eyelashes appear longer and curve up and out instead of down. The distance from the ciliary border to the eyebrow is decreased and more in proportion.

Contemporary upper lid blepharoplasty--tissue invagination.

Blepharoplasty is the most commonly performed operation to enhance facial appearance. Controversy arises over the need for tissue invagination as opposed to simple tissue excision. This article focuses on advanced invagination-type blepharoplasty, discussing who, what, where, when, why, and how.

Essential anatomy for contemporary upper lid blepharoplasty.

A clear understanding of upper eyelid anatomy is an absolute prerequisite for performing advanced invagination-type blepharoplasty. This article describes the author's simple, systematic approach to intraoperative identification of the levator aponeurosis as well as the other key layers of fascia in the upper lid.

Upper blepharoplasty by eyelid invagination. Anchor blepharoplasty.

Anchor or lid invagination blepharoplasty is an operation giving neat, crisp, and youthful lids of a permanency unobtainable by traditional techniques. It allows the surgeon to preserve precious lid skin and give optimal results. Although there is more postoperative edema, long-term results verify the efficacy of the technique.

Optimal procedure in secondary blepharoplasty.

Secondary repair is a common necessity after blepharoplasty. The need stems from faulty methodology in primary aesthetic periorbital repair. Rethinking initial procedures with careful attention to diagnosis, planning, and execution in the light of contemporary knowledge should eliminate the need for most secondary repair.