No pain relief by virtual reality during hysterosalpingography (HSG): results from a randomized controlled trial.

Study Question: Is virtual reality (VR) an effective non-pharmacological tool to reduce procedural pain during hysterosalpingography (HSG)?

Summary Answer: An HSG with VR does not reduce procedural pain scores compared to an HSG without VR.

What Is Known Already: An HSG is often experienced as painful and uncomfortable. VR has been proven successful to reduce acute procedural pain during a variety of medical procedures and interventions.

Cross-cultural validation of two scales to assess mental wellbeing in persons affected by leprosy in Province 1 and 7, Nepal.

To assess mental wellbeing among persons affected by leprosy, this study aimed to validate the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) and the Patient Health Questionnaire (PHQ-9, depression tool) in Province 1 and 7, Nepal. Using purposive and convenience sampling, cross-cultural equivalences were assessed through semi-structured interviews with persons affected by leprosy (>18 years). Data were transcribed, translated, analysed and discussed with experts before revising the tools.

Prevalence, incidence, repair rate, and morbidity of groin hernias in Sierra Leone: cross-sectional household study.

Background: Knowledge about the prevalence of groin hernias in sub-Saharan Africa is limited. Previous studies have demonstrated a higher incidence of the condition than the annual repair rate. This study aimed to investigate prevalence, incidence, annual repair rate, morbidity, and health-seeking behaviour of persons with groin hernias in Sierra Leone.

Physical and Quality of Life Changes in Elderly Patients after Laparoscopic Surgery for Colorectal Cancer-A Prospective Cohort Study.

Background-The incidence of colorectal cancer is increasing among elderly people, where postoperative complications are frequent. Methods-We evaluated postoperative physical and quality of life changes in elderly patients undergoing laparoscopic surgery for colorectal cancer. A prospective cohort study was performed in 31 colorectal cancer patients ≥60 years who were scheduled for laparoscopic surgery due to colorectal cancer.

Handgrip strength in older adults with chronic diseases from 27 European countries and Israel.

Background/objectives: Understanding the association of deconditioned strength with the most prevalent chronic diseases in older adults and inferring possible interventional strategies is of utmost importance. We aimed to investigate the association between handgrip strength and chronic diseases in a large representative European population of adults over the age of 50 years.

Subjects/methods: Individuals aged 50 or older residing in 27 European countries and Israel participated in this cross-sectional study.

Handgrip strength and respiratory disease mortality: Longitudinal analyses from SHARE.

Background: While the association between handgrip strength and all-cause mortality is more deeply explored, no previous studies have been specifically focused on handgrip strength and respiratory disease mortality. The purpose of the study was to investigate the association between handgrip strength and respiratory disease mortality in a large representative sample.

Methods: Individuals aged 50 or over from 27 European countries and Israel participated in this longitudinal study.

Tuber Locations Associated with Infantile Spasms Map to a Common Brain Network.

Objective: Approximately 50% of patients with tuberous sclerosis complex develop infantile spasms, a sudden onset epilepsy syndrome associated with poor neurological outcomes. An increased burden of tubers confers an elevated risk of infantile spasms, but it remains unknown whether some tuber locations confer higher risk than others. Here, we test whether tuber location and connectivity are associated with infantile spasms.

The clinical and educational outcomes of an inter-professional student-led medication review team, a pilot study.

Aims: The involvement of an inter-professional healthcare student team in the review of medications used by geriatric patients could not only provide patients with optimized therapy but also provide students with a valuable inter-professional learning experience. We describe and evaluate the clinical and learning outcomes of an inter-professional student-run mediation review program (ISP).

Subject And Method: A variable team consisting of students in medicine, pharmacy, master advanced nursing practice, and master physician assistant reviewed the medication lists of patients attending a specialized geriatric outpatient clinic.

Correction to: Medical specialists' basic psychological needs, and motivation for work and lifelong learning: a two-step factor score path analysis.

An amendment to this paper has been published and can be accessed via the original article.

Understanding physical activity and sedentary behaviour among preschool-aged children in Singapore: a mixed-methods approach.

Objectives: This study investigated physical activity (PA) and sedentary behaviour (SB) among preschool-aged children in Singapore and potential correlates at multiple levels of the socioecological model from in-school and out-of-school settings.

Design: A cross-sectional study using a mixed-methods approach.

Participants: Parent-child dyads from six preschools in Singapore.

How to … do mixed-methods research.

As a clinician, you will often combine patients' narratives with test results in order to obtain a coherent picture and then decide on a way forward. As an educator, you are also likely to combine different information from your learners to arrive at the best feedback, judgement or supervision plan. This is what researchers do when undertaking mixed-methods research: qualitative and quantitative data are typically brought together to provide different insights than could be achieved with a single type of data and analysis.

Knowledge, skills and beetles: respecting the privacy of private experiences in medical education.

In medical education, we assess knowledge, skills, and a third category usually called values or attitudes. While knowledge and skills can be assessed, this third category consists of 'beetles', after the philosopher Wittgenstein's beetle-in-a-box analogy. The analogy demonstrates that private experiences such as pain and hunger are inaccessible to the public, and that we cannot know whether we all experience them in the same way.

Using paired cultural modelling and cultural consensus analysis to maximize programme suitability in local contexts.

Cultural consensus analysis (CCA) is a quantitative method for determining cohesion in a specified cultural domain and cultural modelling (CM) is a method for designing and testing connections within a cultural domain based on qualitative data collection. After a description of the methods, and examples of their application, we provide a description of three main points in the programme planning, implementation and evaluation cycle at which the method can best be utilized to plan, contextualize or evaluate programmes and policies. In addition, the use of CCA and CM is not constrained to one point in time though, in order to maximize its ability to help with programme design or evaluation, it ought to be done as early as possible in the process.

Medical specialists' basic psychological needs, and motivation for work and lifelong learning: a two-step factor score path analysis.

Background: Continuing professional development and lifelong learning are crucial to secure safe and good quality healthcare. Lack of motivation has been found to be among the most important barriers for participation in lifelong learning. This study was conducted to investigate the relationships between medical specialists' work motivation, lifelong learning motivation, autonomy, competence and relatedness satisfaction.

How to … use qualitative research to change practice.

The 'How to …' series focuses on how to do qualitative research. But how can qualitative research enhance patient care? This paper aims to support health care practitioners, educators and researchers who are interested in bridging the gap between research and practice (both clinical and educational), to guide improvements that can ultimately benefit patients. We present action research and The Change Laboratory method as two approaches that typically involve qualitative research and have potential to change practice, blending scientific inquiry with social action.

The Tumor Microenvironment as a Regulator of Endocrine Resistance in Breast Cancer.

Estrogen receptor positive breast neoplasias represent over 70% of diagnosed breast cancers. Depending on the stage at which the tumor is detected, HER2 status and genomic risk, endocrine therapy is combined with either radio, chemo and/or targeted therapy. A growing amount of evidence supports the notion that components of the tumor microenvironment play specific roles in response to treatment and that strategies targeting these key interactions with tumor cells could pave the way to a new generation of therapies.

Bachelor completion and dropout rates of selected, rejected and lottery-admitted medical students in the Netherlands.

Background: Evidence for the effectiveness of the selection of medical students is weak. This study aimed to examine the added value of a two-step selection procedure (first step non-academic, second step academic tests) to a pre-university GPA-based lottery procedure. Because previous research has suggested that participation in selection (regardless of the outcome) is a predictor of study success, this study is the first to include students who initially applied for selection, then refrained from (actively) participating in selection and were eventually admitted through lottery.

Protocol for a scoping review on the conceptualisation of learning in undergraduate clinical nursing practice.

Introduction: Learning in the clinical setting is a major form of learning in undergraduate nursing education. In spite of this, how nursing students learn in clinical practice is still largely unknown. Moreover, there is no conceptual clarity on learning in practice in the current literature.

International practice variation in postoperative imaging of chronic subdural hematoma patients.

Objective: The value of CT scanning after burr hole surgery in chronic subdural hematoma (CSDH) patients is unclear, and practice differs between countries. At the Brigham and Women's Hospital (BWH) in Boston, Massachusetts, neurosurgeons frequently order routine postoperative CT scans, while the University Medical Center Utrecht (UMCU) in the Netherlands does not have this policy. The aim of this study was to compare the use of postoperative CT scans in CSDH patients between these hospitals and to evaluate whether there are differences in clinical outcomes.

'Failure to fail': the teacher's dilemma revisited.

Noting that failure is a part of learning, Mak‐van der Vossen draws metaphors from the world of medical error to suggest that ‘blame‐free’ approaches to educational support must be established.

Autonomous motivation in medical education.

Intrinsic motivation was a reining concept for many years in self-determination theory (SDT) research. Since the last 10 years, the concept of autonomous motivation is used more commonly by some researchers. Autonomous motivation means motivation arising out of genuine interest or personal endorsement or valuing of an activity.

A Road Map for Attending to Medical Students' Professionalism Lapses.

Purpose: To develop a road map for educators attending to medical students' professionalism lapses, aiming to offer an empirical base for approaching students who display such lapses.

Method: Between October 2016 and January 2018, 23 in-depth interviews with 19 expert faculty responsible for remediation from 13 U.S.