Assuntos
Doença Pulmonar Obstrutiva Crônica/reabilitação , Feminino , Promoção da Saúde , Humanos , Irlanda/epidemiologia , Masculino , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/psicologia , Índice de Gravidade de Doença , Resultado do TratamentoAssuntos
Pneumopatias , Tecido Parenquimatoso , Tomografia Computadorizada por Raios X , Idoso , Tecido Elástico/diagnóstico por imagem , Tecido Elástico/patologia , Feminino , Humanos , Pneumopatias/diagnóstico por imagem , Pneumopatias/patologia , Tecido Parenquimatoso/diagnóstico por imagem , Tecido Parenquimatoso/patologiaRESUMO
While the objective recording of clinical competencies in an electronic portfolio (ePortfolio) has become a key aspect of basic specialist training (BST), it continues to divide opinion. We surveyed medical trainees and their supervisors in the Dublin region examining their views of the ePortfolio and workplace-based assessments (WPBAs). Responses were received from 27 of 149 (18.1%) SHOs and 24 of 307 (7.9%) consultants. Our results highlight significant dissatisfaction amongst trainees with 20 (74.1%) stating that the ePortfolio is not an effective educational tool. Consultants had more mixed views. While 16 (66.7%) reported that feedback sessions were useful for trainee development, only 4 (16.7%) found the ePortfolio to be useful in highlighting trainees' strengths and weaknesses. Although other studies have emphasised its educational potential, our results suggest that practical barriers, such as time constraints and a lack of training, lead to poor engagement and a negative view of the ePortfolio.
Assuntos
Competência Clínica , Educação de Pós-Graduação em Medicina/métodos , Docentes de Medicina , Medicina Interna/educação , Internato e Residência , Atitude do Pessoal de Saúde , Avaliação Educacional/métodos , Humanos , IrlandaAssuntos
Brônquios , Tosse/etiologia , Corpos Estranhos/complicações , Doença Crônica , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
COPD exacerbations results in prolonged hospitalisation, re-admissions, reduces health-related quality of life (HRQoL) and increases mortality. The study aimed to assess the efficacy of a COPD Outreach service in reducing average length of stay (ALOS), reducing readmissions within 90 days of admission, improving HRQoL and reducing mortality among COPD patients with acute exacerbations (AECOPD). AECOPD data for a 2 year period commencing September 2011 was analysed. The COPD Assessment test (CAT) quantified HRQoL at enrolment and 6 weeks post Outreach. COPD Outreach had an ALOS of 2.47 days compared to ALOS 8.59 days and 8.5 days for all AECOPD before and during an operational COPD Outreach. Re-admission rates among patients enrolled in COPD Outreach were 36.3%. CAT improved from mean 19.3 to 13.5. Mortality was 4.9% among Outreach patients and 2.5% for overall AECOPD in 2012-2013. COPD Outreach reduced ALOS and improved HRQoL for selected patients with AECOPD. It did not reduce re-admissions or mortality.
Assuntos
Serviços de Assistência Domiciliar , Tempo de Internação , Doença Pulmonar Obstrutiva Crônica/terapia , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Readmissão do Paciente , Qualidade de VidaAssuntos
Oximetria , Apneia Obstrutiva do Sono , Adulto , Pressão Positiva Contínua nas Vias Aéreas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica/métodos , Monitorização Fisiológica/estatística & dados numéricos , Estudos Retrospectivos , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/fisiopatologia , Apneia Obstrutiva do Sono/terapiaRESUMO
We report the case of a 57 year old man who presented with increased shortness of breath together with increased pulmonary nodules in his upper lobes over a two year period. His strong smoking history and pattern of distribution makes Langerhans cell Histiocytosis a likely diagnosis that was confirmed on biopsy.