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1.
J Microbiol Biol Educ ; : e0020323, 2024 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-38709009

RESUMO

In undergraduate life sciences education, open educational resources (OERs) increase accessibility and retention for students, reduce costs, and save instructors time and effort. Despite increasing awareness and utilization of these resources, OERs are not centrally located, and many undergraduate instructors describe challenges in locating relevant materials for use in their classes. To address this challenge, we have designed a resource collection (referred to as Open Resources for Biology Education, ORBE) with 89 unique resources that are primarily relevant to undergraduate life sciences education. To identify the resources in ORBE, we asked undergraduate life sciences instructors to list what OERs they use in their teaching and curated their responses. Here, we summarize the contents of the ORBE and describe how educators can use this resource as a tool to identify suitable materials to use in their classroom context. By highlighting the breadth of unique resources openly available for undergraduate biology education, we intend for the ORBE to increase instructors' awareness and use of OERs.

2.
Musculoskelet Sci Pract ; 71: 102961, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38664192

RESUMO

BACKGROUND: Previous literature has reported the successful implementation of the Good Life with osteoArthritis in Denmark (GLA:D®) program into predominantly private practice settings. There may be unique challenges present within the public hospital setting that influence GLA:D® implementation in public health. OBJECTIVE: Explore the attitudes and experiences of service providers directly involved in implementing GLA:D® in Australian public tertiary hospitals. DESIGN: Qualitative descriptive study design. METHOD: Service providers (n = 14) from three participating hospitals took part in semi-structured focus groups at the completion of the 6-month implementation period. Inductive thematic analysis was employed to identify primary domains across all facilities. RESULTS: Four broad domains were identified. Factors that influenced uptake included GLA:D® being a recognisable, evidence-based product requiring minimal development or adaptation. The fidelity of the GLA:D® Australia program was challenged by referral of patients with multiple/complex medical comorbidities, and patient preference to complete registry data via paper rather than online. Several operational considerations are required when delivering GLA:D® in a public hospital setting, including adequate numbers of GLA:D®-trained staff, additional screening requirements, obtaining appropriate clinical space, and persisting patient barriers to attending the service. GLA:D® provided benefits beyond improvement in pain and function, including social interactivity, high attendance and promotion of long-term self-management, while also maximising service efficiencies. CONCLUSIONS: Implementing GLA:D® in Australian public hospitals was supported by service providers. Specific operational and administrative factors, including staff training, patient complexity, and registry requirements should be considered when attempting to embed and sustain GLA:D® in large Australian public tertiary hospitals.


Assuntos
Grupos Focais , Hospitais Públicos , Osteoartrite , Humanos , Masculino , Feminino , Osteoartrite/terapia , Austrália , Pessoa de Meia-Idade , Pesquisa Qualitativa , Adulto , Atitude do Pessoal de Saúde , Dinamarca , Idoso , Qualidade de Vida
3.
Musculoskelet Sci Pract ; 71: 102960, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38670811

RESUMO

BACKGROUND: Literature reporting positive outcomes from the Good Life with osteoArthritis in Denmark (GLA:D®) program in Australia mainly involves patients attending private physiotherapy services. OBJECTIVE: Evaluate the feasibility of implementing GLA:D® in Australian public hospitals. DESIGN: Implementation study in three metropolitan tertiary public hospitals over six months. METHOD: Patients aged ≥18 years with knee or hip joint-related problems deemed appropriate for non-surgical care were invited to participate in GLA:D®. Feasibility was evaluated using RE-AIM framework components (Implementation, Effectiveness, Maintenance) using service-level metrics, patient-level data, and program fidelity assessment. Findings of qualitative interviews with service providers are presented in Part 2. RESULTS: Implementation: 70 patients (69 with knee osteoarthritis) participated (13 cohorts). 55 (79%) patients attended both education sessions, and 49 patients (70%) attended 10-12 exercises sessions. Fidelity was met based on environmental, therapist, participant- and program-related criteria. EFFECTIVENESS: At 3 months, patients reported lower average pain (visual analogue scale [0-100 mm]: effect size -0.56, 95% CI -0.88 to -0.23) and disability (HOOS/KOOS-12 [100-0]: 0.67, 0.28 to 1.05), and improved quality of life (EQ-5D overall score: 0.46, 0.11 to 0.80). No adverse events were reported. All patients who completed 3-month assessment (n = 52) would recommend GLA:D®. Maintenance: All participating services elected to continue delivering GLA:D® beyond the study. CONCLUSIONS: Implementing GLA:D® in Australian public hospitals is feasible, safe, and acceptable to patients with knee osteoarthritis. Public hospital patients with knee osteoarthritis reported improvements in pain, disability, and quality of life similar to previous GLA:D® cohorts.


Assuntos
Estudos de Viabilidade , Hospitais Públicos , Osteoartrite do Joelho , Qualidade de Vida , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Austrália , Osteoartrite do Joelho/terapia , Dinamarca , Adulto , Osteoartrite do Quadril/terapia , Modalidades de Fisioterapia
4.
Musculoskelet Sci Pract ; 72: 102946, 2024 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-38574428

RESUMO

OBJECTIVES: Explore healthcare professionals' perspectives on the main problems that their patients with ankle osteoarthritis experience and to propose health-related domains. METHODS: A qualitative study using semi-structured interviews was conducted with an international multidisciplinary group of healthcare professionals identified as ankle experts. Eligibility criteria were aged ≥18 years, and a certified healthcare professional with ≥ 5-year experience post-qualification in working with ankle osteoarthritis and/or chronic ankle pain. Interviews were recorded, transcribed verbatim and thematically analysed. RESULTS: Twenty-one healthcare professionals (20 males; mean (range) age 49 (34-72) years) from four professions (orthopaedic surgeons (n = 9), athletic trainers (n = 5), physiotherapists (n = 4) and podiatrists (n = 3)) were interviewed. Four main themes were identified: 1) people with ankle osteoarthritis have difficulty with weight-bearing activities; 2) symptoms of pain and stiffness predominate, alongside swelling, instability, weakness and poor balance; 3) chronic pain in ankle osteoarthritis has psychosocial consequences; and 4) the loss of activities of daily living and independence compromises quality of life. We proposed 15 health-related domains that emerge from the interview data. CONCLUSION: Healthcare professionals recognise that ankle osteoarthritis patients have difficulty in physical, sporting, and occupational weight-bearing activities, and they live with persistent ankle pain, stiffness and other symptoms that have physical and psychosocial consequences. The health-related domains derived from interviews with expert healthcare professionals will contribute to the development of a core domain set for ankle osteoarthritis.

5.
Neurosurgery ; 2024 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-38682945

RESUMO

BACKGROUND AND OBJECTIVES: Anterior basal encephaloceles are considered a rare entity and are often associated with midline cerebral abnormalities. Those with a large skull base defect and herniation of brain parenchyma in the neonate or young infant present unique challenges for surgical management. METHODS: We analyzed the neurosurgical administrative and operative databases between 1986 and 2022 to determine clinical presentation, operative approach, and outcome of basal encephaloceles. RESULTS: Over the 36-year period, 27 pediatric anterior basal encephaloceles were managed, of which 22 had full documentation and images allowing comprehensive review. Mean age at presentation was 5 years (SD 4.94). The majority were transethmoidal encephaloceles (59%), followed by the transsphenoidal-sphenoethmoidal type (32%). Overall, 91% were managed surgically by a transcranial, endoscopic, or combined approach. Four children required subsequent procedures, predominantly for persistent cerebrospinal fluid leak. No significant differences in proportion of patients requiring interval/revision surgery after initial conservative, endoscopic endonasal, or transcranial surgery was identified. Neither age at surgery nor size of the defect on computed tomography scan was associated with the need for revision surgery. Size of cranial defect was significantly smaller in the endoscopic group (P = .01). There was a historic tendency for younger children with larger defects to have a transcranial approach. With the addition of endoscopic skull base expertise, smaller defects in older children were more recently treated endoscopically. CONCLUSION: Basal encephaloceles are rare and complex lesions and are optimally managed within a skull base multidisciplinary team able to provide multiple approaches. Large skull base defects with brain parenchymal involvement often require a transcranial or combined transcranial-endoscopic approach.

6.
Infect Dis Health ; 2024 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-38609770

RESUMO

BACKGROUND: A rapid large-scale evaluation of a newly available duckbill style P2/N95 respirator, the Care Essentials (CE) MSK-003, was required to determine its suitability for deployment into the Victorian healthcare service. The aims of this study were to assess the feasibility of establishing a rapid, multi-organisational and multi-modal evaluation of the respirator, and to investigate whether this respirator would meet the needs of healthcare workers. METHODS: The evaluation was a collaboration among three healthcare organisations - two tertiary hospitals in metropolitan Melbourne and a rural-based hospital. Participants were healthcare workers undertaking their routine fit tests. They were required to complete quantitative fit testing and a usability assessment survey on the CE MSK-003 respirator. The a priori performance criteria were set as fit test pass rate of >70%, plus satisfactory subjective overall comfort and performance assessments, defined as a rating of adequate, good, or very good in >90% of the cohort. RESULTS: A total of 1070 participants completed the multi-modal assessment within a month. Seventy-eight percent of participants passed their quantitative fit test. Over 90% of survey respondents reported that the CE MSK-003 was adequate, good or very good in terms of its overall comfort and performance assessments. CONCLUSION: We demonstrated that a multi-modal evaluation of a new respirator can be rapidly conducted with a high level of participation in a controlled, consistent manner across multiple organisations. The evaluation results of the CE MSK-003 respirator exceeded our predetermined (a priori) minimal criteria, making it suitable for broad distribution to healthcare organisations.

7.
Musculoskelet Sci Pract ; 72: 102948, 2024 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-38588610

RESUMO

BACKGROUND: Although footwear can improve pain and function in individuals with knee osteoarthritis (OA), perspectives about footwear in this population have not been explored. OBJECTIVES: This qualitative study explored preferences, attitudes and beliefs about footwear in adults with knee OA. METHODS: Twenty individuals with a clinical diagnosis of knee OA (aged 45-79 years, 65% women) participated in semi-structured interviews about factors which influence footwear selection, the effect of footwear on knee symptoms, and footwear modifications. Data were analysed thematically. RESULTS: Four themes, with sub-themes, were identified: i) there are specific footwear characteristics people look for, with comfort as their top priority; ii) shoe appearance is important; iii) footwear can aggravate or ease symptoms; and iv) people with knee OA find footwear in a variety of ways. Participants related built-in arch support, a cushioned insole and low/no heel, without addition of foot orthoses, to comfort, and were willing to pay more for comfort and quality. Appearance was also a consideration, and participants indicated they would tolerate short periods of symptom aggravation for aesthetic shoes. Participants felt that footwear choice affected their knee symptoms and risk of slipping/twisting. Participants reported that their footwear choices were determined through trial-and-error, and sometimes on advice from health professionals or shoe store salespersons. CONCLUSIONS: There are specific footwear features important to individuals with knee OA. Knowledge of these features can be used by health professionals to inform footwear discussions with knee OA patients and serve as considerations when developing footwear targeted for this population.

8.
Musculoskelet Sci Pract ; 71: 102942, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38507868

RESUMO

BACKGROUND: Lower limb osteoarthritis (OA) is a leading cause of disability and can affect an individual's ability to work. OBJECTIVES: To explore Australian physiotherapists' use of work-related interventions in managing patients with lower limb OA, and identify current management practices. METHODS: Physiotherapists with at least two years of experience treating patients with lower limb OA were invited to complete an online survey to understand how physiotherapists manage patients with lower limb OA, specifically regarding interventions related to work. RESULTS: A total of 132 physiotherapists completed the survey. In free text responses, only 1.5% and 2.3% of physiotherapists nominated work-related items in their key components of treatment or educational topics discussed with patients with lower limb OA, respectively. From a range of work-related activities presented, over half of physiotherapists indicated they regularly/always provided education about the benefits of remaining in work (63.5%) and advice on managing symptoms at work (57.4%). Less than 10% of physiotherapists regularly/always used a validated scale to identify barriers for work (9.6%), discussed absences from work (9.6%), conducted a workplace assessment (4.4%), and discussed submitting workers' compensation claims (2.6%). Exercise and patient education were the most frequently nominated physiotherapy treatments in free text (96.2% and 86.3%, respectively) and fixed response (99.2% and 93.9%, respectively) questions. CONCLUSION: Many physiotherapists do not address work-related activities in their management of patients with lower limb OA. In light of work-related challenges commonly experienced by individuals with lower limb OA, this is an important aspect of management of this condition.


Assuntos
Fisioterapeutas , Modalidades de Fisioterapia , Humanos , Estudos Transversais , Feminino , Austrália , Masculino , Fisioterapeutas/estatística & dados numéricos , Pessoa de Meia-Idade , Adulto , Modalidades de Fisioterapia/estatística & dados numéricos , Inquéritos e Questionários , Osteoartrite/terapia , Osteoartrite/reabilitação , Extremidade Inferior/fisiopatologia , Idoso , Osteoartrite do Joelho/terapia , Osteoartrite do Joelho/reabilitação
9.
J Burn Care Res ; 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38486370

RESUMO

The most common cited cause of split-thickness skin graft failure is infection and due to the association between bacterial findings in wound beds an attempt to decrease the bacterial burden before skin-grafting evolved. Thus, pre-operative microbiology swabs of the wound bed became routine at some institutions prior to grafting. This is not standard practice in the Pietermaritzburg burn service. Emphasis is instead placed on a strict protocol of intra-operative wound bed preparation to promote adequate graft take. This pilot study aims to evaluate whether pre-operative wound swabs are appropriate. We performed a prospective observational study to determine if positive wound cultures were associated with graft failure. All patients with a burn surface area of less than 10 %, where delayed grafting (later than 28 days from time of burn injury) was performed, from March to December 2021 were analyzed. Patient demographics, days from burn to graft, %TBSA burn, %TBSA grafted, whether sharp debridement prior to grafting in the same procedure was performed or not, use of topical gentamicin intra-operatively, graft outcome (% graft loss), need for regraft, and organism grown were recorded into an excel spread sheet for analysis. The sample included 52 patients. Of these, 17 (31.5%) were female. The median %TBSA grafted was 8% (IQR 4-13%) and similar in both groups. The median days from burn to grafting was 35 days. Thirty-nine patients (75%) had graft Take and 13 (25%) had graft Failure. In the failed group, median % graft failure was 50% (30 - 70%). Of the group with successful graft take, 90% were noted to have had a positive wound culture prior to grafting. A positive wound culture was not found to be a risk factor for graft failure (p=0.993). Despite the positive wound cultures graft take was more than 90 % in 75% of grafts performed and only 2/52 patients required supplementary grafting. We believe that this demonstrates that our local protocol is reasonable in this setting and that waiting for negative wound swabs prior to grafting should not be a reason to delay grafting.

11.
Brain Inj ; 38(1): 19-25, 2024 01 02.
Artigo em Inglês | MEDLINE | ID: mdl-38219046

RESUMO

BACKGROUND: To elucidate the sociodemographic and study factors involved in enrollment in the Traumatic Brain Injury Model System (TBIMS) database, this study examined the effect of a variety of variables on enrollment at a local TBIMS center. METHODS: A sample of 654 individuals from the local TBIMS center was studied examining enrollment by age, gender, race, ethnicity, homelessness status at date of injury, history of homelessness, health insurance status, presence of social support, primary language, consenting in hospital or after discharge, and the need for an interpreter. Binary logistic regression was conducted to identify variables that predict center-based enrollment into TBIMS. RESULTS: Results demonstrated that older age was associated with decreasing enrollment (OR = 0.99, p = 0.01), needing an interpreter made enrollment less likely (OR = 0.33, p < 0.01), being primarily Spanish speaking predicted enrollment (OR = 3.20, p = 0.02), Hispanic ethnicity predicted enrollment (OR = 7.31, p = 0.03), and approaching individuals in the hospital predicted enrollment (OR = 6.94, p < 0.01). Here, OR denotes the odds ratio estimate from a logistic regression model and P denotes the corresponding p-value. CONCLUSIONS: These results can be useful in driving enrollment strategies at this center for other similar TBI research, and to contribute a representative TBI sample to the national database.


Assuntos
Lesões Encefálicas Traumáticas , Humanos , Cidade de Nova Iorque/epidemiologia , Lesões Encefálicas Traumáticas/epidemiologia , Etnicidade
12.
Childs Nerv Syst ; 40(5): 1339-1347, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38279985

RESUMO

BACKGROUND: Cerebellar mutism (CM) is characterized by a significant loss of speech in children following posterior fossa (PF) surgery. The biological origin of CM remains unclear and is the subject of ongoing debate. Significant recovery from CM is less likely than previously described despite rigorous multidisciplinary neuro-rehabilitational efforts. METHODS: A national multi-centered retrospective review of all children undergoing PF resection in four midsized Canadian academic pediatric institutions was undertaken. Patient, tumor and surgical factors associated with the post-operative development of CM were reviewed. Retrospective identification of PF surgery patients including those developing and those that did not (internal control). RESULTS: The study identified 258 patients across the 4 centers between 2010 and 2020 (mean age 6.73 years; 42.2% female). Overall, CM was experienced in 19.5% of patients (N = 50). Amongst children who developed CM histopathology included medulloblastoma (35.7%), pilocytic astrocytoma (32.6%) and ependymoma (17.1%). Intraoperative impression of adherence to the floor of the 4th ventricle was positive in 36.8%. Intraoperative abrupt changes in blood pressure and/or heart rate were identified in 19.4% and 17.8% of cases. The clinical resolution of CM was rated to be complete, significant resolution, slight improvement, no improvement and deterioration in 56.0%, 8.0%, 20.0%, 14.0% and 2.0%, respectively. In the cohort of children who experienced post-operative CM as compared to their no-CM counterpart, proportionally more tumors were felt to be adherent to the floor of the 4th ventricle (56.0% vs 49.5%), intraoperative extent of resection was a GTR (74% vs 68.8%) and changes in heart rate were noted (≥ 20% from baseline) (26.0% vs 15.9%). However, a multiple regression analysis identified only abrupt changes in HR (OR 5.97, CI (1.53, 23.1), p = 0.01) to be significantly associated with the development of post-operative CM. CONCLUSION: As a devastating surgical complication after posterior fossa tumor surgery with variable clinical course, identifying and understanding the operative cues and revising intraoperative plans that optimizes the child's neurooncological and clinical outcome are essential.


Assuntos
Neoplasias Cerebelares , Neoplasias Infratentoriais , Meduloblastoma , Mutismo , Humanos , Criança , Feminino , Masculino , Estudos Retrospectivos , Mutismo/etiologia , Complicações Pós-Operatórias , Canadá , Neoplasias Infratentoriais/cirurgia , Meduloblastoma/cirurgia , Síndrome , Neoplasias Cerebelares/cirurgia
13.
J Burn Care Res ; 2024 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-38206865

RESUMO

Access to theatre is essential for surgical management of deep burns. This is a scarce resource in low-middle income countries. It underpins the importance of optimizing theatre time. We sought to look at specific factors and their influence on operative time in minor to moderate burn surgery. This knowledge can assist teams where theatre planning and optimization may be beneficial in resource limited settings . Operative records between January and December 2018 at the Regional Hospital , were analysed. Data fields included age, gender, total body surface area of burn, surface area burn operated on, intra-operative position change, seniority of surgeon, presence of an assistant, inclusion of special areas, predicted operative time and actual operative time. Operative records for 265 patients were analysed, with a median operative time of 40 minutes (IQR 25 - 64). Overall factors that predict longer operating time are larger total body surface area burn, larger surface area burn operated on, an operation involving at least one special area, number of special areas operated on, position change, presence of an assistant and longer predicted operative time. Total percentage burn, operated percentage, special areas to be operated and position change are overall factors to be considered when planning a burns list for the non-specialist burn surgeon. This knowledge may be useful for an inexperienced surgeon to understand, and aid in the effective utilisation of limited operative time available for the surgical management of deep burns in resource limited settings.

14.
Phys Ther Sport ; 66: 37-42, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38281361

RESUMO

OBJECTIVE: The Netball KNEE Program is an injury prevention program (IPP) developed by Netball Australia. It is promoted to coaches, but implementation is limited. This study explored community netball coaches' perspectives on factors that influence IPP implementation, and ideas on how it could be improved. METHODS: Twenty-four coaches from 16 netball clubs participated in semi-structured interviews that asked about their beliefs about injury prevention, use of and confidence in delivering IPP, barriers and facilitators to implementation, and suggestions to ease IPP implementation. Interviews were analysed using inductive thematic analysis. RESULTS: Two themes were identified - Factors that influence IPP implementation (4 sub-themes), and Suggestions to improve IPP implementation (2 sub-themes). Coaches thought early development of injury prevention habits was important. Life roles, coaching experience and engagement with development courses influenced IPP delivery. Coaches expressed concerns about Netball KNEE program length and complexity and lack of implementation support. They suggested the need for a short simple IPP and engagement with health/exercise professionals for implementation. CONCLUSIONS: This study engaged with stakeholders to identify barriers that need to be addressed to improve IPP implementation in netball. Coaches desired a short simple standardised IPP, and training from physiotherapists or exercise professionals on implementation.


Assuntos
Basquetebol , Tutoria , Humanos , Basquetebol/lesões , Pesquisa Qualitativa , Exercício Físico , Austrália
15.
Childs Nerv Syst ; 40(1): 213-218, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37428253

RESUMO

OBJECTIVE: The fibroneural stalk of an LDM has variable thickness, complexity, and length, which can span 5 to 6 vertebral segments from its skin attachment to its "merge point" with the dorsal spinal cord. Therefore, complete resection may require extensive multi-level laminotomies. In this technical note, a modification of the procedure is presented that avoids long segment laminectomies while ensuring complete excision of long LDM stalks. RESULTS: An illustrative case of resection of LDM is presented using skip laminectomies. The technique ensures complete removal of the stalk, thus reducing the risk of future intradural dermoid development, while at the same time minimizes the risk for delayed kyphotic deformity. CONCLUSIONS: A technique of "skip-hop" proximal and distal short segment laminectomies in cases of LDM optimizes the objectives of complete stalk resection with preservation of spinal integrity.


Assuntos
Laminectomia , Medula Espinal , Humanos , Medula Espinal/cirurgia , Pele , Coluna Vertebral/cirurgia
16.
Eur Spine J ; 33(3): 1164-1170, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37994987

RESUMO

INTRODUCTION: Os odontoideum refers to a rounded ossicle detached from a hypoplastic odontoid process at the body of the axis. The aetiology has been debated and believed to be either congenital or acquired (resulting from trauma). Os odontoideum results in incompetence of the transverse ligament and thus predisposes to atlantoaxial instability and spinal cord injury. METHODS/RESULTS: Three cases of children with severe dystonic cerebral palsy presenting with myelopathic deterioration secondary to atlantoaxial instability due to os odontoideum are presented. This observation supports the hypothesis of os odontoideum being an acquired phenomenon, secondary to chronic excessive movement with damage to the developing odontoid process. CONCLUSION: In children with cerebral palsy and dystonia, pre-existing motor deficits may conceal an evolving myelopathy and result in delayed diagnosis of clinically significant atlantoaxial subluxation.


Assuntos
Articulação Atlantoaxial , Vértebra Cervical Áxis , Paralisia Cerebral , Distonia , Instabilidade Articular , Processo Odontoide , Doenças da Medula Espinal , Criança , Humanos , Distonia/complicações , Paralisia Cerebral/complicações , Imageamento por Ressonância Magnética/efeitos adversos , Articulação Atlantoaxial/diagnóstico por imagem , Doenças da Medula Espinal/complicações , Processo Odontoide/diagnóstico por imagem , Processo Odontoide/anormalidades , Instabilidade Articular/etiologia , Instabilidade Articular/complicações
17.
J Neurol Sci ; 456: 122850, 2024 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-38142539

RESUMO

Nocardia brain abscesses are rare bacterial infections associated with a high mortality rate, and their preoperative diagnosis can be difficult for various reasons including a nonspecific clinical presentation. While late-stage nocardial brain abscesses may be radiologically characteristic, early-stage lesions are nonspecific and indistinguishable from another inflammatory/infectious process and other mimics. Despite the paucity of previous histopathological descriptions, histopathological examination is critical for the identification of the pathogen, lesion stage(s), and possible coexisting pathology. In this study, we examined the clinical, radiological and histopathological features of 10 patients with brain nocardiosis. Microscopic findings were analysed in correlation with clinical and radiological features in 9 patients, which revealed that brain nocardiosis was characterized by numerous necrotic and non-necrotic foci of various stages (I-IV) along with Nocardia identification, as well as the leptomeningeal involvement in most cases, and co-infection of brain nocardiosis with toxoplasmosis in 2 patients. The imaging features were characteristic with a multilobulated/bilobed ring-enhancing appearance in 8 patients including 2 patients with multiple lobulated and non-lobulated lesions and 1 patient showing the progression from a non-lobulated to lobulated lesion. These findings suggest that nocardial brain abscesses particularly at late-stages share common characteristics. Nevertheless, given the complex pathologic features, including possible co-infection by other pathogens, nocardial brain abscesses remain a therapeutic challenge.


Assuntos
Abscesso Encefálico , Coinfecção , Nocardiose , Nocardia , Humanos , Coinfecção/complicações , Abscesso Encefálico/diagnóstico por imagem , Nocardiose/diagnóstico , Nocardiose/diagnóstico por imagem , Encéfalo/diagnóstico por imagem
18.
J Neurosurg ; : 1-5, 2023 Dec 08.
Artigo em Inglês | MEDLINE | ID: mdl-38064710

RESUMO

OBJECTIVE: Over the past several decades, the number of women applying to medical school has increased significantly. However, parallel recruitment and retention of women in the field of neurosurgery continues to lag. The aim of this study was to identify the ratio and trend of female neurosurgery residents to the total number of residents during the past 7 years across all US neurosurgery residency programs. METHODS: The authors conducted a cross-sectional demographic study investigating the ratio of female neurosurgery residents to the total number of neurosurgery residents across US neurosurgical programs from 2016 to 2022. Using the Fellowship and Residency Electronic Interactive Database, all neurosurgical residency programs in the US were collected. Data were further divided into postgraduate years 1-7 to dissect the data collection per residency year. One hundred fourteen programs were included in the study. RESULTS: The number of female neurosurgery residents was 71 (29.8%) in 2022, 58 (25.2%) in 2021, 65 (27.9%) in 2020, 62 (27.3%) in 2019, 46 (21.4%) in 2018, 33 (15.2%) in 2017, and 34 (15.9%) in 2016. The trend line showed a significant increase using the Mann-Kendall test (p = 0.035). The total number of international medical graduate (IMG) female neurosurgery residents was 3 (4.2%) in 2022, 4 (6.9%) in 2021, 3 (4.6%) in 2020, 1 (1.6%) in 2019, 1 (2.2%) in 2018, 1 (3%) in 2017, and 2 (5.9%) in 2016. CONCLUSIONS: The number of women matching into neurosurgery residency programs is modestly increasing, especially for IMG women. Future steps toward fewer gender disparities should focus on career advancement and leadership diversification in organized and academic neurosurgery.

19.
J Microbiol Biol Educ ; 24(3)2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38108011

RESUMO

In the microbial world, cell size and shape impact physiology, but students struggle to visualize spatial relationships between cells and macromolecules. In prokaryotic cells, cell size is limited by reliance on diffusion for nutrient uptake and the transport of nutrients within the cell. Cells must also meet a minimum size threshold to accommodate essential cellular components such as ribosomes and DNA. Using 3D printing allows for the creation of custom models that can be influential teaching tools in the biology classroom. This lesson uses 3D cell models to teach students enrolled in an introductory microbiology course about bacterial cell size and the biological importance of surface-area-to-volume ratio. During the lesson, students interact with 3D cell models and discuss a series of questions in small groups. Student learning was assessed using quantitative and qualitative student response data collected pre- and post-lesson. Student achievement of learning objectives, and their confidence in their knowledge of these concepts, improved post-lesson, and these gains were statistically significant. Our findings suggest that interacting with 3D-printed cell models improves student understanding about bacterial cell size and diffusion.

20.
J Occup Rehabil ; 2023 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-37995059

RESUMO

PURPOSE: Pain and disability associated with lower limb osteoarthritis (OA) may contribute to difficulties at work. This study aimed to understand the perspectives of workers with lower limb OA on difficulties, concerns, and coping strategies used at work. METHODS: Twenty-two individuals with lower limb OA who were working in paid employment participated in semi-structured interviews. Data were qualitatively analyzed using an inductive thematic approach. Codes were identified and refined through review of interview transcripts and discussion with the research team. RESULTS: Six themes were identified in relation to experiences working with lower limb OA. Themes were as follows: weight-bearing physical demands are challenging; lower limb OA can affect work performance; emotional consequences of pain; concerns about work in the future; positive experiences of supportive colleagues and managers; and minimal effects on sedentary work. Three themes were identified relating to strategies to manage at work: adjustments at work help manage pain and avoid exacerbations; regular strategies to manage pain; and healthcare professionals are consulted, but usually not specifically for work. CONCLUSIONS: Workers with lower limb OA experience physical and emotional difficulties at work that can impact work performance. Workers are concerned about longevity and job security and use a range of strategies to manage symptoms and remain at work. Employers, employees, and healthcare professionals may need to work together to create workplace accommodations to help workers with lower limb OA confidently remain in work.

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