Development of a scale to measure health professions students' self-efficacy beliefs in interprofessional learning.

A need exists for measures to evaluate the impact of interprofessional education (IPE) interventions. We undertook development and evaluation of a scale to measure self-efficacy perceptions of pre-licensure students in medicine, dentistry and health professions. The scale was developed in the context of a project entitled, "Seamless Care: An Experiential Model of Interprofessional Education for Collaborative Patient-Centered Practice". As self-efficacy perceptions are associated with the likelihood of taking on certain tasks, the difficulty of those tasks, and perseverance in the face of barriers, we reasoned that understanding changes in students' perceptions and their relation to other outcomes was important. A 16-item scale was developed from a conceptual analysis of relevant tasks and the existing literature. Content validity was assessed by six Canadian IPE experts. Pre-licensure students (n = 209) participated in a pilot test of the instrument. Content validity was rated highly by the six judges; internal consistency of the scale (Cronbach's α = 96) and subscales 1 (α = .94) and 2 (α = .93) were high. Principal components analysis resulted in identification of two factors, each accounting for 34% of the variance: interprofessional interaction, and interprofessional team evaluation and feedback. We conclude that this scale can be useful in evaluating IPE interventions.

Retinal and Callosal Activity-Dependent Chandelier Cell Elimination Shapes Binocularity in Primary Visual Cortex.

In mammals with binocular vision, integration of the left and right visual scene relies on information in the center visual field, which are relayed from each retina in parallel and merge in the primary visual cortex (V1) through the convergence of ipsi- and contralateral geniculocortical inputs as well as transcallosal projections between two visual cortices. The developmental assembly of this binocular circuit, especially the transcallosal pathway, remains incompletely understood. Using genetic methods in mice, we found that several days before eye-opening, retinal and callosal activities drive massive apoptosis of GABAergic chandelier cells (ChCs) in the binocular region of V1. Blockade of ChC elimination resulted in a contralateral eye-dominated V1 and deficient binocular vision. As pre-vision retinal activities convey the left-right organization of the visual field, their regulation of ChC density through the transcallosal pathway may prime a nascent binocular territory for subsequent experience-driven tuning during the post-vision critical period.

Benefits from a mobile telephone adapter in Combi40+ cochlear implant users.

CONCLUSIONS: Telephone adapters can help cochlear implanted patients to enhance their telephonic conversations. However, these devices should be further developed to be useful for daily life. OBJECTIVES: To test a mobile telephone adapter to improve speech discrimination by mobile telephone in Combi40+ users. To evaluate the influence of the mobile telephone in communication. SUBJECTS AND METHODS: Seventeen Combi40+ implantees were tested with bisyllabic words presented through mobile telephones with and without a telephone adapter in quiet and noisy environments. Speech audiometries in open field were obtained for every patient. RESULTS: Mean speech discrimination without the adapter in a quiet environment was 51.2%. In a noisy environment, mean discrimination increased significantly with the adapter from 30.3% to 42.9%. No statistically significant difference was found between speech discrimination in the quiet environment without the adapter and speech discrimination in the noisy environment with the adapter. When comparing speech discrimination in open field without lip-reading with equivalent telephonic conditions a statistically significant difference was found in favour of the open field.

[Haemangiomas of the geniculate ganglion]. / Hemangiomas del ganglio geniculado.

About 60 cases have been published since Pulec first described hemangiomas of the geniculate ganglion. They usually cause facial weakness even when they are very small. In cases of insidious evolution of facial paralysis, MRI, and CT are very helpful to rule out these tumors. The treatment is based on complete surgical removal, although it has to be individualized, depending on preoperative facial function and the possibility of complete surgical removal with preservation of the facial nerve.

[Facial nerve repair techniques]. / Técnicas reconstructivas del nervio facial.

OBJECTIVE: Post-operative facial function was analyzed in 14 patients undergoing different techniques for facial nerve repair. MATERIAL AND METHOD: The aetiology of facial paralysis included vestibular schwannomas, facial schwannomas, cranioencephalic trauma, and iatrogenic lesions. RESULTS: The mean interval between paralysis and reconstruction surgery was 6 months, although in 2 cases it exceeded 12 months. The first facial signs of recovery were achieved around the sixth month post-operatively, in every patient. All patients achieved a facial function graded III or IV in the House-Brackmann scale, equivalent to a grade II or III on the May scale. There were no differences between the surgical techniques compared, both termino-terminal anastomosis and hypoglossal-facial anastomosis. CONCLUSIONS: The surgical reconstruction techniques for facial nerve repair should be known by all ENT surgeons. At least facial symmetry at rest and complete eye closure are achieved in almost every patient when the procedure is carried out at the proper time.

Evaluación del conocimiento del cáncer oral y manejo odontológico del paciente oncológico en Cali, Colombia / Assessment of knowledge in oral cancer and dental care in cancer patients in Cali, Colombia

Objetivo: evaluar el conocimiento sobre cáncer oral y manejo odontológico del pacien-te oncológico en estudiantes de pregrado, de último año de medicina y odontología, y en odontólogos egresados de diferentes universidades en Cali, Colombia. Métodos:se realizó un estudio descriptivo, cuantitativo de corte transversal. El instrumento de recolección de datos fue una encuesta de 19 preguntas. La muestra incluyó 360 participantes y se realizó un análisis multivariado con pruebas no paramétricas, cuyo grado de confiabilidad es del 95%. Resultados: las categorías evaluadas fueron: I) conocimiento del cáncer oral y II) manejo del paciente oncológico. Según la rúbrica empleada, el nivel alcanzado fue "regular" en ambas categorías, con un promedio de 8,7/19 para estudiantes de odontología; 11,2/19 para estudiantes de medicina y 11,3/19 para odontólogos egresados. La media general fue 10,3 respuestas acertadas (a=0,05). Hubo diferencias estadísticamente significativas al evaluar las tres facultades de odon-tología en ambas categorías y la rúbrica reflejó un desempeño "regular" aún para la universidad con el mejor promedio. Conclusión: según la rúbrica planteada, el nivel de conocimiento sobre cáncer oral y su manejo odontológico en la población evaluada, en Cali, es insuficiente, por lo que se sugiere un replanteamiento de estrategias en el abordaje académico de estos temas.

Objective: To assess the knowledge of oral cancer and oral care, in undergraduate students of last year of medicine and dentistry and dentists graduated from different universities in Cali, Colombia. Methods: A descriptive, quantitative cross-sectional study was conducted. The data collection tool was a 19-question survey. The sample included 360 participants, and a multivariate analysis was performed with nonparametric tests with a 95% degree of reliability. Results: The categories evaluated were I) oral cancer knowledge and II) dental care. According to the rubric used, the level achieved was "regular" in both categories, with an average of 8.7/19 for dental students; 11.2/19 for medicine students and 11.3/19 for graduate dentists. The overall average was 10.3 successful responses (a=0.05). There were statistically significant differences in evaluating the three dental faculties in both categories and the rubric reflects a "regular" performance even for the university with the best average. Conclusions: The level of knowledge in oral cancer and dental care of cancer patients in Cali, Colombia, is insufficient in the assessed population and approach of new strategies to address these issues from an academic perspective is required.

Hearing preservation with the retrosigmoid approach for vestibular schwannoma: myth or reality?

OBJECTIVE: The purpose of this study is to present our experience with the retrosigmoid approach for vestibular schwannoma resection, emphasizing our hearing results, discussing selection and reporting results criteria.Study design and setting The notes of 65 consecutive cases of vestibular schwannoma undergoing the retrosigmoid approach were reviewed. Hearing data were reported according to the recommendations of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS). In addition, the terms normal, serviceable, useful, and measurable hearing were considered. RESULTS: Tumor size ranged from 8 to 50 mm (mean, 24.1 mm). Of the 29 patients with preoperative serviceable hearing (AAO-HNS classes A and B), 5 patients (17%) had postoperative serviceable hearing, and 6 patients (20%) had postoperative useful hearing (AAO-HNS classes A, B, and C). CONCLUSION: The retrosigmoid approach is a reliable surgical procedure for most vestibular schwannoma tumors. However, hearing preservation results show wide differences depending on selection and reporting results criteria. Hearing preservation, although possible, may not be the main reason to choose this approach.

Pro-social behavior in rats is modulated by social experience.

In mammals, helping is preferentially provided to members of one's own group. Yet, it remains unclear how social experience shapes pro-social motivation. We found that rats helped trapped strangers by releasing them from a restrainer, just as they did cagemates. However, rats did not help strangers of a different strain, unless previously housed with the trapped rat. Moreover, pair-housing with one rat of a different strain prompted rats to help strangers of that strain, evidence that rats expand pro-social motivation from one individual to phenotypically similar others. To test if genetic relatedness alone can motivate helping, rats were fostered from birth with another strain and were not exposed to their own strain. As adults, fostered rats helped strangers of the fostering strain but not rats of their own strain. Thus, strain familiarity, even to one's own strain, is required for the expression of pro-social behavior. DOI: http://dx.doi.org/10.7554/eLife.01385.001.

A role for dopamine-mediated learning in the pathophysiology and treatment of Parkinson's disease.

Dopamine contributes to corticostriatal plasticity and motor learning. Dopamine denervation profoundly alters motor performance, as in Parkinson's disease (PD); however, the extent to which these symptoms reflect impaired motor learning is unknown. Here, we demonstrate a D2 receptor blockade-induced aberrant learning that impedes future motor performance when dopamine signaling is restored, an effect diminished by coadministration of adenosine antagonists during blockade. We hypothesize that an inappropriate corticostriatal potentiation in striatopallidal cells of the indirect pathway underlies aberrant learning. We demonstrate synaptic potentiation in striatopallidal neurons induced by D2 blockade and diminished by application of an adenosine antagonist, consistent with behavioral observations. A neurocomputational model of the basal ganglia recapitulates the behavioral pattern and further links aberrant learning to plasticity in the indirect pathway. Thus, D2-mediated aberrant learning may contribute to motor deficits in PD, suggesting new avenues for the development of therapeutics.

Petrous bone Langerhans cell histiocytosis treated with radiosurgery.

Langerhans cell histiocytosis (LCH) is a rare disease that may show as a solitary or multifocal lesion of bone, soft tissue or viscera. Involvement of the temporal bone has been described in 15-61% of patients with LCH, usually in association with multisystemic involvement. We report the case of a 30-year-old man presenting with vertigo and fluctuating hearing loss caused by monosystemic LCH of the left petrous bone. The patient was treated with radiosurgery (covering dose 10 Gy at 85% isodose, maximum dose 11.76 Gy). Two years after treatment, no evidence of recurrent disease was found in the CT scan or MRI. We discuss the treatment of temporal bone LCH, traditionally based on surgery, low-dose radiation therapy and intralesional steroids. To our knowledge, this is the first reported case of LCH of the petrous bone successfully treated with radiosurgery. This approach may be interesting in cases of LCH located on nonaccessible areas of the temporal bone.

Quality of life in postlingually deaf patients following cochlear implantation.

Most cochlear implant studies are focused on improvement of speech perception associated with implantation. The goal of this study was to assess the impact of cochlear implantation on quality of life changes in Spanish users. Thirty postlingually deaf patients fitted with a cochlear implant completed the Glasgow Benefit Inventory, a questionnaire dealing with communication abilities, and an open-ended questionnaire. The Glasgow Benefit Inventory revealed a positive effect in 93% of patients. The use of a cochlear implant significantly enhanced discrimination ability, telephone use and self-confidence. A high degree of satisfaction was achieved in all situations except with background noise. Ninety-six percent of patients would recommend the operation to a friend. A dramatic improvement in quality of life following cochlear implantation is revealed by a great majority of patients. The results cannot only be explained by enhancements to auditory perception.

Diagnóstico y tratamiento del trauma dental / Diagnosis and treatment of dental trauma

Se realizó un estudio acerca del diagnóstico y tratamiento del trauma dental en un grupo de 40 pacientes cuyas edades oscilaron entre 5 y 25 años. La edad en que ocurrió el trauma con mayor frecuencia fue de 5 a 11 años y la porción dentaria más afectada fue la corona, aunque tenemos 2 casos con fracturas radiculares. Se atendieron 31 pacientes que habían sufrido trauma pasados varios días y habían sido atendidos por otros estomatólogos. La conducta que seguimos fue realizar tratamiento en correspondencia con la afección que presentaba el paciente en ese momento. Tres pacientes acudieron a consulta entre 6 y 24 horas y 6 antes de las 5 horas, a los que se les realizó el tratamiento correcto. Todos los pacientes atendidos después de las 24 horas del trauma presentaron sintomatología dolorosa; no ocurrió así para los pacientes atendidos entre las 5 y 24 horas, que su posoperatorio fue exitoso

Manifestaciones sistémicas del brote dentario / Systemic manifestations of tooth eruption

Se realizó un estudio para comprobar la presencia de manifestaciones sistémicas asociadas con el brote dentario, aspecto que ha sido motivo de discrepancias entre médicos y estomatólogos durante mucho tiempo. Para la obtención de los datos se entrevistaron a las madres de 121 infantes, cuyas edades oscilaron entre 6 y 12 meses, por considerarse las edades más propensas a estas manifestaciones. Se aplicó el método estadístico de prueba de contraste de hipótesis. No hubo diferencias en relación con el sexo. Las madres refirieron los síntomas y signos que se presentan durante la erupción dentaria y que se expresan en por cientos; otro grupo planteó que la erupción fue asintomática. Entre las manifestaciones o patologías asociadas, las diarreas tuvieron una mayor incidencia, seguidas de la fiebre, el estado catarral y los vómitos. También estuvieron presentes, aunque con menos incidencia, la irritabilidad y la dermatitis. Según las pruebas estadísticas los resultados fueron altamente significativos, lo que demuestra la relación existente entre manifestaciones sistémicas y el brote dentario

Prevalencia de la Neisseria gonorrhoeae productora de beta lactamasa / Prevalence of Neisseria gonorrhoeae beta lactamase producer

Se tomaron 291 muestras genitourinarias a 29 hombres y 266 mujeres, para determinar la prevalencia de Neisseria gonorrhoeae productora de beta lactamasa (NGBL), identificarla por la tecnica de fermentacion rapida de azucares en medios liquidos y establecer la prevalencia de cepas de crecimiento lento (NGCL) con mas de 48 horas de incubacion. Casi 75% de los hombres y 21% de las mujeres fueron positivos para NG y 4% y 6%, respectivamente, tuvieron NGBL. Al tratarlos con penicilina G procainica o prevecilina, recayeron. Tambien recayeron 17% de las mujeres y 6% de los hombres negativos para NGBL. Asimismo 20% o mas de las cepas fueron NGCL. El 95% o mas de las cepas se identificaron resistentes in vitro o in vivo a penicilina, implica el uso de pruebas de susceptibilidad a otros antibioticos y un seguimiento estricto

Evaluación ultraestructural de la remineralización del esmalte por medio de la saliva después del grabado acido / Teeth polish ultraestructural evaluation

Se realizó un estudio descriptivo con una muestra piloto de 21 dientes que iban a ser extraídos por razones ortodónticas,dichas muestras se dividieron en dos grupos;los que se desmineralizaron y se dejaron en boca por diferentes intervalos de tiempo,1 hora, 24 horas, 48 horas, 72 horas y 96 horas y el segundo grupo control con los mismos intervalos de tiempo que se desmineralizaron post-exodoncia para evitar el contacto con saliva. Estas muestras se observaron al microscopio electrónico de barrido en diferentes magnificaciones, se tomaron microfotografías y se compararon entre sí y con el diente sin desmineralizar. Se encontró que la saliva es un medio eficaz para el proceso de remineralización