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1.
Rural Remote Health ; 23(1): 8144, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36802705

RESUMO

INTRODUCTION: With the introduction of portable handheld ultrasounds, higher levels of technology are more easily available for patients in rural and underserved communities. Point-of-care ultrasound (POCUS) increases accessibility for patients with limited resources, thus reducing costs and decreasing the risk of non-compliance or subsequent loss to follow-up. Despite the increasing utility of ultrasonography, literature demonstrates a lack of sufficient training in POCUS and ultrasound-guided techniques for Family Medicine residents. Integrating unfixed cadavers into the preclinical curriculum may be an ideal adjunct to simulating pathologies and screening sensitive regions. METHODS: In total, 27 unfixed, de-identified cadavers were scanned with a handheld portable ultrasound. Sixteen body systems were screened: ocular, thyroid, carotid artery/internal jugular vein, brachial plexus, heart, kidneys, pancreas, gallbladder, liver, aorta and inferior vena cava, femoral artery and vein, knee, popliteal vessels, uterus, scrotum, and shoulder. RESULTS: Eight of the sixteen body systems, including the ocular, thyroid, carotid artery/internal jugular vein, brachial plexus, liver, knee, scrotum, and shoulder, consistently showed accurate anatomy and pathology. A physician skilled in ultrasound reviewed images obtained from the cadavers and concluded that differences in anatomy and common pathologies of unfixed cadavers were indiscernible compared with live patient ultrasound images. DISCUSSION: Using unfixed cadavers in POCUS training can be a valuable educational tool in preparing Family Medicine Physicians for rural or remote practices because the cadavers display accurate anatomy and pathology under ultrasound evaluation in multiple body systems. Further studies should explore creating artificial pathologies in cadaveric models to broaden the scope of application.


Assuntos
Internato e Residência , Médicos , Masculino , Feminino , Humanos , Sistemas Automatizados de Assistência Junto ao Leito , Ultrassonografia/métodos , Currículo
2.
Chronobiol Int ; 36(3): 307-318, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30409040

RESUMO

Good sleep hygiene practices, including consistent bedtimes and 7-9 h of sleep/night, are theorized to benefit educational learning. However, individuals differ in how much sleep they need, as well as in their chronotype preference. Therefore, some students may be more vulnerable to the cognitive effects of sleep loss, later bedtimes and nonpreferred times of learning than others. One prominent example is the debate regarding whether sleep loss and later bedtimes affect classroom learning more in female or male students. To inform this gender-and-sleep-loss debate, we developed a virtual college-level lecture to use in a controlled, laboratory setting. During Session 1, 78 undergraduate students were randomly assigned to take the lecture at 12:00 (noon condition) or 19:30 (evening condition). Then participants wore wristband actigraphy for 1 week to monitor average and intraindividual variability in sleep duration, bedtime and midpoint of sleep. During Session 2, participants completed a test at the same time of day as Session 1. The test included basic questions that were similar to trained concepts during the lecture (trained items) as well as integration questions that required application of learned concepts (knowledge-transfer items). Bayesian analyses supported the null hypothesis that time of learning did not affect test performance. Collapsed across time of testing, regression analyses showed that shorter sleep durations and later bedtimes explained 13% of the variance in test performance. Longer sleep durations and earlier bedtimes predicted better test performance primarily in females, younger students and morning-types. Interestingly, students with above-median fluid intelligence scores were resilient to short sleep and late bedtimes. Our findings indicate that both sleep and circadian factors should be addressed to optimize educational learning, particularly in the students who are most susceptible to sleep loss.


Assuntos
Ritmo Circadiano/fisiologia , Aprendizagem/fisiologia , Sono/fisiologia , Adolescente , Adulto , Teorema de Bayes , Feminino , Humanos , Inteligência/fisiologia , Masculino , Fatores de Tempo , Adulto Jovem
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