First-Person Point-of-View Instructional Video on Lumbar Puncture Procedure.

OBJECTIVES: Tutorial videos filmed from a first-person point of view (FP-POV) are generally well received. Pediatric residents are expected to be competent in performing the lumbar puncture (LP). The educational effectiveness of a FP-POV in lumbar puncture procedure training for resident physicians has yet to be evaluated. We compared a FPPOV LP video with a standard in-person demonstration of the LP. METHODS: We designed an assigned cohort study to compare a FP-POV procedural instructional video of a simulated pediatric LP to the standard in-person procedure demonstration.After the intervention, residents completed an LP observed by one of two blinded reviewers who assessed the procedure using a modified, published assessment tool.Participants completed preintervention and postintervention surveys to rate self-confidence and usefulness of the FP-POV educational method. The data was analyzed using a Wilcoxon Rank sum test. z Scores were calculated on the raw assessment scores. RESULTS: Eighteen first year pediatric residents participated, nine in each group. The median modified assessment tool score was 17 in the FP-POV group (min, 14; max, 17; IQR:, 1.5) and 14 in the standard demonstration group (min, 6; max, 17; IQR, 4.5), with the higher score being more successful. There was a statistical difference between the assessment scores between the 2 groups (z score = 2.18, P = 0.04). Postintervention survey data demonstrated relative satisfaction with the FPPOV educational method. CONCLUSIONS: This study supports the educational effectiveness of a FP-POV procedure tutorial.Future studies with a larger sample size are needed.

Identification of household dangers by parents from adult versus child visual perspective.

BACKGROUND: This study utilized videos from a child's and an adult's perspective to determine whether perspective influences the number of hazards identified by parents. METHODS: The study measured number of household dangers parents' identified. Parents (n=106) were randomized to view either the child or adult perspective videos. Groups did not differ with respect to median age (p=0.51), education (p=0.55), or number of children living at home (p=0.64). RESULTS: Median number of hazards identified in the bedroom was 3 for participants watching videos taken at either adult or child perspective (p=0.32). Parents viewing child perspective videos of the kitchen identified significantly more hazards (median=4) than parents viewing adult perspective videos (median=3) (p=0.0001). CONCLUSIONS: Although video height (perspective) did not influence the number of hazards identified in the bedroom, parents who observed the kitchen video taken at a child's height identified more hazards than those viewing a video at adult height.

Relations between digital thermal monitoring of vascular function, the Framingham risk score, and coronary artery calcium score.

BACKGROUND: Digital thermal monitoring (DTM) of vascular function was shown to correlate with the presence of known coronary artery disease (CAD). OBJECTIVE: We evaluated whether DTM can identify at-risk, asymptomatic patients with significant coronary artery calcium (CAC) or increased Framingham risk score (FRS). METHODS: Two hundred thirty-three consecutive asymptomatic subjects (58 +/- 11 years; 62% men) without known CAD underwent DTM, CAC, and FRS calculation. DTM measurements were obtained during and after a 5-minute suprasystolic arm-cuff occlusion. After cuff-deflation temperature rebound (TR) and area under the temperature curve (AUC) were measured and correlated with FRS and CAC. RESULTS: TR was lower in patients with FRS > 20% and CAC >or= 100 as compared with FRS < 10% and CAC < 10, respectively (P < 0.05). After adjustment for age, sex, and traditional cardiac risk factors, the odds ratio of the lowest compared with the upper 2 tertiles of TR was 3.96 for FRS >or= 20% and 2.37 for CAC >or= 100 compared with low-risk cohorts. The area under the receiver operating characteristic (ROC) curve to predict CAC >or= 100 increased significantly from 0.66 for FRS to 0.79 for TR to 0.89 for TR + FRS. CONCLUSIONS: Vascular dysfunction measured by DTM strongly correlates with FRS and CAC independent of age, sex, and traditional cardiac risk factors and was superior to FRS for the prediction of significant CAC.