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2.
Artigo em Inglês | MEDLINE | ID: mdl-33114192

RESUMO

The paper presents the results of a students' survey carried out at "Vasile Alecsandri" University of Bacau, Romania, on the quality of educational process on online platforms in the context of the COVID-19 pandemic. The study was addressed to students from the Faculty of Engineering and the Faculty of Physical Education and Sports. The results of survey highlighted that most of students were satisfied with the measures taken by the university during the lockdown period and the way the teaching-learning-assessment process took place. However, some negative aspects were reported as: lack of an adequate infrastructure for some students, less effective teacher-student communication and interaction, impossibility of performing practical applications, lack of socialization, lack of learning motivation, less objective examination (e.g., possibility of cheating), possibility of physical and mental health degradation (e.g., too much time spent in front of screens, installation of a sedentary lifestyle). Consequently, for the new academic year, effective, and efficient measures must be implemented by the management of the university to remove, as much as possible, these negative issues and to improve the performance of online educational process.


Assuntos
Infecções por Coronavirus , Educação , Pandemias , Pneumonia Viral , Estudantes , Betacoronavirus , Educação/normas , Humanos , Romênia , Inquéritos e Questionários , Universidades
3.
Sheng Wu Gong Cheng Xue Bao ; 36(7): 1459-1464, 2020 Jul 25.
Artigo em Chinês | MEDLINE | ID: mdl-32748604

RESUMO

The teaching laboratory is the central place to teach lab courses to undergraduate students. It is thus critical to evaluate how lab skills of students will be affected by the management of this lab. This study attempts to introduce the 6S concept, referring to "Seiri", "Seiton", "Seiso", "Seiketsu", "Shisuke", and "Safety", to the management of teaching laboratory, in particular, to the management of environments, safety, item deposition, reagents and consumables in the laboratory. We find that applying the "6S" management maintains a tidy lab environment, facilitates teaching the lab skills, and improves the quality of teaching, which together achieves the goal of education with the atmosphere. This study can provide a guideline for establishing and managing teaching laboratories in universities.


Assuntos
Educação , Laboratórios , Universidades , Educação/organização & administração , Educação/normas , Planejamento Ambiental , Humanos , Laboratórios/organização & administração , Laboratórios/normas , Estudantes , Universidades/organização & administração , Universidades/normas
4.
Ethn Dis ; 30(3): 437-440, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32742148

RESUMO

As of late May 2020, more than 1.5 million people had tested positive for coronavirus infection in the United States; however, only 3% of Americans had been tested. However, testing is only one of the key elements in the effort to control communicable diseases. There is a need to investigate others who may have been exposed to the virus; this can be accomplished through a foundational public health strategy - contact tracing. Most public health students and professionals have been introduced to the concept of contact tracing; however, competency in this area is undetermined. The purpose of this perspective is to call for national standards for contact tracing training programs that lead to a widely recognized certification process.


Assuntos
Busca de Comunicante/métodos , Infecções por Coronavirus , Educação/normas , Pandemias , Pneumonia Viral , Saúde Pública/educação , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Humanos , Determinação de Necessidades de Cuidados de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Saúde Pública/tendências , Estados Unidos
6.
Am J Kidney Dis ; 76(1): 109-120, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32414662

RESUMO

Cardiovascular disease (CVD) affects more than two-thirds of patients receiving hemodialysis and is the leading cause of death in this population, yet CVD outcomes are infrequently and inconsistently reported in trials in patients receiving hemodialysis. As part of the Standardised Outcomes in Nephrology-Haemodialysis (SONG-HD) initiative, we convened a consensus workshop to discuss the potential use of myocardial infarction and sudden cardiac death as core outcome measures for CVD for use in all trials in people receiving hemodialysis. Eight patients or caregivers and 46 health professionals from 15 countries discussed selection and implementation of the proposed core outcome measures. Five main themes were identified: capturing specific relevance to the hemodialysis population (acknowledging prevalence, risk, severity, unique symptomology, and pathophysiology), the dilemmas in using composite outcomes, addressing challenges in outcome definitions (establishing a common definition and addressing uncertainty in the utility of biomarkers in hemodialysis), selecting a meaningful metric for decision making (to facilitate comparison across trials), and enabling and incentivizing implementation (by ensuring that cardiologists are involved in the development and integration of the outcome measure into registries, trial design, and reporting guidelines). Based on these themes, participants supported the use of myocardial infarction and sudden cardiac death as core outcome measures of CVD to be reported in all hemodialysis trials.


Assuntos
Doenças Cardiovasculares , Ensaios Clínicos como Assunto/normas , Consenso , Educação/normas , Avaliação de Resultados em Cuidados de Saúde/normas , Diálise Renal/normas , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Ensaios Clínicos como Assunto/métodos , Educação/métodos , Pessoal de Saúde/normas , Humanos , Internacionalidade , Avaliação de Resultados em Cuidados de Saúde/métodos , Participação do Paciente/métodos , Diálise Renal/métodos , Sociedades Médicas/normas
7.
Nature ; 580(7805): 636-639, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32350468

RESUMO

Education is a key dimension of well-being and a crucial indicator of development1-4. The Sustainable Development Goals (SDGs) prioritize progress in education, with a new focus on inequality5-7. Here we model the within-country distribution of years of schooling, and use this model to explore educational inequality since 1970 and to forecast progress towards the education-related 2030 SDG targets. We show that although the world is largely on track to achieve near-universal primary education by 2030, substantial challenges remain in the completion rates for secondary and tertiary education. Globally, the gender gap in schooling had nearly closed by 2018 but gender disparities remained acute in parts of sub-Saharan Africa, and North Africa and the Middle East. It is predicted that, by 2030, females will have achieved significantly higher educational attainment than males in 18 countries. Inequality in education reached a peak globally in 2017 and is projected to decrease steadily up to 2030. The distributions and inequality metrics presented here represent a framework that can be used to track the progress of each country towards the SDG targets and the level of inequality over time. Reducing educational inequality is one way to promote a fairer distribution of human capital and the development of more equitable human societies.


Assuntos
Educação/estatística & dados numéricos , Educação/tendências , Previsões , Objetivos , Desenvolvimento Sustentável/tendências , Adolescente , Idoso , Criança , Pré-Escolar , Educação/normas , Feminino , Humanos , Internacionalidade , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Fatores Sexuais , Fatores de Tempo
8.
Sportis (A Coruña) ; 6(2): 365-389, mayo 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-193350

RESUMO

La formación en primeros auxilios es fundamental para poder intervenir en un primer momento en situaciones de emergencia y es por ello que numerosas instituciones han señalado a la educación obligatoria como una de las claves para llevar a cabo dicha formación. En esta investigación se ha analizado la evolución de la presencia de los primeros auxilios en la legislación educativa en España, que han ido perdiendo peso en el currículo educativo desde la LGE, en 1970, hasta la LOE, en 2006, especialmente en el bachillerato y han recuperado su importancia desde ese año hasta la actual LOMCE, de 2013, donde se incluyen estos contenidos en la educación primaria y la educación secundaria obligatoria. Aunque los contenidos se incluyen principalmente en la asignatura de educación física, actualmente se dividen en varias asignaturas del currículo. La evidencia científica actual nos dice que, aunque estos contenidos están presentes en el currículo, no se suelen aplicar por falta de material y también en la formación en el profesorado para impartirlos, sin embargo, ciertas comunidades autónomas aportan material y formación para que puedan ser los propios docentes los que impartan las maniobras de primeros auxilios en las escuelas. Por todo esto, creemos que los primeros auxilios deben ser un contenido obligatorio y relevante en las escuelas y que deben ser los docentes, formados previamente, los que impartan dichos contenidos


Learning first aid is essential to be able to act in an emergency situation and that is why many institutions have pointed at compulsory education as one of the keys to carry out such learning. The evolution of the presence of first aid in educational legislation in Spain has been analyzed in this research. These contents have been losing weight in the educational curriculum from the LGE, in 1970 to the LOE, in 2006, especially in the baccalaureate and have increased its importance since that year until the current LOMCE, 2013, which includes these contents in primary education and compulsory secondary education. Although the contents are mainly included in the subject of physical education, they are currently divided into several subjects of the curriculum. The current scientific evidence tells us that, although these contents are present in the curriculum, they are not usually taught due to the lack of material and training for teachers to teach them. However, certain autonomous communities provide material and training, so that the teachers can teach by themselves the first aid techniques in schools. For all this, we believe that first aid must be a compulsory and relevant content in schools, and teachers, trained in advance, must teach these contents


Assuntos
Humanos , Primeiros Socorros/normas , Educação/legislação & jurisprudência , Ensino Fundamental e Médio , Educação Física e Treinamento/legislação & jurisprudência , Educação/normas , Espanha , Atividades de Lazer , Centros de Convivência e Lazer , Educação Física e Treinamento/normas
9.
Proc Natl Acad Sci U S A ; 117(18): 9808-9814, 2020 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-32300013

RESUMO

Subtle features of common language can imply to young children that scientists are a special and distinct kind of person-a way of thinking that can interfere with the development of children's own engagement with science. We conducted a large field experiment (involving 45 prekindergarten schools, 130 teachers, and over 1,100 children) to test if targeting subtle properties of language can increase science engagement in children's daily lives. Despite strong tendencies to describe scientists as a special kind of person (in a baseline control condition), brief video-based training changed the language that teachers used to introduce science to their students. These changes in language were powerful enough to predict children's science interest and behavior days later. Thus, subtle features of language shape children's beliefs and behaviors as they unfold in real world environments. Harnessing these mechanisms could promote science engagement in early childhood.


Assuntos
Desenvolvimento Infantil/fisiologia , Educação/normas , Idioma , Ciência/educação , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Instituições Acadêmicas , Estudantes/psicologia
10.
Hematology ; 25(1): 91-94, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32070266

RESUMO

Background: Education is needed as an action to reduce morbidity and mortality from sickle cell disease (SCD), an important but largely neglected risk to child survival in most African countries as Democratic Republic of Congo (DRC).Objective: To assess the knowledge of Kisangani University students in DRC regarding SCD.Methods: In this non-experimental, cross-sectional study, a validated questionnaire was used to assess the knowledge of 2 112 Kisangani University students in DRC and data were analyzed using SPSS version 20.Results: Most participants, 92.9% (95% confidence interval [CI]: 91.7-93.9) were knowledgeable about SCD and have heard about it through schools and/or universities (46.3%), followed by family (34.5%) and health-care workers (23.5%). Nine hundred and seventy-three (46.1%; 95% CI: 44.0-48.2) and 37.9% (95% CI: 35.9-40.0) subjects indicated, respectively, that SCD is an acquired and hereditary disease. Moreover, 53.6% (95% CI: 51.5-55.7) said that the diagnosis of SCD is made by blood tests, while 46.2% (95% CI: 44.1-48.3) talked about urine tests. About 85.6% were unaware of the risk of children becoming sickle cell patients when both parents have SCD. To prevent SCD, pre-marital screening was cited by only 7.7% (95% CI: 6.6-8.9) of subjects and no measure was known by 25.4% (95% CI: 23.6-27.3). However, 79.6% (95% CI: 77.8-81.3) approved the need of pre-marital screening of SCD.Discussion: This study highlighted that the Kisangani university students' knowledge regarding SCD is poor and needs to be improved; education programs and motivational campaigns to be enhanced.


Assuntos
Anemia Falciforme/epidemiologia , Educação/normas , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Estudos Transversais , República Democrática do Congo , Feminino , Humanos , Masculino , Estudantes , Adulto Jovem
11.
Australas Psychiatry ; 28(1): 37-41, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31523975

RESUMO

OBJECTIVE: To describe the CAMH in Primary Care Fiji Project. METHODS: The context; process of development and planning; aims and goals; delivery and outcome are described. RESULTS: Two CAMH in Primary Care Fiji training workshops were delivered in 2017 and 2018 with positive structured and unstructured feedback. CONCLUSION: A successful, collaboratively developed, culturally appropriate and replicable training for primary care in CAMH is possible.


Assuntos
Serviços de Saúde do Adolescente , Serviços de Saúde da Criança , Educação , Pessoal de Saúde/educação , Serviços de Saúde Mental , Atenção Primária à Saúde , Adolescente , Serviços de Saúde do Adolescente/organização & administração , Criança , Serviços de Saúde da Criança/organização & administração , Educação/métodos , Educação/normas , Fiji , Humanos , Serviços de Saúde Mental/organização & administração , Atenção Primária à Saúde/organização & administração
12.
Surg Endosc ; 34(2): 728-741, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31102078

RESUMO

BACKGROUND: One of the major impediments to the proliferation of endoscopic submucosal dissection (ESD) training in Western countries is the lack of sufficient experts as instructors. One way to address this gap is to develop didactic systems, such as surgical simulators, to support the role of trainers. Cognitive task analysis (CTA) has been used in healthcare for the design and improvement of surgical training programs, and therefore can potentially be used for design of similar systems for ESD. OBJECTIVE: The aim of the study was to apply a CTA-based approach to identify the cognitive aspects of performing ESD, and to generate qualitative insights for training. MATERIALS AND METHODS: Semi-structured interviews were designed based on the CTA framework to elicit knowledge of ESD practitioners relating to the various tasks involved in the procedure. Three observations were conducted of expert ESD trainers either while they performed actual ESD procedures or at a training workshop. Interviews were either conducted over the phone or in person. Interview participants included four experts and four novices. The observation notes and interviews were analyzed for emergent qualitative themes and relationships. RESULTS: The qualitative analysis yielded thematic insights related to four main cognition-related categories: learning goals/principles, challenges/concerns, strategies, and decision-making. The specific insights under each of these categories were systematically mapped to the various tasks inherent to the ESD procedure. CONCLUSIONS: The CTA approach was applied to identify cognitive themes related to ESD procedural tasks. Insights developed based on the qualitative analysis of interviews and observations of ESD practitioners can be used to inform the design of ESD training systems, such as virtual reality-based simulators.


Assuntos
Educação , Ressecção Endoscópica de Mucosa , Tomada de Decisão Clínica , Cognição , Simulação por Computador , Educação/métodos , Educação/normas , Ressecção Endoscópica de Mucosa/métodos , Ressecção Endoscópica de Mucosa/psicologia , Ergonomia , Humanos , Modelos Anatômicos , Psicologia Educacional , Análise e Desempenho de Tarefas
13.
Nurse Educ Today ; 85: 104262, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31759243

RESUMO

BACKGROUND: Traditional teaching is associated with dilemmas, such as low motivation to learn and passive learning. In contrast, use of a flipped classroom with the proper learning design has the potential to promote accelerated learning, bolster transmission of competencies (i.e., critical thinking, communication and problem-solving skills) and improve teamwork capacity, all of which are of great significance in professional healthcare practice, including nursing, dentistry and medicine. OBJECTIVE: The aim of the study was to examine the effects of using a flipped classroom in ophthalmology courses for undergraduate nursing students, dental students and higher vocational medical students. DESIGN: A quasi-experimental design was used with an intervention (n = 100) and a comparison group (n = 100), pre-/post-testing measures and a mixed-methods approach. SETTING: A university in China. PARTICIPANTS: A total of 200 students were included. METHODS: Students' self-rated learning ability was measured before and after the courses, and skill exams were performed after the courses. In addition, interviews were conducted with the clinical medical students concerning their experiences of the flipped classroom. RESULTS: Students' self-rated learning ability improved significantly more in the intervention than in the comparison group, for the total scale and the three factors 'learning goals', 'self-efficacy and social learning' and 'problem-solving'. Skill exam scores were statistically significantly better in the intervention than in the comparison group. On the whole, the clinical medicine students felt the flipped classroom had a positive impact and improved their learning ability as well as knowledge in ophthalmology. CONCLUSIONS: Use of a flipped classroom for nursing, dental and clinical medical students in ophthalmology courses shows promising results in the form of students' skill exam scores and self-rated learning ability.


Assuntos
Educação/métodos , Avaliação Educacional/estatística & dados numéricos , Oftalmologia/educação , Oftalmologia/métodos , Ensino/tendências , China , Currículo/normas , Currículo/tendências , Educação/normas , Educação/estatística & dados numéricos , Avaliação Educacional/métodos , Humanos , Aprendizagem Baseada em Problemas , Estatísticas não Paramétricas , Estudantes de Odontologia/psicologia , Estudantes de Odontologia/estatística & dados numéricos , Estudantes de Medicina/psicologia , Estudantes de Medicina/estatística & dados numéricos , Estudantes de Enfermagem/psicologia , Estudantes de Enfermagem/estatística & dados numéricos , Inquéritos e Questionários , Universidades/organização & administração , Universidades/estatística & dados numéricos
14.
Urology ; 137: 115-120, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31785277

RESUMO

OBJECTIVE: To determine the relationship between urologic oncology fellowship training (UOFT) and diagnostic yield of prostate biopsy. METHODS: Retrospective review was conducted of patients who underwent prostate biopsy across the Cleveland Clinic between 2000 and 2018. Biopsies done by urologists with and without UOFT were detailed via descriptive statistics and appropriate (chi-square, Student t, Wilcoxon rank-sum) tests. Multivariate logistic regression was used to examine the association between UOFT and positive prostate biopsy, adjusting for relevant covariates. RESULTS: A total of 11,241 biopsies by 129 urologists had complete information available for review. Sixteen urologists (12.4%) had UOFT; 113 either completed a different fellowship or no fellowship. Those with UOFT were more likely to use MRI-guided biopsy (7.80% vs 3.05%, P <.0001), more likely to get a positive biopsy (41.25% vs 32.72%, P <.0001), and more likely to obtain an adequate number (by ≥12) of cores (90.25% vs 74.53%, P <.0001). UOFT remained a significant predictor of positivity when adjusting for patient age and race, PSA, 5-alpha-reductase-inhibitor use, year of biopsy, years in practice, and type of biopsy (MRI or transrectal ultrasound guided). UOFT also predicted higher-risk biopsy (Gleason sum ≥7), adjusting for the same variables, though this association lost significance when adjusting for adequacy of biopsy. The learning curve to achieve a higher percentage of positive biopsies was steeper for nonurologic oncology fellowship trained than for UOFT urologists. CONCLUSION: UOFT is associated with higher diagnostic yield on prostate biopsy, higher uptake of MRI-guided biopsy, and less steep learning curve. This may be due to patient selection, technique, or, as we demonstrate here, adherence to guidelines.


Assuntos
Educação , Bolsas de Estudo , Biópsia Guiada por Imagem/métodos , Próstata/patologia , Neoplasias da Próstata/patologia , Urologia/educação , Idoso , Competência Clínica , Erros de Diagnóstico/prevenção & controle , Educação/métodos , Educação/normas , Bolsas de Estudo/métodos , Bolsas de Estudo/estatística & dados numéricos , Humanos , Curva de Aprendizado , Imagem por Ressonância Magnética Intervencionista/métodos , Masculino , Pessoa de Meia-Idade , Melhoria de Qualidade , Ultrassonografia de Intervenção/métodos , Estados Unidos
15.
Ann Otol Rhinol Laryngol ; 129(4): 340-346, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31731880

RESUMO

OBJECTIVE: Competency-based surgical training involves progressive autonomy given to the trainee. This requires systematic and evidence-based assessment with well-defined standards of proficiency. The objective of this study is to develop standards for the cross-institutional mastoidectomy assessment tool to inform decisions regarding whether a resident demonstrates sufficient skill to perform a mastoidectomy with or without supervision. METHODS: A panel of fellowship-trained content experts in mastoidectomy was surveyed in relation to the 16 items of the assessment tool to determine the skills needed for supervised and unsupervised surgery. We examined the consensus score to investigate the degree of agreement among respondents for each survey item as well as additional analyses to determine whether the reported skill level required for each survey item was significantly different for the supervised versus unsupervised level. RESULTS: Ten panelists representing different US training programs responded. There was considerable consensus on cut-off scores for each item and trainee level between panelists, with moderate (0.62) to very high (0.95) consensus scores depending on assessment item. Further analyses demonstrated that the difference between supervised and unsupervised skill levels was significantly meaningful for all items. Finally, minimum-passing scores for each item was established. CONCLUSION: We defined performance standards for the cross-institutional mastoidectomy assessment tool using the Angoff method. These cut-off scores that can be used to determine when trainees can progress from performance under supervision to performance without supervision. This can be used to guide training in a competency-based training curriculum.


Assuntos
Avaliação Educacional/métodos , Mastoidectomia , Otolaringologia/educação , Competência Clínica , Currículo , Educação/métodos , Educação/normas , Educação de Pós-Graduação em Medicina/métodos , Educação de Pós-Graduação em Medicina/organização & administração , Humanos , Mastoidectomia/educação , Mastoidectomia/métodos , Mastoidectomia/normas , Organização e Administração , Otolaringologia/normas , Treinamento por Simulação/métodos , Estados Unidos
16.
Nurse Educ Today ; 85: 104298, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31816458

RESUMO

BACKGROUND: There is a disconnect between what maternity care providers consider should be done and what they actually do with respect to talking with their pregnant clients about reducing their risk of stillbirth. This suggests that they would benefit from receiving up-to-date knowledge about stillbirth, alongside education that provides them with strategies for talking about stillbirth with pregnant women. OBJECTIVES: To gain an understanding of maternity care provider (obstetricians and midwives) knowledge of stillbirth and determine whether delivering a half day workshop improves knowledge and results in intention to change practice. DESIGN: A pre-post intervention study. SETTING: Maternity care providers (Obstetricians, Midwives) working in the northern areas of Tasmania, Australia were asked, via questionnaire, about their knowledge of stillbirth both before and after attending a half-day workshop. PARTICIPANTS: Maternity care providers (n = 51) attended the workshop and 30 (59%) completed both the pre-workshop and post-workshop surveys. METHODS: A four hour interactive workshop grounded in understanding the stillbirth experience. Participants were given up-to-date information about stillbirth risks and current prevention research as well as provided with an actionable step wise approach to talking about stillbirth prevention in pregnancy. RESULTS: Stillbirth knowledge scores (total of 8-points) significantly increased following the workshop (pre: mean = 2.9 ± 1.5; post: mean = 4.7 ± 1.4 points, t 29 = 7.9, <0.001). Before the workshop, only 20% of participants responded that they "always" or usually" discussed the possibility stillbirth occurring with pregnant women in their care whereas, after the workshop, nearly all (88%) indicated that they planned to "always" discuss stillbirth with their pregnant clients. CONCLUSIONS: Attending a stillbirth awareness for prevention education workshop resulted in significant knowledge improvement and self-reported intention to change practice in a group of Australian maternity care providers. While these results are promising, further study is needed to determine the presence and extent of actual practice change following such education.


Assuntos
Educação/normas , Enfermagem Obstétrica/normas , Natimorto/psicologia , Adulto , Atitude Frente a Morte , Educação/métodos , Educação/estatística & dados numéricos , Educação Continuada em Enfermagem/métodos , Educação Continuada em Enfermagem/normas , Educação Continuada em Enfermagem/estatística & dados numéricos , Feminino , Humanos , Pessoa de Meia-Idade , Enfermagem Obstétrica/métodos , Enfermagem Obstétrica/estatística & dados numéricos , Cuidados Paliativos/métodos , Inquéritos e Questionários , Tasmânia
17.
BMC Med Res Methodol ; 19(1): 237, 2019 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-31830925

RESUMO

BACKGROUND: Trainee research collaboratives (TRCs) have pioneered high quality, prospective 'snap-shot' surgical cohort studies in the UK. Outcomes After Kidney injury in Surgery (OAKS) was the first TRC cohort study to attempt to collect one-year follow-up data. The aims of this study were to evaluate one-year follow-up and data completion rates, and to identify factors associated with improved follow-up rates. METHODS: In this multicentre study, patients undergoing major gastrointestinal surgery were prospectively identified and followed up at one-year following surgery for six clinical outcomes. The primary outcome for this report was the follow-up rate for mortality at 1 year. The secondary outcome was the data completeness rate in those patients who were followed-up. An electronic survey was disseminated to investigators to identify strategies associated with improved follow-up. RESULTS: Of the 173 centres that collected baseline data, 126 centres registered to participate in one-year follow-up. Overall 62.3% (3482/5585) of patients were followed-up at 1 year; in centres registered to collect one-year outcomes, the follow-up rate was 82.6% (3482/4213). There were no differences in sex, comorbidity, operative urgency, or 7-day postoperative AKI rate between patients who were lost to follow-up and those who were successfully followed-up. In centres registered to collect one-year follow-up outcomes, overall data completeness was 83.1%, with 57.9% (73/126) of centres having ≥95% data completeness. Factors associated with increased likelihood of achieving ≥95% data completeness were total number of patients to be followed-up (77.4% in centres with < 15 patients, 59.0% with 15-29 patients, 51.4% with 30-59 patients, and 36.8% with > 60 patients, p = 0.030), and central versus local storage of patient identifiers (72.5% vs 48.0%, respectively, p = 0.006). CONCLUSIONS: TRC methodology can be used to follow-up patients identified in prospective cohort studies at one-year. Follow-up rates are maximized by central storage of patient identifiers.


Assuntos
Bases de Dados Factuais/estatística & dados numéricos , Procedimentos Cirúrgicos do Sistema Digestório/estatística & dados numéricos , Educação/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Idoso , Coleta de Dados/métodos , Coleta de Dados/estatística & dados numéricos , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Educação/métodos , Educação/normas , Feminino , Seguimentos , Guias como Assunto/normas , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde/métodos , Estudos Prospectivos
18.
Cir. Esp. (Ed. impr.) ; 97(10): 560-567, dic. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-187931

RESUMO

Introducción: El acceso de los cirujanos a los equipos de trasplante hepático en España se realiza de manera heterogénea. El objetivo de este estudio ha sido cuantificar los recursos humanos de los equipos de trasplante españoles, la distribución de las diferentes tareas del trasplante entre los miembros del equipo, el mecanismo mediante el cual se adquieren las habilidades, la visión de sus líderes sobre su continuidad, así como las motivaciones de los residentes de cirugía general españoles para elegir el trasplante como su futura carrera profesional. Métodos: Se elaboraron dos encuestas diferentes, para los jefes de equipo y para residentes, sobre número de personas, capacitación, reclutamiento, organización de tareas y motivación para trabajar en trasplantes. Los cuestionarios se enviaron por correo electrónico tanto a los directores de programa de trasplante como a los residentes de cirugía. Resultados: Hay en promedio 8 cirujanos en cada unidad de trasplante. Más de 4 cirujanos realizan la hepatectomía en el 54,2% de los grupos, mientras que el implante lo realiza más de 4 cirujanos en solo el 25% de los centros. El 42% de los jefes de trasplante hepático aboga por un sistema tipo fellowship y el 87,5% cree que el recambio generacional está garantizado. De los 525 residentes, 101 respondieron. Respecto a la formación, un 12,8% no tiene interés en el trasplante. En cuanto a sus preferencias laborales, el 37,6% no está interesado en el trasplante por ser excesivamente exigente, y el 52,5% no desea ser parte de un equipo de trasplante de hígado en el futuro. Conclusiones: El recambio generacional parece estar garantizado según los directores de programa de trasplante de hígado. Las nuevas generaciones de cirujanos generalmente optan por otras áreas de cirugía diferentes al trasplante. Son necesarios estudios con mayor número de respuestas para validar estos resultados


Introduction: The access of surgeons to liver transplant teams in Spain is heterogeneous. This study aims to portray the current human resources of Spanish transplant teams, distribution of transplant duties among team members, how transplant team members acquire their skills, their leaders' view of their future, as well the motivations of Spanish General Surgery residents to choose transplantation as their future career choice. Methods: Two different surveys were created, one for head surgeons and one for residents, about the number of team members and their training, recruitment, organization of tasks and motivation to work in transplantation. The questionnaires were e-mailed to both the transplant program directors and the surgical residents. Results: There are on average 8 surgeons in each transplant unit. More than four surgeons perform the hepatectomy in 54.2% of the groups, while the graft implantation is performed by more than 4 surgeons at just 25% of the centers. Forty-two percent of the transplant chiefs advocated a fellowship training system, and 87.5% believe that generational turnover is guaranteed. Out of 525 residents, 101 responded. Regarding training, 12.8% had no interest in transplantation. Concerning their work preferences, 37.6% were not interested in transplantation because it is excessively demanding, and 52.5% would not like to be part of a liver transplant team in the future. Conclusions: The generational turnover seems to be guaranteed according to liver transplant program directors. The new generations of surgeons generally opt for other areas of surgery other than transplantation. Studies with a greater number of responses are necessary to validate these results


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Emprego/normas , Mão de Obra em Saúde/organização & administração , Transplante de Fígado/estatística & dados numéricos , Cirurgiões/provisão & distribução , Atitude do Pessoal de Saúde , Escolha da Profissão , Competência Clínica , Educação/normas , Emprego/estatística & dados numéricos , Bolsas de Estudo/estatística & dados numéricos , Mão de Obra em Saúde/estatística & dados numéricos , Internato e Residência/estatística & dados numéricos , Motivação/fisiologia , Seleção de Pessoal/métodos , Seleção de Pessoal/estatística & dados numéricos , Diretores Médicos/estatística & dados numéricos , Espanha/epidemiologia , Cirurgiões/normas , Inquéritos e Questionários
19.
Circ Res ; 125(9): 855-867, 2019 10 11.
Artigo em Inglês | MEDLINE | ID: mdl-31600125

RESUMO

Given that cardiovascular safety concerns remain the leading cause of drug attrition at the preclinical drug development stage, the National Center for Toxicological Research of the US Food and Drug Administration hosted a workshop to discuss current gaps and challenges in translating preclinical cardiovascular safety data to humans. This white paper summarizes the topics presented by speakers from academia, industry, and government intended to address the theme of improving cardiotoxicity assessment in drug development. The main conclusion is that to reduce cardiovascular safety liabilities of new therapeutic agents, there is an urgent need to integrate human-relevant platforms/approaches into drug development. Potential regulatory applications of human-derived cardiomyocytes and future directions in employing human-relevant platforms to fill the gaps and overcome barriers and challenges in preclinical cardiovascular safety assessment were discussed. This paper is intended to serve as an initial step in a public-private collaborative development program for human-relevant cardiotoxicity tools, particularly for cardiotoxicities characterized by contractile dysfunction or structural injury.


Assuntos
Cardiotoxicidade/epidemiologia , Cardiotoxinas/toxicidade , Educação/normas , Relatório de Pesquisa/normas , United States Food and Drug Administration/normas , Animais , Cardiotoxicidade/prevenção & controle , Avaliação Pré-Clínica de Medicamentos/métodos , Avaliação Pré-Clínica de Medicamentos/normas , Avaliação Pré-Clínica de Medicamentos/tendências , Educação/tendências , Humanos , Células-Tronco Pluripotentes Induzidas/efeitos dos fármacos , Células-Tronco Pluripotentes Induzidas/patologia , Miócitos Cardíacos/efeitos dos fármacos , Miócitos Cardíacos/patologia , Relatório de Pesquisa/tendências , Estados Unidos/epidemiologia , United States Food and Drug Administration/tendências
20.
Obstet Gynecol ; 134 Suppl 1: 22S-28S, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31568037

RESUMO

OBJECTIVE: To measure future and current resident perspectives on obstetrics and gynecology residency training structure and possible future models. METHODS: Medical students invited for obstetrics and gynecology residency interviews and residents (postgraduate year [PGY]-1-4) at the University of Colorado, the University of Washington, the University of California San Francisco, Loyola University, Saint Joseph's Hospital, and Texas A&M in 2017-2018 received a voluntary, electronic survey regarding possible models for restructuring residency training. Student and resident responses were compared using χ test for categorical and two-sample t-test for continuous items. RESULTS: Applicants (63%, 280/444) and residents (66%, 101/153) had similar response rates (overall response rate 64%). Applicants (24%) and residents (29%) reported having concerns about the current structure of residency training. The ideal residency duration was reported as 4 years by 72% of applicants and 85% of residents. Lack of gynecologic surgical volume was the most frequently reported concern among applicants (75%) and residents (72%). Fourth-year tracking (focusing on training aligned with postgraduation career path) was preferred by 90% of applicants and 77% of residents (P=.002) and 92% among respondents planning fellowship. Most applicants (68%) and residents (75%) preferred not starting fellowship training after the 3rd year of residency. DISCUSSION: The majority of learners surveyed support a 4-year training structure but likewise support individualizing training in PGY-4. It is imperative that obstetrics and gynecology leadership consider this and other feedback from learners when considering modifications to the current training paradigm.


Assuntos
Atitude do Pessoal de Saúde , Competência Clínica , Educação/normas , Ginecologia/educação , Internato e Residência/normas , Obstetrícia/educação , Escolha da Profissão , Educação/métodos , Educação/organização & administração , Ginecologia/organização & administração , Ginecologia/normas , Humanos , Internato e Residência/métodos , Internato e Residência/organização & administração , Obstetrícia/organização & administração , Obstetrícia/normas , Estudantes de Medicina , Inquéritos e Questionários , Fatores de Tempo
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