Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.796
Filtrar
2.
JMIR Med Educ ; 10: e47127, 2024 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-39039926

RESUMO

Background: The Primary Trauma Care (PTC) course was originally developed to instruct health care workers in the management of patients with severe injuries in low- and middle-income countries (LMICs) with limited medical resources. PTC has now been taught for more than 25 years. Many studies have demonstrated that the 2-day PTC workshop is useful and informative to frontline health staff and has helped improve knowledge and confidence in trauma management; however, there is little evidence of the effect of the course on changes in clinical practice. The Kirkpatrick model (KM) and the knowledge, attitude, and practice (KAP) model are effective methods to evaluate this question. Objective: The aim of this study was to investigate how the 2-day PTC course impacts the satisfaction, knowledge, and skills of health care workers in 2 Vietnamese hospitals using a conceptual framework incorporating the KAP model and the 4-level KM as evaluation tools. Methods: The PTC course was delivered over 2 days in the emergency departments (EDs) of Thanh Hoa and Ninh Binh hospitals in February and March 2022, respectively. This study followed a prospective pre- and postintervention design. We used validated instruments to assess the participants' satisfaction, knowledge, and skills before, immediately after, and 6 months after course delivery. The Fisher exact test and the Wilcoxon matched-pairs signed rank test were used to compare the percentages and mean scores at the pretest, posttest, and 6-month postcourse follow-up time points among course participants. Results: A total of 80 health care staff members attended the 2-day PTC course and nearly 100% of the participants were satisfied with the course. At level 2 of the KM (knowledge), the scores on multiple-choice questions and the confidence matrix improved significantly from 60% to 77% and from 59% to 71%, respectively (P<.001), and these improvements were seen in both subgroups (nurses and doctors). The focus of level 3 was on practice, demonstrating a significant incremental change, with scenarios checklist points increasing from a mean of 5.9 (SD 1.9) to 9.0 (SD 0.9) and bedside clinical checklist points increasing from a mean of 5 (SD 1.5) to 8.3 (SD 0.8) (both P<.001). At the 6-month follow-up, the scores for multiple-choice questions, the confidence matrix, and scenarios checklist all remained unchanged, except for the multiple-choice question score in the nurse subgroup (P=.005). Conclusions: The PTC course undertaken in 2 local hospitals in Vietnam was successful in demonstrating improvements at 3 levels of the KM for ED health care staff. The improvements in the confidence matrix and scenarios checklist were maintained for at least 6 months after the course. PTC courses should be effective in providing and sustaining improvement in knowledge and trauma care practice in other LMICs such as Vietnam.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Traumatologia , Adulto , Feminino , Humanos , Masculino , Competência Clínica , Pessoal de Saúde/educação , Atenção Primária à Saúde , Estudos Prospectivos , Inquéritos e Questionários , Traumatologia/educação , Vietnã
3.
J Med Syst ; 48(1): 66, 2024 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-38976137

RESUMO

Three-dimensional (3D) printing has gained popularity across various domains but remains less integrated into medical surgery due to its complexity. Existing literature primarily discusses specific applications, with limited detailed guidance on the entire process. The methodological details of converting Computed Tomography (CT) images into 3D models are often found in amateur 3D printing forums rather than scientific literature. To address this gap, we present a comprehensive methodology for converting CT images of bone fractures into 3D-printed models. This involves transferring files in Digital Imaging and Communications in Medicine (DICOM) format to stereolithography format, processing the 3D model, and preparing it for printing. Our methodology outlines step-by-step guidelines, time estimates, and software recommendations, prioritizing free open-source tools. We also share our practical experience and outcomes, including the successful creation of 72 models for surgical planning, patient education, and teaching. Although there are challenges associated with utilizing 3D printing in surgery, such as the requirement for specialized expertise and equipment, the advantages in surgical planning, patient education, and improved outcomes are evident. Further studies are warranted to refine and standardize these methodologies for broader adoption in medical practice.


Assuntos
Fraturas Ósseas , Impressão Tridimensional , Tomografia Computadorizada por Raios X , Humanos , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/cirurgia , Tomografia Computadorizada por Raios X/métodos , Imageamento Tridimensional/métodos , Traumatologia , Sistemas de Informação em Radiologia/organização & administração , Modelos Anatômicos
5.
Unfallchirurgie (Heidelb) ; 127(7): 492-499, 2024 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-38860995

RESUMO

Due to the war in Ukraine and the treatment of patients with war wounds in the hospitals of the TraumaNetworks of the German Society for Trauma Surgery (TraumaNetzwerke DGU®), injuries from life-threatening mission situations (LebEL), terrorism, violence and war have become a matter of daily professional life. Furthermore, the societal and global feeling of security has fundamentally changed. The much-cited term "turning point in history", the reorientation of the Armed Forces and the investigation of the resilience of the healthcare system with respect to the "fitness for war", approximate to the description of the current challenges for trauma surgery (UCH) in Germany. Based on the developments following the terrorist attacks in Paris in 2015 and in Brussels in 2016, a clarification is given as to which adaptations have already been successful and how quickly an improvement could successfully be achieved. In this context, the concept of tactical care and the course on Terror and Disaster Surgical Care (TDSC), for example, have been game changing. The main challenge currently lies in overcoming the structural alterations in the German healthcare system and professionally in the treatment of war wounded personnel from Ukraine. The knowledge gained from these two national tasks must be analyzed for the future development and adaptation of established treatment structures, e.g., of the TraumaNetzwerke DGU®, under the requirements of the increased resilience against war, terrorism and violence. The aim is to name that which has already been achieved with respect to the national challenges for UCH and at the same time to outline or discuss further necessities for improvements and elimination of possible gaps in capabilities.


Assuntos
Violência , Alemanha , Humanos , Violência/psicologia , Traumatologia , Terrorismo , Lesões Relacionadas à Guerra/cirurgia , Ucrânia , Cirurgia de Cuidados Críticos
6.
Rural Remote Health ; 24(2): 8851, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38909986

RESUMO

INTRODUCTION: Effective trauma care requires the rapid management of injuries. Rural and remote areas face inequity in trauma care due to time, distance and resource constraints, and experience higher morbidity and mortality rates than urban settings. A training needs analysis (TNA) conducted with stakeholders across Queensland, Australia, revealed a lack of contextual, accessible and interprofessional trauma education for clinicians. The Clinical Skills Development Service and Jamieson Trauma Institute developed the Queensland Trauma Education (QTE) program to address these concerns. QTE comprises a face-to-face training course and open access to online training resources created and reviewed by trauma experts. QTE also supports local training through a statewide simulation network and free access to simulation training equipment. The aim of this article is to review the QTE program and assess the benefits to clinicians in both the delivery of education and the provision of trauma care. METHODS: To evaluate the QTE program, a desktop review was conducted. This included analyses of website data, course and website content, and facilitator, stakeholder, participant and user feedback. The data were evaluated using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework, and the program's alignment with the original TNA outcomes was assessed. RESULTS: The results showed that QTE aligns with the identified training needs. Specifically, QTE provides trauma education that is relevant, sustainable, employs best practice, is locally delivered, provides continuous support, is multidisciplinary, multi-platformed, physically accessible and accredited by the Australasian College for Emergency Medicine. The review also highlights how QTE has effectively been reaching its target population, improves knowledge and skills, has become widely adopted, and been implemented and maintained with relative success. CONCLUSION: The innovative QTE program addresses the previous deficits in trauma education and meets the needs identified in the TNA. The review also reveals further opportunities for continuous improvement and program sustainability.


Assuntos
Treinamento por Simulação , Humanos , Queensland , Treinamento por Simulação/organização & administração , Serviços de Saúde Rural/organização & administração , Traumatologia/educação , Competência Clínica , Ferimentos e Lesões/terapia , Avaliação de Programas e Projetos de Saúde
7.
JAMA Netw Open ; 7(6): e2415636, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38900427

RESUMO

Importance: There has been an emerging trend of podcast use in medical education over the past decade. With the increasing number of podcasts and learners' interest in trauma surgery, it is vital to validate the quality of these podcasts. Objective: To determine the quantity and quality of podcast episodes on trauma surgery. Design, Setting, and Participants: This cross-sectional study identified trauma surgery podcasts published globally on the Google, Apple, and Spotify platforms as of May 31, 2023. An initial screening excluded podcasts not fulfilling the inclusion criteria (published as of May 31, 2023, and covering clinical knowledge or mentorship on general trauma surgery). A 10-item checklist developed from a modified Delphi consensus method was created to assess the podcasts' credibility, content, and design as indicators of quality. Data extracted from each podcast episode included the duration, setting, host and guest credentials, and fulfillment of quality indicators. Data were analyzed on August 13, 2023. Main Outcomes and Measures: The quality of each podcast was assessed using the 10-question checklist. A score of at least 80% in credibility (4 of 5 points), 75% in content (3 of 4 points), and 100% in design (1 of 1 point) was required to classify a podcast episode as having good quality. Results: The initial search identified 204 podcasts on trauma surgery, of which 55 podcasts met the inclusion criteria. All 55 podcasts were published after 2014, with the majority hosted by males (85% [61 of 72 hosts]), based in the US (91% [50 of 55 podcasts]), and focused on clinical knowledge (80% [44 of 55 podcasts]). Podcast hosts and guests predominantly held a Doctor of Medicine degree (83% [113 of 136]), with 72% [46 of 64] of guests identifying as practicing trauma surgeons. While all 55 podcasts had excellent quality in terms of content and design, 20% (11 of 55) of podcasts were rated poorly on credibility. Credibility was further reduced for 60% (33 of 55) of podcasts because of nondisclosure of conflicts of interest. Conclusions and Relevance: In this cross-sectional study of trauma surgery podcasts, most had good-quality content and design, but there was a lack of explicit conflict of interest disclosure. Content producers need to disclose their conflicts of interest appropriately to ensure credibility and improve the quality of their podcasts.


Assuntos
Traumatologia , Webcasts como Assunto , Humanos , Estudos Transversais , Traumatologia/normas , Traumatologia/educação , Técnica Delphi , Cirurgia de Cuidados Críticos
8.
Tunis Med ; 102(6): 354-359, 2024 Jun 05.
Artigo em Francês | MEDLINE | ID: mdl-38864199

RESUMO

INTRODUCTION: The increase in hip arthroplasties predicts a rise in periprosthetic fractures in Morocco, posing challenges for orthopedic surgeons. Therapeutic strategies vary considerably, highlighting the absence of a universally accepted treatment protocol. AIM: To analyze the management of per-prosthetic hip fractures, while addressing the challenges associated with them. METHODS: This was a retrospective study, conducted in the trauma-orthopedics department between December 2015 and November 2022. Nineteen patients who presented to the hospital with fractures around a hip prosthesis were included. RESULT: Nineteen periprosthetic fractures were observed. The majority of patients (68%) were women, with an average age of 68. The Vancouver classification showed that 52.6% of the fractures were type B1, and 21.1% type C, while the other fracture types were distributed differently. These fractures were mainly associated with diagnoses such as femoral neck fracture (63.2%) and coxarthrosis (31.6%). We observed variations in treatment recommendations and results between the different series analyzed. We noted discrepancies with certain series concerning fracture types and therapeutic choices. However, in our series, we achieved satisfactory results, with successful consolidation and the absence of complications in all patients. CONCLUSION: These results underline the importance of an individualized approach to fracture management, taking into account the specificities of each case.


Assuntos
Artroplastia de Quadril , Fraturas do Quadril , Hospitais Universitários , Fraturas Periprotéticas , Humanos , Feminino , Estudos Retrospectivos , Fraturas Periprotéticas/epidemiologia , Fraturas Periprotéticas/terapia , Fraturas Periprotéticas/cirurgia , Fraturas Periprotéticas/etiologia , Fraturas Periprotéticas/diagnóstico , Masculino , Marrocos/epidemiologia , Idoso , Pessoa de Meia-Idade , Artroplastia de Quadril/estatística & dados numéricos , Artroplastia de Quadril/métodos , Hospitais Universitários/estatística & dados numéricos , Fraturas do Quadril/epidemiologia , Fraturas do Quadril/cirurgia , Fraturas do Quadril/terapia , Idoso de 80 Anos ou mais , Traumatologia/normas , Traumatologia/métodos , Ortopedia/estatística & dados numéricos , Prótese de Quadril/estatística & dados numéricos , Adulto
9.
World J Surg ; 48(7): 1616-1625, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38757867

RESUMO

BACKGROUND: In Tanzania, inadequate infrastructures and shortages of trauma-response training exacerbate trauma-related fatalities. McGill University's Centre for Global Surgery introduced the Trauma and Disaster Team Response course (TDTR) to address these challenges. This study assesses the impact of simulation-based TDTR training on care providers' knowledge/skills and healthcare processes to enhance patient outcomes. METHODS: The study used a pre-post-interventional design. TDTR, led by Tanzanian instructors at Muhimbili Orthopedic Institute from August 16-18, 2023, involved 22 participants in blended online and in-person approaches with simulated skills sessions. Validated tools assessed participants' knowledge/skills and teamwork pre/post-interventions, alongside feedback surveys. Outcome measures included evaluating 24-h emergency department patient arrival-to-care time pre-/post-TDTR interventions, analyzed using parametric and non-parametric tests based on data distributions. RESULTS: Participants' self-assessment skills significantly improved (median increase from 34 to 58, p < 0.001), along with teamwork (median increase from 44.5 to 87.5, p < 0.003). While 99% of participants expressed satisfaction with TDTR meeting their expectations, 97% were interested in teaching future sessions. The six-month post-intervention arrival-to-care time significantly decreased from 29 to 13 min, indicating a 55.17% improvement (p < 0.004). The intervention led to fewer ward admissions (35.26% from 51.67%) and more directed to operating theaters (29.83% from 16.85%), suggesting improved patient management (p < 0.018). CONCLUSION: The study confirmed surgical skills training effectiveness in Tanzanian settings, highlighting TDTR's role in improving teamwork and healthcare processes that enhanced patient outcomes. To sustain progress and empower independent trauma educators, ongoing refresher sessions and expanding TDTR across low- and middle-income countries are recommended to align with global surgery goals.


Assuntos
Competência Clínica , Equipe de Assistência ao Paciente , Tanzânia , Humanos , Equipe de Assistência ao Paciente/organização & administração , Masculino , Feminino , Treinamento por Simulação/métodos , Traumatologia/educação , Adulto , Ferimentos e Lesões/terapia
10.
Unfallchirurgie (Heidelb) ; 127(7): 547-555, 2024 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-38814464

RESUMO

BACKGROUND: Proximal humeral fractures are a relatively common injury in childhood and adolescence, accounting for 0.45-2% of all fractures [2, 18]. Treatment is usually conservative but is still the subject of a scientific debate [9, 12]. In addition to the S1-LL, there are different recommendations for the diagnostics and treatment of these fractures in the literature. METHODOLOGY: As part of the 10th scientific meeting of the SKT of the DGU, the existing recommendations and the relevant or current literature were critically discussed by a panel of experts and a consensus was formulated. An algorithm for the diagnostics, therapy and treatment was integrated into this. RESULTS: The measurement of axial deviation and tilt is not interobserver and intraobserver reliable [3]. The age limit for when complete correction is possible was set at an age of 10 years, as the correction potential changes around this age. For diagnostic purposes, well-centered X­ray images in 2 planes (true AP and Y­images without thoracic parts) is defined as the standard. At the age of less than 10 years, any malposition can be treated conservatively with Gilchrist bandaging for 2-3 weeks. Surgery can only be indicated in individual cases, e.g., in the event of severe pain or the need for rapid weight bearing. An ad latus displacement of more than half the shaft width should not be tolerated over the age of 10 years. Due to the variance in the measurement results, it is not possible to recommend surgical treatment depending on the extent of the ad axim dislocation. As a guideline, the greater the dislocation and the closer the child is to growth joint closure, the more likely surgical treatment is indicated. The development should be taken into account. The gold standard is retrograde, radial and unilateral ESIN osteosynthesis using two intramedullary nails. Osteosynthesis does not require immobilization. A follow-up X­ray is planned for unstable fractures without osteosynthesis after 1 week, otherwise optional for documentation of consolidation after 4-6 weeks, e.g., if sports clearance is to be granted and before metal removal (12 weeks). CONCLUSION: Recommendations for surgical indications based on the extent of tilt are not reproducible and seem difficult in view of the current literature [3, 9, 12]. A pragmatic approach is recommended. The prognosis of the fracture appears to be so good, taking the algorithm into account, that restitutio ad integrum can be expected in most cases.


Assuntos
Fraturas do Ombro , Humanos , Criança , Adolescente , Fraturas do Ombro/cirurgia , Fraturas do Ombro/diagnóstico por imagem , Fraturas do Ombro/terapia , Alemanha , Traumatologia/normas , Algoritmos , Pré-Escolar , Masculino , Guias de Prática Clínica como Assunto , Feminino , Consenso , Cirurgia de Cuidados Críticos
11.
Sportverletz Sportschaden ; 38(2): 89-99, 2024 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-38781978

RESUMO

Ultrasound (US) has numerous applications in sports traumatology. The technical progress of mobile US devices has led to increasing use of ultrasound as a primary diagnostic tool. New applications such as elastography and 3 D vascularization are used for special indications.The purpose of this review is to present the current status of ultrasound in the diagnosis of sports injuries and sport traumatology including established applications and new technical advances. US is presented both in its comparison to other imaging modalities and as a sole diagnostic tool.US can be used for initial diagnosis to improve the clinical examination and for intensive shortterm follow-up imaging. The main areas of application are currently the diagnosis of acute muscle and tendon injuries as well as overuse injuries. In particular, the exclusion of structural muscle injuries can be adequately ensured with US in the majority of anatomical regions. The recently published guideline on fracture ultrasound has strengthened the clinical evidence in this area, especially in comparison to conventional radiography and in the development of algorithms and standards. The increasing use of mobile ultrasound equipment with adequate image quality makes US a location-independent modality that can also be used at training sites or during road games.


Assuntos
Traumatismos em Atletas , Medicina Esportiva , Ultrassonografia , Humanos , Traumatismos em Atletas/diagnóstico por imagem , Traumatismos dos Tendões/diagnóstico por imagem , Traumatologia , Transtornos Traumáticos Cumulativos/diagnóstico por imagem
12.
West J Emerg Med ; 25(3): 423-430, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38801050

RESUMO

Background and Objectives: Greater lifetime exposure to psychological trauma correlates with a higher number of health comorbidities and negative health outcomes. However, physicians often are not specifically trained in how to care for patients with trauma, especially in acute care settings. Our objective was to identify implemented trauma-informed care (TIC) training protocols for emergency and/or trauma service physicians that have both sufficient detail that they can be adapted and outcome data indicating positive impact. Methods: We conducted a comprehensive literature search in MEDLINE (Ovid), Scopus, PsycInfo, Web of Science, Cochrane Library, Ebsco's Academic Search Premier, and MedEdPORTAL. Inclusion criteria were EM and trauma service clinicians (medical doctors, physician assistants and nurse practitioners, residents), adult and/or pediatric patients, and training evaluation. Evaluation was based on the Kirkpatrick Model. Results: We screened 2,280 unique articles and identified two different training protocols. Results demonstrated the training included patient-centered communication and interprofessional collaboration. One curriculum demonstrated that targeted outcomes were due to the training (Level 4). Both curricula received overall positive reactions (Level 1) and illustrated behavioral change (Level 3). Neither were found to specifically illustrate learning due to the training (Level 2). Conclusion: Study findings from our review show a paucity of published TIC training protocols that demonstrate positive impact and are described sufficiently to be adopted broadly. Current training protocols demonstrated an increasing comfort level with the TIC approach, integration into current practices, and referrals to trauma intervention specialists.


Assuntos
Currículo , Medicina de Emergência , Humanos , Medicina de Emergência/educação , Ferimentos e Lesões/terapia , Assistência Centrada no Paciente , Traumatologia/educação
13.
Rev. Ciênc. Plur ; 10 (1) 2024;10(1): 31518, 2024 abr. 30. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1553540

RESUMO

Introdução: Fotobiomodulação corresponde à exposição de tecidos biológicos a baixos níveis de luz vermelha e infravermelha, esta terapia favorece a reabilitação de diferentes tecidos e que pode ser utilizada para a melhora da prática clínica nas diferentes atuações da fisioterapia, como por exemplo, no tratamento dos acometimentos musculoesqueléticos e inflamatórios. Objetivo: Identificar os benefícios da fotobiomodulação empregados na reabilitação de pacientes nas diferentes patologias traumato-ortopédicas. Metodologia:Trata-se de uma revisão integrativa com busca online nas plataformas de dados: Medline e PubMed. Os descritores foram: fotobiomodulação, taumato-ortopedia e reabilitação. As línguas selecionadas foram: Português, Inglês e Espanhol, entre os anos de 2018 a 2022.Resultados:A descrição dos achados nos ensaios clínicos analisados mostra que a terapia de fotobiomodulação apresenta diferentes usos na prática clínica e que seu uso produz efeito analgésico, anti-inflamatório e regenerativo nos distúrbios musculoesqueléticos. Conclusões:De acordo com a revisão dos artigos, pôde-se perceber que a terapia por fotobiomodulação confirma seus benefícios e eficácia, portando, se fazendo positiva na atuação traumato-ortopédica, gerando resultados significativos quando comparada a outros recursos (AU).


Introduction: Photobiomodulationcorresponds to the exposure of biological tissues to low levels of red and infrared light, this therapy favors the rehabilitation of different tissues and can be used to improve clinical practice in different actions of physiotherapy, such as, for example, in the treatment of musculoskeletal and inflammatory disorders. Objective: To identify the benefits of photobiomodulation used in the rehabilitation of patients with different traumato-orthopedic pathologies. Methodology:This is an integrative review with online search on data platforms: Medline and PubMed. The descriptors were: photobiomodulation, thaumato-orthopedics and rehabilitation. The selected languages were: Portuguese, English and Spanish, from 2018 to 2022. Results: The description of the discovers in the analyzed clinical trials shows that photobiomodulation therapy has different uses in clinical practice and that its use produces analgesic, anti-inflammatory and regenerative effects in musculoskeletal disorders. Conclusions:According to the review of the articles, it could be seen that photobiomodulation therapy confirms its benefits and effectiveness, therefore, becoming positive in the trauma-orthopedic performance, generating significant results when compared to other resources (AU).


Introducción: La fotobiomodulacióncorresponde a la exposición de tejidos biológicos a bajos niveles de luz roja e infrarroja, esta terapia estimula la rehabilitación de diferentes tejidos y puede ser utilizada para mejorar la práctica clínica en diferentes áreas de fisioterapia, como por ejemplo, en tratamiento de Trastornos musculoesqueléticos e inflamatorios. Objetivo: Identificar los beneficios de la fotobiomodulación utilizada en la rehabilitación de pacientes con diferentes patologías traumato-ortopédicas. Metodología: Esta es una revisión integradora con búsqueda en línea en plataformas de datos: Medline y PubMed. Los descriptores fueron: fotobiomodulación, taumato-ortopedia y rehabilitación. Los idiomas seleccionados fueron: portugués, inglés y español, entre los años 2018 a 2022. Resultados: La descripción de los hallazgos en los ensayos clínicos analizados muestra que la terapia de fotobiomodulación tiene diferentes usos en la práctica clínica y que su uso produce efectos analgésicos, antiinflamatorios y regenerador en trastornos musculoesqueléticos. Conclusiones: De acuerdo con la revisión de los artículos, se pudo apreciar que la terapia de fotobiomodulación confirma sus beneficios y efectividad, por lo tanto, tornándose positiva en el desempeño trauma-ortopédico, generando resultados significativos cuando se compara con otros recursos (AU).


Assuntos
Humanos , Patologia , Reabilitação , Traumatologia , Terapia com Luz de Baixa Intensidade/instrumentação , Aderências Teciduais
14.
Am J Disaster Med ; 19(1): 45-51, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38597646

RESUMO

OBJECTIVE: Active duty military surgeons often have limited trauma surgery experience prior to deployment. Consequently, military-civilian training programs have been developed at high-volume trauma centers to evaluate and maintain proficiencies. Advanced Surgical Skills for Exposure in Trauma (ASSET) was incorporated into the predeployment curriculum at the Army Trauma Training Detachment in 2011. This is the first study to assess whether military surgeons demonstrated improved knowledge and increased confidence after taking ASSET. DESIGN: Retrospective cohort study. SETTING: Quaternary care hospital. PATIENTS AND PARTICIPANTS: Attending military surgeons who completed ASSET between July 2011 and October 2020. MAIN OUTCOME MEASURE(S): Pre- and post-course self-reported comfort level with procedures was converted from a five-point Likert scale to a percentage and compared using paired t-tests. RESULTS: In 188 military surgeons, the median time in practice was 3 (1-8) years, with specialties in general surgery (52 percent), orthopedic surgery (29 percent), trauma (7 percent), and other disciplines (12 percent). The completed self-evaluation response rate was 80 percent (n = 151). The self-reported comfort level for all body regions improved following course completion (p < 0.001): chest (27 percent), neck (23 percent), upper extremity (22 percent), lower extremity (21 percent), and abdomen/pelvis (19 percent). The overall score on the competency test improved after completion of ASSET, with averages increasing from 62 ± 18 percent pretest to 71 ± 13 percent post-test (p < 0.001). CONCLUSIONS: After taking the ASSET course, military surgeons demonstrated improved knowledge and increased confidence in the operative skills taught in the course. The ASSET course may provide sustainment of knowledge and confidence if used at regular intervals to maintain trauma skills and deployment readiness.


Assuntos
Medicina Militar , Militares , Cirurgiões , Traumatologia , Humanos , Traumatologia/educação , Estudos Retrospectivos , Competência Clínica
15.
Orthopadie (Heidelb) ; 53(5): 317-323, 2024 May.
Artigo em Alemão | MEDLINE | ID: mdl-38634951

RESUMO

BACKGROUND: The field of orthopedics and trauma surgery is facing a serious shortage of new talent due to the increasing average age of active surgeons and a growing need for staff. The appeal of these specialties is declining among medical students. SOLUTIONS: This trend could be reversed by introducing practice-oriented curricula, mentoring programs, and early integration into professional societies. The quality of surgical education, especially bedside teaching, needs to be improved, as it is often compromised by a lack of time and insufficient pedagogical training of the educators. The practical year (PY) is crucial to attract students to these specialties, but data indicate that the quality of training in orthopedics and trauma surgery is inferior compared to other fields. Professional societies could enhance junior development through targeted programs. Moreover, the problem of recruitment is compounded by imbalanced gender ratios and working conditions that do not align with modern family models or efficient surgical training. There needs to be a rethinking of work scheduling and task distribution in surgery to make the profession more attractive and to ensure the quality of training.


Assuntos
Ortopedia , Traumatologia , Ortopedia/educação , Humanos , Traumatologia/educação , Escolha da Profissão , Masculino , Feminino , Alemanha , Currículo , Recursos Humanos , Cirurgia de Cuidados Críticos
17.
Acta Ortop Mex ; 38(1): 22-28, 2024.
Artigo em Espanhol | MEDLINE | ID: mdl-38657148

RESUMO

Predatory journals are distinguished from legitimate journals by their lack of adequate reviews and editorial processes, compromising the quality of published content. These journals do not conduct peer reviews or detect plagiarism, and accept manuscripts without requiring substantial modifications. Their near 100% acceptance rate is driven by profit motives, regardless of the content they publish. While they boast a prestigious editorial board composed of renowned researchers, in most cases, it is a facade aimed at impressing and attracting investigators. Furthermore, these journals lack appropriate ethical practices and are non-transparent in their editorial processes. Predatory journals have impacted multiple disciplines, including Orthopedics and Traumatology, and their presence remains unknown to many researchers, making them unwitting victims. Their strategy involves soliciting articles via email from authors who have published in legitimate journals, promising quick, easy, and inexpensive publication. The implications and negative consequences of predatory journals on the scientific community and researchers are numerous. The purpose of this work is to provide general information about these journals, specifically in the field of Orthopedics and Traumatology, offering guidelines to identify and avoid them, so that authors can make informed decisions when publishing their manuscripts and avoid falling into the hands of predatory journals or publishers.


Las revistas depredadoras se diferencian de las revistas legítimas por su falta de adecuadas revisiones y procesos editoriales, lo que compromete la calidad del contenido publicado. Estas revistas no llevan a cabo revisiones por pares ni realizan acciones que detecten y prevengan el plagio y aceptan manuscritos sin exigir modificaciones sustanciales. Su tasa de aceptación cercana al 100% se debe a su enfoque lucrativo, sin importarles el contenido que publican. Aunque presumen tener un comité editorial compuesto por investigadores destacados, en la mayoría de los casos es una simulación destinada a impresionar y atraer a los investigadores. Además, estas revistas carecen de prácticas éticas adecuadas y no son transparentes en sus procesos editoriales. Las revistas depredadoras han afectado a múltiples disciplinas, incluida la Ortopedia y Traumatología y su presencia es aún desconocida para muchos investigadores, lo que los convierte en víctimas sin saberlo. Su estrategia consiste en solicitar artículos por correo electrónico a autores que han publicado en revistas legítimas, prometiendo una publicación rápida, sencilla y económica. Las implicaciones y consecuencias negativas de las revistas depredadoras en la comunidad científica y los investigadores son numerosas. El propósito de este trabajo es proporcionar información general sobre estas revistas y específicamente en el campo de la Ortopedia y Traumatología, brindando pautas para identificarlas y evitarlas, para que los autores puedan tomar decisiones informadas al publicar sus manuscritos y evitar caer en manos de revistas o editoriales depredadoras.


Assuntos
Ortopedia , Publicações Periódicas como Assunto , Editoração , Traumatologia , Ortopedia/normas , Publicações Periódicas como Assunto/normas , Traumatologia/normas , Editoração/normas , Políticas Editoriais , Humanos
18.
J Surg Res ; 298: 355-363, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38663262

RESUMO

INTRODUCTION: Over 90% of pediatric trauma deaths occur in low- and middle-income countries (LMICs), yet pediatric trauma-focused training remains unstandardized and inaccessible, especially in LMICs. In Brazil, where trauma is the leading cause of death for children over age 1, we piloted the first global adaptation of the Trauma Resuscitation in Kids (TRIK) course and assessed its feasibility. METHODS: A 2-day simulation-based global TRIK course was hosted in Belo Horizonte in October 2022, led by one Brazilian and four Canadian instructors. The enrollment fee was $200 USD, and course registration sold out in 4 d. We administered a knowledge test before and after the course and a postcourse self-evaluation. We recorded each simulation to assess participants' performance, reflected in a team performance score. Groups received numerical scores for these three areas, which were equally weighted to calculate a final performance score. The scores given by the two evaluators were then averaged. As groups performed the specific simulations in varying orders, the simulations were grouped into four time blocks for analysis of performance over time. Statistical analysis utilized a combination of descriptive analysis, Wilcoxon signed-rank tests, Kruskal-Wallis tests, and Wilcoxon rank-sum tests. RESULTS: Twenty-one surgeons (19 pediatric, one trauma, one general) representing four of five regions in Brazil consented to study participation. Women comprised 76% (16/21) of participants. Overall, participants scored higher on the knowledge assessment after the course (68% versus 76%; z = 3.046, P < 0.001). Participants reported improved knowledge for all tested components of trauma management (P < 0.001). The average simulation performance score increased from 66% on day 1% to 73% on day 2, although this increase was not statistically significant. All participants reported they were more confident managing pediatric trauma after the course and would recommend the course to others. CONCLUSIONS: Completion of global TRIK improved surgeons' confidence, knowledge, and clinical decision-making skills in managing pediatric trauma, suggesting a standardized course may improve pediatric trauma care and outcomes in LMICs. We plan to more closely address cost, language, and resource barriers to implementing protocolized trauma training in LMICs with the aim to improve patient outcomes and equity in trauma care globally.


Assuntos
Países em Desenvolvimento , Humanos , Projetos Piloto , Brasil , Criança , Ferimentos e Lesões/terapia , Ferimentos e Lesões/economia , Feminino , Traumatologia/educação , Masculino , Pediatria/educação , Treinamento por Simulação/economia , Competência Clínica/estatística & dados numéricos , Estudos de Viabilidade , Ressuscitação , Currículo
19.
Orthopadie (Heidelb) ; 53(5): 324-326, 2024 May.
Artigo em Alemão | MEDLINE | ID: mdl-38573373

RESUMO

BACKGROUND: The departure of young habilitated colleagues from their university careers reflects, on the one hand, a move away from university medicine per se and, on the other, an unwillingness to take on university management positions. In addition to the question of "How do I qualify for these positions?", the question of "Why should I aspire to such a position?" is increasingly taking centre stage when less expensive alternatives are available. In addition, there is uncertainty about the extent to which one's own achievements and qualities are sufficient to distinguish oneself clinically and scientifically in the course of one's career and thereby recommend oneself for management positions. AIMS: This is where the KUOU's Excellence Academy comes in, with the aim of identifying young colleagues with high potential for university leadership positions at an early stage, encouraging them to get to know each other, and focusing the attention and visibility of the university locations and the associated appreciation on the members of the Academy. The focus here is on ensuring that excellent colleagues benefit from the many years of experience of the members of the KUOU, receive feedback on their clinical and scientific achievements and are supported in their university career in the form of mentoring. CONCLUSION: The large number of 22 very good applications, of which 12 candidates were accepted, confirms our belief that there are excellently qualified colleagues at our sites, who are ready to take on responsibility in the future in the triad of research, teaching and patient care.


Assuntos
Ortopedia , Humanos , Academias e Institutos , Cirurgia de Cuidados Críticos , Docentes de Medicina , Traumatologia/educação , Universidades
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA