Open Discussion Forum Research Articles

HEREDITARY ENDOCRINE TUMOURS: CURRENT STATE-OF-THE-ART AND RESEARCH OPPORTUNITIES: New and future perspectives for parathyroid carcinoma.

This report summarizes published data on parathyroid cancer, with the inclusion of topics discussed at MEN2019: 16th International Workshop on Multiple Endocrine Neoplasia, 27-29 March 2019, Houston, TX, USA. An expert panel on parathyroid cancer was constituted by the Steering Committee to address key questions in the field. The objectives were to recap open forum discussion of interested parties from multiple disciplines. The expert panel met in a closed session to consult on the data to be highlighted on the evidence-based results and on the future directions. Preceding the Conference, members of the expert panel conducted an extensive literature search. All presentations were based upon the best peer-reviewed information taking into account the historical and current literature. Questions were developed by the expert panel on parathyroid carcinoma. A comprehensive literature search for relevant studies was undertaken. This report represents the expert panel's synthesis of the conference material placed in a context designed to be relevant to clinicians and those engaged in cutting-edge studies of parathyroid carcinoma. This document not only provides a summary of our current knowledge but also places recent advances in its management into a context that should enhance future advances in our understanding of parathyroid carcinoma.

Shall I tell my mentor? Exploring the mentor-student relationship and its impact on students' raising concerns on clinical placement.

To explore student nurses' and nurse mentors' perceptions and experiences of raising concerns on clinical placement and the influence (if any) of their relationship on this process. A secondary aim is to consider the above, from a regulatory perspective in light of current literature and policy developments. Raising concerns whilst on clinical placement has been shown to be challenging for student nurses internationally. Registered nurses in the UK (in this case called "nurse mentors") facilitate learning and assessment in practice. However, limited research exists on the influence of the relationship between the nurse mentor and student nurse on the raising concerns process. A qualitative approach was used to undertake secondary thematic analysis of interview data. The primary data set was generated during a PhD study, focusing on the mentor-student dynamic and the possible influence of this relationship on students' raising concerns. 30 individual semi-structured interviews were subjected to concurrent and thematic analysis. Interviews were undertaken with student nurses (n=16) and nurse mentors (n=14) between April 2016-January 2018. The COREQ 32-item checklist was used during the preparation of this article. The following three interrelated analytical themes were generated from the data, "developing a mentor-student relationship," "keeping your mentor sweet" and "the mentor role in the raising concerns process." Our analysis of participants' experiences and perceptions offers an original contribution to understanding the factors associated with student nurses raising concerns in practice. Student nurses and most mentors believed that students should be encouraged and supported to raise concerns, but students' decisions were strongly influenced by their perceptions of the immediate interpersonal and educational context. Similar barriers to raising concerns have been shown to exist regardless of geographical boundaries, therefore the findings of this study are nationally and internationally relevant. Relevance to clinical practice This study provides new insight into the role of the nurse mentor in supporting students who raise concerns on clinical placements. The majority of the mentor participants believed that students should be encouraged and supported to speak up if they witness poor care or unprofessional behaviour. Focusing on the compexities around raising concerns in mentorship training and updates would rovide a forum for open discussion amongst mentors and educators.

O CURSO DE DIREITO INTERNACIONAL DOS CONFLITOS ARMADOS E A UTILIZAÇÃO DA EDUCAÇÃO A DISTÂNCIA: A VISÃO DOS SEUS DISCENTES

O objetivo deste estudo é apresentar as contribuições da utilização de ferramentas da plataforma Moodle no Curso de Direito Internacional dos Conflitos Armados (CDICA), da Escola Superior de Guerra, segundo a visão dos seus alunos. Esta pesquisa é de abrangência qualitativa, com pesquisas documental e bibliográfica como técnicas exploratórias iniciais. A metodologia compreendeu ainda a aplicação de dois questionários com perguntas abertas aos sujeitos do estudo, 34 alunos, entre militares e civis, de diversas áreas de formação profissional. As coletas de dados foram disponibilizadas via survey online no Ambiente Virtual de Aprendizagem, ao final do curso e abrangeram os campos da gestão e ensino. Os resultados obtidos comprovaram que as expectativas dos alunos foram atendidas satisfatoriamente, e os estudos foram essenciais para subsidiar os desdobramentos que foram aprofundados na fase presencial posteriormente. Ao final, as seguintes contribuições foram apresentadas, a saber: (i) fórum de discussão aberto em ambas as fases do curso; (ii) aplicação e ampliação dos estudos de caso com exercícios de fixação; (iii) criação de uma pasta virtual com todo o material do curso e os estudos realizados pelos estagiários; (iv) possibilidade de especialização futura para os egressos do curso: (v) Plano de Ensino e Aprendizagem aperfeiçoados; e (vi) pré-teste de avaliação dos conhecimentos prévios dos estagiários.

592 Prevention of CAUTIs in a Burn ICU

Abstract Introduction Catheter-associated urinary tract infections (CAUTIs) are the most common hospital-associated infection (HAI). Urinary catheter use is associated with urinary tract infections (UTIs) that can lead to complications such as cystitis, pyelonephritis, bacteremia, septic shock, and death. CAUTIs are associated with an excess length of stay of 2–4 days, increase costs of $0.4–0.5 billion per year nationally, and lead to unnecessary antimicrobial use. Through numerous implementations, a Burn ICU was able to drastically decrease their incidence of CAUTIs. Methods A Burn ICU implemented several interventions to reduce CAUTI rates. These interventions included: Results When this project was initiated in September of 2017, there were 9 CAUTIs identified in a Burn ICU, per the hospital’s Infection Prevention Department. By the end of 2017, there were 11, which equated to a rate of 14.67 per 1000 urinary catheter days. In 2018, the Burn ICU had 1 CAUTI, with a rate of 1.92 per 1000 urinary catheter days. In 2019 (through quarter 2), the Burn ICU has not had a CAUTI per the Infection Prevention Department. We believe the interventions made have drastically decreased the incidence of CAUTIs. Conclusions A Burn ICU implemented many new practices in 2017 when the CAUTI rate and SIR were above the hospital’s overall SIR. The Burn ICU staff now practice proper care and maintenance of urinary catheters and continue to provide excellent care. Although we have decreased our incidence of CAUTIs for 2018 and 2019, it is equally important we sustain this improvement. Therefore, we will continue to provide an open forum for discussion with staff so we can all do our part in keeping patients safe. Applicability of Research to Practice A Burn ICU decreased the incidence of CAUTIs by educating staff on proper care and maintenance of urinary catheters, removing catheters as soon as possible, and testing for UTIs upon admission to determine the patient’s baseline. By doing so, CAUTI rates went from 14.67 to 0 per 1000 urinary catheter days.

DON'T JUST SAY THANK YOU: EXPLORATION OF TYPES OF POSTS INSPIRING AND HINDERING DEEP CONVERSATIONS ONLINE

In an open online discussion forum, where there is no fixed structure or a facilitator like a course forum without any assigned themes, every participant is a facilitator shaping the direction and depth of a conversation. How can we as designers then make sure it leads to an engaging learning community that learners keep coming back to beyond the given course period? This paper reports on sequential analysis of 172 posts in 32 threads and close reading of two threads from an open online discussion forum in a free open online course, specifically looking at the impact of participant actions as facilitative moves, to gain better understanding of the types of actions that lead to deeper and sustained engagement with the ideas of interest. Sequential analysis is an approach that estimates which types of sequences of posts or interactions are most likely to occur in a threaded discussion. The results showed that sharing personal experiences attracted most responses, implying that it is important to encourage participants to share questions or cases connected to their personal experiences. In addition, somewhat paradoxically, we found that posts acknowledging responses tend to conclude and close down the conversation while posts that ask diverging questions tend to attract more discussion.

Clinical Cirrhosis Dilemmas: Survey of Practice from the 7th International Coagulation in Liver Disease Conference.

Hemostatic disorders in chronic liver disease and cirrhosis show continued expansion of research efforts. However, clinical decision making is often practiced on an individual patient level as consensus guidelines are lacking. We aimed to better assess individual day-to-day clinical practice through gauging clinicians' responses to common clinical scenarios. A series of ten clinical scenarios (seven procedural coagulation and three thrombosis management) were posed to conference attendees utilizing real-time polling software (Poll Everywhere). Responses were binomial and were submitted as "Agree" or "Disagree." Results were displayed real time following a standardized response period and an open-forum discussion ensued between conference faculty and attendees following response submission. Twenty conference attendees participated in the clinical scenario plenary session. In general, agreement rates were high. All but one of the ten clinical scenarios had ≥ 70% agreement. Agreement was based both on procedural risk, with greatest agreement seen for low-risk procedures (80-93%), and on peri-procedural coagulation parameters of platelet count and fibrinogen level where > 50,000μ/L and 120mg/dL were the most agreed upon thresholds, respectively. 75-95% agreement was reached when surveying the need for anticoagulation for mesenteric vein thrombosis in liver transplant candidates; slightly less (71%) agreement was found when deciding to proceed with anticoagulation in non-liver transplant candidates with mesenteric vein thrombosis. While large-scale, methodologically rigorous randomized controlled trials are lacking to guide clinical decision making in patients with coagulation disorders and chronic liver disease, consensus expert opinion regarding mitigating peri-procedural bleeding risk and treatment of thrombosis appears consistent and strong.

CONVENTIONAL AND INDIVIDUAL VALUES SYSTEM: THEIR IMPLICATIONS IN THE ENGLISH MEDIA DISCOURSE

Currently, the problem of unspoken text components analysis is gradually becoming more and more relevant, especially of those within the economic media discourse because it covers the most topical issues and problems, both namely economic and related social and sociopolitical issues viewed in their communicative expansion. At the same time articles analyzing non verbal or non explicit components of the above mentioned discourse are quite few in number meanwhile the textual and contextual cognitive backgrounds are getting more and more topical as far as the media discourse itself obtains open and interactive forms in contemporary information trends. This article explores the components (namely, the implicit reflections of the authors conventional and individual value systems) actualized in texts focused upon economic and related phenomena published in numerous Internet sources. The media texts under analysis have been explored either isolated or proceeded with comments written in open forum discussions and panels. The focus has been made on the conventional value system (as a component of both discourse and the personality of the authors as well as of their evaluative paradigms within common value paradigms) from the perspective of the subject set in the media discourse as the chronotopic context of the authors subjective implications and the phenomenon/object oriented at argumentation within extensive variety of the evaluative statements. The material under analysis represents media discourse of various designs written in English and issued in the Internet: articles from Internet journals, political and business blogs, twits, forums and discussions all that represents dialogic or interactive characteristics in media communication.

E-government as an anti-corruption tool: panel data analysis across countries

Over the past two decades, many governments around the world have adopted e-government as an anti-corruption tool. However, there is a lack of empirical evidence on the impacts of e-government on corruption. Thus, this article aims to empirically examine whether e-government reduces corruption across countries. For this purpose, longitudinal data from 2003 to 2016 were collected from 214 countries and then panel data analysis based on a fixed-effect model was conducted. Analysis results reveal that e-government as a whole significantly reduces corruption, while the effects of open government as one type of e-government are unclear. However, the rule of law moderates the relationship between open government and corruption. That is, in countries with more effective legal systems, open government is more likely to reduce corruption than in countries with less effective legal systems. Points for practitioners E-government as a whole can effectively reduce corruption. Open government, such as open data portals and online discussion forums, does not have a direct impact on the reduction of corruption. Open government can have a conditional impact on corruption, relying on the effectiveness of legal systems.

Understanding Patient Preferences and Unmet Needs in Non-alcoholic Steatohepatitis (NASH): Insights from a Qualitative Online Bulletin Board Study.

IntroductionThe aim of this work was to understand how patients with non-alcoholic steatohepatitis (NASH) perceive their disease, unmet needs, and expectations regarding future treatment through online bulletin board (OBB) qualitative research.MethodsOBB is an asynchronous online qualitative market research tool that provides an open forum for interactive discussion among participants. Patients with NASH were recruited via physician referral and completed a screener questionnaire to ensure their eligibility and willingness to participate. A trained moderator managed the discussion that allowed open answers and responses to other participants’ posts. Patient responses were analyzed using a combination of different qualitative analytical tools.ResultsThe OBB ran for 4 days and included 16 patients (n = 8, UK; n = 8, US) with NASH (fibrosis stages F1–F3) and comorbidities including diabetes/prediabetes (n = 9) and obesity (n = 12). The key insights were (1) patients with NASH have a poor understanding of the disease, its progression, and management—they feel a lack of adequate educational support from their physicians; (2) diagnosis of NASH is incidental in most cases, mainly because patients fail to spontaneously associate their signs or symptoms with their liver condition; (3) comorbidities (obesity and diabetes) are more concerning to patients than NASH; and (4) patients perceive that NASH impacts their social life and work performance in more advanced stages.ConclusionsThis OBB provided valuable patient insights into NASH disease perception and management and revealed unmet need areas. In light of no approved therapies, these patient insights can inform early drug development strategies and stakeholder discussions on NASH.FundingNovartis Pharma AG, Basel.Electronic supplementary materialThe online version of this article (10.1007/s12325-018-0856-0) contains supplementary material, which is available to authorized users.

A standardized low-cost peer role-playing training intervention improves medical student competency in communicating bad news to patients in Botswana.

The purpose of this study was to demonstrate effectiveness of an educational training workshop using role-playing to teach medical students in Botswana to deliver bad news. A 3-hour small group workshop for University of Botswana medical students rotating at the Princess Marina Hospital in Gaborone was developed. The curriculum included an overview of communication basics and introduction of the validated (SPIKES) protocol for breaking bad news. Education strategies included didactic lecture, handouts, role-playing cases, and open forum discussion. Pre- and posttraining surveys assessed prior exposure and approach to breaking bad news using multiple-choice questions and perception of skill about breaking bad news using a 5-point Likert scale. An objective structured clinical examination (OSCE) with a standardized breaking bad news skills assessment was conducted; scores compared two medical student classes before and after the workshop was implemented.ResultForty-two medical students attended the workshop and 83% (35/42) completed the survey. Medical students reported exposure to delivering bad news on average 6.9 (SD = 13.7) times monthly, with 71% (25/35) having delivered bad news themselves without supervision. Self-perceived skill and confidence increased from 23% (8/35) to 86% (30/35) of those who reported feeling "good" or "very good" with their ability to break bad news after the workshop. Feedback after the workshop demonstrated that 100% found the SPIKES approach helpful and planned to use it in clinical practice, found role-playing helpful, and requested more sessions. Competency for delivering bad news increased from a mean score of 14/25 (56%, SD = 3.3) at baseline to 18/25 (72%, SD = 3.6) after the workshop (p = 0.0002).Significance of resultsThis workshop was effective in increasing medical student skill and confidence in delivering bad news. Standardized role-playing communication workshops integrated into medical school curricula could be a low-cost, effective, and easily implementable strategy to improve communication skills of doctors.

An Analysis of Learner Autonomy and Autonomous Learning Practices in Massive Open Online Language Courses

The study investigates the perception of learner autonomy with Massive Open Online Language Course (MOOLC) participants, more specifically; (i) to what extent EFL learners in an English MOOLC are autonomous, (ii) the perception of learners’ and teachers’ roles in learner autonomy, and (iii) the autonomous learning practices the learners are involved in by participating in the MOOLCs. It contributes to the understanding of online learner as an agent in highly heterogeneous language learning contexts and the link between online learning and learner autonomy. The mixed-method design is employed to present data from a Learner Autonomy Questionnaire by Joshi (2011) conducted with 57 participants from three English MOOLCs with a variety of focus as well as a content analysis method was used on the interaction data in the form of open discussion forum posts, which were added by the participants, to create a frame of autonomous learning activities in these MOOLCs and learners’ attitudes towards them. The findings show that the English MOOLC participants are highly autonomous and willing to be more responsible for their own learning. Similarly, the learners’ perception of their own roles indicates a positive inclination towards autonomy. Furthermore, the participants favor the MOOLCs that encourage learner-centered and autonomous language learning practices. Due to the interactive, communicative, and collaborative nature of MOOLCs, learners are advised to develop globalized autonomous skills to participate effectively in such multicultural learning platforms because learner autonomy goes beyond traditional classrooms.

From I to We: Group formation and linguistic adaption in an online xenophobic forum

Much of identity formation processes nowadays takes place online, indicating that intergroup differentiation may be found in online communities. This paper focuses on identity formation processes in an open online xenophobic, anti-immigrant, discussion forum. Open discussion forums provide an excellent opportunity to investigate open interactions that may reveal how identity is formed and how individual users are influenced by other users. Using computational text analysis and Linguistic Inquiry Word Count (LIWC), our results show that new users change from an individual identification to a group identification over time as indicated by a decrease in the use of “I” and increase in the use of “we”. The analyses also show increased use of “they” indicating intergroup differentiation. Moreover, the linguistic style of new users became more similar to that of the overall forum over time. Further, the emotional content decreased over time. The results indicate that new users on a forum create a collective identity with the other users and adapt to them linguistically.

An Analysis of Learner Autonomy and Autonomous Learning Practices in Massive Open Online Language Courses

The study investigates the perception of learner autonomy with Massive Open Online Language Course (MOOLC) participants, more specifically; (i) to what extent EFL learners in an English MOOLC are autonomous, (ii) the perception of learners’ and teachers’ roles in learner autonomy, and (iii) the autonomous learning practices the learners are involved in by participating in the MOOLCs. It contributes to the understanding of online learner as an agent in highly heterogeneous language learning contexts and the link between online learning and learner autonomy. The mixed-method design is employed to present data from a Learner Autonomy Questionnaire by Joshi (2011) conducted with 57 participants from three English MOOLCs with a variety of focus as well as a content analysis method was used on the interaction data in the form of open discussion forum posts, which were added by the participants, to create a frame of autonomous learning activities in these MOOLCs and learners’ attitudes towards them. The findings show that the English MOOLC participants are highly autonomous and willing to be more responsible for their own learning. Similarly, the learners’ perception of their own roles indicates a positive inclination towards autonomy. Furthermore, the participants favor the MOOLCs that encourage learner-centered and autonomous language learning practices. Due to the interactive, communicative, and collaborative nature of MOOLCs, learners are advised to develop globalized autonomous skills to participate effectively in such multicultural learning platforms because learner autonomy goes beyond traditional classrooms.

Impact of the new @sigmm records

The SIGMM Records have renewed, with the ambition of continue being a useful resource for the multimedia community. The intention is to provide a forum for (open) discussion and to become a primary source of information (and of inspiration!).

Content Analysis of an Open Online Forum for Band Directors

Abstract Music teacher concerns have been described using case studies, surveys, and mixed methods, but no research exists that compares music teachers’ online interactions with professional development offerings or how these online discussions may evolve over the school year. I used a content analysis approach (Neuendorf, 2002) to describe 6,430 topics in an online open discussion forum for band directors and the professional development sessions (N = 215) offered by one state’s music educators’ association and bandmasters’ association in 1 calendar year. Music repertoire, employment, festival rules and procedures, program administration, and work environment were chief conversation topics for this group of directors. Directors of beginning bands had specialized conversations differing from their peers. As directors moved through the calendar year, their top concerns evolved from music repertoire to festival rules, employment, and program administration. Professional development sessions mostly involved ensemble or individual pedagogy and program administration.

PREDICTING RATINGS FOR USER REVIEWS AND OPINION MINING ANALYZE FOR PHYSICIANS AND HOSPITALS

ABSTRACTHealth care is taking its turn in the internet now and online health information consumption is also booming. Users have started generating healthcarereports like online doctor reviews open to all. Hence, online health forums are increasingly popular these days since people can gather their requireddata by just sitting at home and select the best doctor by considering the reviews available online. The patients also browse on their concerneddiseases and use the open forum for discussion on the topics. On an average, these online health-care providers are mainly focusing on reviews aboutthe physicians. The feedback provided by patients is considered and we also analyze the sentiments of the patient to estimate the value of the reviews.The rating for the doctors is divided into various categories such as Staff, Knowledge, and Helpfulness. We propose support vector machine and apriorifor the classification of data and use sentiment based rating prediction to analyze doctor’s reviews and opinion mining patterns for online patterns.By providing physician ratings in website, it offers the patients to know about the physician and consider the critique and information to make theirdecision.Keywords: Support vector machine, Apriori, Sentiment classification, Opinion mining.

New Hampshire Hospital ‘Stays Safe’ Through Violence-Reduction Program

New Hampshire Hospital ‘Stays Safe’ Through Violence-Reduction Program

Making Milestones: Development and Implementation of a Formal Socioeconomic Curriculum in a Neurosurgical Residency Training Program.

Improved training in the socioeconomic aspects of medicine is a priority of the Accreditation Council for Graduate Medical Education and the American Board of Neurological Surgeons. There is evidence that young neurosurgeons feel ill equipped in these areas and that additional education would improve patient care. To present our experience with the introduction of a succinct but formal socioeconomic training course to the residency curriculum at our institution. A monthly series of twelve 1-hour interactive modules was designed to address the pertinent Accreditation Council for Graduate Medical Education-American Board of Neurological Surgeons outcomes-based educational milestones. Slide-based lectures provided a comprehensive overview of social, legal, and business issues, and a monthly forum for open discussion allowed residents to draw on their applied experience. Residents took a 20-question pre- and postcourse knowledge assessment, as well as feedback surveys at 6 and 12 months. Residents were able to participate in the lectures, with an overall attendance rate of 91%. Residents felt that the course goals and objectives were well defined and communicated (4.88/5) and rated highly the content, quality, and relevance of the lectures (4.94/5). Performance on the knowledge assessment improved from 58% to 66%. Our experience demonstrates the feasibility of including a formal socioeconomic course in neurosurgical residency training with positive resident feedback and achievement of outcomes-based milestones. Extension to a 2-year curriculum cycle may allow the course to cover more material without compromising other residency training goals. Online modules should also be explored to allow for wider and more flexible participation. ABNS, American Board of Neurological SurgeonsACGME, Accreditation Council for Graduate Medical Education.

Web-based Discussion Forums on Pregnancy Complaints and Maternal Health Literacy in Norway: A Qualitative Study.

BackgroundThe Internet is one of the fastest growing information sources for pregnant women and seems to be used across social and economic strata. However, we still lack knowledge on how interaction in Web-based discussion forums influence maternal health literacy, in terms of how pregnant women access, appraise, and apply information to promote and maintain good health.ObjectiveThe aim of this study was to understand how Web-based discussion forums influence maternal health literacy; hence, we explored the role of interactions in Web-based discussion forums among women who experienced health problems during pregnancy. More specifically, we explored why media-literate women experiencing the medically unexplained condition, pelvic girdle pain (PGP), during pregnancy participated in Web-based discussion forums and how they appraised and applied the information and advice that they gained from the Web-based interaction with other women.MethodsWomen were invited to participate in the study via postings on 3 different open websites for pregnant women and mothers. The sample included 11 Norwegian women who participated in open Web-based discussion forums when experiencing PGP in pregnancy. The data were collected using synchronous qualitative email interviews and were analyzed using thematic analysis.ResultsIn our study sample, interaction in Web-based discussion forums influenced maternal health literacy in terms of increased health-related knowledge and competencies, increased awareness of health promotion and health protection, and increased system navigation. The women appraised and selectively applied information and advice that resonated with their own experiences. For many, the information provided online by other women in the same situation was valued more highly than advice from health professionals. Women reported that they used their knowledge and competency in encounters with health professionals but hesitated to disclose the origin of their knowledge. Those with a high level of education in medicine-related fields raised a concern about the Internet as a source of horror stories and erroneous information and were actively engaged in trying to minimize potential negative effects, by providing biomedical information.ConclusionsThe popularity of Web-based discussion forums among pregnant women suggests that this group needs additional sources of information and support to complement traditional consultations with the health professionals. The professionals need to recognize that pregnant women access Web-based discussion forums for support and information to increase their ability to take better health decisions for themselves. This is a potential resource that health professionals may find useful in consultations with pregnant women.

Countering Medicine's Culture of More

Medical education may inadvertently contribute to low-value care by training residents to overuse diagnostic tests and repeat labs, but creating a forum for open discussion of costs and value to prevent patient harm from overuse provides a corrective.