Standard Course Research Articles

Teaching Animals and Religion

Abstract Although animals have served as subjects and objects of religion since the Paleolithic, they are often omitted from standard religious studies courses. In this article, I discuss some best practices for introducing students to the study of animals and religion. After outlining some of the benefits of teaching about animals and religion, I explain the pros and cons of the two main approaches: by tradition or by topic. The majority of the article discusses some of the most important topics to include, as well as how best to approach several of them in terms of pedagogy and media. The final section explains the importance of bringing real animals into courses like this, and offers a variety of experiential education techniques for doing so, including contemplative practices.

Efficacy of short course versus standard course oral co-trimoxazole in the management of children with lower urinary tract infections.

Objective: To compare the efficacy of short course versus standard course oral co-trimoxazole in the management of children presenting with lower urinary tract infections. Study Design: Randomized Controlled Trial. Setting: Department of Paediatric, Federal Government Polyclinic, Islamabad. Period: 6 months from January 2017 to June 2017. Material & Methods: Patients were randomly allocated to two therapy groups by lottery method i.e. oral co-trimoxamole for 3 days (Group A) and oral co-trimoxazole for 10 days (Group B). The antibiotic course was started according to child weight and stopped after 3 and 10 days according to study group allocation. The patients were followed up after 7 days in the short course group and 10 days in the standard therapy group to assess for clinical resolution of UTI. The outcome was noted as clinical cure or relapse/recurrence of UTI. The children with recurrence were sent home after change of therapy to next generation of antibiotic therapy and in case of severe condition, patient was admitted for parenteral therapy. Results: In this study efficacy of short course was seen in 41(85.4%) patients while patients who were given standard course among they m efficacy was seen in only 14(29.2%) patients only. Efficacy of short course treatment was significantly higher as that of that of standard course i.e. p-value=0.000. Efficacy of both treatment regimens was seen in terms of age, gender and duration of symptoms. Stratification of these variables showed that short course efficacy was significantly higher as that of standard course for all these stratified variables. Conclusion: Results of this study demonstrated that short course of oral co-trimoxazole is more effective than standard course in the management of children presenting with lower urinary tract infections. However short course is not only beneficial in terms of cost as well as it cures in a short time span and minimal side effects.

The need for specific first aid and emergency knowledge whilst trekking in remote areas – results of the ADEMED (Aachen DEntal and MEDical) Expedition to the Annapurna region, Nepal

Introduction: Fellow trekkers are often the first responders to their comrades in remote settings. Not everyone undertakes First Aid (FA) training when travelling to remote settings away from comprehensive healthcare, whether travelling independently or in a group. The syllabus of standard urbanised FA courses does not fully cover the needs of such trekkers (ie altitude illnesses). We evaluated the FA and emergency knowledge of trekkers en route in the remote Nepalese Himalayas. Material and methods: A questionnaire about FA, trekking emergencies and water hygiene knowledge was completed by a cohort of 453 trekkers passing through Manang (3,519 m), Nepal, who volunteered their participation. A previously validated questionnaire consisted of 20 multiple choice questions (each using a five-point Likert scale) was used, followed by a subjective self-assessment of 17 key topics using a 5-point rating scale from very good to unsatisfactory knowledge. Demographic data including FA and climbing experience was also collected. Results: The participants generally showed a poor knowledge in FA and trekking emergencies, even though 20.8% had some occupational medical training. In total 59.5% of possible answers were answered correctly. On average each participant managed to answer only one out of 20 questions (5.4%) completely correct. The most unsatisfactory results concerned the following topics, each with only 2.4% correct answers: hypothermia/resuscitation, rescue strategies and rip fractures. The best results were for HACE 33.8%, cranio-cerebral injury 33.6%, angina pectoris/heart attack 31.8% and hypovolemic shock 28.7%. The majority of participants had very limited experience of climbing mountains, rock climbing or ice climbing. Conclusions: This study provides essential data identifying deficiencies in standard FA courses that are targeted for urban settings, and not for trekkers in a remote setting far away from comprehensive health care and rescue. There is a need to develop readily accessible FA curriculums specific to trekkers that would provide education on preventative care prior to, during, and after treks, and to improve their knowledge of medical care of trekking injuries and emergencies.

“Just solving for x”: Retrospective narratives of opportunities of learn on hyper-accelerated algebra I pathways

The study of Algebra I in Grade 7 or earlier in the United States is often a marker of mathematical competence in competition for elite college admissions. Students who hyper-accelerate their study of Algebra I are presumed to be successful from a content perspective of opportunity to learn (OTL) which uses standardized test scores and completed course transcripts as metrics. This phenomenological study layers two narrative analysis techniques to interpret OTL in the retrospective stories of 15 hyper-accelerated students who graduated from the same high school. Selection for Grade 7 Algebra I was a necessity to preserve their identities of smartness. As they reflected upon their OTL in subsequent courses, participants described evolving beliefs about themselves as being “good” at mathematics in terms of competition, help seeking, conceptual understanding, and appropriate challenge seeking. Their lived experiences raise critical questions about tracking and equitable access to meaningful mathematics for all students.

Faculty Development Training in Online Instruction at a Norwegian University: An Experience Report

Introduction: Online learning and work are commonplace in both engineering and professional communication. To be effective online, even experienced face-to-face teachers require new skills. About the case: This case reports on the design and delivery of faculty training on teaching online at a Norwegian university during the COVID-19 pandemic. Two questions are examined: 1. What topics and training designs are suitable for beginning online teachers with little time to implement the results of the training? 2. In this emergency context, how do local conditions impact the design and delivery of such training? The training focused on building interactive online courses, providing formative feedback for students, and choosing between synchronous and asynchronous teaching. Situating the case: The literature suggests that teachers often undergo a shift in their teaching philosophies and methods when transitioning to online environments. Methods/approach: Pretraining and post-training reflection were used as informal data sources to develop the training sessions and to holistically discuss the themes that emerged from the training. Results/discussion: Two online and one face-to-face 2-hour training sessions were delivered to three groups of faculty. Three main themes emerged from the training: active learning, synchronous/asynchronous teaching, and providing formative feedback to students. Conclusions: Challenges included convincing participants to shift from the lecture as the main method of instruction to more interactive and active techniques, as well as reconciling the standardized course study plans with individual teachers' instructional needs. Larger studies of training programs and more formal methods of data analysis are suggested.

Transcutaneous Pacing: An Emergency Nurse’s Guide

Transcutaneous pacing is commonly performed in emergency departments to treat patients with cardiac dysrhythmias. Although emergency nurses are required to complete a standardized course that reviews components of transcutaneous pacing, such as Advanced Cardiac Life Support, performing transcutaneous pacing on patients may be done infrequently in some facilities and can lead to anxiety and fear for bedside emergency nurses, especially novice emergency nurses and nurses who infrequently care for patients requiring external pacing. This manuscript provides a practical guide for emergency nurses to care for patients who require transcutaneous pacing. Key information found in this manuscript includes indications for transcutaneous pacing, the nurse’s role when performing transcutaneous pacing, and transcutaneous pacing troubleshooting information.

Binaural Acoustic Beats in the Psychological Rehabilitation of Patients with Impaired Motor Functions

The course of diseases associated with movement disorders violates the possibility of independent existence of the individual and is accompanied by the formation of symptoms of increased anxiety, depression and catastrophizing. Over the last years, in addition to psychopharmacological drugs, non-drug methods have been actively included in the complex of treatment and rehabilitation for this patients’ group allowing them to influence the patient’s psyche by neuro-biological activation of sanogenesis links. Aim. To study the possibility of using resonance-acoustic vibration (PRAV) programs in the “relaxation” mode when organizing psychological support for patients with movement disorders in the course of medical rehabilitation. Materials and methods. The study included 93 patients with movement disorders of two nosological groups: movement disorders against the stroke (n=57) and motor disorders against the degenerative-dystrophic diseases of large joints and spine of large joints and spine (n=36), undergoing a standard inpatient course of medical rehabilitation. Results. The dynamics of the emotional state, the intensity of the pain syndrome, characteristics of the cognitive sphere (memory, attention) as a result of psychological correction using PRAV were analyzed. The positive effect of the inclusion of the binaural beats complex in the psychological correction of the patients with impaired motor functions state of health as well as an indifferent response to the attempt to correct memory and attention were determined. Conclusion. It testifies that the application of the method is appropriate in correcting the emotional state, general well-being, overcoming fear of movement and is not effective for pain and recovery of cognitive functions.

Evaluation of a laparoscopic abdominal simulator assessment to test readiness for laparoscopic ovariectomy in live dogs.

To predict readiness for laparoscopic ovariectomy of live dogs on the basis of performance on a high-fidelity laparoscopic abdominal simulator and to determine interrater reliability of the assessment. Experimental study. Seventeen fourth-year veterinary students. After a standardized laparoscopic training course, each participant performed a laparoscopic ovariectomy with a simulator. This performance was scored in real time by two evaluators using a rubric. Participants achieving a score of 112 of 160 performed a laparoscopic ovariectomy in a live dog, supervised by an instructor in the room. Two evaluators scored video recordings of each procedure using the rubric. Participants' opinions about the simulator were collected with a survey. All participants scored above the threshold (range, 126-151) and successfully completed laparoscopic ovariectomy in a live dog, with an average of 10 of 17 participants requiring verbal guidance and 5 of 17 participants requiring intervention from the instructor. Interrater concordance was excellent for the rubrics used to score performance on the simulator (R=0.91) and in vivo (R=0.81). All participants agreed that the simulator should be used to assess trainee readiness prior to surgery in a live dog. Participants achieving a score of at least 126 of 160 on the simulator were able to perform a laparoscopic ovariectomy in a live dog under supervision. The scoring system for the simulator had excellent interrater concordance. This simulator and scoring system can be used in laparoscopic training programs to assess readiness for progression to the operative setting.

The Addition of High-Technology Into the Stop the Bleed Program Among School Personnel Improves Short-Term Skill Application, Not Long-Term Retention.

The Stop the Bleed (STB) program trains the general public on identifying and treating life-threatening bleeding. Data on efficacy and retention of skills taught through this program are limited, with the role of high-technology modalities to augment the program, such as simulation and feedback devices, untested. A convenience sample of 66 school personnel participated in an open-label observational study from January to August 2019. The control group received the standard bleeding control course, while the intervention group received the bleeding control course with addition of a simulation and a feedback device for wound packing. Assessment was performed by STB instructors using performance metrics from prior studies as well as a feedback device. Retention testing was performed 2 to 8 months after intervention. The study was approved by the hospital's institutional review board. The intervention group performed better than the control group on correct tourniquet application [90.3% vs. 71.0%; odds ratio (OR) = 11.28; P = 0.015; 95% confidence interval (CI) = 1.86 to 104.67] wound packing scores (59.5% vs. 29.6%; OR = 0.33; P = 0.007; 95% CI = 9.36 to 56.00) and were more likely to assess their safety (OR = 5.49; P = 0.034; 95% CI = 1.28 to 27.66), and reported higher comfort scores on stepping into an emergency scenario (OR = 11.19; P = 0.004; 95% CI = 2.51 to 63.11), wound packing (OR = 5.16; P = 0.025; 95% CI = 1.35 to 22.46), and using a tourniquet (OR = 11.41; P = 0.003; 95% CI = 2.57 to 67.59). Thirty-one participants (46.9%) were assessed again at retention 2 to 8 months later where scores for tourniquet placement and wound packing were not significantly different in the two groups. Augmenting STB with simulation and feedback improved both self-reported comfort level and skill set of participants, but the retention of skills was poor in both groups.

Abstract PS10-23: Five year median follow-up data from a prospective, randomized, placebo-controlled, single-blinded, multicenter, phase IIb study evaluating the reduction of recurrences using HER2/neu peptide GP2 + GM-CSF vs. GM-CSF alone after adjuvant trastuzumab in HER2 positive women with operable breast cancer

Abstract Background: The final analysis of the GP2 prospective, randomized, placebo-controlled, single-blinded, multicenter Phase IIb trial investigating GP2+GM-CSF administered in the adjuvant setting to node-positive and high-risk node-negative breast cancer patients with tumors expressing any degree of HER2 (immuno-histochemistry [IHC] 1-3+) (NCT00524277) is now complete with 5 year follow-up. The trial enrolled HLA-A02 patients randomized to receive GP2+GM-CSF versus GM-CSF alone. The trial's primary objective was to determine if treatment with GP2, a HER2-derived peptide, reduces recurrence rates. Three and 4 year interim analyses for this trial and 3 Phase I studies showing GP2 to be safe and immunogenic have been previously reported by Mittendorf et al. Methods: Each enrolled and consented GP2-treated patient was scheduled to receive a total of 6 GP2+GM-CSF (500 mcg GP2: 125 mcg GM-CSF) intradermal injections every 3-4 weeks as part of the Primary Immunization Series (PIS) for the first 6 months and 4 GP2+GM-CSF booster intradermal injections every 6 months thereafter. Boosters were introduced during the trial, thus some patients did not receive all 4 boosters. Each enrolled and consented placebo patient was scheduled to receive a total of 6 GM-CSF only intradermal injections every 3-4 weeks for the first 6 months and 4 GM-CSF only booster intradermal injections every 6 months thereafter. Results: This 168 patient (ITT: n=180) basket trial across 16 clinical sites explored 96 HER2 3+ patients, who received a standard course of trastuzumab after surgery and subsequently completed the full PIS or placebo, starting the PIS at median 17.1 months after surgery, and 72 HER2 1-2+ patients, who did not receive trastuzumab after surgery and subsequently completed the full PIS or placebo, starting the PIS at median 10.8 months after surgery. Since GP2 is synergistic with trastuzumab, and the HER2 1-2+ patients did not receive trastuzumab, it was prespecified to compare recurrence rates ITT versus per protocol in these 2 distinct, independently reported populations, excluding those patients who did not complete the PIS. GP2 was shown to be well tolerated with no SAEs and elicited a potent immune response measured by local skin tests and immunological assays, which suggest peak immunity is reached at 6 months upon completion of the PIS. After 5 years of follow-up, the Kaplan-Meier estimated 5-year DFS rate in the 46 HER2 3+ patients treated with GP2+GM-CSF, if the patient completed the PIS, was 100% versus 89.4% (95% CI:76.2, 95.5%) in the 50 placebo patients treated with GM-CSF (p = 0.0338). The treated versus placebo HER2 3+ patients were well-matched, where 53% were stage T1, 41% were stages T2-T4, 55% were node positive, 58% were HR positive and received endocrine therapy, 77% received adjuvant radiation, 77% received adjuvant chemotherapy, and 89% received trastuzumab. After 5 years of follow-up, the Kaplan-Meier estimated 5-year DFS rate in the 35 HER2 1-2+ patients treated with GP2+GM-CSF, if the patient completed the PIS, was 77.1% (95% CI:59.5, 87.9%) versus 77.6% (95% CI:60.1, 88.2%) in the 37 placebo patients treated with GM-CSF (p = 0.9142). Conclusions: This study demonstrated that completion of the GP2+GM-CSF PIS safely elicited a potent immune response and reduced recurrence rates to 0% in HER2 3+ patients, who received a standard course of trastuzumab after surgery. A pivotal Phase III trial is being initiated to treat HER2 3+ patients in the neoadjuvant setting. GP2 also may be effective when used in parallel to trastuzumab based therapeutics or in combination with trastuzumab based therapeutics in HER2 1-2+ or other HER2 expressing cancers. Citation Format: Snehal S Patel, David B McWilliams, Marisa S Patel, Christine T Fischette, Jaye Thompson, F Joseph Daugherty. Five year median follow-up data from a prospective, randomized, placebo-controlled, single-blinded, multicenter, phase IIb study evaluating the reduction of recurrences using HER2/neu peptide GP2 + GM-CSF vs. GM-CSF alone after adjuvant trastuzumab in HER2 positive women with operable breast cancer [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS10-23.

Cardiopulmonary resuscitation skill training and retention in teens (CPR START): A randomized control trial in high school students

AimHigh school students are currently the largest group of individuals in the US receiving CPR training every year. This study examines the effect of adding a real-time visual feedback device to a standard instructor-led CPR course on skill acquisition and retention in high school students. MethodsAll study participants underwent baseline CPR skill testing and received a standard instructor-led compression-only CPR course. We then randomized students to a ‘Feedback Group’, consisting of 2 min of CPR training using a real-time visual feedback device, or ‘Standard Group’ that continued to practice on the inflatable manikin. CPR skills for all students were tested afterwards using the feedback device and reported as a compression score (CS) derived from their chest compression depth, rate, hand position, and full chest recoil. We compared the CS at baseline, week-0 (immediately post-intervention), week-10, week-28, and week-52 between groups. ResultsA total of 220 students were included in the analyses (Feedback Group = 110, Standard Group = 110). Both groups showed similar CPR performance at baseline. At week-0, the Feedback Group had a significantly higher CS compared to the Standard Group (adjusted difference: 20% [95% CI: 11%–29%; p < 0.001]). This difference attenuated over time but remained significant at the week-10 and week-28 follow-up; however, by the week-52 follow-up, there was no significant difference between groups. ConclusionsUsing a real-time visual feedback device during CPR training significantly improves skill acquisition and retention in high school students and should be integrated into the high school CPR curriculum.

Using a Manuscript Template to Foster Dissemination of Doctoral Students' Literature Reviews.

The author was asked to teach a new PhD course, Developing Literature Reviews. The course objective is to have students prepare a structured (e.g., integrative, systematic) literature review manuscript that is suitable for publication submission. Course pedagogy and materials were created, including a novel literature review manuscript template. The template served as a guide for communicating essential section components of a rigorous and reproducible literature review manuscript and allowed for an iterative process and efficient faculty-student evaluation system to simulate the peer-review process. To measure student outcomes, standardized course evaluations were reviewed, and the number of students who were successful in disseminating manuscripts was recorded. Students' standardized course evaluations were high. Eighteen students published integrative or systematic literature reviews as first author. Eleven students have presented peer-reviewed abstracts at scientific conferences. The template successfully facilitates PhD student dissemination. The Doctor of Nursing Practice student pedagogy may also benefit from the template. [J Nurs Educ. 2021;60(2):111-115.].

Measurable outcomes for pediatric epileptic encephalopathy: a single-center experience with corticosteroid therapy.

Corticosteroids are commonly used to treat refractory epilepsy in children, but the heterogeneity of the population and lack of standardized outcome measures have limited understanding of their effectiveness. We conducted a single-center study of corticosteroids for epileptic encephalopathy to (a) identify domains for measurement and estimate potential effect sizes, (b) characterize heterogeneity, and (c) identify outcomes that may need better tools for measurement. In this retrospective single-center cohort study, children with epileptic encephalopathy (excluding infantile spasms) were treated with a standardized course of oral dexamethasone or IV methylprednisolone. Long-term video electroencephalography (EEG) was assessed via novel ordinal scales for five features: seizure semiology/burden, epileptiform activity, slowing, organization, and sleep architecture. We abstracted parental assessment of functional domains (i.e., cognition) from the medical records. Pre-treatment and post-treatment EEG features, functional domains, and treatment regimens were compared. Thirty-five children with refractory epilepsy were included. Overall, 16/35 (46%) of individuals had a >50% reduction in seizure frequency from the pre-treatment EEG to the initial post-treatment EEG. In particular, tonic seizures (in a subset of 23 children) were reduced (24-hour tonic seizure count pre-treatment was 8 [4-13] and 3 [1-5] post-treatment EEG#1, p=0.04). For follow-up post-treatment EEGs, there was: (1) better formation of sleep spindles (37% normal pre-treatment to 63% normal post-treatment; p=0.04); and (2) improvement in parental reported cognition (in 43%). Improved cognition was the only outcome that differed between the dexamethasone and methylprednisolone treated groups (58% for dexamethasone [n=11/19] vs. 25% for methylprednisolone [n=4/16]; p=0.03). Large studies should be powered to detect reductions in seizures (particularly tonic as we identified a 2.6-fold reduction), improved EEG organization, and improved sleep architecture (21 percentage points). Cognitive improvements following steroid treatment, reported by parents, should be quantified and fully characterized in future work.

Reviving the Autopsy for Modern Cancer Evolution Research.

Simple SummaryMedical autopsies have a long history, but are currently experiencing a revival in order to progress modern cancer evolution research. Research autopsies represent an unparalleled opportunity to collect large volumes of cancer tissue accessible from multiple sites in a metastatic cancer patient’s body—not usually feasible during the standard clinical course. These collections enable researchers to unravel tumour evolution and heterogeneity questions. Many institutions around the world have recognised the value of these tissues, and have established rapid cancer autopsy programmes. Our article discusses a comprehensive collection of 24 rapid cancer autopsy programmes from across the globe.Outstanding questions plaguing oncologists, centred around tumour evolution and heterogeneity, include the development of treatment resistance, immune evasion, and optimal drug targeting strategies. Such questions are difficult to study in limited cancer tissues collected during a patient’s routine clinical care, and may be better investigated in the breadth of cancer tissues that may be permissible to collect during autopsies. We are starting to better understand key tumour evolution challenges based on advances facilitated by autopsy studies completed to date. This review article explores the great progress in understanding that cancer tissues collected at autopsy have already enabled, including the shared origin of metastatic cells, the importance of early whole-genome doubling events for amplifying genes needed for tumour survival, and the creation of a wealth of tissue resources powered to answer future questions, including patient-derived xenografts, cell lines, and a wide range of banked tissues. We also highlight the future role of these programmes in advancing our understanding of cancer evolution. The research autopsy provides a special opportunity for cancer patients to give the ultimate gift—to selflessly donate their tissues towards better cancer care.

Successful Experience of Fecal Transplantation in a Patient with Severe Pseudomembranous Colitis

Introduction . At the present time there is increase the number of patients diagnosed with pseudomembranous colitis due to Clostridiodes difficile, respectively it significantly increases the frequency of hospitalizations, the length of hospital stay and the cost of treatment. Approved drug methods for correcting a pathological condition are not always able to lead to recovery after the first use, repeated and prolonged courses of therapy are often required, especially with recurrent Clostridiodes difficile. An alternative way of treatment is fecal microbiota transplantation from a donor. Nowadays, fecal microbiota transplantation is included in national clinical guidelines in several countries in Europe, the USA and Australia. In Russia this method has not been registered, however, there are some publications about its successful application in gastrointestinal diseases, oncohematology, and some autoimmune diseases. Aim . To show the result of successful treatment of severe pseudomembranous colitis after a single fecal microbiota transplantation. Material and methods . Outpatient treatment of an acute respiratory infection with a broad-spectrum antibacterial drug caused the development of severe pseudomembranous colitis in a young patient. Standard courses of metronidazole and vancomycin were unsuccessful. Transplantation of fecal microbiota from a donor was performed via ileocolonoscopy. Results. A single fecal microbiota transplantation contributed to the patient’s complete recovery, short term rehabilitation and the absence of recurrence of Clostridiodes difficile within two years. Conclusions. Evidence-based medicine has shown the high efficiency of fecal microbiota transplantation. In Russia a legislative basis is needed for including fecal microbiota transplantation in clinical guidelines for the treatment of severe Clostridiodes difficile resistant to standard therapy .

Dimensions of Craving Interact with COMT Genotype to Predict Relapse in Individuals with Alcohol Use Disorder Six Months after Treatment.

(1) Background: Alcohol use disorder (AUD) is associated with poor medical, psychological, and psychosocial outcomes and approximately 60% of individuals with AUD relapse six months after treatment. Craving is a core aspect of AUD and associated with high risk of relapse. One promising avenue to improve outcomes may be in understanding the relationship between COMT genotype, craving, and treatment outcomes. (2) Methods: To this end, we assessed craving, recent drinking history, and impulsivity in 70 individuals with AUD undergoing a standard course of treatment at a regional Veteran Affairs (VA) medical center. Saliva samples were collected to determine COMT genotype. In this prospective observational study, participants were followed for six months to determine who went on to relapse after treatment. (3) Results: Results revealed a significant interaction between craving and catechol-O-methyltransferse (COMT) genotype in predicting relapse. Post hoc exploratory analyses indicated that Met/Met homozygotes reported the highest levels of craving, and craving was associated with recent drinking history. Among Val/Val homozygotes, who had higher rates of relapse, craving was associated with impulsivity. (4) Conclusions: These associations highlight that specific profiles of psychological and biological factors may be important in understanding which individuals are at highest risk of relapse following treatment. Future studies that build on these findings are warranted.

Across the disciplines: our gained knowledge in assessing a first-year integrated experience

This study discusses a writing assessment for State University’s first year integrated experience of Technology 120: Design Thinking in Technology and English 106: First-Year Writing and the implications it provides for curriculum design. The study used Adaptive Comparative Judgment to determine whether integrated research essays that utilized design thinking were more rhetorically effective (i.e., better attuned to addressing a purpose, audience, and context) than non-integrated English composition research essays. Results showed the non-integrated research essays had a statistically significant better rating than the integrated courses; this finding was counterintuitive to our expectations, therefore we utilized NVivo to conduct a word frequency analysis on judges’ holistic comments to determine strengths and weaknesses of the essays. The word frequency analysis demonstrated writing concepts were much stronger and more effective in a standard composition course. These findings led to the development of three literature-based curriculum and pedagogical changes to ensure that integrated students achieve general education writing outcomes in concert with design thinking principles—something our results showed as lacking significantly in these courses.

Practical Emergency Ultrasound Flashcards with Augmented Reality in Teaching Point-of-Care Ultrasound in ER

BACKGROUND: The use of point-of-care ultrasound (POCUS) has recently proposed the integration of ultrasound into undergraduate medical education. However, the evidence of learning tool for this integration has not been well studied.&#x0D; AIM: The aim of this study was to compare the levels of knowledge improvement of the 6th year medical students before and after receiving the POCUS training in two ways: By employing the traditional methods and by utilizing the new learning tool.&#x0D; METHODS: The practical ultrasound flashcards were developed by a Thai physician. In the study, the 6th year medical students were enrolled and randomized to become members of either the flashcard group or the control group. Participants in both groups attended a 4-week ultrasound training course. Before and after the training course, all students were evaluated using the multiple-choice questions. In addition, the subjects’ attitudes and perceptions about the flashcards were evaluated using a questionnaire.&#x0D; RESULTS: A total of 46 students participated in this study and were randomly assigned to either the flashcard group (n = 23) or the control group (n = 23). It was discovered that the students in the flashcard group had performed better on the POCUS knowledge post-test than those in the control group had. Most students had been satisfied with the flashcards (mean 5 Likert scores = 4.48). However, the students had rated their confidence score to perform POCUS at 3.96 out of 5.0.&#x0D; CONCLUSIONS: Medical students who used the ultrasound flashcards to learn POCUS had resulted in better knowledge scores rather than the others who attended the standard ultrasound training course only. However, it was not possible to evaluate the practical skills and the clinical decision-making processes in this study.

Therapeutic effects of mirror therapy in patients after stroke

To evaluate the effect of mirror therapy on the regression of motor disorders in the paretic arm, functional and psychological disorders, the patient's functioning and quality of life, risk factors for recurrent stroke in the early recovery period of stroke. We examined 219 patients after stroke, including 154 patients after ischemic stroke (IS) and 65 patients after hemorrhagic stroke (HS) in the early recovery period (21 days to 6 months). All patients received a standard medical rehabilitation course including medications, physical rehabilitation, and physiotherapeutic treatment. Patients were divided into four groups depending on the stroke type and the medical rehabilitation course received: two study treatment groups (post-IS and post-HS groups), which consisted of patients receiving the standard medical rehabilitation course and mirror therapy, and two comparison groups (post-IS and post-HS), in which patients received only the standard medical rehabilitation course. All patients before and after the medical rehabilitation course were evaluated for neurological disorders (NIHSS, Ashworth scale of muscle spasticity, Medical Research Council (MRC) Scale and handgrip test), functional limitations (Frenchay Arm Test, Hauser Ambulation Index, Rivermead Mobility Index, Functional Independence Measure (FIM), ICF), mental status («Visual Memory» and «10 Word Memory» methods, Schulte-Platonoff tables, Lüscher color test, Hospital Anxiety and Depression Scale (HADS), Locus of Control Recovery Questionnaire), quality of life (EQ-5D), arterial hypertension (Arterial Hypertension in Adults. Clinical Guidelines, 2020). Addition of the mirror therapy to the standard course provided additional therapeutic effects: in patients with IS, the high tone of the paretic muscles of the arm significantly decreased (by 46%); the target blood pressure was achieved in 96% of patients; severe disorders of functional independence and depression regressed; significant changes of mental functions parameters (visual memory, shifting attention); improvement of activity and participation parameters (carrying in the hands, self-care, housekeeping). In patients with HS, the muscle strength of the paretic arm significantly increased (by 35%); the target blood pressure was achieved in all patients; improvement of mental functions (motivation, shifting attention, visual memory), activity and participation parameters (objects moving and manipulation, self-care), and decreased level of depression were observed. The addition of mirror therapy to the standard of care for patients after stroke resulted in regression of neurological deficit, motor disorders in the paretic arm, improvement of emotions and motivation, mitigation of recurrent stroke risk factors, as well as significant impact on the cognitive functions and enhancement of patients' capabilities of self-care.

Evaluating an International Facial Trauma Course for Surgeons: Did We Make a Difference?

Study Design: Retrospective data analysis study. Objective: Attending continuing professional development (CPD) and continuing medical education (CME) activities is a necessity for practicing surgeons in most parts of the world. To enhance best practices in conducting CME/CPD, objective evaluation of these events is crucial. This article aims to evaluate one such international standardized CPD course conducted for facial surgeons across the globe. The Management of Facial Trauma course was developed by an international planning committee of experienced surgeons and has been implemented in all regions of the world. Method: This 2-day course is delivered using a combination of short lectures, small group discussions, and practical hands-on activities. Data collected from pre- and post-course evaluations of 86 Management of Facial Trauma courses conducted worldwide from 2017-2019 were collated and analyzed. Results: Participant demographics and experience levels varied slightly across the regions. Evaluation of the course effectiveness revealed overall high ratings for educational impact, content usefulness, and faculty performance. Conclusion: Our results indicated that this standardized course met the audience needs and enabled participants to plan changes in clinical practice. In addition, it confirmed that the course was relevant across different specialties and across different cultures and countries.