Team Training Research Articles

Improving lung point-of-care ultrasound (POCUS) training and accreditation - a multidisciplinary, multi-centre and multi-pronged approach to development and delivery using the action learning process

BackgroundPoint-of-Care Ultrasound (POCUS) consists of a range of increasingly important imaging modalities across a variety of specialties. Despite a variety of accreditation pathways available in the UK, lung POCUS training remains difficult to deliver and accreditation rates remain suboptimal. We describe a multidisciplinary, multi-centre, and multi-pronged approach to lung POCUS education within a region.MethodsA survey was conducted in a region. From these results, bottlenecks were identified for improvement. We utilised key stages in an established accreditation pathway, and the Action Learning process. Analysing participant feedback, consensus amongst the team, regional educational needs, and leveraging the expertise within the faculty, we implemented several solutions which were multidisciplinary, multi-centre, and multi-pronged. We also set up a database across several accreditation pathways to facilitate supervision and assessment of rotational trainees.ResultsUtilising the Action Learning process, we implemented several improvements at elements of the lung ultrasound accreditation pathways. An initial regional survey identified key barriers to accreditation: lack of courses (52%), lack of mentors (93%), and difficulty arranging directly supervised scans (73%). A multidisciplinary team of trainers was assembled. Regular courses were organised and altered based on feedback and anecdotal educational needs within the region. Courses were set up to also facilitate continuing professional development and exchange of knowledge and ideas amongst trainers. The barrier of supervision was removed through the organisation of regular supervision sessions, facilitating up to fifty scans per half day per trainer. We collected feedback from courses and optimised them. Remote mentoring platforms were utilised to encourage asynchronous supervision. A database of trainers was collated to facilitate triggered assessments. These approaches promoted a conducive environment and a commitment to learning. Repeat survey results support this.ConclusionLung ultrasound accreditation remains a complex educational training pathway. Utilising an education framework, recruiting a multidisciplinary team, ensuring a multi-pronged approach, and fostering a commitment to learning can improve accreditation success.

Ambulance professionals' experiences of teamwork in the context of a team training programme – a qualitative study

BackgroundTeamwork in the context of ambulance services exhibits unique characteristics, as this environment involves a small core team that must adapt to a dynamic team structure that involves health care professionals and emergency services. It is essential to acquire a deeper understanding of how ambulance teams operate. Therefore, this study aimed to explore the experiences of ambulance professionals with teamwork and how they were influenced by the implementation of a team training programme.MethodsA qualitative descriptive study was conducted involving ambulance professionals who took part in focus group interviews carried out both before and after the implementation of a team training program across seven ambulance stations within a Norwegian hospital trust. The data were analysed using reflexive thematic analysis based on a deductive-inductive approach.ResultsOur analysis revealed 15 subthemes that characterised ambulance professionals’ experiences with teamwork and a team training programme, which were organised according to the five main themes of team structure, communication, leadership, situation monitoring, and mutual support. Ambulance professionals’ experiences ranged from the significance of team composition and interpersonal and professional relationships to their preferences regarding different communication styles and the necessity of team leaders within the ambulance service. The team training programme raised awareness of teamwork, while the adoption of teamwork tools was influenced by both individual and contextual factors. The Introduction/Identity, Situation, Background, Assessment and Recommendation (ISBAR) communication tool was identified as the most beneficial aspect of the programme due to its ease of use, which led to improvements in the structure and quality of consultations and information handover.ConclusionsThis study documented the diverse characteristics and preferences associated with teamwork among ambulance professionals, emphasising the particular importance of proficient partnerships in this context. Participation in a team training programme was perceived as a valuable reminder of the significance of teamwork, thus providing a foundation for the enhancement of communication skills.Trial registrationClinicalTrials.gov—ID: NCT05244928.

Develop a Model of Perfectionism for Abnormal Personality Traits

Introduction: Perfectionism is a psychological issue that psychologists have studied extensively. Research shows that perfectionism can either enhance or hinder performance. Aim: The purpose of this research was to develop a model of perfectionism for abnormal personality traits. Method: This study utilized a mixed exploratory approach, combining qualitative and quantitative methods. The qualitative phase involved 20 university experts knowledgeable about perfectionism in sports, with the sample size reaching theoretical saturation. The quantitative phase included 232 players from the national team's training camps, selected through convenience sampling. Using the onion research method, a model of perfectionism for abnormal personality traits in national team players was developed based on interviews and expert input. A 10-component questionnaire was created from this model. Structural equation modeling and Smart PLS software were used to test relationships within the model. Results: The research yielded a model of perfectionism for abnormal personality traits in national team players, consisting of components such as negativity, expectations of others, coach criticism, self-control, individual standards, positivism, striving for excellence, fear of failure, and performance doubts. Conclusion: The results suggest that perfectionism significantly influences players' attitudes and behaviors, particularly in relation to abnormal personality traits.

Feasibility of Holographic Team Training Simulation: An Information Technology (IT) Perspective for Healthcare and Educational Institutions.

Introduction This study examines the feasibility and practicality of holographic display technology (HDT) in health professions educationfrom an information technology (IT) support staff perspective. Considering a lack of feasibility studies for introducing newer technologies, it focuses on feasibility's acceptance and practicality dimensions during a simulation-based team training workshop. Method A multimethod design feasibility study assessed the acceptability and practicality of HDT for the IT staff through a Unified Theory of Acceptance and Use of Technology (UTAUT)-based survey and a focus group discussion after a team training simulation workshop. Results Quantitative results showed a reliability coefficient (α=0.83) and a positive correlation between facilitating conditions (FC) and effort expectancy (EE), self-efficacy (SE) and social influence (SI), SI and attitude toward technology (AT), SE and attitude to use, and behavioral intention (BI) and EE. Negative correlations included SE and performance expectancy (PE), comfort with technology and FC, comfort and anxiety, and attitude to use and experience. Qualitative findings yielded four key themes from the focus group discussions that corroborated the quantitative findings. Discussion The study findings highlight the promising potential for HDT feasibility in educational settings. Future research should extend to diverse contexts to validate these preliminary findings and explore broader educational applications.

To play or not to play, that is the question: an interview study with amateur football coaches on perceptions of pain during sports participation

Amateur football coaches play a key role in preventing, assessing and treating pain among their players, as they are often the first point of contact and may be the main...

A survey on the knowledges, attitudes, behaviours and practices of goat farmers about peste des petits ruminants disease in goats at Haor and bordered areas in Sylhet district of Bangladesh.

Contagious and economically devastating, peste des petits ruminants (PPR) is a viral disease affecting goats and sheep, causing significant losses in livestock productivity and posing a threat to food security and rural livelihoods worldwide. This study was conducted to assess the status of goat farmer's knowledge, attitude and practice (KAP) about PPR disease at Sylhet district of Bangladesh. A comprehensive cross-sectional survey, conducted over 11 weeks, targeted 130 goat owners. Following a pilot study with 20 farmers, a set of 17 validated questions on PPR KAP was validated. Data collection was performed through face-to-face interviews by a trained team using KOBO Toolbox, with interpretation of responses based on established thresholds for knowledge (>65%), attitude (>75%) and practice (>70%). Overall, 67.7% of participants demonstrated a good level of knowledge about PPR disease. Males exhibited 1.42 times higher odds of knowledge compared to females (odds ratio=1.42). The middle age group (31-45 years) showed significantly higher knowledge levels (83.3%, p<0.001). Within this age group, positive practice levels were also notably higher (54.8%). Those with a higher secondary education background exhibited the most positive practice levels (>80%). Participants whose additional income came from non-governmental organization employment showed a higher positive practice level (71.4%), 1.46 times higher than other income sources. Strategic interventions should prioritize female farmers, educational empowerment and collaboration with non-governmental organizations to bolster livestock health and rural livelihoods in Bangladesh as part of national PPR control strategy to fulfil the goals of Office International des Epizooties/World Organization for Animal Health (OIE/WOAH) and Food and Agriculture Organization (FAO) PPR eradication by 2030.

The implementation of the elective subject "Public Health" in the final year for medical students at Göttingen University Medical Center: results of the UNITE project

International and national frameworks and initiatives call for strengthening the training of health professionals in the public health service (PHS) through cooperation with universities. The German Medical Licensing Regulations of 21st Sep 2021 provides for an integration of PHS into undergraduate medical training in the final year since 1st May 2022. The present study presents the procedure and results of the final year elective Public Health (PH) implementation for medical students at the University Medical Center Göttingen (UMG) in cooperation with the local PHS. In the twelve-month project UNITE (07/21-06/22), the final year elective PH was implemented in seven steps: analysis of the framework conditions, conception of the elective, preparation of a logbook, pilot phase with five students in one-week rotations, public relations for students, introduction of a medical didactic training for staff of the health department and implementation of the elective PHS with students. A cooperation agreement between UMG and the Health Department regulates the training of medical students. Students complete four-week rotations in the areas of public health service and funeral services, paediatric and adolescent medical service, infection control and social psychiatric service. The logbook for students contains learning objectives for individuals specialised in services for self-assessment of the acquired competences. The didactics training was implemented with high learning success of the participating staff. So far three final year students have successfully completed the elective. The implementation of final year elective PHS strengthens the anchoring of public health topics in the education of medical students in Göttingen and makes PHS more visible as a professional perspective. Essential for the successful implementation were the establishment of a continuous cooperation between the university and the health department, student-oriented teaching-learning concept with a logbook suitable for the location, a trained multiprofessional team in the health department, and the evaluation of the elective for quality assurance and further development of the training. The concept presented here can help other locations in establishing the final year elective in PH and can be adapted to specific local conditions.

"Something we must be proud of": An interview and document study of team improvisation in the Dutch convalescent plasma project group.

The COVID-19 pandemic has revealed the importance of organizational resilience, the ability to effectively respond to a disruptive event before, during, and after it occurs. Team improvisation is an important component of organizational resilience as it describes characteristics of team skills and contextual qualities to create order from chaos. In Spring 2020, the Dutch national blood bank, began the convalescent plasma project (CCP). We aimed to study which elements of team improvisation in the CCP group were found and how lessons learned can contribute towards a non-crisis situation for blood establishments. Using Vera and Crossan's framework of improvisation, semi-structured interviews with eight members of the CCP group were conducted. This was simultaneous to performing a document analysis of 21 Intranet posts and seven internal reports. MAXDA 2020 was used to conduct deductive and inductive thematic analyses. The CCP group showed strong characteristics of expertise and memory, teamwork quality, experimental culture, and real-time information and communication that enabled them to improvise in all aspects of the donation process. Improvisation examples included comprehensive communication methods to identify and obtain new donors, asking additional intake questions and collecting additional aliquots to store while waiting for an internal antibody test to be developed, and regulatory respondents allowing a flexible change control procedure to meet the pace of the crisis. Training was evident to a lesser degree. While improvisation impacted set routines and procedures, the safety and quality of the product were not affected. Regarding organizational resilience, our results showed that the CCP group "coped" well using elements of team improvisation. Blood establishments may consider introducing improvisational training and innovation teams throughout the organization for future preparedness and improving organizational resilience.

Design and Effect of Neurosurgical Educational Software Using Gamification on Students' Learning and Motivation.

Gamification is an innovative learning approach that, when combined with technology, aligns well with students' preferences. Recognizing the necessity of employing effective educational methods in surgical team training, this study aims to examine the impact of gamification-based educational software on students' learning and motivation in the surgical technology field. This study was conducted as a quasi-experimental single-group pre-and post-test design in Iran in 2023. The study sample comprised 40 undergraduate students majoring in surgical technology, selected through a census method. The educational software is designed according to the nine principles of the model of Karl Kapp and Sharon Buller, using the mechanics, dynamics and aesthetics (MDA) framework. After implementation, the software's impact on students' learning and motivation was assessed. The students' learning levels before and after using the educational software were evaluated using a multiple-choice test. To measure students' motivation, a researcher-developed questionnaire was utilized. The Shapiro-Wilk test was used to check the normality of the distribution of the studied variables. Through SPSS version 26, descriptive statistics such as frequency, percentage, mean, and standard deviation were analyzed along with inferential statistics, including paired t-tests. Among the participants, 55% were female, and the sample had a mean age of 22.30±0.99 years. A significant difference was observed between the mean learning scores before and after using the educational software (10.43±4.38 vs. 21±4.11, p < 0.001). The motivation level of the students showed a significant increase. Based on the results of this study, gamification-based software has led to improved learning and increased motivation among students in surgical technology.

A Return-to-Performance Pathway for Professional Soccer: A Criteria-based Approach to Return Injured Professional Players Back to Performance

BACKGROUND: Injuries in football (soccer) have a huge financial and performance impact. Teams with fewer injuries and higher player availability have been shown to finish higher in the league than teams with reduced availability and higher injury rates. CLINICAL QUESTION: Given the economic and competitive implications of injury, how can high-performance practitioners guide players’ return to performance (RTPerf)? KEY RESULTS: We share a rehabilitation framework with clear progressions and objective criteria to guide decision making at each phase. Upon completing acute management, normal movement patterns are restored, along with strength, endurance, power, and injury-specific function. Objective profiling helps to determine readiness to return to running (RTRunning). Once running, players are reintroduced to on-field sports-specific actions. Players progress through 6 phases, starting with a reloading phase (Grass Phase 1), moving on to more intensive actions (Grass Phase 2), maximum speed and positional drills (Grass Phase 3), and a progressive team training period (Grass Phase 4) before returning to play (RTPlay) (Grass Phase 5). Upon reaching previous injury metrics or higher, with no restrictions on match exposure, the player has returned to performance (Grass Phase 6). CLINICAL APPLICATION: An 11-phase RTPerf pathway includes examples for practitioners of objective criteria for each phase. The pathway can be adapted for different injury scenarios. JOSPT Open 2024;2(3):166-178. Epub 24 May 2024. doi:10.2519/josptopen.2024.1240

Coverage Evaluation of Mass Drug Administration for Lymphatic Filariasis in Mahoba District of Uttar Pradesh

Background Lymphatic filariasis is a neglected tropical disease. In this disease patient has face hydroceale and lymphedema in leg. 863 million people had risk of lymphatic filariasis in 2020 who were belongs to 50 countries. The present study aimed to assess coverage and compliance of mass drug administration for lymphatic filariasis.MethodsFrom 300 households (1660 individuals) in rural area was covered in coverage evaluation survey by systematic selection of subunits using PPS. Data collected by trained team and data were collected using predesigned questionnaire. MS – Excel spreadsheet used for data compilation.ResultsOverall, estimated 37.8% drugs were swallowed in rural area of District Mahoba. 3.7% person in study population experienced adverse drug effect. In rural area, albendazole was swallowed more by females as compared to males but reverse in case of DEC. The most common reason for both albendazole and DEC not swallowed as reported by study population was not sick.Conclusions For filariasis elimination, need to increase coverage and also increase compliance for take drug. Coverage and compliance increase by perform information education and communication activities perform with different platform.

A method of using modern endpoint detection and response (EDR) systems to protect against complex attacks

The subject of the research in this article is the architecture of Endpoint Detection and Response and the EDR agent as their base parts in terms of mechanisms for detecting and countering complex attacks on information and communication systems (ICS). The aim of the work is to develop of method for improving the efficiency of using Endpoint Detection and Response (EDR) to reduce the risks of compromising ICS information, industrial, and infrastructure objects by effectively redistributing and utilizing the available EDR mechanisms, the cybersecurity team, and other resources available for implementing security measures in an enterprise, institution, or organization. The article addresses the following tasks: reviewing and analyzing existing EDR systems, analyzing the architecture of EDR solutions and EDR agents, the features of their use, the logic behind the construction of methods and mechanisms for detecting threats to the system from malicious actors and malicious code. The task of providing recommendations for the organization of ICS is also separately addressed in terms of the need to protect the entire ICS and its individual elements, as well as in terms of the available resources (the cybersecurity team, their qualifications and level of awareness of the architecture of EDR solutions) and means (available EDR system elements) for organizing protection. The following methods are used: modeling attack mechanisms, modeling attacker behavior. The following results were obtained: general and specific recommendations were formulated for optimizing the operation of EDR systems and ensuring the effective use of EDR system elements in the information and communication networks of enterprises, organizations, and institutions of various types and orientations depending on the available resources and the information requiring protection. Conclusions: The identified recommendations for the application of EDR mechanisms for protecting information systems and networks allow optimizing the costs of creating a protection infrastructure and implementing security measures, taking into account the characteristics of the available tools and the training and awareness of the cybersecurity team both in terms of response time to threats and the complexity and cost of performing protection tasks.

Design error: Its effects on building projects delivery period

Within the construction industry, design errors are an inevitable occurrence stemming from misapplied or inaccessible information. This study assessed the effects of design error on building projects delivery period. To achieve this goal, the study scrutinized literature from various authors and gathered primary data through a structured questionnaire. Out of the ninety-three questionnaires distributed among contractors, skilled labours, unskilled labours and industry professionals, eighty were returned, coded, and analyzed using descriptive statistics, percentiles, and mean item scores. The study concludes that design errors greatly extend construction timelines, disrupt workflows, cause procurement delays, hinder commissioning and testing, and adversely affect the execution of future projects. These disruptions result in higher costs and reduce the overall quality and efficiency of construction activities, emphasizing the crucial need for better design accuracy and management within the construction industry. The study recommends enhancing design review processes, leveraging collaborative project management tools, establishing clear change management protocols, strengthening supplier relationships, implementing rigorous quality assurance measures, and prioritizing team training. These actions are proposed to mitigate the impact of design errors on construction projects, aiming to reduce delays, enhance communication, and improve overall project efficiency.

Regional anaesthesia for district hospitals and clinics.

Pain is a common reason that patients seek care in the emergency department (ED). Regional anaesthesia in the form of nerve blocks provides an excellent alternative to traditional forms of analgesia, and may be superior in managing musculoskeletal pain compared to opioids. Adequate pain management improves patient satisfaction, facilitates examination and minor procedures, and allows for earlier and safe discharge. In low resource settings this modality is underutilised due to lack of trained providers and/or support from specialised services, shortages of equipment, and lack of context-sensitive guidelines. Advances in ultrasound guided regional anaesthesia has the potential to improve access to safe and reliable anaesthesia. It is often not accessible or an active part of training even for emergency physicians. There are, however, a number of nerve blocks that are easy to learn, don't require specialised equipment, and can be readily applied in EDs for minor procedures and longer acting forms of analgesia. Nerve blocks more applicable in the operating theatre or best done under ultrasound guidance are mentioned but not discussed in this article. This continuous professional development (CPD) article aims to provide guidance with respect to several key areas related to more commonly used types of regional anaesthesia in district level services. We discuss the importance of good clinical practice including thorough preparation of equipment and the patient to avoid common complications, clinical indications for regional blocks in the ED, local anaesthetic agents, different techniques for some common regional blocks, potential complications, and the need for a trained interprofessional team.

Decreasing incidence of admission neonatal hypothermia in Gandhi Memorial Hospital, Addis Ababa, Ethiopia: quality improvement project

BackgroundWHO reported that neonatal hypothermia accounts for about 27% of newborn deaths worldwide. It is a serious concern in Ethiopia and other parts of sub-Saharan Africa; it poses a serious...

Increasing Gender Integration inU.S. Marine Corps Recruit Training: Policy Recommendations andRationales From an Interdisciplinary Study.

This article describes alternate models and policy recommendations created by an interdisciplinary team of researchers to increase gender integration at U.S. Marine Corps (USMC) recruit training. The USMC requested a study to analyze current approaches to gender integration at recruit training and provide alternate models that maximize integration, while continuing to train marines to established standards. USMC remains the only service that segregates recruits by gender at the lowest unit level (e.g., platoon) in recruit training and maintains gender-segregated drill instructor teams (i.e., same-gender teams train platoons of same-gender recruits). A mixed-method, interdisciplinary approach was used to capture multiple perspectives and informed recommendations and alternate models for gender integration. The team studied select USMC, army, navy, air force, and coast guard recruit training locations, between June and November 2021. At each site, the team collected qualitative, quantitative, and administrative data as well as physical performance metrics and human performance outcomes. Study participants included recruits, drill instructors, training cadre, service leaders, and subject matter experts on gender integration in military services. Each alternate model was designed to maximize the feasibility of implementation within current USMC training conditions. The research team developed three alternate models and several policy recommendations. Alternate model 1 proposed a methodology for mixed-gender drill instructor teams within the Integrated Company model, USMC's current integrated training model. Alternate model 2 proposed an Integrated Company Plus model which increases the number and types of gender-integrated training events at or below the platoon level within the Integrated Company model. Alternate model 3 outlined an integrated platoon model where recruits fall out into integrated training platoons after their morning routine, with two options of varying integration based on USMC priorities for integration. The team also proposed a set of policy recommendations independent of the three alternate models to support current and future gender integration efforts at the Marine Corps Recruit Depots. Gender-integrated military training has been shown to positively alter perceptions and evaluations of women in military settings over detrimental aspects developed by gender-segregated training. The study team recommended USMC train recruits in the Integrated Company model with mixed-gender drill instructor teams (alternate model 1) and integrate more training events following the priority tiers outlined in the Integrated Company plus model (alternate model 2). The combined execution of these two alternate models would provide USMC recruits increased exposure to direct, sustained training from opposite-gender drill instructors and deliver intentional training opportunities for male and female recruits to work together and interact in meaningful ways. The integrated platoon model (alternate model 3) would offer USMC recruits the most direct exposure to training and working with members of the opposite gender, but it requires substantial changes to current logistics, accountability, and training procedures.

Congenital anomalies in Santa Catarina, Southern Brazil: macroregional and temporal birth prevalence for the period 2011-2020.

Congenital anomalies (CAs) are an important cause of infant mortality and efficient surveillance is necessary for their prevention. Therefore, the objective of this study is to establish baselines of prevalence at birth of priority CAs for surveillance in the state of Santa Catarina, using data from the Live Birth Information System considering the period 2011-2019 (baseline) and 2020 (pandemic year). The analyses were carried out based on the mother's residence health macroregion. The CAs were selected following the ICD-10 coding for chapter XVII. Birth prevalence was calculated per 10,000 live births and the confidence interval was established at 95%. 2011-2019 recorded 88.8/10,000 births with CAs (total). For 2011-2019, limb defects (without polydactyly) were the most prevalent (14.1/10,000), followed by congenital heart defects (8.9), oral clefts (8.2), polydactyly (7.9), Down syndrome (5.6), hypospadias (5.4), neural tube defects (4.7), gastroschisis (3.3), undefined sex (1.2), microcephaly (0.8) and omphalocele (0.3). There were no significant differences in temporal and spatial distribution. However, unusual fluctuations were observed in 2020, which may reflect the pandemic in CAs notifications. In the base period, Santa Catarina recorded CAs below the expected level of being identified at birth. With this, we conclude that the training and awareness of teams are essential for the surveillance of CAs in Santa Catarina.

Problem-Based Learning for Interprofessional Education: A Review of the Concept and Its Application in a Geriatric Team.

The global population is aging, with those aged 65 years or over increasing in number and accounting for a growing share of the population. There are increasing demands for geriatric care which makes the development and delivery of effective geriatric team training a priority. Training in geriatrics is complex because of the multiplicity of medical, psychosocial, and functional issues in elderly individuals which need to be addressed by a multidisciplinary approach using interprofessional education (IPE). Problem-based learning, a student-centered educational model that brings several natural strengths to IPE, is a unique curriculum replacing the traditional lecture-based learning model. This model enhances physician competency after graduation, mainly in psychosocial and teamwork issues that are fundamentally essential for geriatrics. IPE has been shown to have a substantial positive impact on team collaboration, individual development, and healthcare improvement. In this paper, we summarize the current findings from recent studies on training professionals from different healthcare disciplines to deliver care for the elderly in collaborative practice. We also discuss if an interprofessional problem-based geriatric team program in geriatrics is a promising solution to enhance professional collaboration and quality of patient care.

Utilization of Digital Technology in Marketing Education Services at Kusuma Bangsa High School Palembang

This research discusses the utilization of digital technology in the context of marketing educational services at Kusuma Bangsa High School Palembang. This research is a type of qualitative research with descriptive characteristics that explores various qualitative aspects in understanding marketing strategies involving digital technology. In this study, data were obtained through interviews, observations, and documentation from various parties, including the principal, vice principal for student affairs, multimedia experts, and other resource persons who have related information. Data analysis was conducted through data reduction, data presentation, and data verification. To ensure data validity, the research used data triangulation, which includes triangulation of sources, methods and techniques. The results showed that the utilization of digital technology is an important key to the existence of educational institutions in the digital era. Kusuma Bangsa High School Palembang implements an education services marketing strategy through various digital platforms, with content curation and public relations team training. The utilization of digital technology in marketing education services at Kusuma Bangsa High School Palembang has succeeded in maintaining its existence and attracting public interest. This research provides in-depth information about the importance of digital technology in marketing education services and how educational institutions can utilize it effectively. The implications of this research are expected to be useful for other educational institutions that want to improve marketing efforts through digital technology.

LMIC-24. ASSESSING THE TREATMENT OUTCOMES OF PEDIATRIC PATIENTS WITH MEDULLOBLASTOMA UNDER A U.S.-MEXICO CROSS-BORDER NEURO-ONCOLOGY PROGRAM

Abstract BACKGROUND Treating pediatric brain tumors in low-income countries is associated with worse outcomes, likely due to requiring a highly trained interdisciplinary team with ample resources. The Cross-Border Neuro-Oncology Program (CBNP) between Rady Children’s Hospital, San Diego (RCHSD), and Hospital General, Tijuana (HGT), was established to provide comprehensive care for children with brain tumors diagnosed at HGT. Given the most common malignant pediatric brain tumor is medulloblastoma, assessing treatment outcomes for this tumor is essential to establish this program’s validity. METHODS Pediatric patients with medulloblastoma were recruited from 2012-2021 as part of CBNP and risk-stratified into one of two treatment protocols (low - (K) versus high-risk (Y)). Patients underwent surgical resection and chemotherapy, which included cisplatin, etoposide, vincristine, and cyclophosphamide; patients with higher risk additionally received radiation therapy and higher-dose chemotherapy. Clinicopathologic profiles, extent of resection, methylation status and protocol type were analyzed and compared to known prognostic values for pediatric medulloblastoma. RESULTS Seventeen patients with medulloblastoma (age at diagnosis=6.8±5.0 years) were treated as part of CBNP during the study period. Patients were admitted to HGT, underwent resection at RCHSD, and returned to HGT for collaborative management. The mean symptom duration preceding diagnosis was 72.1±99.2 days. Gross total resection was achieved in 53% of cases and 5-year overall survival was 53% (9/17). Eight (47%) patients had residual post-treatment cerebellar signs. Survival data correlated with protocol type and methylation status will be presented. CONCLUSION Our cohort demonstrated a 5-year overall survival of 53%, moderately lower than the reported average 5-year overall survival of ~70% for pediatric medulloblastoma, with the majority of our cohort comprising of higher risk subtype and pathology. This indicates that this twinning model is a valid archetype for treating pediatric patients with brain tumors in low-income countries.