Clinical Procedures

2022 ◽  
pp. 142-184
Author(s):  
Annette M. McCoy ◽  
Erica McKenzie ◽  
Sue Loly
Keyword(s):  
Author(s):  
José G. Centeno

Abstract The steady increase in linguistic and cultural diversity in the country, including the number of bilingual speakers, has been predicted to continue. Minorities are expected to be the majority by 2042. Strokes, the third leading cause of death and the leading cause of long-term disability in the U.S., are quite prevalent in racial and ethnic minorities, so population estimates underscore the imperative need to develop valid clinical procedures to serve the predicted increase in linguistically and culturally diverse bilingual adults with aphasia in post-stroke rehabilitation. Bilingualism is a complex phenomenon that interconnects culture, cognition, and language; thus, as aphasia is a social phenomenon, treatment of bilingual aphasic persons would benefit from conceptual frameworks that exploit the culture-cognition-language interaction in ways that maximize both linguistic and communicative improvement leading to social re-adaptation. This paper discusses a multidisciplinary evidence-based approach to develop ecologically-valid treatment strategies for bilingual aphasic individuals. Content aims to spark practitioners' interest to explore conceptually broad intervention strategies beyond strictly linguistic domains that would facilitate linguistic gains, communicative interactions, and social functioning. This paper largely emphasizes Spanish-English individuals in the United States. Practitioners, however, are advised to adapt the proposed principles to the unique backgrounds of other bilingual aphasic clients.


Author(s):  
Fabio A. Casari ◽  
Nassir Navab ◽  
Laura A. Hruby ◽  
Philipp Kriechling ◽  
Ricardo Nakamura ◽  
...  

Abstract Purpose of Review Augmented reality (AR) is becoming increasingly popular in modern-day medicine. Computer-driven tools are progressively integrated into clinical and surgical procedures. The purpose of this review was to provide a comprehensive overview of the current technology and its challenges based on recent literature mainly focusing on clinical, cadaver, and innovative sawbone studies in the field of orthopedic surgery. The most relevant literature was selected according to clinical and innovational relevance and is summarized. Recent Findings Augmented reality applications in orthopedic surgery are increasingly reported. In this review, we summarize basic principles of AR including data preparation, visualization, and registration/tracking and present recently published clinical applications in the area of spine, osteotomies, arthroplasty, trauma, and orthopedic oncology. Higher accuracy in surgical execution, reduction of radiation exposure, and decreased surgery time are major findings presented in the literature. Summary In light of the tremendous progress of technological developments in modern-day medicine and emerging numbers of research groups working on the implementation of AR in routine clinical procedures, we expect the AR technology soon to be implemented as standard devices in orthopedic surgery.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuji Nishizaki ◽  
Keigo Nozawa ◽  
Tomohiro Shinozaki ◽  
Taro Shimizu ◽  
Tomoya Okubo ◽  
...  

Abstract Background The general medicine in-training examination (GM-ITE) is designed to objectively evaluate the postgraduate clinical competencies (PGY) 1 and 2 residents in Japan. Although the total GM-ITE scores tended to be lower in PGY-1 and PGY-2 residents in university hospitals than those in community-based hospitals, the most divergent areas of essential clinical competencies have not yet been revealed. Methods We conducted a nationwide, multicenter, cross-sectional study in Japan, using the GM-ITE to compare university and community-based hospitals in the four areas of basic clinical knowledge“. Specifically, “medical interview and professionalism,” “symptomatology and clinical reasoning,” “physical examination and clinical procedures,” and “disease knowledge” were assessed. Results We found no significant difference in “medical interview and professionalism” scores between the community-based and university hospital residents. However, significant differences were found in the remaining three areas. A 1.28-point difference (95% confidence interval: 0.96–1.59) in “physical examination and clinical procedures” in PGY-1 residents was found; this area alone accounts for approximately half of the difference in total score. Conclusions The standardization of junior residency programs and the general clinical education programs in Japan should be promoted and will improve the overall training that our residents receive. This is especially needed in categories where university hospitals have low scores, such as “physical examination and clinical procedures.”


Author(s):  
Rune Dall Jensen ◽  
Charlotte Paltved ◽  
Claudia Jaensch ◽  
Jesper Durup ◽  
Randi Beier-Holgersen ◽  
...  

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Manuela Filippa ◽  
Maria Grazia Monaci ◽  
Carmen Spagnuolo ◽  
Paolo Serravalle ◽  
Roberta Daniele ◽  
...  

AbstractPreterm infants undergo early separation from parents and are exposed to frequent painful clinical procedures, with resultant short- and long-term effects on their neurodevelopment. We aimed to establish whether the mother’s voice could provide an effective and safe analgesia for preterm infants and whether endogenous oxytocin (OXT) could be linked to pain modulation. Twenty preterm infants were exposed to three conditions—mother’s live voice (speaking or singing) and standard care—in random order during a painful procedure. OXT levels (pg/mL) in saliva and plasma cortisol levels were quantified, and the Premature Infant Pain Profile (PIPP) was blindly coded by trained psychologists. During the mother’s live voice, PIPP scores significantly decreased, with a concomitant increase in OXT levels over baseline. The effect on pain perception was marginally significant for singing. No effects on cortisol levels were found. The mother’s live voice modulated preterm infants’ pain indicators. Endogenous OXT released during vocal contact is a promising protective mechanism during early painful interventions in at-risk populations.


2021 ◽  
Vol 26 (2) ◽  
pp. 76-80
Author(s):  
Drew Payne ◽  
Martin Peache

COVID-19 has changed the landscape of healthcare in the UK since the first confirmed case in January 2020. Most of the resources have been directed towards reducing transmission in the hospital and clinical environment, but little is known about what community nurses can do to reduce the risk when they nurse people in their own homes? This article looks at what COVID-19 is, how it is spread and how health professionals are at an increased risk from aerosol-generating procedures (AGPs). There is also a discussion on the benefit of mask usage. It defines what AGPs are, which clinical procedures are AGPs, including ones performed in the community setting, and which identified clinical practices that have been mistaken for AGPs. There is also a discussion on the suitability of performing cardiopulmonary resuscitation (CPR). It also describes how to reduce the risk by the use of full personal protective equipment (PPE) and other strategies when AGPs are performed in a patient's home. It ends with general advice about managing the risk of COVID-19 transmission with patients in their homes.


2017 ◽  
Vol 9 (2) ◽  
pp. 201-208 ◽  
Author(s):  
Jeffrey H. Barsuk ◽  
Elaine R. Cohen ◽  
Joe Feinglass ◽  
William C. McGaghie ◽  
Diane B. Wayne

ABSTRACT Background Many medical certifying bodies require that a minimum number of clinical procedures be completed during residency training to obtain board eligibility. However, little is known about the relationship between the number of procedures residents perform and their clinical competence. Objective This study evaluated associations between residents' medical procedure skills measured in a simulation laboratory and self-reported procedure experience and year of training. Methods This research synthesis extracted and summarized data from multiple cohorts of internal medicine, emergency medicine, anesthesiology, and neurology resident physicians who performed simulated clinical procedures. The procedures were central venous catheter insertion, lumbar puncture, paracentesis, and thoracentesis. We compared residents' baseline simulated performance to their self-reported procedure experience using data from 7 research reports written by Northwestern University investigators between 2006 and 2016. We also evaluated how performance differed by postgraduate year (PGY). Results A total of 588 simulated procedures were performed during the study period. We found significant associations between passing the skills examinations and higher number of self-reported procedures performed (P = .011) and higher PGY (P < .001). However, performance for all procedures was poor, as only 10% of residents passed the assessments with a mean of 48% of checklist items correct (SD = 24.2). The association between passing the skills examination and year of training was mostly due to differences between PGY-1 and subsequent years of training. Conclusions Despite positive associations between self-reported experience and simulated procedure performance, overall performance was poor. Residents' clinical experience is not a proxy for skill.


2007 ◽  
Vol 50 (spe) ◽  
pp. 175-182 ◽  
Author(s):  
Severo de Paoli ◽  
Tania Santos Giani ◽  
Giuseppe Antonio Presta ◽  
Marcia Oliveira Pereira ◽  
Adenilson de Souza da Fonseca ◽  
...  

Clove (Caryophyllus aromaticus L.) has been used for clinical procedures. Blood constituents labeled with technetium-99m (99mTc) are used in nuclear medicine. The aim of this work was to evaluate the effects of clove extract on the labeling blood constituents with 99mTc and on the morphology of red blood cells. Blood samples were incubated with clove, stannous chloride and 99mTc. Plasma, blood cells, insoluble fractions of plasma and blood cells were separated. The radioactivity was counted and percentage of radioactivity (%ATI) to each blood fraction was calculated. The shape and morphometric parameter (perimeter/area ratio) were evaluated. Clove extract altered significantly (p<0.05) the %ATI of blood constituents and the shape of red blood cells without modifying the perimeter/area ratio. The results indicate that clove extract presents chemical compounds that interfere with the radiolabeling of blood constituents and alter the morphology of red blood cells by oxidative/chelating actions or interacting with the cellular membrane structure.


Sign in / Sign up

Export Citation Format

Share Document