Challenging Concepts in Respiratory Medicine

2017 ◽  
Keyword(s):  
Learning Process ◽  
Management Strategies ◽  
Evidence Base ◽  
Respiratory Medicine ◽  
Clinical Scenarios ◽  
Expert Commentary ◽  
Learning Points ◽  
Case Based

Challenging Concepts in Respiratory Medicine is a case-based guide to difficult scenarios in the field, covering many of the major subspecialty areas. Consisting of contemporary clinical scenarios with expert commentary, chapters are interspersed with the most up-to-date evidence, management strategies, guidelines, and controversies in management. Using handy ‘Clinical tips’, ‘Learning points’, and ‘Evidence base’ to enhance the learning process, Challenging Concepts in Respiratory Medicine includes valuable ‘Expert Comment’ written by a nationally or internationally renowned expert to provide a unique inside track on how the experts approach these types of challenging cases. Covering a range of respiratory and related conditions, including allergy, tuberculosis, asthma, and narcolepsy, this title is specifically designed for those preparing for their specialist exams.

Application and Evaluation of Case-Based Learning as a Part of Early Clinical Exposure for Undergraduate Medical Education Program

2020 ◽  
Vol 5 (08) ◽  
pp. 284-288
Author(s):  
Vandana Daulatabad ◽  
Prafull K. ◽  
Dr. Surekha S. Kadadi-Patil ◽  
Ramesh S. Patil
Keyword(s):  
Medical Education ◽  
Research Centre ◽  
Muscle Physiology ◽  
Case Scenario ◽  
Clinical Exposure ◽  
Clinical Scenarios ◽  
Case Based Learning ◽  
Nerve Muscle ◽  
Case Based ◽  
Early Clinical Exposure

Introduction: Medical Education is witnessing a significant transition and global shift towards competency based medical education (CBME) which includes early clinical exposure (ECE) program to help students apply and correlate principles of preclinical subjects with clinical scenarios, in various forms and in a variety of settings. One of the easy and feasible methods of ECE being Case Based Learning (CBL), our study aimed to design a case scenario and to evaluate impact of case base learning as a part of ECE module in first year undergraduate medical teaching program in nerve muscle physiology. Methods: The present study was conducted in 96 students at Ashwini Rural Medical College Hospital and Research Centre, Solapur after obtaining institutional ethics committee approval. 3 hrs session of CBL was conducted for a case scenario on myasthenia gravis in the nerve muscle physiology module. The students’ responses on pre-test, post-test and their insights regarding the CBL were taken through a pre validated questionnaire using 5-point Likert scale. Results: High impact of CBL was seen as significant improvement in student’s performance. Maximum students felt CBL to be easy method of learning and was highly appreciated through their feedback. Conclusion: CBL was found to have positive impact on understanding and perception of topic. CBL helped students to understand, evaluate, analyze, diagnose and interpret the case, paving them towards newer approach of self-directed and vertical integrated learning. CBL is easier, feasible an effective method among other early clinical exposure methods as it involves students in deeper and self-directed active learning, encouraging and promoting them to reach higher levels of cognitive domain of Bloom’s taxonomy. This method will be very useful in its practical implementation during online classes for ECE module in the threat of COVID 19 situation as well.

scholarly journals Toward the diagnosis of rare childhood genetic diseases: what do parents value most?

2021 ◽  
Author(s):  
Samantha Pollard ◽  
Deirdre Weymann ◽  
Jessica Dunne ◽  
Fatemeh Mayanloo ◽  
John Buckell ◽  
...  
Keyword(s):  
Focus Groups ◽  
Genetic Disease ◽  
Diagnostic Yield ◽  
Management Strategies ◽  
Health Benefit ◽  
Sampling Technique ◽  
Evidence Base ◽  
Current Evidence ◽  
Genomic Testing ◽  
Current Evidence Base

AbstractGenomic testing is becoming routine for diagnosing rare childhood genetic disease. Evidence underlying sustainable implementation is limited, focusing on short-term endpoints such as diagnostic yield, unable to fully characterize patient and family valued outcomes. Although genomic testing is becoming widely available, evidentiary and outcomes uncertainty persist as key challenges for implementation. We examine whether the current evidence base reflects public tolerance for uncertainty for genomics to diagnose rare childhood genetic disease. We conducted focus groups with general population parents in Vancouver, Canada, and Oxford, United Kingdom, to discuss expectations and concerns related to genomic testing to diagnose rare childhood genetic disease. Applying a purposive sampling technique, recruitment continued until thematic saturation was reached. Transcripts were analysed using thematic analysis. Thirty-three parents participated across four focus groups. Participants valued causal diagnoses alongside management strategies to improve patient health and wellbeing. Further, participants valued expanding the evidence base to reduce evidentiary uncertainty while ensuring security of information. Willingness to pay out of pocket for testing reflected perceived familial health benefit. Diagnostic yield fails to fully capture valued outcomes, and efforts to resolve uncertainty better reflect public priorities. Evaluations of genomic testing that fully integrate valued endpoints are necessary to ensure consistency with best practices and public willingness to accept the uncertain familial benefit.

Learning from the report of the independent medicines and medical devices safety review: “first do no harm”

2022 ◽  
pp. 003693302110584
Author(s):  
Priyanka H Krishnaswamy ◽  
Marie-Anne Ledingham ◽  
Veenu Tyagi ◽  
Karen Lesley Guerrero
Keyword(s):  
Healthcare System ◽  
Medical Devices ◽  
Current Response ◽  
Missed Opportunities ◽  
Safety Review ◽  
Anti Epileptic Drug ◽  
Do No Harm ◽  
Clinical Scenarios ◽  
Health And Social Care ◽  
Learning Points

This is a review of the learning points from the Independent Medicines and Medical Devices Safety Review, 1 chaired by Baroness Julia Cumberlege CBE DL. This system-wide review was initiated by the then Secretary of State for Health and Social Care, following patient-led campaigns. It looked at how the “healthcare system reacted as a whole, and how that response can be made more robust, speedy and appropriate”. We aim to highlight the learning points for doctors in Obstetrics and Gynaecology as these are relevant to our current practice and future changes in our healthcare system. These are: Aims of the review: why it was initiated and how it was conducted Overarching themes and missed opportunities to prevent avoidable harm Three clinical scenarios: their histories, issues and adverse events associated with their use and the current response in Scotland The hormone pregnancy test - Primodos The anti-epileptic drug - sodium valproate Surgical mesh for prolapse & incontinence The recommendations made by the review and implementation guidance Responses to the review, such as apologies issued by BSUG 2 /BAUS 3 /RCOG, 4 and compensations schemes such as the Scottish scheme as recommended by the review

scholarly journals Balint style case-based discussion group for medical students in Bassetlaw Hospital

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S342-S342
Author(s):  
Anu Priya ◽  
Hardev Bhogal
Keyword(s):  
Medical Students ◽  
Discussion Group ◽  
Discussion Groups ◽  
Written Feedback ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Balint Groups ◽  
Balint Group ◽  
Learning Points ◽  
Case Based

AimsTo evaluate feedback from Balint style case based discussion groups and to reflect on learning points.We have three medical students from Sheffield University on six week psychiatry placements at Bassetlaw Hospital and we get eighteen students in a year. In order to further develop their approach towards reflection and their understanding towards the doctor patient relationship we developed the Balint style case based discussion group, and each group of students attend three sessions during their placement.MethodThe groups are held on a weekly basis and consist of the three medical students and 1-2 facilitators. As the group is small one of the facilitators may participate with the students for the Balint process and to help encourage the students. Following completion of the third session of the discussion group we gain written feedback from the students. A total of 17 feedbacks have been reviewed over the period of November 2018 -November 2019.Result16 students stated that this was their first experience at Balint Group and all except one student felt that they were given a good introduction about Balint groups before starting. When asked about the most significant thing that they have learnt in the group, the majority of students marked reflecting feelings to improve relationships with patients, exploring why they feel a certain way with patients and that the doctor patient relationship can affect the consultation.One student stated that they would not recommend it to colleagues as they felt it was relevant more to doctors rather than medical students. Another student recommended having more people in a group.ConclusionOverall, it has been a positive experience with the medical students during the groups and with feedbacks. We have reflected on difficult topics like bereavement, fantasized about the purpose of a patient's delusion and shared the joy of a patient who was discharged after a long stay. While we think we have been able to teach the students some tips on reflection, we ourselves have been able to reflect on certain topics we would not have if not raised by the students. Some medical students have contacted the larger Balint Group in Sheffield for further sessions. Considering our experience, we will continue with the sessions at Bassetlaw Hospital.

scholarly journals Efficacy of Non-Halofuginone-Based Strategies to Prevent or Treat Cryptosporidiosis in Bovine Calves: A Systematic Review

2020 ◽  
Author(s):  
Julii Brainard ◽  
Charlotte C. Hammer ◽  
Kevin Tyler ◽  
Paul R. Hunter
Keyword(s):  
Systematic Review ◽  
Weight Gain ◽  
Kinase Inhibitors ◽  
Management Strategies ◽  
Evidence Base ◽  
High Morbidity ◽  
Case Control Studies ◽  
Nutritional Strategy ◽  
Before And After ◽  
Meta Analyses

Cryptosporidiosis is a common illness in young cattle that causes high morbidity and some mortality. A common prophylactic treatment are halofuginone products but it seems likely disease could be reduced by other other pharmacological products or some management strategies. We undertook a systematic review and meta-analyses on key outcomes for treatment of calves before and after 5 days of age with any management strategy, any nutritional strategy or any non-halofuginone product. A systematic literature search was undertaken with data extracted for outcomes = oocyst shedding, diarrhea, mortality and weight gain. Experiments had to describe results for same age animals in contemporary arms. Control animals had to be observed concurrently in planned experiments (pre-post and case-control studies were not eligible). Both randomized and other clinically controlled trials were eligible. Results were subgrouped by study design and outcomes were described in detail where at least two articles described the same treatment strategy. 55 articles were found. Significantly lower incidence of oocyst shedding, diarrhea burden and mortality was reported in many experimental arms, especially when animals started treatment before 5 days old. Weight gain was not mostly affected by treatment, however, by three weeks of age. The evidence base is at least encouraging but insufficient about paromomycin, bumped kinase inhibitors and azithromycin treatment, especially for diarrhea and oocyst shedding, given late or early. Azithromycin is the most promising of these.

Befriending Anxiety to Reach Potential: Strategies to Empower Our Gifted Youth

2018 ◽  
Vol 41 (4) ◽  
pp. 186-195 ◽  
Author(s):  
Amy H. Gaesser
Keyword(s):  
Learning Process ◽  
Classroom Environment ◽  
Management Strategies ◽  
Gifted Students ◽  
Management Skills ◽  
Anxiety Management ◽  
Management Intervention ◽  
Emotional Freedom Techniques ◽  
Gifted Youth ◽  
Evidenced Based

Gifted students can encounter anxiety-provoking stressors throughout their day. Developing effective anxiety management skills allows them to better navigate these challenges. Concepts from neuroscience help us better understand responses to anxiety and can assist gifted youth and those working with them in recognizing how and when to best apply anxiety management strategies. This article reviews these concepts and integrating them into the classroom environment to assist with this learning process. In addition, it examines an evidenced-based anxiety management intervention that has been found to be efficacious for gifted youth, Emotional Freedom Techniques (EFT). Results of recent EFT research are reviewed and the steps to learning EFT are outlined.

Challenging Concepts in Paediatric Critical Care

2020 ◽  
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Medicine ◽  
Evidence Base ◽  
Paediatric Intensive Care ◽  
Circulatory Support ◽  
Cell Transplant ◽  
Patient Journey ◽  
Expert Commentary ◽  
Paediatric Critical Care

This textbook, ‘Challenging concepts in paediatric critical care’, has been designed to cater to the needs of paediatric intensivists, current trainees and those intending to train in the future. Similar to its predecessors in this ‘Challenging concepts’ series, this book aims to educate clinicians by describing clinical situations that are both common, such as bronchiolitis, sepsis etc., and complex, such as mechanical circulatory support, stem cell transplant etc., in paediatric intensive care medicine. The textbook contains 18 chapters based on challenging scenarios involving variety of diseases and organ dysfunctions. Each chapter contains several “Learning Points”, “Clinical Tips” and “Evidence Base” boxes embedded in the text with the aim to promote memory and stimulate learning. These run alongside an “Expert Commentary” written by an international group of experts in the field, to give practical advice of how they approach these difficult situations. Many chapters include results and imaging to enhance the fidelity and narrative style of text, that encourage the reader to understand the patient journey and feel part of the decision making process. The clinical topics in this book are aligned to match the Royal College of Paediatrics and Child Health’s paediatric intensive care medicine curriculum in the UK, as well as the curriculum of Paediatric Basic assessment and support in intensive care (BASIC) course and the various domains of Paediatric/neonatal European Diploma in Intensive Care (PEDIC) curriculum.

Facial Schwannoma Management Outcomes: A Systematic Review of the Literature

2020 ◽  
Vol 163 (2) ◽  
pp. 293-301
Author(s):  
Matthew Bartindale ◽  
Jeffrey Heiferman ◽  
Cara Joyce ◽  
Douglas Anderson ◽  
John Leonetti
Keyword(s):  
Systematic Review ◽  
Facial Nerve ◽  
Stereotactic Radiosurgery ◽  
Management Strategies ◽  
Treatment Strategies ◽  
Tumor Location ◽  
Subtotal Resection ◽  
Review Of The Literature ◽  
Total Resection ◽  
Clinical Scenarios

Objective To evaluate facial nerve outcomes of various management strategies for facial schwannomas by assimilating individualized patient data from the literature to address controversies in management. Data Sources PubMed–National Center for Biotechnology Information and Scopus databases. Review Methods A systematic review of the literature was performed for studies regarding facial schwannomas. Studies were included if they presented patient-level data, type of intervention, pre- and postintervention House-Brackmann (HB) grades, and tumor location by facial nerve segment. Results Individualized data from 487 patients were collected from 31 studies. Eighty (16.4%) facial schwannomas were managed with observation, 25 (5.1%) with surgical decompression, 20 (4.1%) with stereotactic radiosurgery, 225 (46.2%) with total resection, and 137 (28.1%) with subtotal resection/stripping surgery. Stripping surgery/subtotal resection with good preoperative facial nerve function maintained HB grade 1 or 2 in 96% of cases. With a total resection of intradural tumors, preoperative HB grade did not significantly affect facial nerve outcome (n = 45, P = .46). However, a lower preoperative HB grade was associated with a better facial nerve outcome with intratemporal tumors (n = 56, P = .009). When stereotactic radiosurgery was performed, 40% of patients had improved, 35% were stable, and 25% had worsened facial function. Facial nerve decompression rarely affected short-term facial nerve status. Conclusion The data from this study help delineate which treatment strategies are best in which clinical scenarios. The findings can be used to develop a more definitive management algorithm for this complicated pathology.

Neuroprotection for Mechanical Circulatory Support

2017 ◽  
Author(s):  
Lauren E Dunn ◽  
Joshua Z Willey ◽  
Ronald M Lazar
Keyword(s):  
Mechanical Circulatory Support ◽  
Management Strategies ◽  
Air Embolism ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
Left Ventricular Assist Devices ◽  
Cerebral Air Embolism ◽  
Cerebral Hyperperfusion ◽  
Clinical Scenarios

This chapter examines the adverse neurological events associated with mechanical circulatory support (MCS), which includes left ventricular assist devices (LVAD) and percutaneous devices for cardiac disease. The most frequently encountered neurological events are ischemic and hemorrhagic stroke, as well as intracerebral hemorrhage (ICH), heart failure and cardiovascular disease. The management of acute cerebrovascular conditions in this population poses unique challenges, given concomitant anticoagulation usage, hemodynamically unstable patients, and lack of randomized controlled trials investigating these clinical scenarios. Other acute neurological events include cerebral hyperperfusion and cerebral air embolism. This chapter describes these complications and their risk factors, and the available evidence-based and institutional management strategies.

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