Improving Self-Confidence of Military Medical Providers With Joint Procedure Simulation: A Pilot Study

2021 ◽  
Author(s):  
Victoria m.f Mank ◽  
Zhaohui Arter ◽  
Jeffrey Mank ◽  
Ki Suk Eum ◽  
Jefferson Roberts
Keyword(s):  
Pilot Study ◽  
Simulation Training ◽  
Statistical Significance ◽  
Military Medicine ◽  
P Value ◽  
Medical Providers ◽  
Medical Provider ◽  
Self Confidence ◽  
Before And After ◽  
Military Facilities

ABSTRACT Introduction Military medical providers are a unique population that encounter different environments across the world. From hospital clinics to war zones, these providers must perform procedures and rely on their training and skill to help their patients. This pilot study aimed to assess the self-confidence of military medical providers performing joint aspiration and injection before and after a simulation workshop in both clinical and austere settings. Methods In 2016, 25 military physicians from various military facilities participated in a 1-hour knee arthrocentesis and injection and shoulder injection workshop. Education was provided on the knee and shoulder anatomy and various approaches to performing the procedures before the hands-on portion of the workshop. Surveys assessing self-reported confidence levels by performing the procedures in the clinic and austere settings were completed before and after simulation training. Results The results were analyzed and grouped based on the provider experience level, simulation environment, and specific procedure performed. There was a statistical significance seen in the shoulder arthrocentesis group, which included all participating providers, with a P-value of <.01 in the clinic setting and a P-value of <.001 in the austere setting. In the knee aspiration simulation, there were also improvements in the provider confidence, but it was not statistically significant with P-values of .36 and .14 in the clinical and austere settings, respectively. Conclusion Simulation training can lead to increased medical provider self-confidence in performing musculoskeletal joint aspirations and injections in both clinic and austere settings. The military medicine demographics have had little research in joint injections and provider confidence to date. This pilot study was one of the first to evaluate this unique population. The methods used in this study, and the positive data collected on provider confidence, can be used in larger studies, encompassing other medical providers to increase the confidence of providers throughout various fields of medicine.

scholarly journals Gamma entrainment frequency affects mood, memory and cognition: an exploratory pilot study

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Ryan L. S. Sharpe ◽  
Mufti Mahmud ◽  
M. Shamim Kaiser ◽  
Jianhui Chen
Keyword(s):  
Pilot Study ◽  
Correlation Analysis ◽  
Negative Correlation ◽  
Cognitive Abilities ◽  
Statistical Significance ◽  
Assessment Scores ◽  
Frequency Group ◽  
Before And After ◽  
Mood Score ◽  
40 Hz

AbstractHere we provide evidence with an exploratory pilot study that through the use of a Gamma 40 Hz entrainment frequency, mood, memory and cognition can be improved with respect to a 9-participant cohort. Participants constituted towards three binaural entrainment frequency groups: the 40 Hz, 25 Hz and 100 Hz. Participants attended a total of eight entrainment frequency sessions twice over the duration of a 4-week period. Additionally, participants were assessed based on their cognitive abilities, mood as well as memory, where the cognitive and memory assessments occurred before and after a 5-min binaural beat stimulation. The mood assessment scores were collected from sessions 1, 4 and 8, respectively. With respect to the Gamma 40 Hz entrainment frequency population, we observed a mean improvement in cognitive scores, elevating from 75% average to 85% average upon conclusion of the experimentation at weak statistical significance ($$\alpha$$ α = 0.10, p = 0.076). Similarly, memory score improvements at a greater significance ($$\alpha$$ α = 0.05, p = 0.0027) were noted, elevating from an average of 87% to 95%. In pertinence to the mood scores, a negative correlation across all populations were noted, inferring an overall increase in mood due to lower scores correlating with elevated mood. Finally, correlation analysis revealed a stronger R$$^2$$ 2 value (0.9838) within the 40 Hz group between sessions as well as mood score when compared across the entire frequency group cohort.

scholarly journals Hematologic Changes in Patients with Graves’ disease in Gorgan During 2014-2015

2017 ◽  
Vol 2 (3) ◽  
pp. 106
Author(s):  
Maryam Zahedi ◽  
Farzam Mirkamali ◽  
Sharabeh Hezarkhani ◽  
Armineh Motiee ◽  
Arash Rezaei Shahmirzadi ◽  
...  
Keyword(s):  
Blood Cells ◽  
Complete Blood Count ◽  
Statistical Significance ◽  
White Blood Cells ◽  
P Value ◽  
Graves Disease ◽  
Thyroid Disorder ◽  
Cross Sectional ◽  
Mild Anemia ◽  
Before And After

Background: The most common cause of hyperthyroidism in areas without iodine deficiency is Graves’ disease. There are reports of some hematological alterations in hyperthyroidism. This study was designed to measure the hematologic profile in the patients with Graves’ disease before and after the treatment.Methods: In this cross-sectional study, 100 patients were selected with convenience sampling that diagnosed as autoimmune Graves’ disease in our academic endocrinology clinic during 2014-2015. Inclusion criteria included autoimmune hyperthyroidism in patients who were referred to this center during the study period. Patients who refused to take part in the research, had recent infections disease, malignancies, surgical procedures, severe trauma, received immunosuppressive drugs or corticosteroids, high erythrocyte sedimentation rate (ESR) values during the last six months, and not responded to treatment with methimazole were excluded from the study. The simple sampling technique was used to select the patients.   A complete blood count (CBC) was taken before and after treatment. The P-value less than 0.05 was considered as the statistical significance level. All data were analyzed using the Statistical Package for the Social Sciences 16.0 (SPSS Inc., Chicago, IL, USA) software.Results: One hundred patients with a mean age of 38 ± 9.8 years were included. There were no significant changes in the white blood cells (WBC) count, red blood cells (RBC) count, and platelets. Mild anemia (Hb=12.16±1.23) present before treating the hyperthyroidism that was significantly improved after treatment (P= 0.000). Conclusions: Our results showed that the only significant hematologic change in patients with Graves’ disease was mild anemia that improves after treating the underlying thyroid disorder. 

scholarly journals Chicken or the thumb? Comparing chicken femora with human metacarpals

2021 ◽  
Vol 103 (4) ◽  
pp. 196-201
Author(s):  
N Sargazi ◽  
Y Oskrochi ◽  
J Houghton ◽  
B Rai ◽  
D Brown ◽  
...  
Keyword(s):  
Cortical Thickness ◽  
Simulation Training ◽  
Statistical Significance ◽  
Hand Surgery ◽  
Medullary Canal ◽  
Radius Of Curvature ◽  
P Value ◽  
Canal Diameter ◽  
Metacarpal Bones ◽  
Significant Difference

Introduction While the gold standard for simulation training in hand surgery is cadaveric hands, ethical issues and cost limit their use. Chicken thighbones have been utilised to replicate human metacarpals but there is a lack of literature to validate such a model. The aim of this study was to determine whether chicken femurs are morphologically similar to human metacarpal bones. Methods Computed tomography imaging was obtained of hands undertaken at our institute between 1 January and 31 December 2015. A total of 114 chicken thighs were also scanned. Bones with previous trauma or incomplete imaging were excluded. Bone length, distance to isthmus, radius of curvature, medullary canal diameter and cortical thickness were compared between the groups. Statistical analysis was conducted using Student’s t-test or the Mann-Whitney U test, with statistical significance implied with a p-value of < 0.05. Results A total of 146 human CT scans were identified, of which 36 were included in the study, resulting in 158 human metacarpals in 5 female and 31 male patients, with an average age of 39.5 years (range: 16–77 years). Of 114 chickens scanned, 101 were suitable for analysis. Mean length, distance to isthmus, radius of curvature, medullary canal diameter and cortical thickness were 57.3mm (standard deviation [SD]: 8.7mm), 32.9mm (SD: 8.2mm), 68.8mm (SD: 19.5mm), 9.3mm (SD: 1.6mm) and 1.7mm (SD: 0.4mm) respectively in human metacarpals, compared with 66.7mm (SD: 5.1mm), 34.1mm (SD: 6.4mm), 89.1mm (SD: 15.1mm), 6.4mm (SD: 0.6mm) and 1.6mm (SD: 0.1mm) respectively in chicken femurs. There was no significant difference in bone geometry between the groups, with p-values of >0.05 for all parameters described. Conclusions The chicken thigh model provides an anatomically suitable and more cost effective alternative to human cadaveric metacarpals in simulation training for hand surgery.

The impact of a digital solution on tumor board preparation time for nurse navigators.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18020-e18020
Author(s):  
Donna Fowler ◽  
Lincoln R Sheets ◽  
Matthew S Prime ◽  
Athanasios Siadimas ◽  
Yariv Z Levy ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Interdisciplinary Approach ◽  
Tumor Board ◽  
P Value ◽  
Preparation Time ◽  
Time Saving ◽  
University Of Missouri ◽  
Oncology Nurse ◽  
Before And After ◽  
The Impact

e18020 Background: A multidisciplinary tumor board (MTB) provides an interdisciplinary approach for decision-making in cancer care. Oncology nurse navigators (NN) have been introduced to facilitate patient access to services and resources, and to improve continuity and coordination of care. Little is known about how digital technologies support this role. Methods: A prospective IRB approved cohort study was undertaken to evaluate NN time preparation for MTBs before and after the implementation of the NAVIFY Tumor Board (NTB) solution at University of Missouri Health Care (MU). Data was collected using a digital time-tracking application. The NTB manual version was implemented via a phased roll-out (Hematology – Apr 9, 2018; Breast May 18, 2018; Gastrointestinal Jul 11, 2018). Subsequently, the integrated version was introduced (Oct 4, 2018). Results: Time preparation for 101 MTBs (828 cases) were evaluated throughout 2018 (35 Breast; 213 cases / 32 GI; 302 cases / 34 Hematology; 313 cases). Data showed NN meeting preparation time decreased for each MTB after the introduction of NTB; further time saving was achieved with NTB integrated version (Table 1). For the Breast MTB there was statistical significance between time preparation pre- & post-NTB (p-value = 0.011) but not between the manual and integrated versions (p-value = 0.118). For the Gastrointestinal MTB, there was no statistical significance between pre- & post-NTB (p-value = 0.214). For Hematology MTB there was statistical significance between the change from the NTB manual version vs. integration (p-value = 0.004). Note before NTB implementation Hematology MTB was not supported by NN. Conclusions: Introduction of the NTB reduced time spent by NNs preparing for 3 different MTBs, EMR integration delivered further time-savings. No discernable learning curve was observed suggesting user-training was sufficient and NTB was easy to learn. A reduction in variance (SD & IQR) for time preparation across all MTBs was seen. This suggests the NTB solution standardized the process for MTB preparation. Less time spent preparing for MTBs gives NNs more time to support patients.

scholarly journals The Augmented Reality for Teaching Thai Students about the Human Heart

2018 ◽  
Vol 13 (06) ◽  
pp. 203 ◽  
Author(s):  
Sumitra Nuanmeesri
Keyword(s):  
Augmented Reality ◽  
Diffusion Of Innovation ◽  
Human Heart ◽  
English Language ◽  
Statistical Significance ◽  
P Value ◽  
Use Of Technology ◽  
Before And After ◽  
Thai Students ◽  
Living Organisms

Biology is a science about living organisms. Organisms have complex systems consisting of complex organs. Focusing on the human body, if the organ or its structure is visually presented, the learners are more likely to understand it and its function. This research aims to explore the bilingual (Thai and English language), development of an augmented reality tool for use in teaching students about the human heart. The augmented reality application was evaluated by five experts, who analyzed its content consistency by using the Index of Item Objective Congruence (IOC), Diffusion of Innovation (DOI), and the content validity index (CVI), indicating that the augmented reality can be used for publicizing. A sample of 30 subjects were evaluated after AR training. It was determined that the learning result post AR obtained higher ratings when compared with the ratings prior to the use of augmented reality tool. The before and after augmented reality learning results were analyzed for statistical significance at p value < 0.001 with the use of a T-Test. Afterwards, the effectiveness of the tool was evaluated by users focusing on the acceptance of the augmented reality tool to teach the anatomy of the heart; the evaluation of which was based on the theory of Unified Theory Acceptance and Use of Technology (UTAUT) in which the results of the arithmetic mean and the standard deviation were 4.65 and 0.48, respectively. This demonstrated that the users generally accepted the augmented reality tool to teach about the heart at the highest level.

scholarly journals PENGARUH PENERAPAN SENAM HOOK UPS TERHADAP TINGKAT PERCAYA DIRI ANAK

2020 ◽  
Vol 5 (1) ◽  
pp. 441-448
Author(s):  
R. Nur Abdurakhman ◽  
Eva Latifatul Fajriyah
Keyword(s):  
T Test ◽  
P Value ◽  
Test Statistics ◽  
Confidence Levels ◽  
Self Confidence ◽  
Before And After ◽  
Post Test ◽  
Comparison Groups ◽  
Quasi Experimental ◽  
Paired T Test

Salah satu aspek  yang perlu diperhatikan pada siswa sekolah  adalah percaya diri (self confidence), percaya diri merupakan salah satu modal dalam kehidupan yang harus ditumbuhkan pada  setiap siswa agar mereka dapat menjadi manusia yang bisa mengontrol berbagai aspek yang ada pada dirinya.masalah fisik, obesitas dan kurangnya berat badan, keterlambatan dalam menerima pelajaran dikelas, yang mengakibatkan seorang anak kurang percaya diri. salah satu metodenya yaitu dengan memberikan gerakan senam hook ups.  Adapun tujuan penelitian ini adalah untuk mengetahui pengaruh penerapan senam hook ups terhadap peningkatan percaya diri anak kelas dua. Metode penelitian yang digunakan adalah eksperimen semu atau quasy eksperimen tanpa kelompok pembanding (one group pretest and post test), dengan jumlah sampel sebanyak 35 siswa/i kelas dua MIN Guwa Kidul. Pengumpulan data selama satu bulan untuk pre test dilakukan dengan responden mengisi kuisioner sebelum intervensi,  post test  dilakukan pengumpulan data pada minggu ke empat . Uji statistik dengan Uji Paired t – test dengan nilai t- post test 85.636 dan p Value 0.000.Hasil uji statistik didapatkan bahwa  ada perbedaan tingkat percaya diri sebelum dan sesudah dilakukan senam Hook Ups dengan nilai mean 0,32 dan menunjukkan ada peningkatan tingkat percaya diri setelah dilakukan senam Hook Ups ( p value 0,000).Kata Kunci          : senam Hook Ups, tingkat percaya diri.ABSTRACTOne aspect to note is the school student confidence (self-confidence), self-confidence is one of the capital in a life that must be grown on each student so that they can be a man who can control every aspect of the physical dirinya.masalah, obesity and lack of weight gain, delays in receiving lessons in class, which resulted in a child's lack of confidence. one method is to provide the hook ups gymnastics movement. The purpose of this study was to determine the effect of the application of gymnastics hook ups to the increased confidence graders.The method used was experimental or quasi-experimental Quasy without comparison groups (one group pretest and post-test), with a sample size of 35 students / class i MIN Guwa two Kidul. The collection of data for a month to pre-test conducted with respondents fill out questionnaires before the intervention, post-test data collection at week four. Test statistics with the Paired t- test, post test  85.636 and p Value 0.000.Statistical test results showed that there are differences in confidence levels before and after exercise Hook Ups with a mean of 0.32 and showed no increase in confidence levels after exercise Hook Ups (p value 0.000).Keywords             : gymnastics Hook Ups, confidence level.

scholarly journals Improvement of eating activity by patients after ischemic stroke – use of adaptation in occupational therapy

2020 ◽  
Vol 24 (2) ◽  
Author(s):  
Paulina Kasprzyk ◽  
Paulina Kruk
Keyword(s):  
Ischemic Stroke ◽  
Pilot Study ◽  
Occupational Therapy ◽  
Statistical Significance ◽  
P Value ◽  
Moderate Degree ◽  
Intervention Adaptation ◽  
Final Assessment ◽  
Occupational Therapy Intervention ◽  
Study Inclusion

Introduction: Beginning the occupational therapy intervention, an occupational therapist determines what occupational difficulties a patient has during observation and interview. Patients after ischemic stroke belong to one of the groups of recipients of occupational therapy. These people have various difficulties, also in term of Activities of Daily Living and one of these activities may be eating. In this publication, the results are shown of the authors’ pilot study on training in the independent consumption of meals by patients who have undergone ischemic stroke. Materials and methods: As part of the applied intervention, adaptation consisted of using a special wristband in 10 patients, to which cutlery can be attached. The use of the wristband was aimed at enabling patients to eat independently. The following study inclusion criteria were adopted: ischemic stroke no later than six months prior to beginning the study, constraint of the dominant upper limb, preserved mobility of the shoulder and elbow joints in moderate degree and no possibility to hold cutlery. Results: Assessment regarding the significance of eating meals increased after therapy and the p-value reached 0.03. Final assessment concerning the satisfaction of performing the activity was better than initial evaluation, the level of statistical significance reaching 0.005. The duration of performing the activity significantly decreased after applying the proposed adaptation. The results were statistically significant at the level of (p=0.005). Conclusions: The results of the pilot study allow to conclude that the use of the wristband facilitates patients in eating meals themselves. The examined sample pointed to the greater convenience of using cutlery, which as an effect, leads to an increase in satisfaction with performing activities during the final assessment.

scholarly journals Efficacy and safety of high dose hydroxyurea in transfusion dependent thalassemic children: a quasi experimental study

2017 ◽  
Vol 4 (4) ◽  
pp. 1514
Author(s):  
Kiran Suthar ◽  
Pramod Sharma ◽  
Manish Verma ◽  
Vishnu Kr. Goyal
Keyword(s):  
Statistical Significance ◽  
Significant Rise ◽  
P Value ◽  
High Dose ◽  
Comparison Study ◽  
Post Intervention ◽  
Before And After ◽  
Quasi Experimental ◽  
Haemoglobin Synthesis ◽  
Day Care Centre

Background: This study was conducted to find out whether high dose hydroxyurea is an effective and safe modality, in inducing haemoglobin synthesis to decrease blood transfusion requirement in transfusion dependent thalassemics.Methods: This quasi experimental un-control before and after comparison study was conducted in Thalassemia Day Care Centre, Department of Pediatrics over a period of six months after obtaining an approval from the Institute’s ethical committee. Fifty transfusions dependent thalassemic children belonging from 2 to 18 yrs were given hydroxyurea in dose of 20mg/kg after getting consent. Pre and post intervention haemoglobin and HbF levels were obtained using Hb electrophoresis by HPLC. Paired t test was applied to find out statistical significance and p value <0.05 was taken as significant.Results: Significant rise in haemoglobin pre and post intervention (p<0.001) but the rise in HbF was not significant (p=0.110). One patient had bone marrow depression which was reversible with drug withdrawal and one patient had rise in s. creatinine.Conclusions: High dose hydroxyurea is an effective and safe drug in inducing Hemoglobin synthesis in transfusion dependent thalassemics.  

EFEKTIVITAS LATIHAN KEPERCAYAAN DIRI DALAM MENINGKATKAN HARGA DIRI REMAJA PUTUS SEKOLAH

2019 ◽  
Vol 11 (1) ◽  
pp. 19-26
Author(s):  
Ice Yulia Wardani ◽  
Tantri Widyarti Utami ◽  
Rahma Fadillah Sopha
Keyword(s):  
Psychosocial Development ◽  
Intervention Group ◽  
School Dropout ◽  
Self Esteem ◽  
School Intervention ◽  
Control Group ◽  
P Value ◽  
Self Confidence ◽  
Before And After ◽  
Quasi Experimental

Remaja merupakan periode kritis peralihan dari anak menjadi dewasa. Kejadian putus sekolah merupakan salah satu faktor pencetus yang dapat menyebabkan munculnya masalah dalam beradaptasi terhadap perubahan yang terjadi. Penelitian ini bertujuan mengetahui efektivitas latihan kepercayaan diri dalam meningkatkan harga diri remaja putus sekolah. Penelitian menggunakan desain quasi experimental with control group yang melibatkan 34 responden kelompok intervensi dan 29 responden kelompok kontrol berusia 12-18 tahun yang putus sekolah di jenjang pendidikan SD dan SMP. Kelompok intervensi diberikan latihan kepercayaan diri sementara kelompok kontrol diberikan stimulasi perkembangan psikososial remaja. Untuk mengetahui keefektifan terapi, dilakukan penilaian terhadap harga diri sebelum dan setelah intervensi menggunakan self-esteem questionnaire dengan nilai reliabilitas 0,76. Data hasil penelitian diolah menggunakan analisis bivariat uji beda dua mean dependen guna mengetahui perbedaan mean harga diri remaja sebelum dan setelah intervensi. Analisis statistik menunjukkan adanya perbedaan signifikan harga diri remaja setelah latihan kepercayaan diri (p value= 0,000) dibandingkan remaja setelah pemberian stimulasi perkembangan psikososial. Penelitian ini membuktikan bahwa latihan kepercayaan diri efektif dalam meningkatkan harga diri remaja. Terapi ini dapat dijadikan salah satu intervensi untuk mengatasi masalah harga diri rendah pada remaja putus sekolah.   Kata Kunci: harga diri, latihan kepercayaan diri, remaja.   THE EFFECTIVENESS OF SELF-CONFIDENCE PRACTICE TO INCREASE SELF-ESTEEM IN SCHOOL DROPOUT ADOLESCENCES   ABSTRACT Adolescence is transfer critical periods from child into adult. School dropout is one of precipitation factor that can create problems in adolescence to adapt with those changes. This study aimed to determine the effectiveness of self-confidence practice to increase self-esteem in school dropout adolescences. This study used quasi experimental with control group included 34 intervention group respondents and 29 control group respondents who were 12-18 years old and had school dropout in elementary and junior high school. Intervention group was given self-confidence practice whereas control group was given adolescence’s psychosocial development stimulation. To determine therapy effectiveness, we used scoring of respondents’ self-esteem before and after interventions. Questionnaire that was used was self-esteem questionnaire with reliability score 0,76.  Data was analyzed using bivariat analysis paired sample t test to know mean differentiation of self-esteem in adolescences before and after intervention. Statistical analysis showed there was significant difference between self-esteem in school dropout’s adolescences after self-confidence practice (p value= 0,000) rather than adolescence’s psychosocial development stimulation. This study shown that self-confidence practice was effective to increase adolescences’ self-esteem. This therapy can be intervention to solve low self-esteem problems in school dropout adolescences.   Keywords: adolescence, self-esteem, self-confidence practice.

Pilot Study of Novel Test Instrumentation to Evaluate Therapeutic Horseback Riding

1984 ◽  
Vol 1 (1) ◽  
pp. 30-36 ◽  
Author(s):  
V. Marie Fox ◽  
Valorie A. Lawlor ◽  
Marvin W. Luttges
Keyword(s):  
Pilot Study ◽  
Horseback Riding ◽  
Therapeutic Horseback Riding ◽  
Self Confidence ◽  
Test Instrument ◽  
Sitting Balance ◽  
Before And After ◽  
Ankle Strength ◽  
Test Instrumentation ◽  
Field Setting

A novel test instrument was designed to objectively quantify the progress of persons who participated in therapeutic horseback riding programs. Nineteen handicapped children, ages 7 to 14 years, with heterogeneous impairments were evaluated before and after riding. For measures of sitting balance and coordination, and hand, hip, knee, and ankle strength, marked improvements were noted for most children. Clinical impressions of therapists and parents suggested concomitant progress in characteristics such as self-confidence and interaction with others. Results from this pilot study appeared to support the use of the apparatus in that field setting.

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