scholarly journals Objectively Structured Clinical Teaching (OSCT) in Undergraduate Clinical Teaching: A Pilot Study

2021 ◽  
Vol 13 (1) ◽  
pp. 17-30
Author(s):  
HMP Singh ◽  
Jaiprakash Mohanraj ◽  
Heethal Jaiprakash ◽  
Veena Joshi ◽  
Siva Achanna ◽  
...  
Keyword(s):  
Content Validity ◽  
Clinical Teaching ◽  
Cost Effective ◽  
Simulated Patients ◽  
Teaching Tool ◽  
Effective Manner ◽  
Significant Difference ◽  
Primary Care Medicine ◽  
Standardised Patients ◽  
Real Patients

In this study, the efficacy of a clinical teaching tool, objectively structured clinical teaching (OSCT) was assessed by comparing students’ performance in assessing standardised patients (SPs) and real patients (RPs). The final-year students were randomly divided into two arms and their performance in three different disciplines such as medicine, obstetrics and gynaecology (O&G) and primary care medicine (PCM) was assessed with RPs in one arm and SPs/simulated patients in the other. The assessments were conducted in history-taking, clinical examination and management stations by the content experts under a structured rubric. Students’ scores in each arm were compared in the respective disciplines and overall. The perceptions of both students and SPs were recorded. The OSCT and rotational average scores of the participant students in SPs and RPs were compared. The students’ mean scores for their rotational exam and OSCT were 65.31 ± 5.56 and 61.14 ± 8.53, respectively. The performance at the management station in O&G was significantly higher compared with medicine and PCM. The overall performance at all other stations in the three disciplines was comparable, with no significant difference. The reliability and content validity of OSCT was established by calculating Cronbach’s alpha and testing content validity. The results indicated that OSCT is an innovative and effective teaching tool that can be used in clinical teaching in the early clinical years to lower the student load in hospitals in a cost-effective manner.

scholarly journals S-Vest: a novel hybrid method to allow standardised patients to put on the objective physical examination findings of a disease

2019 ◽  
Vol 5 (2-3) ◽  
pp. 78-81
Author(s):  
Dale Berg ◽  
Katherine Berg
Keyword(s):  
Aortic Stenosis ◽  
Physical Examination ◽  
Clinical Skills ◽  
Low Cost ◽  
Simulated Patients ◽  
Teaching Tool ◽  
Educational Tools ◽  
Standardised Patients ◽  
Single Modality

BackgroundSimulation hybrids combine single modality simulation such as simulated patients (SP) with low-fidelity simulation to create a potentially more powerful set of educational tools. To make a hybrid that is credible, standardised and inexpensive remains a challenge. We describe the development of the simulation vest (S-Vest), an inexpensive, standardised teaching tool that is ‘worn’ by an SP to form a hybrid.MethodsWe have created a vest which contains a set of speakers placed in an anatomical manner and produce sounds. The sounds played from a multitrack audio player are recorded in vivo from a patient with the real disease findings. The SP provides history while the vest provides the objective palpable and auscultatory findings. The speakers are placed in the routine standardised locations taught in physical examination.ResultsWe have developed several case scenarios designed for the vest. One of these cases is an elderly patient with aortic stenosis. The aortic stenosis case audio file has four unique tracks recorded over the precordium. Each track is played at the speaker appropriate to the physical exam findings. The SP plays an elderly man with chest pain. The vest provides the sounds of a loud systolic murmur with marked diminishment of S2 and a palpable thrill.ConclusionsThe S-Vest is a low-fidelity, low-cost simulator to use in hybrid and simulation. The S-Vest can be used in a formative and summative Objective Structured Clinical Examination (OSCE) station and in skills attainment for learners in healthcare. We believe these tools will be of significant import to teaching clinical skills.

scholarly journals Online support for commerce processes: The Dutch food retailing sector

2004 ◽  
Vol 4 (2) ◽  
pp. 95-109
Author(s):  
Adam Lindgreen ◽  
Michael Antioco ◽  
Joost Wouters
Keyword(s):  
World Wide Web ◽  
Electronic Commerce ◽  
Web Sites ◽  
World Wide ◽  
Cost Effective ◽  
Food Retailing ◽  
Food Retail ◽  
Effective Manner ◽  
Significant Difference ◽  
The World

Advances in information technology have changed not only traditional goods and services, but also business-to-consumer relationships in terms of interactivity. For example, by facilitating access to company data, offering additional services, and/or providing self-service options through the World Wide Web, consumer requests can be recorded, handled faster, and dealt with more individually in a cost-effective manner. This article examines the extent to which companies in the Dutch food retailing sector are using the World Wide Web and its associated technologies to conduct their business. Employing the electronic commerce architecture suggested by Basu and Muylle (1999, 2002), Muylle and Basu (2003), we analyse the commercial Web sites of Dutch food retail companies (numbering 34 in all) to determine which commerce processes are being supported online in this sector. The results of the research provide insights to academics on the adoption of electronic commerce in a particular industry sector and to food retail managers on their competitors' usage of the World Wide Web. Our findings show that, generally, support for electronic commerce processes and sub-processes is merely 16 per cent of the considered sample. Most retailers use the Internet only as a medium of communications, although others have set up commercial Web sites that provide higher customer support. Several sub-processes appear to be supported such as core logistics, online search of products, and price information display and determination. With the exception of search, there is practically no online customisation possible in the processes. A high correlation was observed between search, valuation, and authentication on the one hand and support for online payment on the other hand. Lastly, there is no significant difference between regional/national retailers or firm size, especially for the search and valuation processes, which share close to identical extent of support.

Strategic planning in grassland farming: Principles andapplications

1997 ◽  
pp. 191-197
Author(s):  
W.J. Parker ◽  
N.M. Shadbolt ◽  
D.I. Gray
Keyword(s):  
Strategic Planning ◽  
Performance Indicators ◽  
Cost Effective ◽  
Key Performance Indicators ◽  
Strategic Plans ◽  
Effective Manner ◽  
Farm Business ◽  
Pastoral Farming ◽  
Financial Environment

Three levels of planning can be distinguished in grassland farming: strategic, tactical and operational. The purpose of strategic planning is to achieve a sustainable long-term fit of the farm business with its physical, social and financial environment. In pastoral farming, this essentially means developing plans that maximise and best match pasture growth with animal demand, while generating sufficient income to maintain or enhance farm resources and improvements, and attain personal and financial goals. Strategic plans relate to the whole farm business and are focused on the means to achieve future needs. They should be routinely (at least annually) reviewed and monitored for effectiveness through key performance indicators (e.g., Economic Farm Surplus) that enable progress toward goals to be measured in a timely and cost-effective manner. Failure to link strategy with control is likely to result in unfulfilled plans. Keywords: management, performance

scholarly journals Effect of leg wrapping technique on prevention of spinal induced hypotension and fetal acidosis during cesarean section: Randomized controlled trial

2019 ◽  
Vol 10 (2) ◽  
pp. 70
Author(s):  
Samah Nasser Abd El-Aziz El-Shora ◽  
Amina Mohamed Rashad El-Nemer
Keyword(s):  
Randomized Controlled Trial ◽  
Cesarean Section ◽  
Controlled Trial ◽  
Intervention Group ◽  
Cost Effective ◽  
Control Group ◽  
Induced Hypotension ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Wrapping Technique

Background and aim: Hypotension during cesarean section (CS) under spinal anesthesia has been a subject of scientific study for more than 50 years and the search for the most effective strategy to achieve hemodynamic stability remains challenging. Aim: The study was carried out to apply leg wrapping technique for the prevention of spinal-induced hypotension (SIH) during CS.Methods: Randomized Controlled Trial design was utilized at cesarean delivery operating room Mansoura General Hospital in El-Mansoura City during the period from May 2018 to November 2018. A purposive sample of 88 pregnant women, assigned randomly to an intervention group (n = 44) in which their legs wrapped with elastic crepe bandage and control group (n = 44) in which no wrapping was done. Data collected for maternal, neonatal hemodynamic and signs of hypotension, the feasibility of application and cost analysis.Results: There was a statistically significant difference in the incidence of SIH and Ephedrine use among both groups (18.20% in leg wrapping group whereas 75% in control group). In addition, neonatal acidosis and NICU admission were less among leg wrapping group (11.40%, 9.10% respectively). Economically, leg wrapping technique was cost effective compared to the cost of the hospital regimen for treating SIH and admission to (NICU).Conclusion and recommendations: Leg wrapping technique was cost effective and an efficient method for decreasing SIH, neonatal acidosis and Ephedrine administration. It is recommended to apply leg wrapping technique in maternal hospitals' protocol of care for decreasing SIH during CS.

scholarly journals Novel Regeneration Approach for Creating Reusable FO-SPR Probes with NTA Surface Chemistry

Nanomaterials ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 186
Author(s):  
Jia-Huan Qu ◽  
Karen Leirs ◽  
Remei Escudero ◽  
Žiga Strmšek ◽  
Roman Jerala ◽  
...  
Keyword(s):  
Surface Chemistry ◽  
Fluorescent Protein ◽  
Cost Effective ◽  
Nitrilotriacetic Acid ◽  
Antibody Fragments ◽  
Rapid Screening ◽  
Red Fluorescent Protein ◽  
Effective Manner ◽  
Surface Regeneration ◽  
Sensitivity Specificity

To date, surface plasmon resonance (SPR) biosensors have been exploited in numerous different contexts while continuously pushing boundaries in terms of improved sensitivity, specificity, portability and reusability. The latter has attracted attention as a viable alternative to disposable biosensors, also offering prospects for rapid screening of biomolecules or biomolecular interactions. In this context here, we developed an approach to successfully regenerate a fiber-optic (FO)-SPR surface when utilizing cobalt (II)-nitrilotriacetic acid (NTA) surface chemistry. To achieve this, we tested multiple regeneration conditions that can disrupt the NTA chelate on a surface fully saturated with His6-tagged antibody fragments (scFv-33H1F7) over ten regeneration cycles. The best surface regeneration was obtained when combining 100 mM EDTA, 500 mM imidazole and 0.5% SDS at pH 8.0 for 1 min with shaking at 150 rpm followed by washing with 0.5 M NaOH for 3 min. The true versatility of the established approach was proven by regenerating the NTA surface for ten cycles with three other model system bioreceptors, different in their size and structure: His6-tagged SARS-CoV-2 spike fragment (receptor binding domain, RBD), a red fluorescent protein (RFP) and protein origami carrying 4 RFPs (Tet12SN-RRRR). Enabling the removal of His6-tagged bioreceptors from NTA surfaces in a fast and cost-effective manner can have broad applications, spanning from the development of biosensors and various biopharmaceutical analyses to the synthesis of novel biomaterials.

An evaluation of a shoulder rehabilitation class in a UK hospital following evidence-based modifications

2021 ◽  
pp. 1-8
Author(s):  
Emily Kell ◽  
John A. Hammond ◽  
Sophie Andrews ◽  
Christina Germeni ◽  
Helen Hingston ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Shoulder Pain ◽  
Management Strategies ◽  
Cost Effective ◽  
Rehabilitation Programme ◽  
Patient Specific ◽  
Satisfaction Survey ◽  
Evidence Based ◽  
Patient Satisfaction Survey ◽  
Significant Difference

OBJECTIVES: Shoulder pain is a common musculoskeletal disorder, which carries a high cost to healthcare systems. Exercise is a common conservative management strategy for a range of shoulder conditions and can reduce shoulder pain and improve function. Exercise classes that integrate education and self-management strategies have been shown to be cost-effective, offer psycho-social benefits and promote self-efficacy. This study aimed to examine the effectiveness of an 8-week educational and exercise-based shoulder rehabilitation programme following the introduction of evidence-based modifications. METHODS: A retrospective evaluation of a shoulder rehabilitation programme at X Trust was conducted, comparing existing anonymised Shoulder Pain and Disability Index (SPADI) and Patient-Specific Functional Scale (PSFS) scores from two cohorts of class participants from 2017-18 and 2018-19 that were previously collected by the physiotherapy team. Data from the two cohorts were analysed separately, and in comparison, to assess class efficacy. Descriptive data were also analysed from a patient satisfaction survey from the 2018-19 cohort. RESULTS: A total of 47 patients completed the 8-week shoulder rehabilitation programme during the period of data collection (2018-2019). The 2018-19 cohort showed significant improvements in SPADI (p 0.001) and PSFS scores (p 0.001). No significant difference was found between the improvements seen in the 2017-18 cohort and the 2018-19 cohort. 96% of the 31 respondents who completed the patient satisfaction survey felt the class helped to achieve their goals. CONCLUSION: A group-based shoulder rehabilitation class, which included loaded exercises and patient education, led to improvements in pain, disability and function for patients with rotator cuff related shoulder pain (RCRSP) in this outpatient setting, but anticipated additional benefits based on evidence were not observed.

scholarly journals Postnatal management of children with antenatal hydronephrosis

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Mohammed S. ElSheemy
Keyword(s):  
Renal Function ◽  
Urinary Tract Obstruction ◽  
Cost Effective ◽  
Voiding Cystourethrography ◽  
Main Body ◽  
Antenatal Hydronephrosis ◽  
Postnatal Management ◽  
Effective Manner ◽  
Lower Urinary Tract Obstruction

Abstract Background Postnatal management of infants with antenatal hydronephrosis (ANH) is still one of the most controversial issues. The majority of infants with ANH are asymptomatic with only few children who develop renal insufficiency. Thus, the biggest challenge for pediatric urologists is to distinguish children who will require further investigations and possible intervention prior to the development of symptoms, complications or renal damage in a cost effective manner without exposing them to the hazards of unnecessary investigations. Main body In this review article, literature on ANH were reviewed to present the current suggestions, recommendations, guidelines and their rational for postnatal management of ANH. It is agreed that a large portion of infants with ANH will improve; thus, the protocol of management is based mainly on observation and follow-up by ultrasound to detect either resolution, stabilization or worsening of hydronephrosis. The first 2 years of life are critical for this follow-up as the final picture is mostly reached during that period. Advanced imaging using voiding cystourethrography or renal scintigraphy are required for children at risk. Then, surgical intervention is selected only for a subgroup of these infants who showed worsening of hydronephrosis or renal function. Conclusions The protocol of management is based mainly on observation and follow-up by US to detect either resolution, stabilization or worsening of hydronephrosis. Postnatal evaluation should be performed for any neonate with a history ANH at any stage during pregnancy even if it was resolved during third trimester. Exclusion of UTI should be performed by urinalysis for all cases followed by urine culture if indicated. Serum creatinine should be performed especially in patients with bilateral ANH. US is the initial standard diagnostic imaging technique. Other imaging modalities like VCUG and nuclear renal scans may be required according to the results of the US evaluation. The most important items in decision making are the presence of bilateral or unilateral hydronephrosis, presence or absence of hydroureter, presence of lower urinary tract obstruction and degree of hydronephrosis on the initial postnatal US. Then an intervention is selected only for a subgroup of these patients who showed deterioration in renal function or degree of hydronephrosis or were complicated by UTIs. All these recommendations are based on the available literature. However, management of ANH is still a controversial issue due to lack of high evidence-based recommendations. Randomised controlled studies are still needed to provide a high level evidence for different aspects of management.

scholarly journals An Artificial-Intelligence-Discovered Functional Ingredient, NRT_N0G5IJ, Derived from Pisum sativum, Decreases HbA1c in a Prediabetic Population

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1635
Author(s):  
Sweeny Chauhan ◽  
Alish Kerr ◽  
Brian Keogh ◽  
Stephanie Nolan ◽  
Rory Casey ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Pisum Sativum ◽  
Cost Effective ◽  
Glycated Haemoglobin ◽  
Glucose Regulation ◽  
Functional Ingredient ◽  
Effective Manner ◽  
Human Skeletal Muscle Cells ◽  
Increased Risk

The prevalence of prediabetes is rapidly increasing, and this can lead to an increased risk for individuals to develop type 2 diabetes and associated diseases. Therefore, it is necessary to develop nutritional strategies to maintain healthy glucose levels and prevent glucose metabolism dysregulation in the general population. Functional ingredients offer great potential for the prevention of various health conditions, including blood glucose regulation, in a cost-effective manner. Using an artificial intelligence (AI) approach, a functional ingredient, NRT_N0G5IJ, was predicted and produced from Pisum sativum (pea) protein by hydrolysis and then validated. Treatment of human skeletal muscle cells with NRT_N0G5IJ significantly increased glucose uptake, indicating efficacy of this ingredient in vitro. When db/db diabetic mice were treated with NRT_N0G5IJ, we observed a significant reduction in glycated haemoglobin (HbA1c) levels and a concomitant benefit on fasting glucose. A pilot double-blinded, placebo controlled human trial in a population of healthy individuals with elevated HbA1c (5.6% to 6.4%) showed that HbA1c percentage was significantly reduced when NRT_N0G5IJ was supplemented in the diet over a 12-week period. Here, we provide evidence of an AI approach to discovery and demonstrate that a functional ingredient identified using this technology could be used as a supplement to maintain healthy glucose regulation.

scholarly journals Spectroscopic detection of forest diseases: a review (1970–2020)

2021 ◽  
Author(s):  
Lorenzo Cotrozzi
Keyword(s):  
Early Detection ◽  
Optical Sensors ◽  
Near Infrared ◽  
Sustainable Forest Management ◽  
Visible Spectrum ◽  
Cost Effective ◽  
Infrared Region ◽  
Forest Disturbances ◽  
Effective Manner ◽  
Forest Diseases

AbstractSustainable forest management is essential to confront the detrimental impacts of diseases on forest ecosystems. This review highlights the potential of vegetation spectroscopy in improving the feasibility of assessing forest disturbances induced by diseases in a timely and cost-effective manner. The basic concepts of vegetation spectroscopy and its application in phytopathology are first outlined then the literature on the topic is discussed. Using several optical sensors from leaf to landscape-level, a number of forest diseases characterized by variable pathogenic processes have been detected, identified and quantified in many country sites worldwide. Overall, these reviewed studies have pointed out the green and red regions of the visible spectrum, the red-edge and the early near-infrared as the spectral regions most sensitive to the disease development as they are mostly related to chlorophyll changes and symptom development. Late disease conditions particularly affect the shortwave-infrared region, mostly related to water content. This review also highlights some major issues to be addressed such as the need to explore other major forest diseases and geographic areas, to further develop hyperspectral sensors for early detection and discrimination of forest disturbances, to improve devices for remote sensing, to implement long-term monitoring, and to advance algorithms for exploitation of spectral data. Achieving of these goals will enhance the capability of vegetation spectroscopy in early detection of forest stress and in managing forest diseases.

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