Delivering a modified continuous objective structured clinical examination for ophthalmology residents through a hybrid online method

Since coronavirus disease 2019 was declared a global pandemic by the World Health Organization, it has become a challenging situation to continue medical education, including in Indonesia. The situation prohibited face-to-face (direct) educational activities in clinical settings, therefore also postponing examinations involving especially procedural skills. Adaptations were urgently needed to maintain the delivery of high-stake examinations to sustain the number of ophthalmology graduates and the continuation of eye health service. Objective structured clinical examination (OSCE) has been one of our widely used method to assess clinical competencies for ophthalmology residents, and is the one method that involves gatherings, close contact of examiners, examinees and patients, therefore the most difficult to adjust. Pandemic challenges brought technical changes in our delivering the OSCE to online, maximizing digital platforms of meetings, while still concerned to guarding the safety of candidates, patients and staffs. OSCE scenarios were also made as timely efficient as possible by changing continuous station models to a cascade one. The purpose of this article is to document our experience in conducting a feasible and reproducible OSCE in this pandemic era filled with limitations.

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Obstacles to Claiming Permanence and Injury-Relatedness for “Posttraumatic” Headache

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2009.mayjun02 ◽

2009 ◽

Vol 14 (3) ◽

pp. 3-6

Author(s):

Robert J. Barth

Keyword(s):

Complete Recovery ◽

World Health ◽

Related Factors ◽

Posttraumatic Headache ◽

Sixth Edition ◽

Causative Relationship ◽

Short Period ◽

The One ◽

Health Organization ◽

Subjective Reports

Abstract “Posttraumatic” headaches claims are controversial because they are subjective reports often provided in the complex of litigation, and the underlying pathogenesis is not defined. This article reviews principles and scientific considerations in the AMAGuides to the Evaluation of Permanent Impairment (AMA Guides) that should be noted by evaluators who examine such cases. Some examples in the AMA Guides, Sixth Edition, may seem to imply that mild head trauma can cause permanent impairment due to headache. The author examines scientific findings that present obstacles to claiming that concussion or mild traumatic brain injury is a cause of permanent headache. The World Health Organization, for example, found a favorable prognosis for posttraumatic headache, and complete recovery over a short period of time was the norm. Other studies have highlighted the lack of a dose-response correlation between trauma and prolonged headache complaints, both in terms of the frequency and the severity of trauma. On the one hand, scientific studies have failed to support the hypothesis of a causative relationship between trauma and permanent or prolonged headaches; on the other hand, non–trauma-related factors are strongly associated with complaints of prolonged headache.

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Standardization of Factor VIII – IV. Establishment of the 3rd International Standard for Factor VIII: C Concentrate

Thrombosis and Haemostasis ◽

10.1055/s-0038-1665290 ◽

1983 ◽

Vol 50 (03) ◽

pp. 697-702 ◽

Cited By ~ 14

Author(s):

T W Barrowcliffe ◽

A D Curtis ◽

D P Thomas

Keyword(s):

Factor Viii ◽

High Purity ◽

Collaborative Study ◽

World Health ◽

Current Standard ◽

Two Stage ◽

International Standard ◽

One Stage ◽

The One ◽

Health Organization

SummaryAn international collaborative study was carried out to establish a replacement for the current (2nd) international standard for Factor VIII: C, concentrate. Twenty-six laboratories took part, of which 17 performed one-stage assays, three performed two-stage assays and six used both methods. The proposed new standard, an intermediate purity concentrate, was assayed against the current standard, against a high-purity concentrate and against an International Reference Plasma, coded 80/511, previously calibrated against fresh normal plasma.Assays of the proposed new standard against the current standard gave a mean potency of 3.89 iu/ampoule, with good agreement between laboratories and between one-stage and two- stage assays. There was also no difference between assay methods in the comparison of high-purity and intermediate purity concentrates. In the comparison of the proposed standard with the plasma reference preparation, the overall mean potency was 4.03 iu/ampoule, but there were substantial differences between laboratories, and the two-stage method gave significantly higher results than the one stage method. Of the technical variables in the one-stage method, only the activation time with one reagent appeared to have any influence on the results of this comparison of concentrate against plasma.Accelerated degradation studies showed that the proposed standard is very stable. With the agreement of the participants, the material, in ampoules coded 80/556, has been established by the World Health Organization as the 3rd International Standard for Factor VIII :C, Concentrate, with an assigned potency of 3.9 iu/ampoule.

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Reflections on FDA and WHO recommendations concerning clinical trials

Psychiatry and Psychobiology ◽

10.1017/s0767399x00002960 ◽

1989 ◽

Vol 4 (2) ◽

pp. 117-122 ◽

Cited By ~ 2

Author(s):

J.-F. Dreyfus ◽

D. Cremniter ◽

J.D. Guelfi

Keyword(s):

Clinical Trials ◽

Drug Users ◽

Objective Evaluation ◽

World Health ◽

Measuring Instruments ◽

New Techniques ◽

The Usa ◽

The One ◽

Health Organization

SummaryWe are still confronted by numerous different nosographic models and problems concerning the objective evaluation of patients progress during treatment. It is interesting to consider the consequences of this situation in psychiatry which still involves a relative diversity of practical methods used in clinical trials. The recommendations of the USA Food and Drug Administration, on the one hand, constitute a highly structured and precise reference. The World Health Organization, on the other hand, promulgates general recommendations resulting from a compromise designed to satisfy the greatest number of clinicians.Despite the apparently diverse principles and the different practical methods they propose, both those sets of recommendations have been useful in inspiring clinicians to reflect upon these different methodological approaches. The qualities of the inclusion criteria used in the study of patients and the sensitivity of the different measuring instruments have allowed psychotropic drug users as well as producers to recognize the need for a certain rigour in clinical trials.The FDA and WHO guidelines have certainly improved the quality of clinical trials in psychopharmacology. However, they also represent a source of resistance to innovation.A series of consensus meetings to first reconcile US and European points of view and later to include new techniques in the recognized sets of methods would therefore be helpful.

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(Mis)Information on Digital Platforms: Lessons from Twitter and Sina Weibo in the COVID-19 Pandemic (Preprint)

10.2196/preprints.31793 ◽

2021 ◽

Author(s):

Sarah Kreps

Keyword(s):

Public Health ◽

World Health Organization ◽

Public Discourse ◽

The United States ◽

World Health ◽

Sina Weibo ◽

Digital Platforms ◽

The World ◽

Health Organization ◽

Relative Prevalence

BACKGROUND Misinformation about COVID-19 has presented challenges to public health authorities during pandemics. Understanding the prevalence and type of misinformation across contexts offers a way to understand the discourse around COVID-19 while informing potential countermeasures. OBJECTIVE The aim of the study was to study COVID-19 content on two prominent microblogging platform, Twitter, based in the United States, and Sina Weibo, based in China, and compare the content and relative prevalence of misinformation to better understand public discourse of public health issues across social media and cultural contexts. METHODS A total of 3,579,575 posts were scraped from both Weibo and Twitter, focusing on content from January 30th, 2020, when the World Health Organization (WHO) declared COVID-19 a “Public Health Emergency of International Concern” and February 6th, 2020. A 1% random sample of tweets that contained both the English keywords “coronavirus” and “covid-19” and the equivalent Chinese characters was extracted and analyzed based on changes in the frequencies of keywords and hashtags. Misinformation on each platform was compared by manually coding and comparing posts using the World Health Organization fact-check page to adjudicate accuracy of content. RESULTS Both platforms posted about the outbreak and transmission but posts on Sina Weibo were less likely to reference controversial topics such as the World Health Organization and death and more likely to cite themes of resisting, fighting, and cheering against the coronavirus. Misinformation constituted 1.1% of Twitter content and 0.3% of Weibo content. CONCLUSIONS Quantitative and qualitative analysis of content on both platforms points to cross-platform differences in public discourse surrounding the pandemic and informs potential countermeasures for online misinformation.

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From Syphilis to Autism, How the Anti-Vaccination Movement of Today is an Echo of the Past

McGill Journal of Medicine ◽

10.26443/mjm.v19i1.770 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Kayleigh Beaveridge

Keyword(s):

Personal Narratives ◽

World Health ◽

Statistical Characteristics ◽

Vaccine Hesitancy ◽

Vaccine Preventable Diseases ◽

Vaccination Rates ◽

The World ◽

The One ◽

Health Organization ◽

The 19Th Century

Introduction: The anti-vaccination movement has led to decreased vaccination rates and increased vulnerability to vaccine-preventable diseases in the general population. In order to better understand the anti-vaccination movement of today, the anti-vaccination movement that emerged in the 19th century is examined and measured against the one observed in the 20th century. Discussion: Though the population of the 19th and 20th centuries differ in many regards and our knowledge of vaccine and immune mechanisms are far greater; the anti-vaccination movement seen today stands on the same pillars as that of the 1800s with the sentiment of fear at its core. Though the façade of these pillars has been altered to suit the world today, both movements exploited the influence of prominent public figures, maintained false associations with dire vaccine consequences and emphasized these through the use of visual media, repetition and personal narratives. The persistence of the anti-vaccination movement lies largely in the use of personal stories which are more impactful and memorable then the statistical characteristics of scientific study. Conclusion: The pro-vaccination movement must respond to the tactics used by the anti-vaccination movement and create accessible, understandable and equally impactful communication strategies in order to prevent the spread of misinformation and counter the efforts of the current anti-vaccination movement. Relevance: Vaccine hesitancy was listed amongst the top 10 global health threats in 2019 by the World Health Organization. In order to shift the negative rhetoric surrounding vaccines, the anti-vaccination movement of today and its historic roots need to be understood.

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Preliminary study of coronavirus disease 2019 on pets in pandemic in Denpasar, Bali, Indonesia

Veterinary World ◽

10.14202/vetworld.2021.2979-2983 ◽

2021 ◽

pp. 2979-2983

Author(s):

Hamong Suharsono ◽

Ali Ghufron Mukti ◽

Ketut Suryana ◽

I. Wayan Masa Tenaya ◽

Dilasdita Kartika Pradana ◽

...

Keyword(s):

Close Contact ◽

Genetic Material ◽

Rna Isolation ◽

World Health ◽

Intermediate Hosts ◽

Rt Pcr ◽

Pcr Products ◽

Preliminary Study ◽

Health Organization ◽

Respiratory Droplets

Background and Aim: Coronavirus disease 2019 (COVID-19) is an acute infectious respiratory disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and has spread rapidly globally, resulting in a pandemic. In humans, the main routes of transmission are respiratory droplets and close contact with infected individuals or through contact with an object infected with the virus, followed by touching mouth, nose, or eyes. It is assumed that SARS-CoV-2 was originated in wild animals and was then transmitted to humans. Although some wildlife and domestic animals can be naturally or experimentally infected with the virus, the intermediate hosts that transmitted it to humans are still unknown. Understanding the dynamics of SARS-CoV-2 associated with possible zoonotic transmission of intermediate hosts is considered critical. Reportedly, cats or dogs living with COVID-19-positive humans tested positive for the disease, suggesting that the virus was transmitted to the animals from humans. Information regarding the epidemiological investigation and comprehensive studies is limited. Therefore, it is still unclear how high is the correlation of infection in humans and pet animals, especially those living together. The aim of this study was to investigate the possibility of SARS-CoV-2 infection in the pets of patients with COVID-19 who were hospitalized at the Wangaya hospital, Denpasar, Bali, Indonesia. Materials and Methods: A total of seven clinically asymptomatic pets (six dogs of different races and sexes and a cat [age, 360-2920 days]) were included in this study. These animals belonged to patients with confirmed SARS-CoV-2 infection from August to November 2020. Nasal swab and nasopharyngeal samples were collected from the pets individually under anesthetic condition and were collected 6-12 days after confirmed SARS-CoV-2 infection in owners and hospitalization at the Wangaya Hospital. The swab samples were then processed for RNA isolation and tested using reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2, in accordance with the World Health Organization manual 2020. Results: RT-PCR results for all seven RNA samples, prepared from the swab samples, were negative. For the samples, all PCR products were below the threshold limit, suggesting no genetic material belonging to the samples tested. Conclusion: This was the first preliminary study of COVID-19 on pets in pandemic using RT-PCR. The study tested a very limited quantity of samples, and all of them were negative. However, the way in which the samples were prepared was considered appropriate. Therefore, in further studies, testing of more samples of pets of more individuals with confirmed SARS-CoV-2 infection is required.

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A cluster of rubella in Malta, December 2007 - January 2008

Eurosurveillance ◽

10.2807/ese.13.16.18840-en ◽

2008 ◽

Vol 13 (16) ◽

Author(s):

G Spiteri ◽

A-M Fenech Magrin ◽

M Muscat

Keyword(s):

Close Contact ◽

Control Unit ◽

World Health ◽

Work Place ◽

Reference Laboratory ◽

The Third ◽

Health Organization ◽

Travel Abroad ◽

In The Beginning ◽

And Control

A cluster of rubella has been identified by the Infectious Disease Prevention and Control Unit (IDCU) of Malta in the beginning of January 2008. Two men and a woman aged between 23 and 28 years were affected. The index case had onset of illness on 23 December 2007. The second case had onset of rash on 3 January and the third case displayed symptoms on 6 January 2008. Two of the three cases were laboratory-confirmed (IgM positive), the third displayed typical symptoms and was a close contact of a laboratory-confirmed case but was IgM and IgG negative. None of the affected patients had received vaccination against rubella and there was no history of recent travel abroad. All three cases were linked through a work place. Blood samples were submitted to the World Health Organization (WHO) Regional Reference Laboratory for Measles and Rubella, Luxembourg, for further investigations. None of the cases had any complications. To date no further cases have been identified.

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Assessment of the susceptibility status of Aedes aegypti (Diptera: Culicidae) populations to pyriproxyfen and malathion in a nation-wide monitoring of insecticide resistance performed in Brazil from 2017 to 2018

Parasites & Vectors ◽

10.1186/s13071-020-04406-6 ◽

2020 ◽

Vol 13 (1) ◽

Author(s):

Kauara Brito Campos ◽

Ademir Jesus Martins ◽

Cynara de Melo Rodovalho ◽

Diogo Fernandes Bellinato ◽

Luciana dos Santos Dias ◽

...

Keyword(s):

Insecticide Resistance ◽

Mosquito Control ◽

Natural Populations ◽

Adult Emergence ◽

World Health ◽

Two Generations ◽

Wide Scale ◽

Susceptibility Tests ◽

The One ◽

Health Organization

Abstract Background Chemical mosquito control using malathion has been applied in Brazil since 1985. To obtain chemical control effectiveness, vector susceptibility insecticide monitoring is required. This study aimed to describe bioassay standardizations and determine the susceptibility profile of Ae. aegypti populations to malathion and pyriproxyfen, used on a national scale in Brazil between 2017 and 2018, and discuss the observed impacts in arbovirus control. Methods The diagnostic-doses (DD) of pyriproxyfen and malathion were determined as the double of adult emergence inhibition (EI) and lethal doses for 99% of the Rockefeller reference strain, respectively. To monitor natural populations, sampling was performed in 132 Brazilian cities, using egg traps. Colonies were raised in the laboratory for one or two generations (F1 or F2) and submitted to susceptibility tests, where larvae were exposed to the pyriproxyfen DD (0.03 µg/l) and adults, to the malathion DD determined in the present study (20 µg), in addition to the one established by the World Health Organization (WHO) DD (50 µg) in a bottle assay. Dose-response (DR) bioassays with pyriproxyfen were performed on populations that did not achieve 98% EI in the DD assays. Results Susceptibility alterations to pyriproxyfen were recorded in six (4.5%) Ae. aegypti populations from the states of Bahia and Ceará, with Resistance Ratios (RR95) ranging from 1.51 to 3.58. Concerning malathion, 73 (55.3%) populations distributed throughout the country were resistant when exposed to the local DD 20 µg/bottle. On the other hand, no population was resistant, and only 10 (7.6%) populations in eight states were considered as exhibiting decreased susceptibility (mortality ratios between 90 and 98%) when exposed to the WHO DD (50 µg/bottle). Conclusions The feasibility of conducting an insecticide resistance monitoring action on a nation-wide scale was confirmed herein, employing standardized and strongly coordinated sampling methods and laboratory bioassays. Brazilian Ae. aegypti populations exhibiting decreased susceptibility to pyriproxyfen were identified. The local DD for malathion was more sensitive than the WHO DD for early decreased susceptibility detection.

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Use of mask in COVID-19 era: absence of evidence is not evidence of absence

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v7i1.28880 ◽

2020 ◽

Vol 7 (1) ◽

pp. 89-90

Author(s):

Rano Mal Piryani ◽

Suneel Piryani ◽

Jay Narayan Shah

Keyword(s):

United States Of America ◽

Close Contact ◽

Healthy Person ◽

World Health ◽

Source Control ◽

Community Settings ◽

Policy Makers ◽

Risk Of Exposure ◽

Health Organization ◽

Healthy Persons

World Health Organization (WHO) in its interim guidance of 6 April 2020 advises policy makers on the use of masks for healthy people in community settings. The rationale for mask use by healthy person is prevention from COVID-19, when there is risk of exposure, like working in close contact with public, people with comorbidities, where physical distancing cannot be maintained such as travelling in buses, staying in slum areas. Furthermore, WHO says the purpose and reason for mask use should be clear– whether it is to be used for source control (used by infected persons) or prevention of COVID-19 (used by healthy persons).1 Centers for Disease Control (CDC) United States of America (USA) updated its advisory on 4 Apr 2020, and recommended everyone (except some) should wear at least a cloth face covering when they have to go out in public. It will protect other people in case you are infected.2,3 This advisory of no strict demand on use of face masks could be possibly due to unavailability of disposable masks.

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Evaluation of the quality of life of clients with chronic ischemic pain

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692011000100010 ◽

2011 ◽

Vol 19 (1) ◽

pp. 67-72 ◽

Cited By ~ 5

Author(s):

Débora Fernanda Amaral Pedrosa ◽

Andressa Karina Amaral Plá Pelegrin ◽

Hilze Benigno de Oliveira Moura Siqueira ◽

Talita de Cássia Raminelli da Silva ◽

Orlando Carlos Gomes Colhado ◽

...

Keyword(s):

Quality Of Life ◽

World Health ◽

Physical Domain ◽

Ischemic Pain ◽

World Health Organization Quality ◽

The Social ◽

Organization Quality ◽

The One ◽

Health Organization

The evaluation of quality of life (QOL) faced with chronic ischemic pain involves the clients in their subjectivity and multidimensionality. This descriptive study aimed to evaluate the quality of life of clients who presented chronic ischemic pain. A total of 100 clients of hospital institutes participated in the study. The instrument used to assess pain was an 11 point numerical scale, and to assess the quality of life, the World Health Organization Quality of Life-abbreviated questionnaire. The arithmetic mean for chronic pain was 5.59±3.16 points. The means for quality of life were: in the physical domain, 44.75±16.98; in the overall domain, 50.0±22.40; in the environment, 55.06±13.51, in the psychological, 56.21±17.19 and in the social domain, 68.33±21.84. Thus, the physical domain was, among the areas analyzed, the one which presented a greater impact on the quality of life of the clients with chronic ischemic pain.

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