Evaluation of Students to Select Different Educational Technique Using Dreem

Introduction: Problem-Based Learning (PBL) could be an instructing strategy in which complex real-world issues are utilized as the vehicle to promote student learning of concepts and standards as opposed to direct introduction of facts and ideas. In expansion to course content, PBL can promote the improvement of basic thinking aptitudes, problem-solving abilities, and communication skills. It can also show new horizons for working in group to become a lifelong learner. Objective: To evaluate the educational environment in medical and allied health sciences students at Rawalpindi Medical University. Material & Method: Study design: quantitative cross sectional Settings: Rawalpindi Medical University Duration: Six months i.e. 1st January 2021 to 30th June 2021 Methodology: The students of medical from medical college and Physiotherapy from allied health sciences have been selected. Pre validated questionnaire DREEM was used to evaluate the perception of educational environment at Rawalpindi Medical University students for using educational strategies. The students enrolled in the study after giving consent. Results: The total number and percentages were 1200/1750 (68.5%) from medical students and 70/150 (46.6%) from allied health sciences participated in the study from Rawalpindi Medical University. Table 2 shows two groups, total participants, maximum score, mean value, Standard deviation and p value. The overall DREEM score of medical group was 135/200 which use PBL approach and Allied group score was 102/200 which was on traditional strategy. It is also noticed that mean score from the medical group is greater than 3 while Allied health sciences lower than 2. Conclusion: Differentiating student discernments of educational environments appear related with the medical schools embracing different educational methodologies in our setting. Cautious and detailed interpretation of DREEM symptomatic results can be utilized to identify qualities and shortcomings of educational program and needed intervention. In any case to sort of educational programs experienced, institutional mediations show up fundamental in the areas of academic and social support and stress management. Continuous assessment of learning situations ought to be linked to making strides the instructive encounters for medical students. Keywords: PBL, DREEM, Educational Environment, Learning

Lateral distal tibial locking compression plate fixation through single lateral incision technique is biologically superior and mechanically equivalent alternative to medial plate fixation for lower third tibia-fibula fractures

<p><strong>Background:</strong> A number of surgical options for management of distal tibia fractures makes scenario confusing and available techniques are associated with complications. Recently lateral plating of tibia has shown good promise. To compare results between medial and lateral distal tibial locking compression plate for treatment of distal third tibia fractures</p><p><strong>Methods:</strong> Prospective clinical study was carried out among 24 patients presenting with distal third tibia fractures. Patients were randomized into two groups of 12 each. One group was allocated into medial distal tibial LCP and second group was allocated into lateral distal tibial LCP. In first group, approach taken was medial or anteromedial while in second group, approach taken was lateral. Follow up was done for six months after surgery.</p><p><strong>Results:</strong> There were 10 cases in medical group and eight cases in lateral group which had fracture due to road traffic accidents. All cases in medical group had concomitant fibula fracture while such cases were 10 in lateral group. One case in each group developed infection after surgery. There was one case of superficial skin dehiscence and one case of hardware problem in medial group compared to none in lateral group. Two cases from medial group required removal of implant compared to none from medial group.</p><p><strong>Conclusions:</strong> Lateral distal tibial LCP seems to provide biological advantage than medial distal tibial LCP without difference in biomechanical properties of implants. Single lateral incision technique is an ingenious, biologically sound, and cosmetically superior for fixation of both lower third tibia &amp; fibula fractures together.</p>

Outcomes and Blood Product Use in 89 Surgically Managed and 79 Medically Managed Cases of Acute Spontaneous Hemoperitoneum in the Dog

Objective: To describe a population of dogs with acute spontaneous hemoperitoneum (ASH) that were treated with either surgical or medical management in the first 12 h after presentation, and to perform a preliminary investigation into whether there were differences in achieving cardiovascular stabilization or patterns of red blood cell (RBC) transfusion between patients treated with early (&lt;12 h) surgery vs.medical management.Design: A retrospective multicenter preliminary study performed on 168 dogs presenting with ASH between January 2015 and May 2019. Patients were excluded if they were euthanized or discharged from hospital within the first 12 h, or if clinical records were incomplete. All patients received appropriate medical stabilization efforts. Statistical analysis was performed comparing patients that underwent early (&lt;12 h) surgery and those that did not.Results: Eighty-nine patients were in the early surgical group and 79 patients in the medical group. A significantly higher proportion of medical cases were euthanized (p &lt; 0.001). A significantly higher proportion of early surgical cases were discharged from hospital (p = 0.005). There was no statistically significant difference between groups in achieving cardiovascular stabilization (OR 1.07 p = 0.82). A higher proportion of patients with body-weight over 20 kg achieved stabilization within 12 h than those with body-weight of 20 kg or less (62.7 vs. 41.4%, p &lt; 0.01). A higher proportion of patients with splenic conditions achieved stabilization than patients with non-splenic conditions (56.5 vs. 28.6%, p = 0.05). The odds of receiving an RBC transfusion were higher in the early surgical group than the medical group [OR 3.81 (p &lt; 0.001)].Conclusions: This preliminary study did not identify a significant difference in the ability to achieve cardiovascular stabilization in the first 12 h in dogs with ASH that underwent early surgical intervention vs. those managed medically. Patients in the early surgical group were more likely to receive a RBC transfusion than those in the medical group. At this time the decision on whether to pursue medical or early surgical management should be made on a case by case basis.

Exploring the Nature of Business Strategy Change for Mental Health Practices in the Age of COVID-19

The Convergence Lab (TCL), a mental health medical group practice that provides group and individual therapy for its adult clients. TCL is a 5-year old organization with five (5) clinicians inclusive of and one (1) full-time office manager and 5 clinicians are full time staff. As a result of COVID-19, TCL has experienced an 75% decrease in revenue since patients are unable to complete their appointments in person. The paper examines how one mental health medical group practice used a management consultant to help the practice change its business strategy to respond to COVID-induced business challenges using automation and technology driven strategic approaches. This inquiry uses organizational development action research intervention and a content analysis of the literature to create real-world solutions that will have value to scholar practitioners that are doing applied research to help similar organizations that are challenged to respond to the global pandemic.

Depression predicts chronic pain interference in racially-diverse, low-income patients

ABSTRACT Background Chronic pain is one of the most common reasons adults seek medical care in the US, with estimates of prevalence ranging from 11% to 40%. Mindfulness meditation has been associated with significant improvements in pain, depression, physical and mental health, sleep, and overall quality of life. Group medical visits are increasingly common and are effective at treating myriad illnesses including chronic pain. Integrative Medical Group Visits (IMGV) combine mindfulness techniques, evidence based integrative medicine, and medical group visits and can be used as adjuncts to medications, particularly in diverse underserved populations with limited access to non-pharmacological therapies. Objective and Design The objective of the present study was to use a blended analytical approach of machine learning and regression analyses to evaluate the potential relationship between depression and chronic pain in data from a randomized clinical trial of IMGV in socially diverse, low income patients suffering from chronic pain and depression. Methods This approach used machine learning to assess the predictive relationship between depression and pain and identify and select key mediators, which were then assessed with regression analyses. It was hypothesized that depression would predict the pain outcomes of average pain, pain severity, and pain interference. Results Our analyses identified and characterized a predictive relationship between depression and chronic pain interference. This prediction was mediated by high perceived stress, low pain self-efficacy, and poor sleep quality, potential targets for attenuating the adverse effects of depression on functional outcomes. Conclusions In the context of the associated clinical trial and similar interventions, these insights may inform future treatment optimization, targeting, and application efforts in racially diverse, low income populations, demographics often neglected in studies of chronic pain.

Organizational Development Intervention on the Impact of COVID-19 on a Mental Health Medical Group in the USA

This inquiry concerns managerial adaptability and strategic planning of a mental health organization attempting to adapt to the marketplace and business disruption of COVID-19. The medical group has seen a noteworthy decreased in revenue of more than three-quarters (80 percent). It is for this reason, that it is imperative for the MHMG to carefully examine the presented issue and immediately strategize ways to address such issue. This analysis intends to review the literature and engage in action organizational development research to provide an understanding of the issue, its severity and spread as well as propose appropriate recommendations that could alleviate the business complexities that have been created by the pandemic.

THE APPLICATION OF ATHLETICS TOOLS IN DUE TO DEVELOP SPEED OF SECONDARY SCHOOL CHILDREN

The research is dedicated to searching of new tools for higher effectiveness of the application of athletic tools to develop speed of secondary school children. The goal of research is to prove theoretically and test experimentally the program for speed development of secondary school children (11-12 years) with priority use of athletic tools.To realize the goal such methods were applied: scientific theoretical, pedagogical observation, experiment, mathematical statistics methods. Boys are from 6 grades (11-12 years old) have participated. Pupils belong to main medical group. The results. There was elaborated and experimentally proved the program’s effectiveness. We have got statistically significant difference (p0.05), better results from experimental group of performing control exercises: “30m run (sec)”, “30m run from place (sec)”, “run at the place during 5sec (number of movements)”. One exercise has got better result from control group - “run at the place during 5sec (number of movements)”. We have performed evaluation of students’ speed development before and after the experiment. Amount of pupils with high level of competence has grown in exercises “30m run (sec)” for 13.3%, “60m run (sec)” for 20%, “shuttle run 4×9m (sec)” for 6.7%, “long jump from place (cm) for 13.3%.

A Cloud-Based Solution to Support Patient Outreach and Engagement for Chronic Disease and Preventative Care-A Retrospective Study (Preprint)

BACKGROUND Patients more actively engaged in their care have better clinical outcomes. OBJECTIVE To examine the performance of a widely adopted cloud-based patient engagement system for management of diabetes, hypertension, and preventative screenings at two large healthcare systems. METHODS We included patients with diabetes, hypertension, and those due for breast cancer screenings and/or bi-annual wellness visits and at Loudon Medical Group (LMG) in Virginia, and Basset Medical Group (BMG) in New York between 2019-2021. We examined outreach outcomes including successful contact rate (SCR), patient response rate (PRR), and adherent response rate (ARR). Associations between demographic characteristics and outcome measures were explored with Chi-square or Fisher’s exact tests. RESULTS Attempted contacts with patients with diabetes (N=2567) at LMG resulted in SCR of 87.1%, PRR of 47.2%, and ARR of 38.4%. At BMG, attempted contacts with patients with diabetes (N=3621), hypertension (N=10881), patients for breast cancer screening (N=2441), and wellness visits (N=9070) resulted in SCR values of 91.0%, 93.2%, 90.1%, and 92.1%; PRR of 57.0%, 59.8%, 50.8%, and 52.0%; and ARR of 45.2%, 39.8%, 6.8%, and 11.5% respectively. Outreach outcomes measures were significantly higher in patients with hypertension, and those carrying commercial or Medicare insurance vs. those who were self-insured or on Medicaid plans (SCR P<.0001, PRR P<.0001, and ARR P=.0013). Among diabetic patients, only SCR (P=.0008) was significantly associated with commercial or Medicare insurance. In general, rate of contact (SCR) had more favorable results as compared to the rate of follow-up visits (PRR, ARR), with higher PRR significantly associated with female sex (P<.0001), and a higher SCR seen among patients contacted by text (P<.0001). Age-stratified analysis showed that 60-69 years old diabetic patients had the highest SCR and ARR. Hypertensive patients between the ages of 70-79 had the highest SCR, PRR, and ARR. CONCLUSIONS This cloud-based patient outreach system demonstrated high rates of contact in patients with hypertension, diabetes and/or eligible for preventative screenings. Overall response rates were over 50%, with moderate adherence rates for diabetes and hypertension, but low adherence for preventative screenings. Older patients had higher adherence rates. Additional strategies are needed to translate successful patient contact into response and adherence. CLINICALTRIAL NA