Task Force Report
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2021 ◽  
pp. postgradmedj-2021-140261
David Bowes ◽  
Cindy Shearer ◽  
Trisha Daigle-Maloney ◽  
John Dornan ◽  
Andrew Lynk ◽  

BackgroundQuality improvement and patient safety (QIPS) have been assigned a higher profile in CanMEDS 2015, CanMEDS–Family Medicine 2017 and new accreditation standards, prompting an initiative at Dalhousie University to create a vision for integrating QIPS into postgraduate medical education.ObjectiveThe purpose of this study is to describe the implementation of a QIPS strategy across residency education at Dalhousie University.MethodsA QIPS task force was formed, and a literature review and needs assessment survey were completed. A needs assessment survey was distributed to all Dalhousie residency programme directors. 12 programme directors were interviewed individually to collect additional feedback. The results were used to develop a ‘road map’ of recommendations with a graduated timeline.ResultsA task force report was released in February 2018. 46 recommendations were developed with a timeframe and responsible party identified for each. Implementation of the QIPS strategy is underway, and evaluation and challenges faced will be described.ConclusionsWe have developed a multiyear strategy that is available to provide guidance and support to all programmes in QIPS. The development and implementation of this QIPS framework may serve as a template for other institutions who seek to integrate these competencies into residency training.

2021 ◽  
Vol 14 (2) ◽  
pp. 80-90
Hassan Abbas ◽  
Jubran Fahad

The phenomenon of liquefaction is one of the most important problems in engineering projects.  It occurs in saturated sandy soils during the occurrence of earthquakes. Methods based on the standard penetration test (SPT) were developed to calculate the liquefaction potential according to the seismic loads. These methods have been developed and updated over time by some researchers. This paper analyses the comparison between methods of calculating liquefaction potential. The case study that was selected for the analysis of the comparison methods is Diyala Governorate soil. The methods that have been chosen for making a comparative analysis are the Japanese method, National Centre for Earthquake Engineering Research 1997 (NCEER) workshop, Task Force Report 2007 (Vancouver) and Boulanger and Idriss 2014. The analysis of results stated that the Boulanger and Idriss method is considered more suitable than others for calculating the potential for liquefaction in Diyala Governorate soil. It is found that the Boulanger and Idriss method has higher safety factor than the two methods (80.7% from Vancouver and 38.8% from the NCEER workshop) and less than the Japanese method  

Lupus ◽  
2021 ◽  
pp. 096120332110203
Savino Sciascia ◽  
Massimo Radin ◽  
Irene Cecchi ◽  
Roger A Levy ◽  
Doruk Erkan

The objectives of the 16th International Congress on Antiphospholipid Antibodies (aPL) Task Force on Clinical Manifestations of Antiphospholipid Syndrome (APS) were to critically analyze: a) the definition of “APS”; b) the current knowledge on non-traditional manifestations associated with aPL; and c) the risk stratification strategies in aPL-positive patients. The quality of evidence was assessed by the GRADE system. The task force concluded that: a) APS does not have a uniform definition given the heterogeneity of the clinical presentations and different aPL profiles; b) current literature supports the role for aPL testing in cases of thrombocytopenia and recurrent cardiac events but are limited by vast heterogeneity, providing an overall low-to-very low level of evidence; and c) risk stratification strategies in aPL-positive patients, such as aPL-Score and Global APS Score, can be useful in clinical practice. International multicenter studies are still highly needed to improve the quality of available evidence and consequently the strength of future recommendations.

Allergy ◽  
2021 ◽  
O Pfaar ◽  
KC Bergmann ◽  
Ss Bonini ◽  
E Compalati ◽  
N Domis ◽  

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A209-A210
Ashima Mittal ◽  
Murray B Gordon

Abstract Introduction: Atypical femur fractures (AFF) are reported in patients taking prolonged bisphosphonate therapy, but Paget’s disease (PD) has been rarely reported as a cause of AFF. Case: 71-year-old female with past medical history of right hip osteoarthritis, seizure disorder, hypertension, and Hashimoto’s thyroiditis presented with persistent right hip pain. There was no history of trauma or fall. She had otosclerosis with bilateral hearing loss and bilateral stapedectomies. Her medications were primidone, levothyroxine, lisinopril-hydrochlorothiazide, and vitamin D. She did not smoke tobacco or drink alcohol. She had elevated serum alkaline phosphatase of 300 U/L (35–104). The X-ray of the skull was negative for any cortical thickening. CT of right femur revealed cortical thickening and coarsening of trabeculae of the proximal right femur consistent with PD and incomplete atypical subtrochanteric proximal fracture. Urine NTx 303 BCE/mM Cr (<89). Bone scan showed uptake in the R proximal femur, L distal tibia, and L3-L4 vertebral bodies suspicious of PD. DXA showed osteopenia. She was given zoledronic acid 5 mg IV. Discussion: PD leads to an increased incidence of fractures particularly of the lower extremities with most fractures transverse in nature. Non-union is not uncommon1. Stress fractures in PD are caused by disorganized bone remodeling due to excessive breakdown and formation of bone. Our patient met the major criteria for AFF as per the ASBMR 2010 task force report but there was no exposure to bisphosphonates2. The ASBMR task force recommended that bisphosphonates should be discontinued in patients with bisphosphonate-associated AFF due to their severely suppressed bone turnover status. On the other hand, the AFF in patients with PD may heal in response to bisphosphonate treatment. References: 1. Singer FR. Bone Quality in Paget’s Disease of Bone. Curr Osteoporos Rep. 2016;14(2):39–42. DOI:10.1007/s11914-016-0303-62. Shane E, Burr D, Ebeling PR, Abrahamsen B, Adler RA et.al. Atypical subtrochanteric and diaphyseal femoral fractures: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res. 2010; 25:2267–2294.

N Blanca‐Lopez ◽  
M Atanaskovic‐Markovic ◽  
ER Gomes ◽  
M Kidon ◽  
S Kuyucu ◽  

2021 ◽  
Vol 24 (4) ◽  
pp. 463-472
Olena (Lena) Mandrik ◽  
J.L. (Hans) Severens ◽  
Ariel Bardach ◽  
Salah Ghabri ◽  
Candyce Hamel ◽  

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