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Ambulance clinical placements – A pilot study of students' experience
Malcolm J Boyle, Brett Williams, Jennifer Cooper, Bridget Adams, Kassie Alford
BMC Medical Education , 2008, DOI: 10.1186/1472-6920-8-19
Abstract: In this pilot study we employed a cross-sectional study methodology, using a convenience sample of undergraduate paramedic students available in semester one of 2007 to ascertain the students' views on their reception by on-road paramedics and their overall experience on emergency ambulance clinical placements. Ethics approval was granted.There were 77 students who participated in the survey, 64% were females, with 92% of students < 25 years of age and 55% < 65 Kg in weight. There was a statistically significant difference in average height between the genders (Male 179 cm vs Female 168 cm, p < 0.001). Clinical instructors were available to 44% of students with 30% of students excluded from patient management. Thirty percent of students felt there was a lot of unproductive down time during the placement. Paramedics remarked to 40% of students that they doubted their ability to perform the physical role of a paramedic, of this group 36% were advised this more than once.This study demonstrates that for a small group of students, emergency ambulance clinical placements were not a positive experience clinically or educationally. Some qualified paramedics doubt if a number of female students can perform the physical role of a paramedic.Current Australian undergraduate paramedic programs integrate theoretical teaching with clinical placement education in a variety of clinical settings. These settings include non-emergency ambulance, emergency ambulance, hospital wards and departments, community health centres, and rehabilitation centres for variable periods of time. This linkage between theory and practice (praxis) is critical to undergraduate paramedic programs as many have limited scope or capacity for clinical education periods. This potential reduction is largely due to timetabling constraints, health care organisations not able to meet the demands of clinical placements [1], often in direct competition with other allied health care professions [2]. Added to this, red
The Millimeter Astronomy Legacy Team 90 GHz (MALT90) Pilot Survey  [PDF]
Jonathan B. Foster,James M. Jackson,Elizabeth Barris,Kate Brooks,Maria Cunningham,Susanna C. Finn,Gary A. Fuller,Steve N. Longmore,Joshua L. Mascoop,Nicholas Peretto,Jill Rathborne,Patricio Sanhueza,Frédéric Schuller,Friedrich Wyrowski
Physics , 2011, DOI: 10.1088/0067-0049/197/2/25
Abstract: We describe a pilot survey conducted with the Mopra 22-m radio telescope in preparation for the Millimeter Astronomy Legacy Team Survey at 90 GHz (MALT90). We identified 182 candidate dense molecular clumps using six different selection criteria and mapped each source simultaneously in 16 different lines near 90 GHz. We present a summary of the data and describe how the results of the pilot survey shaped the design of the larger MALT90 survey. We motivate our selection of target sources for the main survey based on the pilot detection rates and demonstrate the value of mapping in multiple lines simultaneously at high spectral resolution.
Handheld computers and the 21st century surgical team: a pilot study
Omer Aziz, Sukhmeet S Panesar, Gopalakrishnan Netuveli, Paraskevas Paraskeva, Aziz Sheikh, Ara Darzi
BMC Medical Informatics and Decision Making , 2005, DOI: 10.1186/1472-6947-5-28
Abstract: The study looked at a heterogeneous team of doctors (n = 9) working in a busy surgical setting at St. Mary's Hospital in London and compared the use of a personal digital assistant with mobile phone and web-browsing facilities to the existing pager system. The primary feature of this device being compared to the conventional pager was its use as a mobile phone, but other features evaluated included the ability to access the internet, and reference data on the device. A crossover study was carried out for 6 weeks in 2004, with the team having access to the personal digital assistant every alternate week. The primary outcome measure for assessing efficiency of communication was the length of time it took for clinicians to respond to a call. We also sought to assess the ease of adoption of new technology by evaluating the perceptions of the team (n = 9) to personal digital assistants, by administering a questionnaire.Doctors equipped with a personal digital assistant rather than a pager, responded more quickly to a call and had a lower of failure to respond rate (RR: 0.44; 95%CI 0.20–0.93). Clinicians also found this technology easy to adopt as seen by a significant reduction in perceptions of nervousness to the technology over the six-week study period (mean (SD) week 1: 4.10 (SD 1.69) vs. mean (SD) week 6: 2.20 (1.99); p = 0.04).The results of this pilot study show the possible effects of replacing the current hospital pager with a newer, more technologically advanced device, and suggest that a combined personal digital assistant and mobile phone device may improve communication between doctors. In the light of these encouraging preliminary findings, we propose a large-scale clinical trial of the use of these devices in facilitating inter-professional communication in a hospital setting.Worldwide, there has been increasing interest in the use of wireless handheld technologies such as the personal digital assistant (PDA) in hospitals, with recent reports suggesting th
Pilot Study of CYP2B6 Genetic Variation to Explore the Contribution of Nitrosamine Activation to Lung Carcinogenesis  [PDF]
Catherine A. Wassenaar,Qiong Dong,Christopher I. Amos,Margaret R. Spitz,Rachel F. Tyndale
International Journal of Molecular Sciences , 2013, DOI: 10.3390/ijms14048381
Abstract: We explored the contribution of nitrosamine metabolism to lung cancer in a pilot investigation of genetic variation in CYP2B6, a high-affinity enzymatic activator of tobacco-specific nitrosamines with a negligible role in nicotine metabolism. Previously we found that variation in CYP2A6 and CHRNA5-CHRNA3-CHRNB4 combined to increase lung cancer risk in a case-control study in European American ever-smokers ( n = 860). However, these genes are involved in the pharmacology of both nicotine, through which they alter smoking behaviours, and carcinogenic nitrosamines. Herein, we separated participants by CYP2B6 genotype into a high- vs. low-risk group ( *1/*1 + *1/*6 vs. *6/*6). Odds ratios estimated through logistic regression modeling were 1.25 (95% CI 0.68–2.30), 1.27 (95% CI 0.89–1.79) and 1.56 (95% CI 1.04–2.31) for CYP2B6, CYP2A6 and CHRNA5-CHRNA3-CHRNB4, respectively, with negligible differences when all genes were evaluated concurrently. Modeling the combined impact of high-risk genotypes yielded odds ratios that rose from 2.05 (95% CI 0.39–10.9) to 2.43 (95% CI 0.47–12.7) to 3.94 (95% CI 0.72–21.5) for those with 1, 2 and 3 vs. 0 high-risk genotypes, respectively. Findings from this pilot point to genetic variation in CYP2B6 as a lung cancer risk factor supporting a role for nitrosamine metabolic activation in the molecular mechanism of lung carcinogenesis
A Format for Phylogenetic Placements  [PDF]
Frederick A. Matsen, Noah G. Hoffman, Aaron Gallagher, Alexandros Stamatakis
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0031009
Abstract: We have developed a unified format for phylogenetic placements, that is, mappings of environmental sequence data (e.g., short reads) into a phylogenetic tree. We are motivated to do so by the growing number of tools for computing and post-processing phylogenetic placements, and the lack of an established standard for storing them. The format is lightweight, versatile, extensible, and is based on the JSON format, which can be parsed by most modern programming languages. Our format is already implemented in several tools for computing and post-processing parsimony- and likelihood-based phylogenetic placements and has worked well in practice. We believe that establishing a standard format for analyzing read placements at this early stage will lead to a more efficient development of powerful and portable post-analysis tools for the growing applications of phylogenetic placement.
Student Perceptions of Adverse Health Events During Ambulance Clinical Placements
Education , 2012, DOI: 10.5923/j.edu.20120202.02
Abstract: This pilot study intended to augment current literature in the clinical placement field by investigating the frequency and nature of adverse health events experiences by paramedic students undertaking ambulance clinical placements. Supports accessed post event were also reviewed. A purposive sample of fifty-six paramedic students completed the questionnaire. The results indicate that a number of students experience adverse health events while on clinical placement, with fourteen cases of verbal abuse, one case of physical abuse, nine cases of sexualised behavior and seven cases of psychological distress reported. While some case related incidents were flagged by ambulance services and followed up by peer support, students did not initiate any formal support processes themselves. Moreover, no student filed a formal report regarding any of the incidents raised. The results of this pilot study require further investigation. In the interim, the benefits of clinical placements must be weighed against their risks, and processes put in place to minimize the risk to students undertaking clinical placements.
Feasibility of motivational interviewing delivered by a glaucoma educator to improve medication adherence
Paul F Cook, Robert W Bremer, AJ Ayala, et al
Clinical Ophthalmology , 2010, DOI: http://dx.doi.org/10.2147/OPTH.S12765
Abstract: sibility of motivational interviewing delivered by a glaucoma educator to improve medication adherence Original Research (3980) Total Article Views Authors: Paul F Cook, Robert W Bremer, AJ Ayala, et al Published Date September 2010 Volume 2010:4 Pages 1091 - 1101 DOI: http://dx.doi.org/10.2147/OPTH.S12765 Paul F Cook1, Robert W Bremer2, AJ Ayala4, Malik Y Kahook3 1College of Nursing, 2Department of Psychiatry, 3Department of Ophthalmology, School of Medicine, University of Colorado Denver, Aurora, CO, USA; 4Rocky Mountain Lions Eye Institute, University of Colorado Hospital, Aurora, CO, USA Introduction: Adherence to glaucoma treatment is poor, potentially reducing therapeutic effects. A glaucoma educator was trained to use motivational interviewing (MI), a patient-centered counseling style, to improve adherence. This study was designed to evaluate whether MI was feasible in a busy ophthalmology practice. Methods: Feasibility was assessed using five criteria from the National Institutes of Health Behavior Change consortium: fidelity of intervention components to MI theory; success of the training process; delivery of MI-consistent interventions by the glaucoma educator; patient receipt of the intervention based on enrollment, attrition, and satisfaction; and patient enactment of changes in motivation and adherence over the course of the intervention. Results: A treatment manual was designed by a multidisciplinary team with expertise in health psychology, public health, and ophthalmology. The glaucoma educator received 6 hours of training including role-play exercises, self-study, and individual supervision. His MI-related knowledge and skills increased following training, and he delivered exclusively MI-consistent interventions in 66% of patient encounters. 86% (12/14) of eligible patients agreed to be randomized into glaucoma educator support or a control condition. All 8 patients assigned to the glaucoma educator completed at least 2 of 6 planned contacts, and 50% (4/8) completed all 6 contacts. Patients assigned to the glaucoma educator improved over time in both motivation and adherence. Conclusion: The introduction of a glaucoma educator was feasible in a busy ophthalmology practice. Patients improved their adherence while participating in the glaucoma educator program, although this study was not designed to show a causal effect. The use of a glaucoma educator to improve glaucoma patients’ medication adherence may be feasible at other ophthalmology clinics, and can be implemented with a standardized training approach. Pilot data show the intervention can be implemented with fidelity, is acceptable to patients and providers, and has the potential to improve adherence.
Feasibility of motivational interviewing delivered by a glaucoma educator to improve medication adherence  [cached]
Paul F Cook,Robert W Bremer,AJ Ayala,et al
Clinical Ophthalmology , 2010,
Abstract: Paul F Cook1, Robert W Bremer2, AJ Ayala4, Malik Y Kahook31College of Nursing, 2Department of Psychiatry, 3Department of Ophthalmology, School of Medicine, University of Colorado Denver, Aurora, CO, USA; 4Rocky Mountain Lions Eye Institute, University of Colorado Hospital, Aurora, CO, USAIntroduction: Adherence to glaucoma treatment is poor, potentially reducing therapeutic effects. A glaucoma educator was trained to use motivational interviewing (MI), a patient-centered counseling style, to improve adherence. This study was designed to evaluate whether MI was feasible in a busy ophthalmology practice.Methods: Feasibility was assessed using five criteria from the National Institutes of Health Behavior Change consortium: fidelity of intervention components to MI theory; success of the training process; delivery of MI-consistent interventions by the glaucoma educator; patient receipt of the intervention based on enrollment, attrition, and satisfaction; and patient enactment of changes in motivation and adherence over the course of the intervention.Results: A treatment manual was designed by a multidisciplinary team with expertise in health psychology, public health, and ophthalmology. The glaucoma educator received 6 hours of training including role-play exercises, self-study, and individual supervision. His MI-related knowledge and skills increased following training, and he delivered exclusively MI-consistent interventions in 66% of patient encounters. 86% (12/14) of eligible patients agreed to be randomized into glaucoma educator support or a control condition. All 8 patients assigned to the glaucoma educator completed at least 2 of 6 planned contacts, and 50% (4/8) completed all 6 contacts. Patients assigned to the glaucoma educator improved over time in both motivation and adherence.Conclusion: The introduction of a glaucoma educator was feasible in a busy ophthalmology practice. Patients improved their adherence while participating in the glaucoma educator program, although this study was not designed to show a causal effect. The use of a glaucoma educator to improve glaucoma patients’ medication adherence may be feasible at other ophthalmology clinics, and can be implemented with a standardized training approach. Pilot data show the intervention can be implemented with fidelity, is acceptable to patients and providers, and has the potential to improve adherence.Keywords: adherence, counseling, glaucoma, medication, training
Motivational Interviewing and Social Justice  [cached]
William R. Miller, PhD
Motivational Interviewing : Training, Research, Implementation, Practice , 2013, DOI: 10.5195/mitrip.2012.32
Abstract: This address explores the relationship between motivational interviewing (MI) and six broad humane values: compassion, respect, fairness, human potential, prizing of differences, and collaboration. These values are implicit in the spirit and practice of MI, and have implications far beyond professional practice.
A pilot study on the effects of a team building process on the perception of work environment in an integrative hospital for neurological rehabilitation
Thomas Ostermann, Mathias Bertram, Arndt Büssing
BMC Complementary and Alternative Medicine , 2010, DOI: 10.1186/1472-6882-10-10
Abstract: Seventy seven staff members and 44 patients' relatives were asked to complete a survey that included the Work Environment Scale (WES-10), a Life Satisfaction Scale (BMLSS), the Conviction of Therapeutic Competency (CTC) scale and the Client Satisfaction Questionnaire (CSQ-8). To evaluate the outcome of the team building process, we analyzed changes over time in the WES-10 subscales. Additionally the interrelationship between the WES-10 subscales with other subscales and with sociodemographic parameters like age, gender was calculated by means of a bivariate correlation analysis.The team building process had a significant positive effect on perceived work environment in only one area. There was a significant improvement in the ward staffs' perception of their ability to constructively resolve conflicts 3 years after inception of the team building process than there was before inception. However, even in a unit that utilized holistic treatment and nursing in the care of severely disable patients, such care necessitating a very heavy workload, the measurements on the Self Realization, Life Satisfaction and Conviction of Therapeutic Competency scales remained high and unchanged over the three year time period of the study.Strategic interventions might be an option to improve interpersonal relationships and finally quality of patient care.The nature of the environment in which a medical staff does their work plays an important role in job satisfaction and performance. Several studies already investigated the relationship between the milieu in which health professionals work and the impact on job satisfaction. They proved that poor work environment is associated with reduced job satisfaction, absenteeism, somatic complaints, burnout and depression [1-3]. Moreover, poor work environment might also influence the work performance negatively, and might also promote negative and cynical attitudes towards patients and colleagues [4], which in turns will have an impact on the pa
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