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Selected AbstractsAn intervention to improve school and student performancePERFORMANCE IMPROVEMENT, Issue 9 2008Becky Shaver Georgia Leadership Institute for School Improvement (GLISI) used ISPI's 10 Standards of Performance Technology to share the design, development, and implementation of an intervention striving to help Georgia districts and schools share their success stories in a clear and concise format. This intervention took the form of a PowerPoint presentation, GLISI Promising Practices, and has become a successful tool for districts to share and communicate their success. [source] 10 A Rapid, Simple and Inexpensive Method for Construction of Peripheral Vascular Ultrasound PhantomsACADEMIC EMERGENCY MEDICINE, Issue 2008Hal Minnigan Background and Introduction:, Emergency department bedside ultrasound has grown to include ultrasound guidance of vascular access, most recently, peripheral IV access has been described with ultrasound guidance. Simulation of procedures that are crucial to clinical practice is an efficient and reliable way to train and assess competency prior to performance on an actual patient. Ultrasound phantoms that simulate patient anatomy allow the development of hand-eye coordination, orientation and manipulation of the instruments in a controlled setting. In an effort to obviate the cost of commercial products I have developed a very simple and rapid method for building vascular ultrasound phantoms for teaching ultrasound guided peripheral IV placement. Materials and Methods:, Using easily obtainable and inexpensive materials, a simple method is described which allows construction of the phantom in less than 1 hour. This method requires no special tools or construction skills. The total cost for 1 phantom is about $30.00. Most of the components can be reused when the phantom needs to be repoured , the cost to repour a phantom is less than 2. Results:, These phantoms are realistic in terms of visualization of deep upper extremity veins, and include fluid filled vessels which are gravity fed by colored saline. The system is versatile and can be customized to fit the needs of the individual user. Attendees will be provided with a CD comprising a complete materials list with sources of supply, a PowerPoint presentation to guide construction with each step detailed using digital photographs, and videos of use of the phantom. [source] Latest news and product developmentsPRESCRIBER, Issue 2 2007Article first published online: 1 MAR 200 Venlafaxine: same suicide risk Venlafaxine (Efexor) is probably not associated with a higher risk of suicide than citalopram, fluoxetine or dosulepin, even when prescribed for patients at higher risk, according to an analysis of the UK General Practice Research Database (BMJ, doi:10.1136/bmj.39041.445104.BE. Published 12 December 2006). The retrospective cohort study found that venlafaxine was associated with a significantly higher risk of completed and attempted suicide in adults than the other antidepressants but, after adjusting for risk factors, the authors concluded that much, if not all, of the difference could be explained by confounding. Raised glucose with thiazides not clinically significant? A new analysis of the ALLHAT trial suggests that the small increase in blood glucose levels associated with long-term thiazide therapy is not associated with an increased risk of cardiovascular events (Arch Intern Med 2006;166:2191-201). The ALLHAT trial compared cardiovascular outcomes in over 18 000 patients with hypertension who were treated with chlortali- done (Hygroton), amlodipine and lisinopril. After two years, fasting blood glucose had increased in all groups (by 0.47, 0.31 and 0.19mmol per litre respectively); compared with chlortalidone, the odds of developing diabetes were 45 per cent lower with lisinopril and 27 per cent lower with amlodipine. However, there was no significant link between fasting blood glucose levels and cardiovascular events, end-stage renal disease or death; developing diabetes was associated with an increased risk of CHD overall but this was not statistically significant for chlortalidone in particular. Withdrawing alendronate after five years' treatment Discontinuing treatment of osteoporosis with alendronate after five years does not significantly increase fracture risk for many women, a US study has shown (J Am Med Assoc 2006;296:2927-38). In this five-year extension to the Fracture Intervention Trial, 1099 women who had taken alendronate for five years were randomised to continue treatment or switch to placebo for a further five years. In those taking placebo, bone mineral density decreased by 2.4 per cent at the hip and 3.7 per cent in the spine but remained above pre- treatment levels. Continuing with alendronate was associated with a lower risk of clinical vertebral fractures (2.4 vs 5.3 per cent) but no significant reduction in morphometric vertebral fractures (9.8 vs 11.3 per cent respectively). The cumulative risk of nonvertebral fractures was 19 per cent in each group. The authors conclude that women at very high risk of clinical vertebral fractures may benefit from continuing alendronate, but for many discontinuation does not appear to increase fracture risk. Instructions on labels Patients with low levels of literacy are at high risk of not understanding medicines labelling (Ann Intern Med 2006;145:887-94). In 395 English-speaking adults, 71 per cent correctly repeated simple label instructions, but only 35 per cent could demonstrate the correct number of tablets involved. Low literacy levels were associated with a twofold increased risk of misunderstanding labelling. Statins campaign The National Prescribing Centre (NPC) has launched a campaign to increase prescribing of low-cost statins. Resources available from its website at www.npc.co.uk/statins.htm are divided into four categories: policy and guidance, therapeutics, implementation resources and monitoring tools. Formats include documents and case studies, Powerpoint presentations and E-learning workshops. patients feeling rested on waking and daytime functioning. The Z-drugs were also believed to cause fewer adverse effects. GPs believe in ,Z' drugs A survey of GPs in Lincolnshire has revealed that their beliefs about nonbenzodiazepine hypnotics are inconsistent with NICE guidance and published evidence (Br J Gen Pract 2006; 56:964-7). Responders believed that zaleplon (Sonata), zopiclone and zolpidem were superior to benzodiazepines in increasing sleep time, patients feeling rested on waking and daytime functioning. The Z-drugs were also believed to cause fewer adverse effects. The authors note that, while benzodiazepine prescribing is declining, that of the Z-drugs is increasing, and they suggest this may be explained by misplaced beliefs about their relative effectiveness and safety. Pharmacy EHC guidance Pharmacists can supply emergency hormonal contraception (EHC) in advance but should consider when it is clinically appropriate to do so, according to revised guidance from the Royal Pharmaceutical Society. The move follows support for advance supply from the British Pregnancy Advisory Service and Marie Stopes International. Pharmacists are advised to decline repeated requests and recommend contraception instead, and to counsel users on using EHC safely and appropriately. More support from NICE NICE has developed two databases to support implementation of its recommendations. The shared learning database (www.nice.org.uk/ sharedlearning) includes experiences of implementing NICE guidance. The second, known as ERNIE (Evaluation and Review of NICE Implementation Evidence), includes data provided by NICE on uptake of its advice and external information (www.nice.org.uk/ernie). Mental health briefings The DoH (www.dh.gov.uk) has published several briefing documents to explain the main changes to mental health legislation, covering professional roles, criteria for detention and supervised community treatment (SCT). SCT applies to patients with a stable chronic mental disorder who have been discharged from hospital and who, but for their treatment, may pose a risk to themselves or others. Patients remain the responsibility of the mental health team. Copyright © 2007 Wiley Interface Ltd [source] 16 A Novel Approach to "See One, Do One": Multimedia Presentations before Procedure Workshops and SimulationACADEMIC EMERGENCY MEDICINE, Issue 2008Amita Sudhir We propose that residents and medical students are likely to gain more from a simulation experience or procedure workshop if they are given educational materials conveying key concepts to review beforehand. Several multimedia formats are available to accomplish this task. Digital video and Powerpoint presentations can be converted to podcasts with or without audio tracks using programs like Profcast, GarageBand, Camtasia, and Keynote. There are also procedure videos available from sources like the New England Journal of Medicine. Participants are provided these instructional materials via a secure web server or email attachment several days prior to the educational session. These presentations are kept short in length (no greater than 10-15 minutes) to optimize compliance while delivering information efficiently. They can be reviewed at the learner's convenience on a personal computer or on an iPod with video capability. This method can significantly reduce the time required for didactic teaching in a procedure workshop; for example, when medical students review a video on basic suturing before attending a suturing workshop, they are prepared to begin practicing with minimal initial instruction. Furthermore, conveying the same information repeatedly through different instructional methods can help learners consolidate knowledge, as in the case of a presentation provided to residents before a simulation session containing the basic clinical teaching points of the case. Participant feedback regarding these resources has been favorable. [source] Mental Health and the Churches: the Story of LucreciaINTERNATIONAL REVIEW OF MISSION, Issue 376-377 2006Brenda Consuelo Ruiz In this article, prepared originally as a powerpoint presentation, Brenda Consuelo Ruiz attempts to show, by way of a case study, bow churches can contribute to the mental and physical illness of individuals and families in the church, as well as to their health. She also proposes different ways in which churches can engage in promoting mental health. [source] |