Intensive cataract training: a novel approach.
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ABSTRACT:
SUBMITTER: Baxter JM
PROVIDER: S-EPMC3682359 | biostudies-other | 2013 Jun
REPOSITORIES: biostudies-other
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Project description:PURPOSE:To determine the effect of the early introduction of cataract surgery training on the complication rates of resident-performed cataract surgery. SETTING:University of California San Diego, San Diego, California, USA. DESIGN:Retrospective case series. METHODS:Two classes of ophthalmology residents were examined, one class with a late introduction of cataract surgery and one with an early introduction of cataract surgery. All cataract cases in which residents acted as primary surgeon were included. Patient charts were reviewed to collect data on patient characteristics, surgical details, and intraoperative and postoperative complications. RESULTS:The late-introduction cohort comprised 3 residents who performed 540 cataract cases, all during their final year of residency. The early-introduction cohort comprised 4 residents who performed 780 cataract cases beginning in the first year of residency. The late-introduction cohort had higher rates of major intraoperative complications than the early-introduction cohort (8.5% versus 3.1%) and of anterior vitrectomy (7.6% versus 2.1%) (both P < .001). Examination of the anterior vitrectomy rate as a function of experience showed the early-introduction cohort had a stable anterior vitrectomy rate of 1% to 2% throughout training, while the late-introduction cohort had a peak anterior vitrectomy rate of 12% at approximately case 20. Multivariable regression analysis showed the early-introduction cohort was independently associated with a lower rate of anterior vitrectomy (hazard ratio, 0.49; 95% confidence interval, 0.36-0.66) after adjusting for differences in patient characteristics and surgical complexity. CONCLUSIONS:Early introduction of cataract surgery training significantly decreased the rate of major intraoperative complications, specifically anterior vitrectomy, in resident-performed cataract surgeries.
| S-EPMC6157597 | biostudies-literature
Project description:BackgroundNetworks are increasingly regarded as essential in health research aimed at influencing practice and policies. Less research has focused on the role networking can play in researchers' careers and its broader impacts on capacity strengthening in health research. We used the Canadian Coalition for Global Health Research (CCGHR) annual Summer Institute for New Global Health Researchers (SIs) as an opportunity to explore networking among new global health researchers.MethodsA mixed-methods exploratory study was conducted among SI alumni and facilitators who had participated in at least one SI between 2004 and 2010. Alumni and facilitators completed an online short questionnaire, and a subset participated in an in-depth interview. Thematic analysis of the qualitative data was triangulated with quantitative results and CCGHR reports on SIs. Synthesis occurred through the development of a process model relevant to networking through the SIs.ResultsThrough networking at the SIs, participants experienced decreased isolation and strengthened working relationships. Participants accessed new knowledge, opportunities, and resources through networking during the SI. Post-SI, participants reported ongoing contact and collaboration, although most participants desired more opportunities for interaction. They made suggestions for structural supports to networking among new global health researchers.ConclusionsNetworking at the SI contributed positively to opportunities for individuals, and contributed to the formation of a network of global health researchers. Intentional inclusion of networking in health research capacity strengthening initiatives, with supportive resources and infrastructure could create dynamic, sustainable networks accessible to global health researchers around the world.
| S-EPMC3916077 | biostudies-literature
Project description:To evaluate current trainers' attitudes and practices for informing patients about the trainee participation in cataract surgery within the United Kingdom.An anonymous online survey was distributed to current cataract surgery trainers via all Royal College of Ophthalmologists' tutors within the United Kingdom. Trainers were asked specific questions about their current consent practice regarding trainee participation in the cataract surgery. Questions also targeted experiences of patient complaints about training.One hundred and twenty-three trainers completed the survey. Ninety-three percent (n=114) of responders were consultants and 7% (n=8) were non-consultant career-grade doctors or other grades. A total of 34% (n=42) of responders stated that consent was usually taken by themselves or the trainee assigned to the list, whereas 26% (n=32) always took consent themselves. Sixty percent of responders (n=74) stated that consent is taken on the day of surgery; 59% (n=73) indicated consent is taken where listing takes place. Thirty-three percent (n=41) of trainers indicated that they had experienced patient dissatisfaction or complaints. Surgical complications, length of surgery, and discussions during surgery were the leading causes of complaints. Thirty-nine percent (n=48) would operate themselves if patients requested no trainee participation.There is a wide variety in the current practice of disclosure and level of information given regarding trainee participation in surgery. This will influence patients' expectations, experiences, and satisfaction.
| S-EPMC3351061 | biostudies-other
Project description:Effective communication is a requisite skill for scientists. However, formalized training in this area is often unavailable for members of the scientific community. As one approach to combat this problem, the American Society for Biochemistry and Molecular Biology (ASBMB) developed The Art of Science Communication, an eight-week-long online course that provides facilitated instruction on how to communicate science in an oral format. The course is offered three times a year, and as of December 2017, nearly 200 individuals from all career stages have taken part in it. The course completion rate is currently 60%, a rate three to five times as high as the average for similar Massive Open Online Courses (MOOCs). Participants have indicated that taking the course has improved their ability to communicate about their research, and that the skills and lessons learned have benefited them professionally. Moving forward, we are examining approaches that will help us improve the course and expand its reach throughout the scientific community. This article details the development of the course and examines the role and potential of such training within the larger scientific community.
| S-EPMC5969408 | biostudies-literature
Project description:After stroke, enduring rehabilitation is required for maximum recovery, and ideally throughout life to prevent functional deterioration. Hence we developed a new concept for at-home low-cost motor rehabilitation, the NTT, an Internet-based interactive system for upper-limb rehabilitation. In this paper we present the NTT design concepts, its implementation and a proof of concept study with 10 healthy participants. The NTT brings together concepts of optimal learning, engagement, and storytelling to deliver a personalized training to its users. In this study we evaluate the feasibility of NTT as a tool capable of automatically assessing and adapting to its user. This is achieved by means of a psychometric study where we show that the NTT is able to assess movement kinematics-movement smoothness, range of motion, arm displacement and arm coordination-in healthy users. Subsequently, a modeling approach is presented to understand how the measured movement kinematics relate to training parameters, and how these can be modified to adapt the training to meet the needs of patients. Finally, an adaptive algorithm for the personalization of training considering motivational and performance aspects is proposed. In the next phase we will deploy and evaluate the NTT with stroke patients at their homes.
| S-EPMC3350995 | biostudies-literature
Project description:Objective:The purpose of this paper was to conduct a systematic review of existing literature on simulation-based training of cataract surgery. Available literature was evaluated and projections on how current findings could be applied to cataract surgery training were summarised. The quality of included literature was also assessed. Methods and analysis:The PubMed, Embase and Cochrane Library databases were searched for articles pertaining to simulation training in cataract surgery on 18 November 2019. Selected articles were qualitatively analysed. Results:A total of 165 articles were identified out of which 10 met inclusion criteria. Four studies reported construct validity of the EyeSi simulator. Six studies demonstrated improved surgical outcomes corresponding to training on the simulator. Quality assessment of included studies was satisfactory. Conclusion:Current studies on simulation training in cataract surgery all point towards it being an effective training tool with low risk of study biases confounding this conclusion. As technology improves, surgical training must embrace and incorporate simulation technology in training.
| S-EPMC7481074 | biostudies-literature
Project description:Cortical oscillations serve as an index of both sensory and cognitive processes and represent one of the most promising candidates for training and targeting the top-down mechanisms underlying executive functions. Research findings suggest that theta (?) oscillations (3-7 Hz) recorded over frontal-midline electrodes are broadly associated with a number of higher-order cognitive processes and may serve as the mechanistic backbone for cognitive control. Frontal-midline theta (FM?) oscillations have also been shown to inversely correlate with activity in the default mode network (DMN), a network in the brain linked to spontaneous thought processes such as mind-wandering and rumination. In line with these findings, we previously observed increased FM? oscillations in expert meditation practitioners during reported periods of focused-attention meditation practice when compared to periods of mind-wandering. In an effort to narrow the explanatory gap by directly connecting observed neurophysiological activity in the brain to the phenomenological nature of reported experience, we designed a methodologically novel and adaptive neurofeedback protocol with the aim of modulating FM? while having meditation novice participants implement breath-focus strategies derived from focused-attention mediation practices. Participants who received eight sessions of the adaptive FM?-meditation neurofeedback protocol were able to significantly modulate FM? over frontal electrodes using focused-attention meditation strategies relative to their baseline by the end of the training and demonstrated significantly faster reaction times on correct trials during the n-back working memory task assessed before and after the FM?-meditation neurofeedback protocol. No significant differences in frontal theta activity or behavior were observed in the active control participants who received age and gender matched sham neurofeedback. These findings help lay the groundwork for the development of brain training protocols and neurofeedback applications that aim to train features of the mental states and traits associated with focused-attention meditation.
| S-EPMC7344173 | biostudies-literature
Project description:PurposeTo compare the surgical duration for routine phacoemulsification surgeries in residents with and without virtual simulator training.MethodsRetrospective cohort study of operative times of routine phacoemulsification cataract surgeries performed by 29 different third-year residents rotating at one academic institution. One group underwent mandatory virtual cataract surgery simulator training (SIM) in their second year of residency before starting surgeries while the other group did not undergo any simulator training (NOSIM). Outcomes measured were comparative surgical times and vitreous loss rates between groups in their third year of residency.Results722 surgeries were included. Surgeries in the SIM group were on average 6.7 min (min) shorter compared to the NOSIM group (P = 0.0001). Although both groups required less time for surgery over the course of the academic year, regression analysis showed that NOSIM group residents overall required 17% longer time for an uncomplicated clear corneal phacoemulsification surgery (incidence rate ratio 1.17; p = 0.0001). In the final month of their residency residents in the SIM group (32.2 ± 3 min) were 9 min faster than NOSIM peers (41.2 ± 3 min mean ± SE; p = 0.02). Vitreous loss rates were 1.4% in the SIM group and 3.6% in the NOSIM group (p = 0.06).Conclusion and importanceEarly and continuous implementation of mandatory virtual simulator surgical training before starting intraocular surgeries significantly decreases operative times in third year residents learning phacoemulsification compared to non-simulator trained peers.
| S-EPMC6926105 | biostudies-literature
Project description:This will be a pilot study investigating the feasibility of using pressurized irrigation of the stomach mucosa to obtain gastric aspirate cell samples for analysis and identification of premalignant lesions of the stomach.
| 2328713 | ecrin-mdr-crc
Project description:ObjectiveThe objective of this study was to determine whether individualized gait training is more effective than usual care for reducing mobility disability and pain in individuals with symptomatic knee osteoarthritis.DesignAdults aged 60 yrs or older with symptomatic knee osteoarthritis and mobility limitations were randomized to physical therapist-directed gait training on an instrumented treadmill, with biofeedback individualized to optimize knee movements, biweekly for 3 mos or usual care (control). Mobility disability was defined using Late Life Function and Disability Index Basic Lower Limb Function score (primary); mobility limitations, using timed 400-m walk, chair-stand, and stair-climb tests; and symptoms, using the Knee Injury/Osteoarthritis Outcome Score at baseline, as well as at 3, 6, and 12 mos. The analyses used longitudinal mixed models.ResultsThere were no significant intergroup differences between the 35 gait-training (74.3% women; age, 69.7 ± 8.2 yrs) and 21 control (57.1% women; age, 68.9 ± 6.5 yrs) participants at baseline. At 3 mos, the gait-training participants had greater improvement in mobility disability (4.3 ± 1.7; P = 0.0162) and symptoms (8.6 ± 4.1; P = 0.0420). However, there were no intergroup differences detected for pain, 400-m walk, chair-stand, or stair-climb times at 3 mos or for any outcomes at 6 or 12 mos.ConclusionsCompared with usual care, individualized gait training resulted in immediate improvements in mobility disability knee symptoms in adults with symptomatic knee osteoarthritis, but these effects were not sustained.
| S-EPMC4567520 | biostudies-literature