21 results on '"Sims L"'
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2. The Psychological Foundations of The Mediating Learning Support Assistant (MeLSA) Training Programme
- Author
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Stanley-Duke, M., Wright, D., Cook, E., Reid, A., Cogan, O., Reese, S., Bull-Beddows, R., Sims, L., and Graves, F.
- Abstract
It is estimated that a quarter of the mainstream school workforce in the UK are learning support staff. This is a substantial number of adults who have the potential to foster learning. This paper provides a brief summary regarding the impact of support staff on children and young people’s learning. It describes how the Mediating Learning Support Assistant (MeLSA) training programme was developed to meet a training gap identified in the literature. This paper also details the psychological theories and research evidence which provide the foundations for MeLSA and describes the format of the training programme, which consists of six days (mediating learning and mindset, thinking about thinking, memory and recall, mathematics, literacy, and implementation) followed by ongoing supervision. The aim of MeLSA is to ensure that learning support staff have the psychological and evidence-informed expertise to enable those with whom they are working to become competent and independent learners.
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- 2022
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3. From Healer to Harmer: Preparing Senior Medical Students for Patient Harm Events in a Transition-to-Residency Course.
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Grant C, Warns S, Sims L, and Fletcher KE
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- Humans, Surveys and Questionnaires, Patient Harm prevention & control, Education, Medical, Undergraduate methods, Curriculum, Medical Errors prevention & control, Education methods, Students, Medical psychology, Students, Medical statistics & numerical data, Internship and Residency methods, Adaptation, Psychological
- Abstract
Introduction: A physician's first patient harm event oftentimes occurs during the intern year. Residents encounter and are responsible for medical errors, yet little training is offered in how to properly cope with these events. Earlier and more in-depth education about how to process patient harm events is needed., Methods: We developed a 110-minute workshop focused on coping strategies for patient harm events and delivered it to a cohort of fourth-year medical students during a transition-to-residency course just before graduation. The workshop emphasized interns' increasing exposure to medical errors, how to personally process them, and how to debrief near-peers in processing them., Results: A total of 190 students participated in the workshop. Our survey response rate was 88%. Students' confidence in defining second casualty after the workshop grew from eight responding very or extremely confident (7%) to 95 responses (87%). Comfort utilizing positive coping mechanisms improved from 14 very or extremely confident responses (12%) to 73 responses (67%). Confidence utilizing first responder structure grew from three very or extremely confident responses (3%) to 61 responses (56%). Comfort helping colleagues cope with patient harm events grew from 16 very or extremely confident responses (14%) to 78 responses (72%)., Discussion: This workshop fills an important gap in UME by preparing senior-level students to resolve emotional conflict related to patient harm events. Our findings illustrate that a short-term intervention on this topic can impact students' confidence. We believe discussion around how patient harm events emotionally impact trainees should be expanded., (© 2024 Grant et al.)
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- 2024
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4. Avian influenza: past, present and future.
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Sims LD
- Subjects
- Animals, Humans, Influenza, Human epidemiology, Influenza, Human prevention & control, Influenza, Human virology, Influenza A virus pathogenicity, Influenza A virus classification, Influenza Vaccines immunology, Influenza A Virus, H5N1 Subtype pathogenicity, Influenza in Birds epidemiology, Influenza in Birds virology, Influenza in Birds prevention & control, Birds
- Abstract
Avian influenza is not a new disease, but the emergence of high pathogenicity avian influenza (HPAI) viruses of the A/Goose/Guangdong/1/96 lineage (Gs/GD) has necessitated fundamental changes to prevention and control strategies for this disease. No longer just an avian disease, avian influenza is capable of causing severe disease in humans and is considered a potential human pandemic threat requiring One Health approaches. In addition, Gs/GD HPAI viruses have developed the capacity to be carried across and between continents by migratory birds. Given the persistence of the current A(H5N1) clade 2.3.4.4b viruses in wild birds, enhanced measures to prevent and control infection will be needed. In most countries, infection in poultry can be eliminated, although questions will remain about the sustainability of repeated stamping out. Systematic preventive vaccination should be seriously considered as a method for reducing the number of outbreaks. HPAI will not be eliminated from countries where Gs/GD viruses remain enzootic until major changes are made to the way that poultry are reared and sold, vaccination is improved and other factors that inhibit reporting and response are overcome. Currently, focus lies on Gs/GD HPAI, yet control of low pathogenicity avian influenza viruses also requires attention, including the development of vaccines that are appropriately matched to circulating strains of virus.
- Published
- 2024
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5. Strategic challenges in the global control of high pathogenicity avian influenza.
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Swayne DE, Sims LD, Brown I, Harder T, Stegeman A, Abolnik C, Delgado M, Awada L, Pavade G, and Torres G
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- Animals, Humans, Influenza A virus pathogenicity, Virulence, Animals, Wild, Influenza in Birds prevention & control, Influenza in Birds epidemiology, Influenza in Birds virology, Influenza in Birds transmission, Birds, Global Health
- Abstract
H5Nx A/Goose/Guangdong/1/96 Eurasian lineage high pathogenicity avian influenza (HPAI) viruses have been the main HPAI strains detected globally since 2005. These have spread around the world, causing a panzootic that has spanned six continents, with continual threat to not only wild and captive birds and poultry, but also wild, captive and domestic mammals and humans. The viruses' ecology and epidemiology - especially the 2.3.4.4b clade - have changed, with over 489 species of birds infected and spreading the virus over migratory routes. This results in the death of many birds, including endangered species, and serves as a source of transmission to poultry and mammals. Improved surveillance and sharing of HPAI virus sequences, metadata and viruses across the veterinary, public health, wildlife and environment sectors are needed to elucidate the population dynamics of the infections, which is crucial to addressing this complex One Health issue. The development of appropriate mitigation strategies or changes in husbandry, production and selling practices can reduce the risk of viruses being introduced into farms, as well as their amplification and viral evolution, and any spill-back to wild birds. Approaches to prevention and control of HPAI in countries where these 2.3.4.4b viruses remain entrenched in poultry, or places at risk of virus introduction via wild bird populations, involve measures to reduce the effects of the disease in poultry (including enhanced farm bio-security, vaccination, zoning and compartmentalisation). Their uptake reflects the difficulties encountered in relying solely on biosecurity for disease prevention and on stamping out alone for virus control and elimination. The World Organisation for Animal Health's Terrestrial Animal Health Code allows use of vaccination of poultry under specific conditions and without negatively impacting HPAI-free status if appropriate surveillance is conducted, thus supporting safe trade in poultry and poultry products. Nevertheless, concerns regarding loss of valuable export markets still interfere with greater utilisation of vaccination.
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- 2024
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6. Improving prescribing learning in problem-based learning.
- Author
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Bull S and Sims L
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- Humans, United Kingdom, Clinical Competence, Drug Prescriptions standards, Students, Medical, Education, Medical, Undergraduate, Curriculum, Medication Errors prevention & control, Problem-Based Learning
- Abstract
Background: Prescribing errors are known to occur in clinical practice. To ensure prescribing competence, foundation doctors in the United Kingdom now need to pass a national Prescribing Safety Assessment (PSA). Medical students are requesting more prescribing learning. We propose that early year's problem-based learning (PBL) sessions in medical curricula may be a place where more prescribing-related material could be added to ensure preparedness to prescribe., Approach: We modified existing PBL material by adding prescribing-related tasks within the patient cases. To ensure relevancy, the prescribing tasks were blueprinted to the assessment structure of the PSA. An example task would be to tailor prescribing, advise on required monitoring and provide information about medication to the (fictional) patients., Evaluation: Free text questionnaires were sent to second-year medical students at two points in the academic year. Thirty-eight of 244 participants responded. Students expressed perceived deficits in their prescribing education both within PBL and in other curriculum areas. Students desired more faculty-led approaches to learning, yet acknowledged that the tasks introduced in PBL sessions, especially those that promoted use of clinical guidelines and national prescribing resources were useful., Implications: Although students expressed a desire for increased faculty-led learning on prescribing, the introduction of prescribing tasks into early-year's PBL cases has a place. For example, tasks that promote students' use of prescribing and evidence-based resources may build their confidence in using them throughout their medical degree and within the PSA assessment (where the formularies can be used by candidates)., (© 2024 The Author(s). The Clinical Teacher published by Association for the Study of Medical Education and John Wiley & Sons Ltd.)
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- 2024
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7. Does Addition of a Longer Acting Local Anesthetic Improve Postoperative Pain After Carpal Tunnel Release? A Randomized Controlled Trial.
- Author
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Chan E, Billard K, Sims L, Yang C, and Sauder D
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- Humans, Male, Female, Middle Aged, Aged, Adult, Anesthetics, Combined administration & dosage, Decompression, Surgical, Treatment Outcome, Lidocaine administration & dosage, Lidocaine therapeutic use, Pain, Postoperative drug therapy, Carpal Tunnel Syndrome surgery, Anesthetics, Local administration & dosage, Bupivacaine administration & dosage, Pain Measurement
- Abstract
Purpose: Carpal tunnel release (CTR) is a simple and effective treatment for carpal tunnel syndrome in patients who have failed nonsurgical management. This surgery is often performed in the ambulatory clinic under local anesthesia, with lidocaine, a short-acting agent. Few studies have investigated the use of longer acting agents, such as bupivacaine, for outpatient CTR. Therefore, the aim of our study was to compare the postoperative pain experience after CTR with the use of either our standard lidocaine solution (control) or a mixture consisting of lidocaine and bupivacaine in equal amounts (intervention)., Methods: Patients undergoing CTR were randomized into control or intervention groups. Postoperative pain severity and numbness were recorded at several timepoints within the first 72 hours. The timing and quantity of postoperative analgesic use (acetaminophen and/or ibuprofen) was also documented. Both patients and assessor were blinded to allocation., Results: Our study cohort included 139 patients: 67 in the control group and 72 in the intervention group. Postoperative pain scores were significantly lower in the intervention group at 6 hours (2.3 vs 3.2) and 8 hours (2.9 vs 3.9). Additionally, patients in the intervention group reported longer time to first analgesic use than those in the control group (5.2 hours vs 3.7 hours). A greater proportion of patients in the intervention group reported postoperative numbness at nearly all time points, compared to the control group., Conclusions: Our study shows that a mixture of bupivacaine and lidocaine improves early postoperative pain but causes prolonged finger numbness when compared to lidocaine alone. As both medications are effective and feasible for outpatient CTR, surgeon and patient preference should guide local anesthetic choice., Type of Study/level of Evidence: Therapeutic Ib., Competing Interests: Conflicts of Interest Dr Chan reports support from Saskatoon City Hospital Orthopedic Advancement Fund. No benefits in any form have been received or will be received by the other authors related directly to this article., (Copyright © 2024 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)
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- 2024
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8. An Achilles Tendinopathy Educational Intervention for Generalist Physicians Raises Awareness and Improves Knowledge for Treating Ballet Dancers.
- Author
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Coates WC and Sims L
- Subjects
- Humans, Prospective Studies, Male, Female, Health Knowledge, Attitudes, Practice, Tendinopathy therapy, Dancing injuries, Dancing physiology, Achilles Tendon injuries
- Abstract
Background: Achilles tendinopathy can be a devastating condition in ballet dancers. Initial medical evaluation is frequently conducted by generalist physicians, who may lack the perspective of dance and sports medicine focused training and often prescribe complete rest for chronic overuse injuries. In order to provide targeted information about Achilles tendinopathy and the unique needs of elite athletes, such as ballet dancers, we designed an educational intervention that covers relevant anatomy, physiology, biomechanics, clinical presentation and evaluation, and recommendations for initial treatment and sub-specialty referral. The objectives of this study were to determine baseline understanding of Achilles tendinopathy by generalist physicians and to evaluate the efficacy of an educational intervention on their knowledge., Methods: This was a prospective pre- post-test study, to measure improvement in knowledge about Achilles tendinopathy. Emergency Medicine and Primary Care physicians participated in an educational intervention with didactic and hands-on components. Data were analyzed using a two-tailed t -test., Results: Twenty generalist physicians participated. There was significant improvement in their knowledge of Achilles tendinopathy for all our educational objectives (Pre-test: 59% correct answers; post-test: 79% correct answers; P < .0001; 95% CI: 6.32-10.78.)., Conclusions: A brief educational intervention leads to increased knowledge of Achilles tendinopathy in generalist physicians. By increasing awareness of Achilles tendinopathy through a standard educational model, we propose that our curriculum can be portable and accessible to all health care providers who encounter dancers and other athletes with Achilles tendinopathy and may serve as a model for expanded education to generalists about other conditions commonly encountered in ballet dancers., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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- 2024
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9. Sticking together: independent evolution of biofilm formation in different species of staphylococci has occurred multiple times via different pathways.
- Author
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Crossman L, Sims L, Dean R, Felgate H, Calvo TD, Hill C, McNamara I, Webber MA, and Wain J
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- Phylogeny, Bacterial Proteins genetics, Bacterial Proteins metabolism, Evolution, Molecular, Biofilms growth & development, Staphylococcus genetics, Staphylococcus physiology
- Abstract
Background: Staphylococci cause a wide range of infections, including implant-associated infections which are difficult to treat due to the presence of biofilms. Whilst some proteins involved in biofilm formation are known, the differences in biofilm production between staphylococcal species remains understudied. Currently biofilm formation by Staphylococcus aureus is better understood than other members of the genus as more research has focused on this species., Results: We assembled a panel of 385 non-aureus Staphylococcus isolates of 19 species from a combination of clinical sources and reference strains. We used a high-throughput crystal violet assay to assess the biofilm forming ability of all strains and assign distinct biofilm formation categories. We compared the prevalence of Pfam domains between the categories and used machine learning to identify amino acid 20-mers linked to biofilm formation. This identified some domains within proteins already linked to biofilm formation and important domains not previously linked to biofilm formation in staphylococci. RT-qPCR confirmed the expression of selected genes predicted to encode important domains within biofilms in Staphylococcus epidermidis. The prevalence and distribution of biofilm associated domains showed a link to phylogeny, suggesting different Staphylococcus species have independently evolved different mechanisms of biofilm production., Conclusions: This work has identified different routes to biofilm formation in diverse species of Staphylococcus and suggests independent evolution of biofilm has occurred multiple times across the genus. Understanding the mechanisms of biofilm formation in any given species is likely to require detailed study of relevant strains and the ability to generalise across the genus may be limited., (© 2024. The Author(s).)
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- 2024
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10. Evaluation of a Novel Equity-Focused Curriculum for Early-Stage Medical Students.
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Roper KL, South AM, Palmer S, Johnson J, Sims L, Hustedde C, and Mangino AA
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Objectives: Medical school curricula have increasingly incorporated topics and content related to health equity and affiliated social determinants of health. However, there is limited literature to guide how programs might measure the success of these initiatives. Previous studies assessed medical student attitudes and perceived knowledge, preparedness, and skills. Based on self-reported measures of these attributes, we compared within-group and between-group differences at the onset of a novel equity-focused curriculum implementation., Methods: A multi-component approach to "thread" lectures, panel discussions, and other content dedicated to health equity concepts was assessed using adapted versions of two validated survey instruments of the measured constructs. Baseline data were collected prior to coursework and at follow-up early in students' second year assessed change attributable to the equity-focused curriculum thread, with additional comparison to a cohort of second-year students who had no exposure to the curriculum. Data were collected at the beginning of academic years 2021-2022 and 2022-2023., Results: The multivariate analysis of variance indicated significant change over time (p < 0.001) with the analyses of variance identifying students' perceived current skills and topic knowledge increasing over time. No significant differences were found between two separate groups of M2 students., Conclusions: Students' perceived skills at working with diverse patient populations and knowledge of topics focused on health equity increased across the study, despite a much smaller response rate for the same student cohort at follow-up. Students' perception that they are prepared to care for patients of diverse backgrounds was unaffected. Attitudinal assessment revealed a ceiling effect at baseline, which should be explored further with longitudinal assessment. For the ongoing effort to evaluate the success of equity-focused curricula and programs, this study contributes evidence of change on some but not all outcomes, and can help guide other programs in determining which outcomes best reflect areas of programmatic need and impact., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)
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- 2024
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11. Suicide-Related Out-of-Hospital Cardiac Arrests in Queensland, Australia: Temporal Trends of Characteristics and Outcomes over 14 Years.
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Doan TN, Rashford S, Sims L, Wilson K, Garner S, and Bosley E
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- Female, Male, Humans, Queensland epidemiology, Australia, Out-of-Hospital Cardiac Arrest epidemiology, Out-of-Hospital Cardiac Arrest therapy, Cardiopulmonary Resuscitation methods, Emergency Medical Services, Suicide
- Abstract
Background: Research into suicide-related out-of-hospital cardiac arrests (OHCA) using OHCA registries is scant. A more complete understanding of methods, patient characteristics, and outcomes is essential to inform prehospital management strategies and public health interventions., Methods: Included were all OHCA attended by Queensland Ambulance Service (Australia) paramedics between 1 January 2007 and 31 December 2020, where suicide-related causes could be identified. Age- and sex-standardized incidence rates were calculated. Suicide methods, patient characteristics, and survival outcomes were described. Factors associated with survival outcomes were investigated., Results: Seven thousand three hundred and fifty-six suicide-related OHCA cases were included. The incidence rates increased from 9.0 per 100,000 population in 2007 to 12.4 in 2020. The incidence rates for males were four times those for females; however, incidence rates for females have increased faster than for males. Hanging was the most common suicide method (63%). Twenty-three percent of patients received resuscitation attempts by paramedics. Among those, the rates of return of spontaneous circulation (ROSC) sustained to hospital arrival, survival to hospital discharge, and survival to 30 days were 28.6, 8.5, and 8.0%, respectively. Over time, the rates of ROSC upon hospital arrival increased, whereas the rates of survival to discharge and 30-day survival remained stable., Conclusion: The incidence of prehospital-identified suicide-related OHCA in Queensland has increased over time. The prognosis of suicide-related OHCA is poor. Prevention measures should focus on early identification and treatment of individuals having a high risk of suicide. Emergency medical services need to have sufficient training for telecommunicators and paramedics in suicide risk assessment and identification.
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- 2024
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12. Whole-cell studies of substrate and inhibitor specificity of isoprene monooxygenase and related enzymes.
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Sims L, Wright C, Crombie AT, Dawson R, Lockwood C, Le Brun NE, Lehtovirta-Morley L, and Murrell JC
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- Alkynes, Bacteria genetics, Methane, Mixed Function Oxygenases genetics, Oxygenases genetics, Oxygenases chemistry
- Abstract
Co-oxidation of a range of alkenes, dienes, and aromatic compounds by whole cells of the isoprene-degrading bacterium Rhodococcus sp. AD45 expressing isoprene monooxygenase was investigated, revealing a relatively broad substrate specificity for this soluble diiron centre monooxygenase. A range of 1-alkynes (C
2 -C8 ) were tested as potential inhibitors. Acetylene, a potent inhibitor of the related enzyme soluble methane monooxygenase, had little inhibitory effect, whereas 1-octyne was a potent inhibitor of isoprene monooxygenase, indicating that 1-octyne could potentially be used as a specific inhibitor to differentiate between isoprene consumption by bona fide isoprene degraders and co-oxidation of isoprene by other oxygenase-containing bacteria, such as methanotrophs, in environmental samples. The isoprene oxidation kinetics of a variety of monooxygenase-expressing bacteria were also investigated, revealing that alkene monooxygenase from Xanthobacter and soluble methane monooxygenases from Methylococcus and Methylocella, but not particulate methane monooxygenases from Methylococcus or Methylomicrobium, could co-oxidise isoprene at appreciable rates. Interestingly the ammonia monooxygenase from the nitrifier Nitrosomonas europaea could also co-oxidise isoprene at relatively high rates, suggesting that co-oxidation of isoprene by additional groups of bacteria, under the right conditions, might occur in the environment., (© 2023 The Authors. Environmental Microbiology Reports published by Applied Microbiology International and John Wiley & Sons Ltd.)- Published
- 2023
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13. The "Bubble": What Can Be Learned from the National Basketball Association (NBA)'s 2019-20 Season Restart in Orlando during the COVID-19 Pandemic.
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Mack CD, Merson MH, Sims L, Maragakis LL, Davis R, Tai CG, Meisel P, Grad YH, Ho DD, Anderson DJ, LeMay C, and DiFiori J
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- Humans, Pandemics, Seasons, SARS-CoV-2, COVID-19, Basketball
- Abstract
Background: The National Basketball Association (NBA) suspended operations in response to the COVID-19 pandemic in March 2020. To safely complete the 2019-20 season, the NBA created a closed campus in Orlando, Florida, known as the NBA "Bubble." More than 5000 individuals lived, worked, and played basketball at a time of high local prevalence of SARS-CoV-2., Methods: Stringent protocols governed campus life to protect NBA and support personnel from contracting COVID-19. Participants quarantined before departure and upon arrival. Medical and social protocols required that participants remain on campus, test regularly, physically distance, mask, use hand hygiene, and more. Cleaning, disinfection, and air filtration was enhanced. Campus residents were screened daily and confirmed cases of COVID-19 were investigated., Results: In the Bubble population, 148 043 COVID-19 reverse transcriptase PCR (RT-PCR) tests were performed across approximately 5000 individuals; Orlando had a 4% to 15% test positivity rate in this timeframe. There were 44 COVID-19 cases diagnosed either among persons during arrival quarantine or in non-team personnel while working on campus after testing but before receipt of a positive result. No cases of COVID-19 were identified among NBA players or NBA team staff living in the Bubble once cleared from quarantine., Conclusions: Drivers of success included the requirement for players and team staff to reside and remain on campus, well-trained compliance monitors, unified communication, layers of protection between teams and the outside, activation of high-quality laboratory diagnostics, and available mental health services. An emphasis on data management, evidence-based decision-making, and the willingness to evolve protocols were instrumental to successful operations. These lessons hold broad applicability for future pandemic preparedness efforts., (© Association for Diagnostics & Laboratory Medicine 2023. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
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- 2023
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14. Empowering future pharmacists - Embedding prescribing in the United Kingdom pharmacy undergraduate degree.
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Girvin B, Sims L, and Haughey S
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- Pharmacists, United Kingdom, Curriculum, Drug Prescriptions, Education, Pharmacy
- Abstract
Introduction: Pharmacy education within the United Kingdom (UK) is on the cusp of a major change with the integration of pharmacist independent prescribing into the undergraduate Master of Pharmacy (MPharm) degree and foundation year. This presents an opportunity for schools of pharmacy to completely review and redesign the MPharm degree in order to embed prescribing. This commentary details what needs to change within the MPharm degree and how these changes can be enacted., Commentary: The learning outcomes for the new degree place greater emphasis on diagnostic and consultation skills, risk management, professional judgement, and leadership. Course content needs to be sequenced so that complexity builds throughout the programme and clinical skills are taught and practised within the context of prescribing. There will be more emphasis on higher-order cognitive skills, such as collaborative clinical decision-making, considering potential risks and benefits. Teaching will need to align with learning on placements and time needs built into the curriculum for preparation and debrief sessions following placements and simulation scenarios. The increased responsibility that comes with prescribing rights will require review of how professional identity is formed and professionalism skills are taught and assessed., Implications: Pharmacists' expertise in medicines means that they are well-placed to be prescribers, which will help meet health service demands. Long-term funding will be required for placements in community, general practice, and hospital settings, including the provision of training and support to pharmacists mentoring students on placements. In spite of the challenges of curriculum redesign, this opportunity is wholeheartedly welcomed., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 Elsevier Inc. All rights reserved.)
- Published
- 2023
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15. Coracoclavicular bursal changes on MRI: a diagnostic consideration in patients with shoulder pain and reduced coracoclavicular distance.
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Obaid H, Mondal P, Sims L, Shepel M, and Vassos N
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- Bursa, Synovial, Humans, Magnetic Resonance Imaging, Retrospective Studies, Shoulder Joint, Shoulder Pain diagnostic imaging
- Abstract
Objective: To describe MRI changes of the coracoclavicular bursa in patients presenting with shoulder pain and examine whether there is an association with coracoclavicular distance measurements., Methods: Retrospective analysis of 198 shoulder 3T MRI scans for patients with shoulder pain was performed. Two musculoskeletal trained radiologists read all MRI scans. Inter-reader and intra-reader agreements for the bursal changes were assessed using the Kappa coefficient. The coracoclavicular distance was stratified into three intervals: < 5 mm, 5-10 mm, and > 10 mm. Statistical analysis for the coracoclavicular bursal changes and coracoclavicular distance was conducted using Fisher's exact test., Results: Coracoclavicular bursal changes were detected in 9% (n = 18/198) of patients. There was a statistically significant association between coracoclavicular distance (< 5 mm) and the presence of coracoclavicular bursal changes (p-value = 0.011). All patients (100%, n = 18/18) with coracoclavicular bursal fluid presented with shoulder pain with 44.5% of the patients (n = 8/18) describing anterior shoulder pain. A statistically significant association was detected between coracoclavicular bursal changes and anterior shoulder pain (p-value = 0.0011). Kappa coefficient for the bursal changes inter-reader agreement was moderate (0.67) and the intra-reader agreement was almost perfect (0.91)., Conclusion: Coracoclavicular bursal changes were detected in 9% of shoulder MRI scans and were associated with reduced coracoclavicular distance (< 5 mm) suggesting an underlying mechanical disorder such as a friction or an impingement process. Documenting coracoclavicular bursal changes in the MRI report could help address patients' concerns and guide further management particularly in the context of shoulder pain and coracoclavicular distance of less than 5 mm., (© 2022. Crown.)
- Published
- 2022
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16. Correlation between superior humeral head migration and proximal long head of biceps tendon pathology in patients with and without rotator cuff tears using magnetic resonance imaging and radiography.
- Author
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Rattee J, Sims L, Leswick DA, and Obaid H
- Abstract
Background: The biomechanical role of the proximal long head of the biceps tendon (PLHB) in glenohumeral joint stability remains controversial. This retrospective study aims to correlate between humeral head migration and PLHB pathology in patients with and without rotator cuff tendon tears using imaging., Methods: Seventy-nine patients who underwent 3T magnetic resonance imaging of the shoulder were retrospectively reviewed. Imaging findings were documented by a fellowship-trained musculoskeletal radiologist. PLHB tendon diameter change, contour irregularity, and signal intensity change were assessed. Rotator cuff status was given a binary assignment of intact vs. torn. Radiographs were used for measurement of the acromiohumeral distance and a cutoff value of 7 mm was set as a lower limit of normal., Results: In the cohort of 79 shoulders, 41.8% (33/79) of patients had intact PLHB tendon and rotator cuff, 26.6% (21/79) demonstrated isolated PLHB tendon pathology, 13.9% (11/79) demonstrated isolated rotator cuff tears, and 17.7% (14/79) demonstrated concomitant PLHB tendon pathology and rotator cuff tears. Acromiohumeral distance was preserved in 97.0% (32/33) of patients with intact PLHB tendon and rotator cuff, 28.6% (6/21) of patients with isolated PLHB tendon pathology, 81.8% (9/11) of patients with isolated rotator cuff tears, and 14.3% (2/14) of patients with concomitant PLHB tendon pathology and rotator cuff tears ( P < .0001)., Conclusion: Results of this study have shown that a statistical correlation was present between superior humeral head migration and PLHB tendon pathology with or without rotator cuff tears, compared to rotator cuff pathology alone. Findings suggest that intact PLHB tendon plays an important role in glenohumeral stability., (© 2022 The Author(s).)
- Published
- 2022
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17. Cannabis use patterns among patients with upper extremity conditions at the time of legalization in Canada.
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Sims L, Goetz T, White N, Badre A, Grammon B, Trenholm A, Strelzow J, and Grewal R
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- Analgesics, Canada epidemiology, Cross-Sectional Studies, Humans, Legislation, Drug, Upper Extremity, Cannabis
- Abstract
Background: Recreational cannabis use was legalized in Canada in 2018. Cannabis use patterns and patient attitudes toward cannabis use, particularly in the context of these legal changes, are not well understood. Our aim was to evaluate baseline cannabis use patterns and attitudes at the time of legalization among patients with upper extremity conditions in Canada., Methods: In 2018, we conducted a multicentre cross-sectional survey study of 1561 patients with upper extremity conditions at 7 surgical centres. Participants were asked whether they currently use cannabis. If yes, they were asked questions regarding usage patterns and perceptions of cannabis use, including likelihood of use, safety and comfort discussing it with their physician., Results: In the 6 months after legalization, 790 (51%) participants felt that cannabis was safer than prescription narcotics, with 450 (29%) currently using cannabis. Reasons for cannabis use included pain (56%), stress (51%) and recreation (42%). Of the 1105 patients not using cannabis, 267 (24%) were more likely to consider it after legalization. Of the 450 cannabis users, 73 (16%) had been using it for less than 6 months, 206 (46%) stated they were more comfortable discussing cannabis with their physician after legalization and 195 (43%) were using cannabis more than 4 times per week., Conclusion: Many patients with upper extremity conditions were regularly using cannabis. Patients were more comfortable discussing cannabis with their physician than before legalization. Treating surgeons should be aware of these trends and expect to receive questions regarding cannabis use., Competing Interests: Competing interests: Neil White reports research support from Bioventus, Arthrex and Acumud, and speaker and consulting fees from Conmed and Bioventus. Jason Strelzow reports consulting fees from OrthoXel, Acumed, BoneSupport, and speaker fees from Acumed and BoneSupport. He also reports committee participation with the Orthopaedic Trauma Association and the American Society for Surgery of the Hand. He is an associate editor with the Journal of Bone and Joint Surgery and the Journal of Hand Surgery. No other competing interests were declared., (© 2022 CMA Impact Inc. or its licensors.)
- Published
- 2022
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18. Severe Acute Respiratory Syndrome Coronavirus 2 Reinfection: A Case Series From a 12-Month Longitudinal Occupational Cohort.
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Mack CD, Tai C, Sikka R, Grad YH, Maragakis LL, Grubaugh ND, Anderson DJ, Ho D, Merson M, Samant RM, Fauver JR, Barrett J, Sims L, and DiFiori J
- Subjects
- Humans, Reinfection, Research, COVID-19, SARS-CoV-2
- Abstract
Findings are described in 7 patients with severe acute respiratory syndrome coronavirus 2 reinfection from the National Basketball Association 2020-2021 occupational testing cohort, including clinical details, antibody test results, genomic sequencing, and longitudinal reverse-transcription polymerase chain reaction results. Reinfections were infrequent and varied in clinical presentation, viral dynamics, and immune response., (Published by Oxford University Press for the Infectious Diseases Society of America 2021.)
- Published
- 2022
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19. Four-Corner Arthrodesis With Differing Methods of Osteosynthesis: A Systematic Review.
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Hayes E, Cheng Y, Sauder D, and Sims L
- Subjects
- Bone Plates, Hand Strength, Humans, Range of Motion, Articular, Retrospective Studies, Wrist Joint diagnostic imaging, Wrist Joint surgery, Arthrodesis methods, Scaphoid Bone diagnostic imaging, Scaphoid Bone surgery
- Abstract
Purpose: The purpose of this study was to compare the union rates and clinical outcomes of 4-corner arthrodesis with different methods of osteosynthesis., Methods: A systematic review of studies published in Ovid, Medline, Embase, and PubMed was conducted. Primary studies that reported clinical and radiographic results following 4-corner arthrodesis for scapholunate advanced collapse (SLAC), scaphoid nonunion advanced collapse (SNAC), or other types of wrist arthritis in human subjects were eligible. Biomechanical or cadaveric studies, case reports, studies that did not define and report a radiographic union rate, reviews and technical articles, studies that did not report the method of osteosynthesis, and studies that used multiple methods of osteosynthesis, but did not separate results for individual methods of osteosynthesis were excluded. Radiographic union rate, range of motion, and grip strength were analyzed., Results: We identified and reviewed 291 full texts, selecting 57 studies for coding. The radiographic union rate did not significantly differ between studies using K-wire, screw, staple, nonlocking plate, metal locking plate, and radiolucent locking plate osteosynthesis. Fixation method significantly affected flexion, but pairwise comparison did not reveal any significant differences between individual groups. Grip strength as a percentage of the contralateral limb was significantly lower in studies with metal locking plate fixation compared to K-wire fixation (63.2% vs 82.6%). There were no other statistically significant differences between groups with respect to flexion, extension, radial deviation, ulnar deviation, and grip strength., Conclusions: All methods of osteosynthesis result in similar union rates, with no significant differences between methods. While there are some significant differences in range of motion and grip strength, these differences are unlikely to be clinically relevant., Type of Study/level of Evidence: Therapeutic IV., (Copyright © 2021 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)
- Published
- 2022
- Full Text
- View/download PDF
20. Pelvic floor exercises and female stress urinary incontinence.
- Author
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Sims L, Hay-Smith J, and Dean S
- Subjects
- Exercise Therapy, Female, Humans, Pelvic Floor, Urinary Incontinence, Stress therapy
- Published
- 2022
- Full Text
- View/download PDF
21. Epidemiology, management and survival outcomes of adult out-of-hospital traumatic cardiac arrest due to blunt, penetrating or burn injury.
- Author
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Doan TN, Wilson D, Rashford S, Sims L, and Bosley E
- Subjects
- Adult, Hospitals, Humans, Retrospective Studies, Burns, Out-of-Hospital Cardiac Arrest epidemiology, Out-of-Hospital Cardiac Arrest etiology, Out-of-Hospital Cardiac Arrest therapy, Wounds, Gunshot
- Abstract
Background: Survival from out-of-hospital traumatic cardiac arrest (TCA) is poor. Regional variation exists regarding epidemiology, management and outcomes. Data on prognostic factors are scant. A better understanding of injury patterns and outcome determinants is key to identifying opportunities for survival improvement., Methods: Included were adult (≥18 years) out-of-hospital TCA due to blunt, penetrating or burn injury, who were attended by Queensland Ambulance Service paramedics between 1 January 2007 and 31 December 2019. We compared the characteristics of patients who were pronounced dead on paramedic arrival and those receiving resuscitation from paramedics. Intra-arrest procedures were described for attempted-resuscitation patients. Survival up to 6 months postarrest was reported, and factors associated with survival were investigated., Results: 3891 patients were included; 2394 (61.5%) were pronounced dead on paramedic arrival and 1497 (38.5%) received resuscitation from paramedics. Most arrests (79.8%) resulted from blunt trauma. Motor vehicle collision (42.4%) and gunshot wound (17.7%) were the most common injury mechanisms in patients pronounced dead on paramedic arrival, whereas the most prevalent mechanisms in attempted-resuscitation patients were motor vehicle (31.3%) and motorcycle (20.6%) collisions. Among attempted-resuscitation patients, rates of transport and survival to hospital handover, to hospital discharge and to 6 months were 31.9%, 15.3%, 9.8% and 9.8%, respectively. Multivariable model showed that advanced airway management (adjusted OR 1.84; 95% CI 1.06 to 3.17), intravenous access (OR 5.04; 95% CI 2.43 to 10.45) and attendance of high acuity response unit (highly trained prehospital care clinicians) (OR 2.54; 95% CI 1.25 to 5.18) were associated with improved odds of survival to hospital handover., Conclusions: By including all paramedic-attended patients, this study provides a more complete understanding of the epidemiology of out-of-hospital TCA. Contemporary survival rates from adult out-of-hospital TCA who receive resuscitation from paramedics may be higher than historically thought. Factors identified in this study as associated with survival may be useful to guide prognostication and treatment., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2022
- Full Text
- View/download PDF
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