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Background: The aim of this study was to describe the proficiency of ChatGPT (GPT-4) on certification style exams from the Canadian Association of Medical Radiation Technologists (CAMRT), and describe its performance across multiple exam attempts., Methods: ChatGPT was prompted with questions from CAMRT practice exams in the disciplines of radiological technology, magnetic resonance (MRI), nuclear medicine and radiation therapy (87-98 questions each). ChatGPT attempted each exam five times. Exam performance was evaluated using descriptive statistics, stratified by discipline and question type (knowledge, application, critical thinking). Light's Kappa was used to assess agreement in answers across attempts., Results: Using a passing grade of 65 %, ChatGPT passed the radiological technology exam only once (20 %), MRI all five times (100 %), nuclear medicine three times (60 %), and radiation therapy all five times (100 %). ChatGPT's performance was best on knowledge questions across all disciplines except radiation therapy. It performed worst on critical thinking questions. Agreement in ChatGPT's responses across attempts was substantial within the disciplines of radiological technology, MRI, and nuclear medicine, and almost perfect for radiation therapy., Conclusion: ChatGPT (GPT-4) was able to pass certification style exams for radiation technologists and therapists, but its performance varied between disciplines. The algorithm demonstrated substantial to almost perfect agreement in the responses it provided across multiple exam attempts. Future research evaluating ChatGPT's performance on standardized tests should consider using repeated measures., (Copyright © 2024. Published by Elsevier Inc.)

Abstract: Glucocorticoids are key components of the standard-of-care treatment regimens for B-cell malignancy. However, systemic glucocorticoid treatment is associated with several adverse events. ABBV-319 is a CD19-targeting antibody-drug conjugate engineered to reduce glucocorticoid-associated toxicities while possessing 3 distinct mechanisms of action (MOA) to increase therapeutic efficacy: (1) antibody-mediated delivery of a glucocorticoid receptor modulator (GRM) payload to activate apoptosis, (2) inhibition of CD19 signaling, and (3) enhanced fragment crystallizable (Fc)-mediated effector function via afucosylation of the antibody backbone. ABBV-319 elicited potent GRM-driven antitumor activity against multiple malignant B-cell lines in vitro, as well as in cell line-derived xenografts and patient-derived xenografts (PDXs) in vivo. Remarkably, a single dose of ABBV-319 induced sustained tumor regression and enhanced antitumor activity compared with repeated dosing of systemic prednisolone at the maximum tolerated dose in mice. The unconjugated CD19 monoclonal antibody (mAb) also displayed antiproliferative activity in a subset of B-cell lymphoma cell lines through the inhibition of phosphoinositide 3-kinase signaling. Moreover, afucosylation of CD19 mAb enhanced Fc-mediated antibody-dependent cellular cytotoxicity. Notably, ABBV-319 displayed superior efficacy compared with afucosylated CD19 mAb in human CD34+ peripheral blood mononuclear cell-engrafted NSG-Tg(Hu-IL15) transgenic mice, demonstrating enhanced antitumor activity when multiple MOAs are enabled. ABBV-319 also showed durable antitumor activity across multiple B-cell lymphoma PDX models, including nongerminal center B-cell diffuse large B-cell lymphoma and relapsed lymphoma after R-CHOP treatment. Collectively, these data support the ongoing evaluation of ABBV-319 in a phase 1 clinical trial., (© 2024 American Society of Hematology. Published by Elsevier Inc. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.)

Background: The phenomenon of being 'with woman' is central to the profession of midwifery. There is currently no available evidence that explicitly explores this phenomenon. In Western Australia, over a third of childbearing women choose to engage the services of a private obstetrician who provides antenatal care and manages the care provided by midwives during labour and birth., Aim: The aim of this study was to explore midwives' experiences of being 'with woman' during labour and birth in the private obstetric model., Methods: Using a descriptive phenomenological approach, 11 midwives working in the private obstetric model in Western Australia were interviewed. Data analysis was conducted using Giorgi's framework., Findings: Two main themes emerged (1) triad of relationships and (2) the intersection between being 'with woman' and the private obstetric model; seven subthemes are reported., Discussion: Being 'with woman' is an important element of midwifery practice and fundamental to midwifery theory and philosophy. Relationships between the woman, midwife and obstetrician are key to implementing 'with woman' practices in the private obstetric model. The interrelatedness of midwifery philosophy and practice is revealed through shared common challenges and enablers to being 'with woman' from the perspective of midwives., Conclusion: Findings offer insight into midwives' experiences of being 'with woman' within the context of the private obstetric model. New understandings are revealed of a phenomenon central to midwifery professional philosophy that is embedded within midwifery practices which has implications for service mangers, professional leaders and educators., (Copyright © 2018 Australian College of Midwives. All rights reserved.)

Background: Midwives being 'with woman' is embedded in professional philosophy, standards of practice and partnerships with women. In light of the centrality of being 'with woman' to the profession of midwifery, it is timely to review the literature to gain a contemporary understanding of this phenomenon., Aim: This review synthesises research and theoretical literature to report on what is known and published about being 'with woman'., Methods: A five step framework for conducting an integrative literature reviews was employed. A comprehensive search strategy was utilised that incorporated exploration in electronic databases CINAHL, Scopus, Proquest, Science Direct and Pubmed. The initial search resulted in the retrieval of 2057 publications which were reduced to 32 through a systematic process., Findings: The outcome of the review revealed three global themes and corresponding subthemes that encompassed 'with woman': (1) philosophy, incorporated two subthemes relating to midwifery philosophy and philosophy and models of care; (2) relationship, that included the relationship with women and the relationship with partners; and (3) practice, that captured midwifery presence, care across the childbirth continuum and practice that empowers women., Conclusion: Research and theoretical sources support the concept that being 'with woman' is a fundamental construct of midwifery practice as evident within the profession's philosophy. Findings suggest that the concept of midwives being 'with woman' is a dynamic and developing construct. The philosophy of being 'with woman' acts as an anchoring force to guide, inform and identify midwifery practice in the context of the rapidly changing modern maternity care landscapes. Gaps in knowledge and recommendations for further research are made., (Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.)

Background: When transfer in labour takes place from a birth centre to a tertiary maternity hospital the woman, her partner and the midwife (the triad) are involved, representing three different perspectives. The purpose of this paper is to explore the integration of these intrapartum transfer experiences for the birth triad., Methods: Giorgi's descriptive phenomenological method of analysis was used to explore the 'lived' experiences of Western Australian women, their partners and midwives across the birth journey. Forty-five interviews were conducted., Findings: Findings revealed that experiences of intrapartum transfer were unique to each member of the triad (woman, partner and midwife) and yet there were also shared experiences. All three had three themes in common: 'The same journey through three different lenses'; 'In my own world' and 'Talking about the birth'. The woman and partner shared two themes: 'Lost birth dream' and 'Grateful to return to a familiar environment'. The woman and midwife both had: 'Gratitude for continuity of care model' and the partner and midwife both found they were: 'Struggling to adapt to a changing care model' and their 'Inside knowledge was not appreciated'., Conclusion: Insight into the unique integrated experiences during a birth centre intrapartum transfer can inform midwives, empowering them to better support parents through antenatal education before and by offering discussion about the birth and transfer after. Translation of findings to practice also reinforces how midwives can support their colleagues by recognising the accompanying midwife's role and knowledge of the woman., (Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.)

Background: When transfer in labour takes place from a woman-centred, midwifery led centre to a tertiary maternity hospital it is accepted that women are negatively affected, however the midwife's role is unevaluated, there is no published literature exploring their experience. This study aimed to describe these experiences., Methods: Giorgi's descriptive phenomenological method of analysis was used to explore the 'lived' experiences of the midwives. Seventeen interviews of transferring midwives took place and data saturation was achieved., Findings: The overall findings suggest that midwives find transfer in labour challenging, both emotionally and practically. Five main themes emerged: (1) 'The midwife's internal conversation' with subtheme: 'Feeling under pressure', (2) 'Challenged to find a role in changing circumstances' with subtheme: 'Varying degrees of support', (3) 'Feeling out of place' with subtheme: 'Caught in the middle of different models of care, (4) 'A constant support for the parents across the labour and birth process' with subthemes: 'Acknowledging the parents' loss of their desired birth' and (5) 'The midwives' need for debrief'., Conclusion: Midwives acknowledged the challenge of finding the balance between fulfilling parents' birth plan wishes with hospital protocol and maintaining safety. Transfer for fetal or maternal compromise caused anxiety and concern. The benefits of providing continuity of care were acknowledged by the midwife's knowledge of the woman and her history but these were not always recognised by the receiving team. Discussing the transfer story afterwards helped midwives review their practice. Effective communication between all stakeholders is essential throughout the transfer process., (Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.)

Background: Strategies within the public health system to curtail costs, increase efficiency and service utilisation have resulted in reduced hospital stays following elective orthopaedic procedures. Although there are advantages that support the concept of early discharge from hospital, very little is known about how patients manage the transition from hospital to home., Aim: The aim of this qualitative study was to describe the post-discharge experience of elderly patients following primary total hip replacement (THR)., Methods: Ten patients, six women and four men, provided descriptions of their experience. Data were collected by face-to-face interviews and the analysis process was based on Giorgi's phenomenological scientific methodology (Giorgi, 1994, 1997, 2000)., Results: The analysis of the data resulted in four themes, namely; an inadequate assessment of suitable adaptive aids and personal needs; personal frustration; coping with the physical and mobility and limited social interaction., Conclusion: Findings from this study demonstrated a need to review the discharge process and implement strategies to prepare patients for the stressors that the participants in this study encountered as a result of their early discharge., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Background: Adolescent pregnancy continues to pose a challenge in both the developed and developing countries across the globe. Adolescent maternity clients (AMCs) have special needs and it is imperative to ensure that maternity services are able to respond appropriately to their needs. OBJECTIVE OR QUESTION: The purpose of this study was to explore adolescent maternity clients' perceptions of maternity care and to identify important characteristics of an adolescent-friendly maternity service., Method: A qualitative approach was used and a total of 18 adolescent maternity clients, between 15 and 19 years of age, were purposively recruited from antenatal and postnatal services. Data were collected through individual and group interviews. FINDINGS OR DISCUSSION: Findings fell into 3 categories: AMC-health care provider (HCP) interaction; health care system; and health education. Participants wanted HCPs to be caring and supportive. Additionally HCPs should use appropriate interaction and body language to make adolescent clients feel respected and comfortable within the health care setting. Participants expected clinic waiting times to be decreased and measures to make the waiting rooms comfortable be put in place. AMCs also expressed the importance of having extra support during labour and birth. Health education was perceived as essential to their preparation for childbirth and parenting, with them having a role in peer education., Conclusion: The relationship between the HCP and AMC is essential to ensuring an optimal outcome for mother and baby. Careful consideration needs to be given to how the health care facility and system are set up in order to ensure that the AMC is comfortable within this context., (Copyright © 2011 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.)

The article provides an overview of specific lower-extremity and foot injuries. The areas of concentration are sinus tarsi syndrome, tendon injuries, stress fractures, ankle sprains, and plantar fascitis. Diagnosis, treatment, and rehabilitation techniques have been discussed for each injury. The authors have also included biomechanical treatment modalities using orthotics for rehabilitation of these injuries.