Notes

Appraisal involving handicap perceptions along with program associated with student nurses: a materials evaluate.
In this phantom- and cadaver study we investigated the differences of coronary artery calcium (CAC) volume on ultra-high-resolution computed tomography (U-HRCT) scans and conventional CT.

We scanned a coronary calcium phantom and the coronary arteries of five cadavers using U-HRCT in normal- and super-high resolution (NR, SHR) mode. The NR mode was similar to conventional CT; 896 detector channels, a matrix size of 512, and a slice thickness of 0.5 mm were applied. In SHR mode, we used 1792 detector channels, a matrix size of 1024, and a slice thickness of 0.25 mm. The CAC volume on NR- and SHR images were recorded. Differences in the physical- and the calculated CAC volume were defined as the error value and compared between NR- and SHR images of the phantom. Differences between the CAC volume on NR- and SHR scans of the cadavers were also recorded.

The mean error value was lower on SHR- than NR images of the phantom (14.0 %, SD 11.1 vs 20.1 %, SD 15.2, p = 0.01). The mean CAC volume was significantly higher on SHR- than NR images of the cadavers (153.4 mm
, SD 161.0 vs 144.7 mm
, SD 164.8, p < 0.01).

As small calcifications were more clearly visualized on U-HRCT images in SHR mode than on conventional (NR) CT scans, SHR imaging may facilitate the accurate quantification of the CAC.
As small calcifications were more clearly visualized on U-HRCT images in SHR mode than on conventional (NR) CT scans, SHR imaging may facilitate the accurate quantification of the CAC.The purpose of this cross-sectional survey study is to explore transgender teens' and their parents' interest in and preferences regarding support groups in an effort to optimally serve the entire family's needs. The aims of the study were to (1) describe transgender teens interest level and preferences regarding support groups; (2) describe parents of transgender teens interest level and preferences regarding support groups; and (3) compare responses based on demographics including teens versus parent, natal sex, and gender identity. De-identified surveys were collected from a convenience sample of transgender patients (N = 26), ages 13-18 years, and their parents (N = 20). Overall level of interest in support groups was 7.20/10 for youth and 7.95/10 for parents where 0 is not interested and 10 is very interested. Both groups endorsed benefits of a support group, including help with managing school issues, learning about local resources for transgender teens, and providing peer support. Both groups indicated "no time" as the most common potential barrier to attendance. Both groups expressed moderate interest in support groups, with minor differences between youths and parents noted in preferred support group structure. Further examination is warranted to determine optimal support group characteristics aimed specifically at parents and, separately, for youth. Additional support services might complement groups for a more comprehensive approach to support resources for this community.Background Children have benefited from participation in obesity prevention programs. Aims The objectives of this study were to evaluate the impact of a healthy eating intervention for children in after-school programs and to use photovoice to document change in eating behavior. Methods Forty-two children in three after-school programs participated. Children participated in lessons from an existing program to learn about healthy eating. A mixed methods study was conducted, using surveys to assess parent and child perceptions, and photovoice to capture children's perceptions of how they and their family changed eating habits. Member-checking was used to verify themes in the data. Twenty parents completed surveys evaluating the program. Results Findings indicated that children learned program information, were interested in eating healthier (more fruits and vegetables), and quantitative data revealed there was a pre-post trend for eating more fruits at home. They reported that using the photovoice method helped them to monitor their behavior and helped them improve personal and family eating habits. Member checking confirmed themes. A majority of parents were satisfied with the program and reported that their children were discussing what they learned at home. Conclusions Findings suggested that the photovoice methodology helped children to change in a positive way, increasing their agency in improving their own health and that of their family. Assessing longitudinal change in attitudes about healthy eating and eating behaviors will provide information about whether children maintain gains in knowledge and healthy eating over time.
Focused cardiac ultrasound (FoCUS) is an increasingly used diagnostic modality for anesthesiologists and intensivists. However, training residents in its use can be resource intensive. SU1498 order We investigated the feasibility of implementing a self-guided FoCUS curriculum for anesthesiology residents rotating in the postanesthesia care unit (PACU).

We created a FoCUS curriculum with the aim of providing a consistent largely self-guided experience that would improve FoCUS knowledge and skills while minimizing ongoing time commitment from faculty. To achieve this, we used several methods (1) developed video didactics and quizzes; (2) used an online educational delivery platform to automate delivery of educational content, monitor resident progress, and elicit feedback; (3) used the transthoracic echocardiography simulator for aided hands-on learning; (4) dedicated educational time that integrated into PACU workflow; (5) worked with a cardiac sonographer; and (6) used image storage software to facilitate remote feedback by ultrasound faculty. The response to the curriculum was evaluated using Kirkpatrick levels 1-3.

Forty-one anesthesiology residents rotated through the PACU over a 1-year period and completed this weeklong self-guided FoCUS curriculum. Interesting findings include (1) favorable evaluation from the residents and (2) improvement in image acquisition skills by objective measures. Once the curriculum was established, ongoing faculty time commitment was approximately 1 hour 20 minutes per week.

The implementation of a FoCUS curriculum in the PACU resulted in favorable resident evaluation and improved FoCUS skills. The curriculum was feasible and self-sustainable because of the novel educational approach employed.
The implementation of a FoCUS curriculum in the PACU resulted in favorable resident evaluation and improved FoCUS skills. The curriculum was feasible and self-sustainable because of the novel educational approach employed.
Managing pediatric crises necessitates the acquisition of unique skills and confidence in its execution. Our aim was to develop and assess a curriculum based on the constructivist learning environment to enhance learning, orientation, and preparation of graduating pediatric anesthesiology fellows.

Fifty pediatric anesthesiology fellows from 9 academic institutions in the United States were recruited for an advanced boot camp over a 2-year period. Training stations were developed using high-fidelity simulation, standardized patients, self-reflection modules, and facilitated discussions. The curriculum was evaluated using an anonymous survey that assessed knowledge, self-confidence, appropriateness of case-scenario complexity, and usefulness for transitioning into an independent practitioner on a Likert scale (
to
). Data points were expressed as the median and interquartile range (IQR).

Ninety-eight percent of the fellows completed a survey. Fellow perceptions of the advanced boot camp was positive. The median scores (IQR) for knowledge, self-confidence, appropriateness of case complexity, and usefulness for transition in 2017 were 5 (3,5), 4.5 (3,5), 5 (3,5), and 5 (3,5), respectively, and 5 (3,5), 4.5 (3,5), 5 (4,5), and 5 (3,5), respectively, in 2018. The IQR in the assessment for an appropriate level of complexity for their level of training, narrowed in 2018 (4,5), when compared with 2017 (3,5).

Fellow responses support the idea that the advanced boot camp provided tools and strategies for their transition. A narrowed IQR regarding the appropriate level of complexity of scenarios in 2018, when compared with 2017, might suggest an improvement in the curriculum.
Fellow responses support the idea that the advanced boot camp provided tools and strategies for their transition. A narrowed IQR regarding the appropriate level of complexity of scenarios in 2018, when compared with 2017, might suggest an improvement in the curriculum.
Multiple factors have led to an extremely high volume of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription polymerase chain reaction (RT-PCR) testing. Concerns exist about sensitivity and false-negative SARS-CoV-2 RT-PCR testing results. We describe a retrospective observational study examining the utility of repeat nasopharyngeal (NP) SARS-CoV-2 RT-PCR testing at an academic center in a low-prevalence setting.

All patients within our health system with >1 NP SARS-CoV-2 RT-PCR test result were included. SARS-CoV-2 RT-PCR testing was performed according to 1 of 4 validated assays. Key clinical and demographic data were collected, including whether the patient was inpatient or outpatient at time of the test and whether the test was performed as part of a person under investigation (PUI) for possible coronavirus disease 2019 or for asymptomatic screening.

A total of 660 patients had >1 NP SARS-CoV-2 PCR test performed. The initial test was negative in 638. There were ay be higher than previously believed. These results have helped shape diagnostic stewardship guidelines, in particular guidance to decrease repeated testing in the inpatient setting to optimize test utilization and preserve resources.We compared oropharyngeal swab test performance with nasopharyngeal testing for discontinuation of transmission-based COVID-19 precautions. We performed a retrospective review of confirmed COVID-19-positive patients who received paired nasopharyngeal and oropharyngeal SARS-CoV-2 tests for clearance from isolation from May 4, 2020, to May 26, 2020. Using nasopharyngeal swabs as the reference standard, we calculated the sensitivity, specificity, and negative predictive value of oropharyngeal swabs. We also calculated the kappa between the 2 tests. A total of 189 paired samples were collected from 74 patients. Oropharyngeal swab sensitivity was 38%, specificity was 87%, and negative predictive value was 70%. The kappa was 0.25. Our study suggests that oropharyngeal swabs are inferior to nasopharyngeal swabs for test-based clearance from COVID-19 isolation.This report describes the treatment of Klebsiella pneumoniae carbapenemase (KPC)-3-producing multidrug-resistant K. pneumoniae with ceftazidime/avibactam (CAZ-AVI) in a patient who developed postneurosurgical meningitis and bacteremia. Therapeutic drug monitoring of cerebrospinal fluid and blood samples demonstrated CAZ-AVI concentration levels 20-fold greater than the minimum inhibitory concentration in the first 60 minutes postinfusion, providing evidence for the utility of CAZ-AVI in treating KPC-Klebsiella pneumoniae central nervous system infections.
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