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Dübendorf, Switzerland

De Boer P.G.,AO Foundation | Buckley R.,U of Calgary | Schmidt P.,E Learning | Fox B.,U of Oklahoma
Injury | Year: 2012

Background: All orthopaedic and trauma surgeons attend educational events throughout their careers. Many surgeons find that when they return to practice they are unable to put into effect those things that they have learned. Methods: This study focussed on 708 surgeons from 2 different cultural backgrounds (developed and developing world) who attended 7 separate trauma Educational events. Surgeons were contacted by e-mail at least 6 weeks after the event and asked if they had encountered any Barriers, which had prevented them from putting into practice what they had learned at the event. If Barriers had been encountered they were asked to categorize them and state if they were able to overcome them. Results: Barriers affect nearly every learner and learners are usually unable to overcome them. The study identified what barriers exist for implementation of acquired knowledge, how they vary with the degree of experience of the surgeon and his or her cultural background. Conclusion: The commonest barrier amongst all surgeons is not having contact with a suitable patient to treat with their new knowledge and skills. Inability to get access to equipment and facilities is a major barrier for many surgeons especially in the developing world. This has profound implications for organizers of educational events that will need to incorporate strategies into their educational planning to help surgeon learners avoid or overcome barriers. © 2011 Elsevier Ltd. All rights reserved.

Aprea F.,Dick White Referrals | Martin-Jurado O.,AO Foundation | Jenni S.,University of Zurich | Mosing M.,University of Zurich
Journal of Veterinary Emergency and Critical Care | Year: 2014

Objective: To describe bispectral index (BIS) findings and compare them with cardiovascular and respiratory trends during cardiac arrest and successful CPR in a propofol-anesthetized calf. Case Summary: A 3-month-old calf was anesthetized as part of a research project. A thromboxane analog drug (U46619) was administered IV to induce pulmonary hypertension. Within 10 minutes following U46619 administration, cardiac activity deteriorated, leading to asystole. At this point, BIS and suppression rate were 0 and 100, respectively. Anesthetic drug delivery was discontinued and external chest compressions were initiated. During CPR, end-tidal CO2 concentration decreased and BIS increased, but no spontaneous cardiac activity was noted, thus IV epinephrine was administered. Return of spontaneous circulation was achieved and systemic arterial hypertension developed, while BIS briefly decreased and then increased during the following 2 minutes. The calf's cardiopulmonary variables returned to physiological ranges within 10 minutes after the return of spontaneous circulation and remained stable. Unique Information Provided: This is the first report in which BIS is documented together with standard monitoring techniques during cardiopulmonary arrest and resuscitation in a calf. BIS varied with cardiovascular performance, and may be indicative of cerebral blood flow in this context. Further research may be warranted to define the role of BIS for monitoring cerebral activity during CPR. © Veterinary Emergency and Critical Care Society 2014.

Dror I.,University College London | Schmidt P.,AO Foundation | O'Connor L.,Northwestern University
Medical Teacher | Year: 2011

As new technology becomes available and is used for educational purposes, educators often take existing training and simply transcribe it into the new technological medium. However, when technology drives e-learning rather than the learner and the learning, and when it uses designs and approaches that were not originally built for e-learning, then often technology does not enhance the learning (it may even be detrimental to it). The success of e-learning depends on it being 'brain friendly', on engaging the learners from an understanding of how the cognitive system works. This enables educators to optimize learning by achieving correct mental representations that will be remembered and applied in practice. Such technology enhanced learning (TEL) involves developing and using novel approaches grounded in cognitive neuroscience; for example, gaming and simulations that distort realism rather than emphasizing visual fidelity and realism, making videos interactive, training for 'error recovery' rather than for 'error reduction', and a whole range of practical ways that result in effective TEL. These are a result of e-learning that is built to fit and support the cognitive system, and therefore optimize the learning. © 2011 Informa UK Ltd All rights reserved.

Wernick M.B.,Tierklinik Thun Sud AG | Martin-Jurado O.,AO Foundation | Beaufrere H.,University of Guelph
Comparative Clinical Pathology | Year: 2013

Blood samples were collected from 102 clinically healthy gyr falcons (Falco rusticolus) over a time period of approximately 3 years as part of routine examination procedures. Standard blood chemistry analyses were carried out to establish normal reference values for the species. Plasma chemistry analyses included alkaline phosphatase (ALP), amylase, blood urea nitrogen, bile acids, calcium, cholesterol, creatinine, creatine kinase (CK), aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), glucose, phosphate, iron, total protein, total bilirubin, and uric acid. Reference intervals were determined using a quantile approach with 90 % confidence intervals of the limits. Juveniles and adults differ in ALT, creatinine, AST, glucose, LDH, and uric acid. Sexes differ in ALP, CK, AST, and phosphorus. This study provides valuable information on the plasma biochemistry values for gyr falcons that may help in the medical management of this endangered and commonly used falconry species. © 2013 Springer-Verlag London.

Sawaguchi T.,Toyama Municipal Hospital | Sakagoshi D.,Toyama Municipal Hospital | Shima Y.,Hokuriku Hospital | Ito T.,Saiseikai Toyama Hospital | Goldhahn S.,AO Foundation
Injury | Year: 2014

Purpose: Asian patients with osteoporosis suffer from an increased incidence of hip fracture and a potentially increased risk of fixation failure due to anatomical differences compared to Caucasians. To cope with these differences, an Asian size-and geometry-adapted Proximal Femoral Nail Antirotation (PFNA-II) was developed. The objective of this prospective multicenter study was to assess the risk of fracture fixation complications (FFCs), the occurrence of mismatch and the quality of life status of patients treated with the PFNA-II. Patients and methods: 176 Japanese patients with an isolated, unstable, closed trochanteric fracture were treated with the PFNA-II. Patients were prospectively screened for anticipated complications and classified accordingly; complications were centrally reviewed by a complication review board to avoid bias by the treating surgeon, and categorized using a standardized reporting system. Outcome measurements included the occurrence and evaluation of FFCs, the radiological assessment of mismatch and quality of life measured with the EQ-5D score. Results: 3 Intraoperative and 15 postoperative complications were found in 16/176 patients. The risk of sustaining any intraoperative or postoperative FFC was 1.7% (3/176; 95% CI: 0.35-4.9) and 8% (14/176; 95% CI: 4.4-13), respectively. The most likely cause for FFCs was the "bone/fracture" factor (9/14 patients). Radiologically detectable contact of the implant with the inner cortex ("mismatch") was reported for 17/173 patients (10%). Conclusions: The reported complication risks and mismatches are reasonable for this patient cohort. The geometry-and size-adapted PFNA-II is relatively safe but requires standardized assessment in a larger target cohort. © 2014 Elsevier Ltd. All rights reserved.

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