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Heal C, D'Souza K, Hall L, Smith J, Jones K. Changes to objective structured clinical examinations (OSCE) at Australian medical schools in response to the COVID-19 pandemic. MEDICAL TEACHER 2022; 44:418-424. [PMID: 34762549 DOI: 10.1080/0142159x.2021.1998404] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Objective Structured Clinical Examinations (OSCE) are used to assess clinical skills. We investigated how exit OSCEs changed in Australian medical schools in response to the COVID-19 pandemic. MATERIALS AND METHODS The lead ACCLAiM assessment academic from 12 eligible Australian medical school members of the Australian Collaboration for Clinical Assessment in Medicine (ACCLAiM) received a 45-item semi-structured online questionnaire. RESULTS All schools (12/12) responded. Exit OSCEs were not used by one school in 2019, and 3/11 schools in 2020. Of eight remaining schools, four reduced station numbers and testing time. The minimum OSCE testing time decreased from 64 min in 2019 to 54 min in 2020. Other modifications included: a completely online 'e-OSCE' (n = 1); hybrid delivery (n = 4); stations using: videos of patient encounters (n = 3), telephone calls (n = 2), skill completion without face-to-face patient encounters (n = 3). The proportion of stations involving physical examination reduced from 33% to 17%. Fewer examiners were required, and university faculty staff formed a higher proportion of examiners. CONCLUSIONS All schools changed their OSCEs in 2020 in response to COVID-19. Modifications varied from reducing station numbers and changing delivery methods to removing OSCE and complete assessment re-structuring. Several innovative methods of OSCE delivery were implemented to preserve OSCE validity and reliability whilst balancing feasibility.
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Simko S, Jones K, Abidi A, Park S. Comparison of laparoscopic hysterectomies for benign indication by surgical complexity to assess for differences in surgical outcomes. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.12.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Turner MJ, Miller A, Youngs H, Barber N, Brick NE, Chadha NJ, Chandler C, Coyle M, Didymus FF, Evans AL, Jones K, McCann B, Meijen C, Rossato CJL. “I must do this!”: A latent profile analysis approach to understanding the role of irrational beliefs and motivation regulation in mental and physical health. J Sports Sci 2022; 40:934-949. [DOI: 10.1080/02640414.2022.2042124] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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AlHelou A, Watson A, Russell K, Jones K, Johnson H, Chellappah G, Mukherjee R. Technology-enabled multidisciplinary team in-reach for oral corticosteroid stewardship and optimizing care of suspected airways disease exacerbations. Acute Med 2022; 21:205-206. [PMID: 36809453 DOI: 10.52964/amja.0926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Overuse of corticosteroids is an important problem not only in asthma but also the management of other airways diseases including bronchiectasis and COPD and results in associated risks of serious side effects and irreversible harm. We report a pilot using an in-reach solution to review patients, optimise their care and facilitate early discharge. We discharged >20% of our patients immediately, which is potentially a significant reduction in hospital bed use and, most importantly, through this approach we were able to establish early diagnosis and reduce inappropriate oral corticosteroid use.
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Jones K, Kempton H, Carroll J, Muller D, Roy D. Valve-in-Valve Transcatheter Aortic Valve Implantation for Failing Aortic Valve Bioprostheses. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Kempton H, Jones K, Muller D, Roy D. Vascular Access for TAVI in the Era of Intravascular Lithotripsy. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kempton H, Jones K, Carroll J, Muller D, Roy D. Durability of TAVI as a Valve-in-Valve Treatment for Failed Bioprosthetic AVR. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Kempton H, Jones K, McCready M. Persistent Troponin Elevation: Macrotoponin and Diagnostic Pathways for the Unexplainable Positive Troponin Result. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Breto A, Cullison K, Jones K, Zavala-Romero O, Ford J, Mellon E, Stoyanova R. A Deep Learning Approach for Automated Volume Delineation on Daily MRI Scans in Glioblastoma Patients. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Blacklock C, Jones K, Baker G, Kealey D. 1270 Secondary Survey Documentation in Trauma Patients - A Review Following Implementation of a Dedicated Trauma Ward. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
A secondary survey is a detailed head to toe assessment performed in trauma patients following initial primary survey and patient stabilisation. It forms part of the ATLS guidelines and is an important tool in the recognition of patient injury. We performed an audit within the Regional Trauma Unit to assess the standard of documentation of secondary surveys in trauma admissions. We then repeated this audit following staff teaching and the implementation of a dedicated Trauma Ward, with an aim of improving secondary survey documentation and the early recognition and management of associated injuries.
Method
Admission notes for all trauma patients admitted in the three months prior to the opening of the dedicated Trauma Ward were reviewed for documentation of a secondary survey (n = 30), with the incidence of any missed injuries on follow up recorded. A further audit loop was then performed on all trauma admissions following the opening of the Trauma Ward and trauma staff teaching (n = 52).
Results
Complete documentation of a full secondary survey improved from 10% to 98% for trauma patient admissions. This also improved early identification of initially missed injuries from the primary survey including extremity fractures, chest trauma, and multi-ligament knee injuries.
Conclusions
Secondary surveys are an important tool in assessing trauma patients and can help identify significant injuries. The implementation of a dedicated Trauma Ward along with teaching to the trauma staff has led to an improvement in performance of secondary surveys with a direct improvement in identifying associated injuries in trauma patients.
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Jones CS, Higginbotham G, Gormley A, Jones K, Main BG. 858 Transoral Robotic Surgery: Comparing the Geography of Research Publications with The Global Burden of Disease. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
Transoral robotic surgery (TORS) is increasingly used for the resection of oropharyngeal tumours. It is unclear if there is equitable access to this innovative technique worldwide, specifically in areas of greatest need. This study aimed to map the geographic distribution of publications on TORS and compare this to global disease burden.
Method
Systematic searches identified all studies of TORS from inception to 2018. The country of origin of each study was identified. The incidence and age standardised rate (ASR) of oropharyngeal cancer for each country was obtained from The Global Cancer Observatory (GLOBOCAN) database. World Bank classifications of countries by income level were obtained.
Results
A total of 132 studies were identified. The majority (96%) were published in high-income countries, 2% in lower-middle, and 2% in upper-middle income countries. Eighty-nine were published in the USA, the country with the second-highest incidence of oropharyngeal cancer worldwide (13% of total), but 20th by ASR. The greatest incidence was in India (21%), however this was the source of only 2% of studies. Of the ten countries with the highest incidence, eight were represented in published studies, in comparison to four of the top 10 by ASR.
Conclusions
There is evident disparity in the geographical distribution of published studies of TORS. This disparity may represent unequal access to surgical technologies, or a lack of evaluation of the technology in different healthcare settings. This may impact the generalisability of research findings. Equitable access to novel surgical technologies is ethical and can help address global disease burden.
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Moore U, James M, Spuler S, Day J, Jones K, Bharucha-Goebel D, Salort-Campana E, Pestronk A, Walter M, Paradas C, Stojkovic T, Yoshimura MM, Bravver E, Pegoraro E, Mendell J, Bushby K, Straub V, Mayhew A. LGMD. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Blakely C, Urisman A, Kerr D, Wu W, Bacaltos B, Rotow J, Gubens M, Jones K, Bivona T, Joo S, Riess J, Aisner D, Doebele R, Patil T, Schenk E, Kratz J, Jablons D. P26.02 A Phase II Trial of Neoadjuvant Osimertinib for Surgically Resectable EGFR-Mutant Non-Small Cell Lung Cancer: Updated Results. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Webster A, Jones K, Steel R. PO-1965 Investigating the impact of Day Zero SABR appointments and role of the Therapy Radiographer (RTT). Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08416-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Jones K, Webster A, Ntentas G, Brady J, Mikhaeel N. PO-1972 DIBH for mediastinal lymphoma: Implementation and evaluation of a 5-year service. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08423-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Choudhury G, Safdar Y, Jones K. A CURIOUS CASE OF THE GIRL WITH THE MISSING TEETH. Oral Surg Oral Med Oral Pathol Oral Radiol 2021. [DOI: 10.1016/j.oooo.2021.03.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Macneal P, Brar S, Dassanayake S, Jones K, Ghareib A, Moledina J. 474 Increasing the Availability of Operation Notes at Hand Surgery Follow-Up Through the Use of Electronic Operation Notes. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
The availability of operation notes is crucial to provide high-quality post-operative care. This clinical audit evaluates the availability of operation notes at post-operative follow-up, in a Tertiary Hand Unit, before and after implementation of electronic operation notes.
Method
This was a prospective audit analysing the availability of operation notes at the first post-operative hand surgery appointment. The initial data collection was over a 6-week period (July – August 2019). Following this, a standardised electronic operation note template was created in line with BSSH Hand Trauma Guidelines and RCS Good Surgical Practice. Six months later, a re-audit was conducted over a 4-week period (March 2020).
Results
The initial audit included 104 adult patients, with operation notes available for 64% (n = 67) of patients, and 94% (n = 63) of those were in paper format. Following implementation of electronic operation notes, the re-audit included 53 adult patients. For these patients, 96% (n = 51) of their operation notes were available, and 96% (n = 49) of the operation notes were electronic.
Conclusions
These findings demonstrate that electronic operation notes greatly increased the availability of operation notes at follow-up This innovation has significant implications for upholding well-coordinated continuity of care for patients undergoing surgery.
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Draeger A, Thomas E, Jones K, Godwin P, Davis A, Porr S. 81 Cannabidiol in the horse: Effects on movement and reactivity. J Equine Vet Sci 2021. [DOI: 10.1016/j.jevs.2021.103544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Jones K. Carol Sze Ki Lin, Guneet Kaur, Chong Li, and Xiaofeng Yang, (Eds): Waste Valorisation; Waste Streams in a Circular Economy. Chromatographia 2021. [DOI: 10.1007/s10337-020-03998-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Jones K, Kempton H, Phan J, Carroll J, Roy A, Muller D, Roy D. The Effect of the Cusp Overlap Technique on the Need for Permanent Pacing Post-TAVI. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Jones K, Carroll J, Cunio C, O'Lone E, Kempton H, Roy A, Muller D, Roy D. Mechanism of Failure of Surgical Aortic Bioprosthetic Valves Undergoing Valve-in-Valve TAVI. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gill K, Johnson L, Dietrich J, Myer L, Marcus R, Wallace M, Pidwell T, Mendel E, Fynn L, Jones K, Wiesner L, Slack C, Strode A, Spiegel H, Hosek S, Rooney J, Gray G, Bekker LG. Acceptability, safety, and patterns of use of oral tenofovir disoproxil fumarate and emtricitabine for HIV pre-exposure prophylaxis in South African adolescents: an open-label single-arm phase 2 trial. THE LANCET. CHILD & ADOLESCENT HEALTH 2020; 4:875-883. [PMID: 33222803 PMCID: PMC9832157 DOI: 10.1016/s2352-4642(20)30248-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/22/2020] [Accepted: 07/14/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND HIV incidence among adolescents in southern Africa remains unacceptably high. Pre-exposure prophylaxis (PrEP) is an effective HIV prevention intervention but there are few data on its implementation among adolescents. We aimed to investigate the safety, feasibility, and acceptability of PrEP with oral tenofovir disoproxil fumarate and emtricitabine as part of a comprehensive HIV prevention package in an adolescent population in South Africa. METHODS This open-label single-arm phase 2 study (PlusPills) was done in two research clinics in Cape Town and Johannesburg, South Africa. Adolescents aged 15-19 years were recruited into the study through recruitment events and outreach in the community. Potential participants were eligible for enrolment if they reported being sexually active. Exclusion criteria were a positive test for HIV or pregnancy at enrolment, breastfeeding, or any relevant co-morbidities. Participants were given oral tenofovir disoproxil fumarate and emtricitabine for PrEP to take daily for the first 12 weeks and were then given the choice to opt in or out of PrEP use at three monthly intervals during scheduled clinic visits. Participants were invited to monthly visits for adherence counselling and HIV testing during the study period. The primary outcomes were acceptability, use, and safety of PrEP. Acceptability was measured by the proportion of participants who reported willingness to take up PrEP and remain on PrEP at each study timepoint. Use was defined as the number of participants who continued to use PrEP after the initial 12-week period until the end of the study (week 48). Safety was measured by grade 2, 3, and 4 laboratory and clinical adverse events using the Division of AIDS table for grading the severity of adult and paediatric adverse events, version 1.0. Dried blood spot samples were collected at each study time-point to measure tenofovir diphosphate concentrations. This trial is registered with ClinicalTrials.gov, NCT02213328. FINDINGS Between April 28, 2015, and Nov 11, 2016, 244 participants were screened, and 148 participants were enrolled (median age was 18 years; 99 participants [67%] were female) and initiated PrEP. PrEP was stopped by 26 of the 148 (18%) participants at 12 weeks. Cumulative PrEP opt-out, from the total cohort, was 41% (60 of 148 participants) at week 24 and 43% (63 of 148 participants) at week 36. PrEP was well tolerated with only minor adverse events (grade 2) thought to be related to study drug, which included headache (n=4, 3%), gastrointestinal upset (n=8, 5%), and skin rash (n=2, 1%). Two participants (1%) experienced grade 3 weight loss, which was deemed related to the study drug and resolved fully when PrEP was discontinued. Tenofovir diphosphate concentrations were detectable (>16 fmol/punch) in dried blood spot samples in 108 (92%) of 118 participants who reported PrEP use at week 12, in 74 (74%) of 100 participants at week 24, and in 22 (59%) of 37 participants by the study end at week 48. INTERPRETATION In this cohort of self-selected South African adolescents at risk of HIV acquisition, PrEP appears safe and tolerable in those who continued use. PrEP use decreased throughout the course of the study as the number of planned study visits declined. Adolescents in southern Africa needs access to PrEP with tailored adherence support and possibly the option for more frequent and flexible visit schedules. FUNDING National Institute of Allergy and Infectious Diseases of the US National Institutes of Health.
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Philippou Y, Sjoberg H, Murphy E, Jones K, Gordon-Weeks A, McKenna G, Uzi G, Cerundolo V, Mills I, Hamdy F, Muschel R, Bryant R. PO-1821: Investigating immune microenvironment effects of radiotherapy in pre-clinical prostate cancer models. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01839-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Dooley S, Jones K, Llorente R, Ford J, Diwanji T, Mellon E. Edema Progression during MRI-Guided Glioblastoma Radiotherapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Tan M, Nyamundanda G, Fontana E, Hazell S, Ragulan C, Jones K, Abah B, Jacobs T, Bowes J, Sadanandam A, Huddart R. PO-1207: Exploring molecular subtype as a biomarker of radiation response in muscle-invasive bladder cancer. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01225-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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