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Article ; Online: Evaluating the Quality of Narrative Feedback for Entrustable Professional Activities in a Surgery Residency Program.

Fernandes, Rosephine Del / de Vries, Ingrid / McEwen, Laura / Mann, Steve / Phillips, Timothy / Zevin, Boris

2024

Abstract: Objective: We assessed the quality of narrative feedback given to surgical residents during the first five years of Competency-Based Medical Education (CBME) implementation.: Summary background data: CBME requires ongoing formative assessments and ... ...

Abstract	Objective: We assessed the quality of narrative feedback given to surgical residents during the first five years of Competency-Based Medical Education (CBME) implementation. Summary background data: CBME requires ongoing formative assessments and feedback on learners' performance. Methods: We conducted a retrospective cross-sectional study using assessments of Entrustable Professional Activities (EPAs) in the Surgical Foundations curriculum at Queen's University from 2017-2022. Two raters independently evaluated quality of narrative feedback using the Quality of Assessment of Learning (QuAL) Score (0-5). Results: A total of 3,900 EPA assessments were completed over 5 years. Fifty-seven percent (2229/3900) of assessments had narrative feedback documented with a mean QuAL score of 2.16±1.49. Of these, 1614 (72.4%) provided evidence about the resident's performance, 951 (42.7%) provided suggestions for improvement, and 499/2229 (22.4%) connected suggestions to the evidence. There was no meaningful change in narrative feedback quality over time (r=0.067, P=0.002). Variables associated with lower quality of narrative feedback include: Attending role (2.04±1.48) compared to medical student (3.13±1.12, P<0.001) and clinical fellow (2.47±1.54, P<0.001), concordant specialties between the assessor and learner (2.06±1.50 vs. 2.21±1.49, P=0.025), completion of the assessment one month or more after the encounter versus one week (1.85±1.48 vs. 2.23±1.49, P<0.001), and resident entrustment versus not entrusted to perform the assessed EPA (2.13±1.45 vs. 2.35±1.66; P=0.008). The quality of narrative feedback was similar for assessments completed under direct and indirect observation (2.18±1.47 vs. 2.06±1.54; P=0.153). Conclusions: Just over half of the EPA assessments of surgery residents contained narrative feedback with overall fair quality. There was no meaningful change in the quality of feedback over 5 years. These findings prompt future research and faculty development.
Language	English
Publishing date	2024-04-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/SLA.0000000000006308
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Article ; Online: Sex, stress and the brain: interactive actions of hormones on the developing and adult brain.

McEwen, B S

Climacteric : the journal of the International Menopause Society

2014 Volume 17 Suppl 2, Page(s) 18–25

Abstract: The brain is a target of steroid hormone actions that affect brain architecture, molecular and neurochemical processes, behavior and neuroprotection via both genomic and non-genomic actions. Estrogens have such effects throughout the brain and this ... ...

Abstract	The brain is a target of steroid hormone actions that affect brain architecture, molecular and neurochemical processes, behavior and neuroprotection via both genomic and non-genomic actions. Estrogens have such effects throughout the brain and this article provides an historical and current view of how this new view has come about and how it has affected the study of sex differences, as well as other areas of neuroscience, including the effects of stress on the brain.
MeSH term(s)	Adult ; Age Factors ; Brain/growth & development ; Brain/physiology ; Estrogens/physiology ; Female ; Gonadal Steroid Hormones/physiology ; Hormones/physiology ; Humans ; Male ; Neuronal Plasticity/physiology ; Sex Characteristics ; Stress, Physiological/physiology
Chemical Substances	Estrogens ; Gonadal Steroid Hormones ; Hormones
Language	English
Publishing date	2014-12
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1469153-x
ISSN	1473-0804 ; 1369-7137
ISSN (online)	1473-0804
ISSN	1369-7137
DOI	10.3109/13697137.2014.949662
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Zs.A 5245: Show issues

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Article ; Online: A combined exercise and cognitive training intervention induces fronto-cingulate cortical plasticity in first-episode psychosis patients.

McEwen, S C / Jarrahi, B / Ventura, J / Subotnik, K L / Nguyen, J / Woo, S M / Nuechterlein, K H

Schizophrenia research

2022 Volume 251, Page(s) 12–21

Abstract: Objective: Schizophrenia (SZ) is characterized by neurobiological and associated cognitive and functional deficits, including pronounced cortical thinning, that lead to acute and long-term functional impairment. Research with older adults supports the ... ...

Abstract	Objective: Schizophrenia (SZ) is characterized by neurobiological and associated cognitive and functional deficits, including pronounced cortical thinning, that lead to acute and long-term functional impairment. Research with older adults supports the role of non-pharmacological interventions, such as exercise (E) and cognitive training (CT), for cognitive impairments. This literature influenced the development of combined CT&E treatments for individuals with SZ. However, the impact of longer combined treatment duration (6 months) on neuroanatomy has yet to be explored in patients in the early course of the illness. The impact of adding exercise to cognitive training for key brain regions associated with higher-order cognition was examined here using magnetic resonance imaging (MRI) in first-episode psychosis (FEP) patients. Methods: UCLA Aftercare Research Program patients with a recent first episode of schizophrenia were randomly assigned to either combined cognitive and exercise training (CT&E) (N = 20) or cognitive training alone (CT) (N = 17) intervention. Cortical thickness was measured longitudinally and analyzed for two regions of interest using FreeSurfer. Results: Compared to patients in the CT group, those in the CT&E group demonstrated an increase in cortical thickness within the left anterior cingulate cortex over the six-month treatment period (ACC: F Conclusions: These findings suggest that exercise and cognitive training may synergistically increase fronto-cingulate cortical thickness to mitigate progressive neural atrophy in the early course of SZ. This combined intervention appears to be a valuable adjunct to standard pharmacologic treatment in FEP patients.
MeSH term(s)	Humans ; Aged ; Gyrus Cinguli ; Cognitive Training ; Psychotic Disorders/diagnostic imaging ; Psychotic Disorders/therapy ; Psychotic Disorders/pathology ; Schizophrenia/therapy ; Schizophrenia/drug therapy ; Magnetic Resonance Imaging/methods ; Exercise
Language	English
Publishing date	2022-12-15
Publishing country	Netherlands
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	639422-x
ISSN	1573-2509 ; 0920-9964
ISSN (online)	1573-2509
ISSN	0920-9964
DOI	10.1016/j.schres.2022.12.001
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Zs.MO 543: Show issues

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Article ; Online: An Unexpected Case of Cutaneous Vasculitis Following Zoledronic Acid Infusion.

Zahedi, Bita / Wallace, Zachary S / Côté, Maya McEwen / Yu, Elaine W

JCEM case reports

2023 Volume 1, Issue 4, Page(s) luad085

Abstract: We report a case of isolated cutaneous small vessel vasculitis (SVV) occurring after zoledronic acid (Zol) infusion in a 58-year-old postmenopausal woman with a history of sleeve gastrectomy. This was the patient's first exposure to a bisphosphonate ... ...

Abstract	We report a case of isolated cutaneous small vessel vasculitis (SVV) occurring after zoledronic acid (Zol) infusion in a 58-year-old postmenopausal woman with a history of sleeve gastrectomy. This was the patient's first exposure to a bisphosphonate medication. Within minutes of the Zol infusion, she developed an episode of diffuse watery diarrhea. Although the diarrheal symptoms resolved quickly, she experienced nonsteroidal anti-inflammatory drug-responsive generalized myalgias and skin tenderness in her abdomen and extremities within a few hours. These symptoms progressed in severity over the next 5 days, and she developed nonblanching, palpable purpura extending from the ankles to the knees. Prior to Zol, labs showed sufficient 25-hydroxyvitamin D and calcium as well as normal renal and liver function. On day 10, laboratory tests revealed aspartate transaminase twice and alanine transaminase thrice the upper limit of normal. The patient was diagnosed with cutaneous SVV, with a timeline highly suggestive of an idiosyncratic reaction to Zol. She was successfully treated with a prednisone taper. No prior cases of Zol-induced cutaneous vasculitis have been reported, although there are a handful of reported cases of giant cell arteritis and urticarial vasculitis after bisphosphonate therapy. Clinicians should be aware that isolated cutaneous SVV may be a rare complication of Zol.
Language	English
Publishing date	2023-07-14
Publishing country	England
Document type	Case Reports
ISSN	2755-1520
ISSN (online)	2755-1520
DOI	10.1210/jcemcr/luad085
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Article ; Online: Anaphylaxis associated with intravenous administration of alphaxalone in a dog.

Haworth, M / McEwen, M / Dixon, B / Purcell, S L

Australian veterinary journal

2019 Volume 97, Issue 6, Page(s) 197–201

Abstract: Case report: We describe the clinical signs and management of a case of anaphylaxis in a dog after intravenous administration of alphaxalone (Alfaxan®, Jurox, NSW, Aust), which has not been previously published. A female spayed cattle dog undergoing ... ...

Abstract	Case report: We describe the clinical signs and management of a case of anaphylaxis in a dog after intravenous administration of alphaxalone (Alfaxan®, Jurox, NSW, Aust), which has not been previously published. A female spayed cattle dog undergoing routine imaging for forelimb lameness was induced with Alfaxan after receiving sedation with acepromazine and methadone 70 min prior. Immediately after intravenous administration of Alfaxan, the dog exhibited vomiting and diarrhoea associated with acute hypotension. Gallbladder wall oedema was visualised consistent with anaphylaxis. The dog responded to rapid volume expansion. Adrenaline was not required. The dog made a full recovery within 6 h of the reaction and was re-anaesthetised 3 days later without incident, using propofol as the induction agent. Conclusion: To our knowledge, this is the first published case of anaphylaxis associated with intravenous Alfaxan in the dog. The APVMA reporting of reactions in small animals from 2003 to 2013 of Alfaxan is consistent with this case report's finding involving the respiratory, circulatory and gastrointestinal systems.
MeSH term(s)	Anaphylaxis/chemically induced ; Anaphylaxis/veterinary ; Anesthetics/adverse effects ; Anesthetics/therapeutic use ; Animals ; Dog Diseases/chemically induced ; Dogs ; Female ; Pregnanediones/adverse effects ; Pregnanediones/therapeutic use
Chemical Substances	Anesthetics ; Pregnanediones ; alphaxalone (BD07M97B2A)
Language	English
Publishing date	2019-06-17
Publishing country	England
Document type	Case Reports
ZDB-ID	41542-x
ISSN	1751-0813 ; 0005-0423
ISSN (online)	1751-0813
ISSN	0005-0423
DOI	10.1111/avj.12824
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Article ; Online: Stressful experiences in youth: "Set-up" for diminished resilience to chronic pain.

Nelson, Sarah / Burns, Maureen / McEwen, Bruce / Borsook, David

Brain, behavior, & immunity - health

2020 Volume 5, Page(s) 100095

Abstract: Chronic pain in youth is common, with prevalence rates in some reports exceeding 50%. Given the plasticity of brain systems in youth and their general level of activity, the underlying processes relating to the evolution of chronic pain may be different ... ...

Abstract	Chronic pain in youth is common, with prevalence rates in some reports exceeding 50%. Given the plasticity of brain systems in youth and their general level of activity, the underlying processes relating to the evolution of chronic pain may be different from that observed in adults. One aspect that affects brain development is childhood stress. Preliminary research indicates that maladaptive responses to stressful events that induce biological and psychological inability to adapt may be related to pain chronicity in youth. This relationship is particularly notable given the high rates of exposure to stressful events in pediatric pain populations. A review of the literature was performed in the areas of biological, cognitive, psychological and social processes associated with chronic pain and psychological stress and trauma in youth and adult populations. The current review presents a theoretical framework, adapted from McEwen's model (1998) on stress and allostatic load, which aims to outline the potential connection between exposure to stressful events and pediatric chronic pain. Avenues for future investigation are also identified.
Language	English
Publishing date	2020-06-11
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2666-3546
ISSN (online)	2666-3546
DOI	10.1016/j.bbih.2020.100095
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Article ; Online: Effects of war exposure on pubertal development in refugee children.

Black, Candace J / McEwen, Fiona S / Smeeth, Demelza / Popham, Cassandra M / Karam, Elie / Pluess, Michael

Developmental psychology

2023 Volume 59, Issue 9, Page(s) 1559–1572

Abstract: ... We hypothesized that (a) energetic stress suppresses pubertal development; (b) war exposure accelerates pubertal ...

Abstract	Increasing research shows pubertal development accelerates following threats while it decelerates following deprivation. Yet, these environmental stressors are unlikely to occur in isolation. We investigated how war exposure and energetic stress impact pubertal development using data from the longitudinal Biological Pathways of Risk and Resilience in Syrian Refugee Children study. Our sample included 1,600 male and female Syrian refugee children and their caregivers who lived in temporary settlements in Lebanon. We hypothesized that (a) energetic stress suppresses pubertal development; (b) war exposure accelerates pubertal timing in boys and increases risk of menarche in girls, but only when energetic stress is low; and (c) when energetic stress is elevated, effects of war exposure on pubertal development will be attenuated. Among boys, we did not find support for Hypothesis 1, but Hypotheses 2 and 3 were supported. Exposure to morbidity/mortality threats accelerated pubertal timing; this effect was attenuated under conditions of elevated energetic stress. Among girls, we found support for Hypothesis 1, but not for Hypotheses 2 and 3. Elevated energetic stress decreased the risk of menarche in girls. Neither war exposure, nor any interactions with energetic stress, predicted risk of menarche. Sensitivity analyses revealed a significant interaction between bombing exposure and the amount of time since leaving Syria. Bombing decreased the risk of menarche, but only for girls who had left Syria four or more years prior to data collection. We discuss implications for translational efforts advocating for puberty screening in medical and mental health settings to identify trauma-exposed youth. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
MeSH term(s)	Adolescent ; Humans ; Male ; Child ; Female ; Refugees/psychology ; Puberty ; Menarche ; Mental Health ; War Exposure
Language	English
Publishing date	2023-07-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	2066223-3
ISSN	1939-0599 ; 0012-1649
ISSN (online)	1939-0599
ISSN	0012-1649
DOI	10.1037/dev0001569
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Article ; Online: Insulin resistance-a missing link no more.

Rasgon, N L / McEwen, B S

Molecular psychiatry

2016 Volume 21, Issue 12, Page(s) 1648–1652

Language	English
Publishing date	2016-12
Publishing country	England
Document type	Journal Article
ZDB-ID	1330655-8
ISSN	1476-5578 ; 1359-4184
ISSN (online)	1476-5578
ISSN	1359-4184
DOI	10.1038/mp.2016.162
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Article ; Online: Primate cognition in zoos: Reviewing the impact of zoo-based research over 15 years.

McEwen, Emma S / Warren, Elizabeth / Tenpas, Sadie / Jones, Benjamin / Durdevic, Kresimir / Rapport Munro, Emilie / Call, Josep

American journal of primatology

2022 Volume 84, Issue 10, Page(s) e23369

Abstract: Primate cognition research is reliant on access to members of the study sp ecies and logistical infrastructures to conduct observations and experiments. Historically founded in research centers and private collections, and spreading to modern zoos, ... ...

Abstract	Primate cognition research is reliant on access to members of the study sp ecies and logistical infrastructures to conduct observations and experiments. Historically founded in research centers and private collections, and spreading to modern zoos, sanctuaries, and the field, primate cognition has been investigated in diverse settings, each with benefits and challenges. In our systematic review of 12 primatology, animal behavior, and animal cognition journals over the last 15 years, we turn a spotlight on zoos to quantify their current impact on the field and to highlight their potential as robust contributors to future work. To put zoo-based research in context, we compare zoos to three other site types: university-owned or independent research centers, sanctuaries, and field sites. We assess the contributions of zoos across several critical considerations in primate cognition research, including number of investigations, species diversity, sample size, research topic diversity, and methodology. We identified 1119 publications reporting studies of primate cognition, almost 25% of which report research conducted in zoos. Across publications, zoo-based research has greater species diversity than research centers and covers a diverse range of research topics. Although our review is merely a snapshot of primate cognition research, our findings suggest that zoos may present advantages to researchers regarding species diversity, and lack some of the methodological constraints of field sites, allowing greater ease of access to a diverse range of subjects for cognition investigations. We suggest that zoos have great potential as key contributors for future investigations in primate cognition. Finally, we shed light on the symbiotic relationship that can emerge between researchers and zoos, forming partnerships that bring unique advantages to both parties.
MeSH term(s)	Animals ; Animals, Zoo ; Behavior, Animal ; Cognition ; Humans ; Primates ; Research
Language	English
Publishing date	2022-03-14
Publishing country	United States
Document type	Journal Article ; Review ; Systematic Review ; Research Support, Non-U.S. Gov't
ZDB-ID	1495834-X
ISSN	1098-2345 ; 0275-2565
ISSN (online)	1098-2345
ISSN	0275-2565
DOI	10.1002/ajp.23369
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Article ; Online: Veterinary Forensic Pathology: The Search for Truth.

McDonough, S P / McEwen, B J

Veterinary pathology

2016 Volume 53, Issue 5, Page(s) 875–877

Abstract: Veterinary forensic pathology is emerging as a distinct discipline, and this special issue is a major step forward in establishing the scientific basis of the discipline. A forensic necropsy uses the same skill set needed for investigations of natural ... ...

Abstract	Veterinary forensic pathology is emerging as a distinct discipline, and this special issue is a major step forward in establishing the scientific basis of the discipline. A forensic necropsy uses the same skill set needed for investigations of natural disease, but the analytical framework and purpose of forensic pathology differ significantly. The requirement of legal credibility and all that it entails distinguishes the forensic from routine diagnostic cases. Despite the extraordinary depth and breadth of knowledge afforded by their training, almost 75% of veterinary pathologists report that their training has not adequately prepared them to handle forensic cases. Many veterinary pathologists, however, are interested and willing to develop expertise in the discipline. Lessons learned from tragic examples of wrongful convictions in medical forensic pathology indicate that a solid foundation for the evolving discipline of veterinary forensic pathology requires a commitment to education, training, and certification. The overarching theme of this issue is that the forensic necropsy is just one aspect in the investigation of a case of suspected animal abuse or neglect. As veterinary pathologists, we must be aware of the roles filled by other veterinary forensic experts involved in these cases and how our findings are an integral part of an investigation. We hope that the outcome of this special issue of the journal is that veterinary pathologists begin to familiarize themselves with not only forensic pathology but also all aspects of veterinary forensic science.
MeSH term(s)	Animal Welfare ; Animals ; Forensic Medicine ; Pathology, Veterinary
Language	English
Publishing date	2016-09
Publishing country	United States
Document type	Editorial
ZDB-ID	188012-3
ISSN	1544-2217 ; 0300-9858
ISSN (online)	1544-2217
ISSN	0300-9858
DOI	10.1177/0300985816647450
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