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  1. AU="Sehdev, Simran"
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  1. Artikel: Use of Virtual Reality in the Education of Orthopaedic Procedures: A Randomised Control Study in Early Validation of a Novel Virtual Reality Simulator.

    Gomindes, Austin R / Adeeko, Elizabeth S / Khatri, Chetan / Ahmed, Imran / Sehdev, Simran / Carlos, William John / Ward, Thomas / Leverington, James / Debenham, Luke / Metcalfe, Andrew / Ward, Jayne

    Cureus

    2023  Band 15, Heft 9, Seite(n) e45943

    Abstract: Background Virtual reality (VR) simulation is a potential solution to the barriers surgical trainees are facing. There needs to be validation for its implementation within current training. We aimed to compare VR simulation to traditional methods in ... ...

    Abstract Background Virtual reality (VR) simulation is a potential solution to the barriers surgical trainees are facing. There needs to be validation for its implementation within current training. We aimed to compare VR simulation to traditional methods in acquiring surgical skills for a TFN-ADVANCED™ Proximal Femoral Nailing System (TFNA; DePuy Synthes, Auckland, New Zealand) femoral nailing system. Methods Thirty-one surgical trainees were randomised to two groups: traditional-training group (control group) and a VR-training group (intervention group) for insertion of a short cephalomedullary TFNA nail. Both groups then inserted the same TFNA system into saw-bone femurs. Surveys evaluated validity of the relevant activities, perception of simulation, confidence, stress and anxiety. The primary outcomes were tip-apex distance (TAD) and user anxiety/confidence levels. Secondary outcomes included number of screw- and nail-guidewire insertion attempts, the time taken to complete and user validity of the VR system. Results There was no statistical difference in TAD between the intervention and control groups (9mm vs 15mm, p=0.0734). The only TAD at risk of cut-out was in the control group (25mm). There was no statistical difference in time taken (2547.5ss vs 2395ss, p=0.668), nail guide-wire attempts (two for both groups, p=0.355) and screw guide-wire attempts (one for both groups, p=0.702). The control group versus intervention had higher anxiety levels (50% vs 33%) and had lower confidence (61% vs 84%). Interpretation There was no objective difference in performance on a saw-bone model between groups. However, this VR simulator resulted in more confidence and lower anxiety levels whilst performing a simulated TFNA. Whilst further studies with larger sample sizes and exploration of transfer validity to the operating theatre are required, this study does indicate potential benefits of VR within surgical training.
    Sprache Englisch
    Erscheinungsdatum 2023-09-25
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.45943
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; Online: Anti-cholinergic drug burden in patients with dementia increases after hospital admission: a multicentre cross-sectional study.

    Hook, Annabelle / Randall, Jessica L / Grubb, Carla M / Ellis, Natalie / Wellington, Jack / Hemmad, Aayushi / Zerdelis, Agisilaos / Winnett, Andrew R D / Geers, Benjamin D W / Sykes, Bethany / Auty, Charlotte N / Vinchenzo, Cecilia / Thorburn, Christiane E / Asogbon, Daniella / Granger, Emily / Boagey, Heather / Raphael, Juliet / Patel, Kajal / Bhargava, Kartik /
    Dolley, Mary-Kate M / Maden, Matthew J / Shah, Mehdin M / Lee, Qao M / Vaidya, Ratnaraj / Sehdev, Simran / Barai, Sneha / Roche, Sophie / Khalid, Uzair / Codling, David A / Harrison, Judith R

    BMC geriatrics

    2022  Band 22, Heft 1, Seite(n) 783

    Abstract: Background: Anticholinergic medications are drugs that block cholinergic transmission, either as their primary therapeutic action or as a secondary effect. Patients with dementia may be particularly sensitive to the central effects of anticholinergic ... ...

    Abstract Background: Anticholinergic medications are drugs that block cholinergic transmission, either as their primary therapeutic action or as a secondary effect. Patients with dementia may be particularly sensitive to the central effects of anticholinergic drugs. Anticholinergics also antagonise the effects of the main dementia treatment, cholinesterase inhibitors. Our study aimed to investigate anticholinergic prescribing for dementia patients in UK acute hospitals before and after admission.
    Methods: We included 352 patients with dementia from 17 UK hospital sites in 2019. They were all inpatients on surgical, medical or Care of the Elderly wards. Information about each patient's medications were collected using a standardised form, and the anticholinergic drug burden of each patient was calculated with an evidence-based online calculator. Wilcoxon's rank test was used to look at the correlation between two subgroups upon admission and discharge.
    Results: On admission to hospital, 37.8% of patients had an anticholinergic burden score ≥ 1 and 5.68% ≥3. On discharge, 43.2% of patients with an anticholinergic burden score ≥ 1 and 9.1% ≥3. The increase in scores was statistically significant (p = 0.001). Psychotropics were the most common group of anticholinergic medications prescribed at discharge. Of those patients taking cholinesterase inhibitors, 44.9% were also prescribed anticholinergic medications.
    Conclusions: Our cross-sectional, multicentre study found that people with dementia are commonly prescribed anticholinergic medications, even if concurrently taking cholinesterase inhibitors, and are significantly more likely to be discharged from hospital with a higher anticholinergic burden than on admission.
    Mesh-Begriff(e) Aged ; Cholinergic Antagonists/adverse effects ; Cholinesterase Inhibitors/therapeutic use ; Cross-Sectional Studies ; Dementia/chemically induced ; Dementia/drug therapy ; Dementia/epidemiology ; Hospitals ; Humans
    Chemische Substanzen Cholinergic Antagonists ; Cholinesterase Inhibitors
    Sprache Englisch
    Erscheinungsdatum 2022-10-06
    Erscheinungsland England
    Dokumenttyp Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2059865-8
    ISSN 1471-2318 ; 1471-2318
    ISSN (online) 1471-2318
    ISSN 1471-2318
    DOI 10.1186/s12877-022-03235-9
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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