Silvahickman2202

The main stage of developing an educational health technology is meeting the expectations of users. Nurses in Brazil can benefit from online training about therapeutic play interventions. This study identified the learning demands of nurses for acquiring competence in the use of therapeutic play to build an online course.

Focus groups study, guided by the COREQ guidelines. Nurses experienced in pediatric care participated in eight groups held in hospitals across all Brazilian regions in 2018. The focus group interviews had a mean duration of two hours and were moderated by the main researcher and an observer, both of whom were nurses experienced in qualitative research. All interviews were audio recorded. The transcripts of the audios were coded, from which the themes were developed, and thematic analysis performed.

Nurses (N=53, 8.5±6.3years of experience in pediatric care) reported their learning demands in three themes "Learning theoretical concepts", "Developing therapeutic play skills", and "Learning the therapeutic play in a fun, interactive and motivational online environment".

Nurses learning demands involve theoretical concepts and skills to implement therapeutic play through an interesting online course.

By developing play-based competence through an online learning environment nurses can feel confident in implementing therapeutic play into their pediatric practice, setting the stage for a future of positive interaction between nurses and children in pediatric health care.

By developing play-based competence through an online learning environment nurses can feel confident in implementing therapeutic play into their pediatric practice, setting the stage for a future of positive interaction between nurses and children in pediatric health care.

In many countries, as in France, medical training is not complete until the defense of a thesis, based on a research project; however, the publication of research work is not mandatory. This study investigated the evolution of the publication pattern of pediatric residents and identified the possible factors associated with an increased productivity, by investigating both thesis and non-thesis-related publications.

We conducted a retrospective cohort study of pediatric residents who graduated from the Medical University of Marseille in France over a 20-year period (1996-2015). Their theses were retrieved from the French database of university theses (SUDOC). Their publications were collated by scanning the PubMed and Google Scholar databases. Non-thesis-related publications were included up to 1year after the medical thesis defense and medical thesis publications were included without date limits. For each thesis or publication, the resident's characteristics, the supervisor's characteristics, the thesis ), when he or she had published more papers during the post-residency period (β=0.40; P<0.0001***) and when he or she graduated at an older age (β=0.24; P=0.04*).

The thesis publication rate of pediatric residents has improved significantly in 20 years; however, these results are from a single-center study. Publishing the thesis was significantly associated with shorter dissertation length and a more experienced thesis supervisor.

The thesis publication rate of pediatric residents has improved significantly in 20 years; however, these results are from a single-center study. Publishing the thesis was significantly associated with shorter dissertation length and a more experienced thesis supervisor.

The lesser trochanter (LT) fragment in the multifragmentary intertrochanteric femur fracture (AO 31A2.2) may extend distally. LDC195943 If the fragment extends too distally, fixation with a short proximal femoral nail antirotation (PFNA-II) device may not be sufficient. The exact length of distal extension that can be tolerated by the short PFNA-II is not known, therefore it is our objective to determine it.

A finite element analysis was performed on AO 31A2.2 fracture fixed with a 200mm length size 10 PFNA-II. The construct was loaded vertically to clinical failure of 10mm displacement. This was repeated with the size of the LT fragment increasing distally at intervals, up to 120mm from the base of the LT. The process was also repeated with the bone properties substituted with osteoporotic properties. The stiffness, maximum vertical reaction force, and the plastic deformation area were investigated.

In both non-osteoporotic and osteoporotic model, the stiffness and the maximum vertical reaction force of the construct dropped significantly when the LT fragment is larger than 40mm. Beyond 40mm of LT fragment size, there was a rapid increase in the area of plastic deformation of the cortical bone distal to the intertrochanteric fracture, signifying structural failure of the construct.

A long PFNA-II should be considered when fixing a multifragmentary intertrochanteric fracture if the LT fragment extends 40mm distal to the distal base of the LT as the construct fails rapidly upon uniaxial load to failure. Clinically, this threshold may be smaller to account for the multi-axial and dynamic stresses.

A long PFNA-II should be considered when fixing a multifragmentary intertrochanteric fracture if the LT fragment extends 40mm distal to the distal base of the LT as the construct fails rapidly upon uniaxial load to failure. Clinically, this threshold may be smaller to account for the multi-axial and dynamic stresses.

Strategic medical evacuation (MEDEVAC) allows airborne repatriation of soldiers injured or sick on missions to their national territory. The aim of this study was to describe the epidemiology of strategic MEDEVAC performed by intensive care physicians (ICP) and to analyze the role of the ICP in the management of critical care situations in flight.

All soldiers who had high or medium dependency conditions and who benefited from a strategic MEDEVAC with an ICP on board between 1 January 2001 and 30 November 2017 were included in this epidemiological retrospective study.

A total of 452 soldiers were repatriated; the causes of repatriation were either trauma (n=245; 54%) or medical pathologies (n=207; 46%). Two hundred and seventy-six (61%) evacuations were performed within 48h. The median annual number of strategic MEDEVAC with an ICP was 26 [20-32]. One hundred and fifty-five (34%) patients were mechanically ventilated and 103 (23%) received catecholamines. The median SAPS II score was 13 [8-24]. One hundred and seventy-eight adverse events were identified, of which 123 (69%) related to a worsening of the patient's clinical condition and 30 (20%) related to a technical problem.