Marymount Hospital is a 322-bed acute-care facility located in Garfield Heights, Ohio. The hospital primarily serves southern and southeastern Cuyahoga County. Marymount provides cancer care, cardiology, diabetes, emergency, orthopaedics, outpatient rehabilitation, stroke care, vascular surgery, and women's health. The hospital campus also includes a medical office building, a behavioral health center, Critical Care Tower and Surgery Center.
SignificanceFluorescence guided surgery (FGS) has demonstrated improvements in decision making and patient outcomes for a wide range of surgical procedures. Not only can FGS systems provide a higher level of structural perfusion accuracy in tissue reconstruction cases but they can also serve for real-time functional characterization. Multiple FGS devices have been Food and Drug administration (FDA) cleared for use in open and laparoscopic surgery. Despite the rapid growth of the field, there has been a lack standardization methods.AimThis work overviews commonalities inherent to optical imaging methods that can be exploited to produce such a standardization procedure. Furthermore, a system evaluation pipeline is proposed and executed through the use of photo-stable indocyanine green fluorescence phantoms. Five different FDA-approved open-field FGS systems are used and evaluated with the proposed method.ApproachThe proposed pipeline encompasses the following characterization: (1) imaging spatial resolution and sharpness, (2) sensitivity and linearity, (3) imaging depth into tissue, (4) imaging system DOF, (5) uniformity of illumination, (6) spatial distortion, (7) signal to background ratio, (8) excitation bands, and (9) illumination wavelength and power.ResultsThe results highlight how such a standardization approach can be successfully implemented for inter-system comparisons as well as how to better understand essential features within each FGS setup.ConclusionsDespite clinical use being the end goal, a robust yet simple standardization pipeline before clinical trials, such as the one presented herein, should benefit regulatory agencies, manufacturers, and end-users to better assess basic performance and improvements to be made in next generation FGS systems.
Context. GP's provide palliative care in the community. Managing complex palliative needs can be challenging for GPs and even more so for GP trainees. During the postgraduate training period GP trainees are working in the community but have more time for education. This time in their career could present a good opportunity for palliative care education. For any education to be effective their educational needs must first be clarified.Objectives. To explore the perceived palliative care education needs and preferred education methods of GP trainees.Methods. A national, multisite qualitative study involving a series of semistructured focus group interviews with third and fourth year GP trainees. Data were coded and analyzed using Reflexive Thematic Analysis.Results. Perceived Educational Needs: five themes were conceptualized: 1) Empowerment vs. Disempowerment; 2) Commu-nity Practice; 3) Intra-and Interpersonal Skills; 4) Formative Experiences; 5) Contextual Challenges.Preferred Educational Methods. Three themes were conceptualized: 1) Oriented Learning-experiential vs. didactic; 2) Practicalities; 3) Communication Skills.Conclusion. This is the first multisite national qualitative study exploring the perceived palliative care educational needs and preferred educational methods of GP trainees. Trainees expressed a unanimous need for experiential palliative care education. Trainees also identified means to address their educational requirements. This study suggests that a collaborative approach between specialist palliative care and general practice is necessary to create educational opportunities.(c) 2023 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
Udeh, Chiedozie1; Canfield, Christina2; Brown, Abigail3; Castro, Jonathan4; Hata, Steven5 Author Information
