Science.gov

Sample records for online anaphylaxis training

  1. Long-term Effectiveness of Online Anaphylaxis Education for Pharmacists

    PubMed Central

    Vale, Sandra; Sanfilippo, Frank M; Loh, Richard; Clifford, Rhonda M

    2014-01-01

    Objective. To evaluate the long-term effectiveness of an Australasian Society of Clinical Immunology and Allergy (ASCIA) anaphylaxis e-learning program compared to lectures or no training. Design. A controlled interrupted-time-series study of Australian pharmacists and pharmacy students who completed ASCIA anaphylaxis e-learning or lecture programs was conducted during 2011-2013. Effectiveness was measured using a validated test administered pretraining, posttraining, and 3 and 7 months after training. Assessment. All learning groups performed significantly better on all posttests compared to the pretest, and compared to a control group (p<0.001). The proportion of e-learners achieving the minimum standard for anaphylaxis knowledge improved from 45% at pretest to 87% at 7 months. Conclusion. The ASCIA e-learning program significantly increased anaphylaxis knowledge. The high proportion of participants achieving the minimum standard at 7 months indicates long-term knowledge change. PMID:25258441

  2. Long-term effectiveness of online anaphylaxis education for pharmacists.

    PubMed

    Salter, Sandra M; Vale, Sandra; Sanfilippo, Frank M; Loh, Richard; Clifford, Rhonda M

    2014-09-15

    To evaluate the long-term effectiveness of an Australasian Society of Clinical Immunology and Allergy (ASCIA) anaphylaxis e-learning program compared to lectures or no training. A controlled interrupted-time-series study of Australian pharmacists and pharmacy students who completed ASCIA anaphylaxis e-learning or lecture programs was conducted during 2011-2013. Effectiveness was measured using a validated test administered pretraining, posttraining, and 3 and 7 months after training. All learning groups performed significantly better on all posttests compared to the pretest, and compared to a control group (p<0.001). The proportion of e-learners achieving the minimum standard for anaphylaxis knowledge improved from 45% at pretest to 87% at 7 months. The ASCIA e-learning program significantly increased anaphylaxis knowledge. The high proportion of participants achieving the minimum standard at 7 months indicates long-term knowledge change.

  3. Anaphylaxis

    MedlinePlus

    ... US » Peanut allergy prevention strategy does not impact growth or nutrition » Trends, characteristics, and incidence of anaphylaxis: A population-based study » Utility navigation Donate Annual meeting Browse ...

  4. Anaphylaxis.

    PubMed

    Simons, F Estelle R

    2010-02-01

    Anaphylaxis occurs commonly in community settings. The rate of occurrence is increasing, especially in young people. Understanding potential triggers, mechanisms, and patient-specific risk factors for severity and fatality is the key to performing appropriate risk assessment in those who have previously experienced an acute anaphylactic episode. The diagnosis of anaphylaxis is based primarily on clinical criteria and is valid even if the results of laboratory tests, such as serum total tryptase levels, are within normal limits. Positive skin test results or increased serum specific IgE levels to potential triggering allergens confirm sensitization but do not confirm the diagnosis of anaphylaxis because asymptomatic sensitization is common in the general population. Important patient-related risk factors for severity and fatality include age, concomitant diseases, and concurrent medications, as well as other less well-defined factors, such as defects in mediator degradation pathways, fever, acute infection, menses, emotional stress, and disruption of routine. Prevention of anaphylaxis depends primarily on optimal management of patient-related risk factors, strict avoidance of confirmed relevant allergen or other triggers, and, where indicated, immunomodulation (eg, subcutaneous venom immunotherapy to prevent Hymenoptera sting-triggered anaphylaxis, an underused, potentially curative treatment). The benefits and risks of immunomodulation to prevent food-triggered anaphylaxis are still being defined. Epinephrine (adrenaline) is the medication of first choice in the treatment of anaphylaxis. All patients at risk for recurrence in the community should be equipped with 1 or more epinephrine autoinjectors; a written, personalized anaphylaxis emergency action plan; and up-to-date medical identification. Improvements in the design of epinephrine autoinjectors will help to optimize ease of use and safety. Randomized controlled trials of pharmacologic agents, such as

  5. Anaphylaxis

    MedlinePlus

    ... that may lead to anaphylaxis include the following:Foods such as shellfish, nuts, peanuts, eggs, and fruitsMedicines such as antibiotics, aspirin, over-the-counter pain relievers (such as ibuprofen), allergy shots, and contrast dye for imaging proceduresLatex or rubber found in surgical ...

  6. Anaphylaxis.

    PubMed

    Hernandez, Lorenzo; Papalia, Sarah; Pujalte, George G A

    2016-09-01

    Anaphylaxis is an acute, systemic reaction mediated by immunoglobulin E hypersensitivity. Release of bioactive factors causes vasodilation and bronchiole constriction that can lead to hypotensive shock and asphyxiation. Differential diagnosis includes acute asthma, localized angioedema, syncope, and anxiety/panic attacks. Diagnostic tests lack specificity. Clinical diagnosis is based on demonstration of specific airway or cardiovascular compromise within proximity of allergen exposure. Treatment includes epinephrine, antihistamines, fluid resuscitation, and airway management. Prevention focuses on awareness/avoidance of triggers, implementation of personalized action plans, as well as immune modulation by desensitization in a closely controlled setting where available. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Anaphylaxis in Latin America: a report of the online Latin American survey on anaphylaxis (OLASA).

    PubMed

    Sole, Dirceu; Ivancevich, Juan Carlos; Borges, Mario Sanchez; Coelho, Magna Adaci; Rosario, Nelson A; Ardusso, Ledit Ramón Francisco; Bernd, Luis Antônio Guerra

    2011-01-01

    The aims of the Online Latin American Survey of Anaphylaxis (OLASA) were to identify the main clinical manifestations, triggers, and treatments of severe allergic reactions in patients who were seen by allergists from July 2008 to June 2010 in 15 Latin American countries and Portugal (n =634). Of all patients, 68.5% were older than 18 years, 41.6% were male, and 65.4% experienced the allergic reaction at home. The etiologic agent was identified in 87.4% of cases and predominantly consisted of drugs (31.2%), foods (23.3%), and insect stings (14.9%). The main symptom categories observed during the acute episodes were cutaneous (94.0%) and respiratory (79.0%). The majority of patients (71.6%) were treated initially by a physician (office/emergency room) within the first hour after the reaction occurred (60.2%), and 43.5% recovered in the first hour after treatment. Most patients were treated in an emergency setting, but only 37.3% received parenteral epinephrine alone or associated with other medication. However, 80.5% and 70.2% were treated with corticosteroids or antihistamines (alone or in association), respectively. A total of 12.9% of the patients underwent reanimation maneuvers, and 15.2% were hospitalized. Only 5.8% of the patients returned to the emergency room after discharge, with 21.7% returning in the first 6 hours after initial treatment. The main clinical manifestations of severe allergic reactions were cutaneous. The etiologic agents that were identified as causing these acute episodes differed according to age group. Following in order: drugs (31.2%), foods (23.3% and insect stings (14.9%) in adults with foods predominance in children. Treatment provided for acute anaphylactic reactions was not appropriate. It is necessary to improve educational programs in order to enhance the knowledge on this potentially fatal emergency.

  8. Anaphylaxis in Latin America: a report of the online Latin American survey on anaphylaxis (OLASA)

    PubMed Central

    Solé, Dirceu; Ivancevich, Juan Carlos; Borges, Mario Sánchez; Coelho, Magna Adaci; Rosário, Nelson A; Ardusso, Ledit Ramón Francisco; Bernd, Luis Antônio Guerra

    2011-01-01

    OBJECTIVES: The aims of the Online Latin American Survey of Anaphylaxis (OLASA) were to identify the main clinical manifestations, triggers, and treatments of severe allergic reactions in patients who were seen by allergists from July 2008 to June 2010 in 15 Latin American countries and Portugal (n = 634). RESULTS: Of all patients, 68.5% were older than 18 years, 41.6% were male, and 65.4% experienced the allergic reaction at home. The etiologic agent was identified in 87.4% of cases and predominantly consisted of drugs (31.2%), foods (23.3%), and insect stings (14.9%). The main symptom categories observed during the acute episodes were cutaneous (94.0%) and respiratory (79.0%). The majority of patients (71.6%) were treated initially by a physician (office/emergency room) within the first hour after the reaction occurred (60.2%), and 43.5% recovered in the first hour after treatment. Most patients were treated in an emergency setting, but only 37.3% received parenteral epinephrine alone or associated with other medication. However, 80.5% and 70.2% were treated with corticosteroids or antihistamines (alone or in association), respectively. A total of 12.9% of the patients underwent reanimation maneuvers, and 15.2% were hospitalized. Only 5.8% of the patients returned to the emergency room after discharge, with 21.7% returning in the first 6 hours after initial treatment. CONCLUSION: The main clinical manifestations of severe allergic reactions were cutaneous. The etiologic agents that were identified as causing these acute episodes differed according to age group. Following in order: drugs (31.2%), foods (23.3% and insect stings (14.9%) in adults with foods predominance in children. Treatment provided for acute anaphylactic reactions was not appropriate. It is necessary to improve educational programs in order to enhance the knowledge on this potentially fatal emergency. PMID:21808856

  9. Online Training in Australia

    ERIC Educational Resources Information Center

    Kuzic, Joze

    2013-01-01

    On-line training is becoming an interesting phenomenon in Australia and has attracted a lot of interest across many industries and businesses (Chan and Ngai, 2007). The research reported here looks at the use of online training in corporations in Australia. It focuses on two aspects of online training, the factors that "warrant" its…

  10. [Training of resident physicians in the recognition and treatment of an anaphylaxis case in pediatrics with simulation models].

    PubMed

    Enríquez, Diego; Lamborizio, María J; Firenze, Lorena; Jaureguizar, María de la P; Díaz Pumará, Estanislao; Szyld, Edgardo

    2017-08-01

    To evaluate the performance of resident physicians in diagnosing and treating a case of anaphylaxis, six months after participating in simulation training exercises. Initially, a group of pediatric residents were trained using simulation techniques in the management of critical pediatric cases. Based on their performance in this exercise, participants were assigned to one of 3 groups. At six months post-training, 4 residents were randomly chosen from each group to be re-tested, using the same performance measure as previously used. During the initial training session, 56 of 72 participants (78%) correctly identified and treated the case. Six months after the initial training, all 12 (100%) resident physicians who were re-tested successfully diagnosed and treated the simulated anaphylaxis case. The training through simulation techniques allowed correction or optimization of the treatment of simulated anaphylaxis cases in resident physicians evaluated after 6 months of the initial training.

  11. What Price Online Training?

    ERIC Educational Resources Information Center

    Ganzel, Rebecca

    1999-01-01

    Discusses the difficulties involved with pricing an online training course. Looks at such issues as the size of the marketplace, the ability to use the same course many times, the switch from time-centered to content-centered courses, the amount of time needed to complete a specific course, and the need for multimedia training materials. (JOW)

  12. Evaluation of an Anaphylaxis Training Program for Unlicensed Assistive Personnel

    ERIC Educational Resources Information Center

    Litarowsky, Jean A.; Murphy, Susan O.; Canham, Daryl L.

    2004-01-01

    This study evaluated a training program designed to prepare unlicensed assistive personnel (UAP) in high school settings to recognize and respond effectively to an anaphylactic emergency. Subjects included 53 adults employed by a high school district in the San Francisco Bay Area of California. A training model was developed based on Bandura's…

  13. Evaluation of an Anaphylaxis Training Program for Unlicensed Assistive Personnel

    ERIC Educational Resources Information Center

    Litarowsky, Jean A.; Murphy, Susan O.; Canham, Daryl L.

    2004-01-01

    This study evaluated a training program designed to prepare unlicensed assistive personnel (UAP) in high school settings to recognize and respond effectively to an anaphylactic emergency. Subjects included 53 adults employed by a high school district in the San Francisco Bay Area of California. A training model was developed based on Bandura's…

  14. Online weight training.

    PubMed

    McNamara, John M; Swalm, Ricky L; Stearne, David J; Covassin, Tracey M

    2008-07-01

    The purpose of this study was to determine how a traditional weight training class compared to nontraditional classes that were heavily laden with technology. Could students learn resistance exercises by watching video demonstrations over the Internet? Three university weight training classes, each lasting 16 weeks, were compared. Each class had the same curriculum and workout requirements but different attendance requirements. The online group made extensive use of the Internet and was allowed to complete the workouts on their own at any gym that was convenient for them. Seventy-nine college-aged students were randomized into 3 groups: traditional (n = 27), hybrid (n = 25), and online (n = 27). They completed pretest and posttest measures on upper-body strength (i.e., bench press), lower-body strength (i.e., back squat), and knowledge (i.e., written exam). The results indicated that all 3 groups showed significant improvement in knowledge (p < 0.05). The online group did not require the students to attend class and may have resulted in significantly lower scores on the bench press (p < 0.05) and squats (p < 0.05). This study indicates that an online weight training course may improve knowledge but not strength. Possible reasons for a lack of improvement in the online group included lack of motivation, low accountability, and the possibility that the self-reported workouts were not accurate. These results suggest that there is a limit to how much technology can be used in a weight training class. If this limit is exceeded, some type of monitoring system appears necessary to ensure that students are actually completing their workouts.

  15. Implementation of Anaphylaxis Management Guidelines: A Register-Based Study

    PubMed Central

    Grabenhenrich, Linus; Hompes, Stephanie; Gough, Hannah; Ruëff, Franziska; Scherer, Kathrin; Pföhler, Claudia; Treudler, Regina; Mahler, Vera; Hawranek, Thomas; Nemat, Katja; Koehli, Alice; Keil, Thomas; Worm, Margitta

    2012-01-01

    Background Anaphylaxis management guidelines recommend the use of intramuscular adrenaline in severe reactions, complemented by antihistamines and corticoids; secondary prevention includes allergen avoidance and provision of self-applicable first aid drugs. Gaps between recommendations and their implementation have been reported, but only in confined settings. Hence, we analysed nation-wide data on the management of anaphylaxis, evaluating the implementation of guidelines. Methods Within the anaphylaxis registry, allergy referral centres across Germany, Austria and Switzerland provided data on severe anaphylaxis cases. Based on patient records, details on reaction circumstances, diagnostic workup and treatment were collected via online questionnaire. Report of anaphylaxis through emergency physicians allowed for validation of registry data. Results 2114 severe anaphylaxis patients from 58 centres were included. 8% received adrenaline intravenously, 4% intramuscularly; 50% antihistamines, and 51% corticoids. Validation data indicated moderate underreporting of first aid drugs in the Registry. 20% received specific instructions at the time of the reaction; 81% were provided with prophylactic first aid drugs at any time. Conclusion There is a distinct discrepancy between current anaphylaxis management guidelines and their implementation. To improve patient care, a revised approach for medical education and training on the management of severe anaphylaxis is warranted. PMID:22590513

  16. Anaphylaxis (image)

    MedlinePlus

    Anaphylaxis is an acute systemic (whole body) type of allergic reaction which occurs when a person has ... blood vessels to dilate and tissues to swell. Anaphylaxis may be life threatening if obstruction of the ...

  17. Penicillin anaphylaxis.

    PubMed

    O'Leary, M R; Smith, M S

    1986-05-01

    A case of oral penicillin anaphylaxis is described, and the terminology, occurrence, clinical manifestations, pathogenesis, prevention, and treatment of anaphylaxis are reviewed. Emergency physicians should be aware of oral penicillin anaphylaxis in order to prevent its occurrence by prescribing the antibiotic judiciously and knowledgeably and to offer optimal medical therapy once this life-threatening reaction has begun.

  18. Idiopathic anaphylaxis.

    PubMed

    Fenny, Nana; Grammer, Leslie C

    2015-05-01

    Idiopathic anaphylaxis is a diagnosis of exclusion after other causes have been thoroughly evaluated and excluded. The pathogenesis of idiopathic anaphylaxis remains uncertain, although increased numbers of activated lymphocytes and circulating histamine-releasing factors have been implicated. Signs and symptoms of patients diagnosed with idiopathic anaphylaxis are indistinguishable from the manifestations of other forms of anaphylaxis. Treatment regimens are implemented based on the frequency and severity of patient symptoms and generally include the use of epinephrine autoinjectors, antihistamines, and steroids. The prognosis of idiopathic anaphylaxis is generally favorable with well-established treatment regimens and effective patient education. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Recognition and treatment of anaphylaxis.

    PubMed

    Younker, Jackie; Soar, Jasmeet

    2010-01-01

    The aim of this paper is to discuss the recognition, treatment and investigation of anaphylaxis. Anaphylaxis is a severe, life-threatening, generalized or systemic hypersensitivity reaction. It is characterized by rapidly developing life-threatening airway and/or breathing and/or circulation problems usually associated with skin and/or mucosal changes. The incidence of anaphylaxis appears to be increasing. A wide range of triggers can cause anaphylaxis. Drugs are the commonest cause of anaphylaxis in hospital and foods in the out-of-hospital setting. Patients having anaphylaxis should be treated using the airway, breathing, circulation, disability, exposure (ABCDE) approach. Early treatment with intramuscular adrenaline is the treatment of choice for patients having anaphylaxis. Intravenous adrenaline must only be used when the patient is monitored and only by those skilled and experienced in its use. A raised serum mast cell tryptase suggests a diagnosis of anaphylaxis. All those who are suspected of having anaphylaxis should be referred to a specialist in allergy. Individuals at high risk of anaphylaxis where the trigger is difficult to avoid should carry an adrenaline auto-injector and receive training and support in its use.

  20. Idiopathic anaphylaxis.

    PubMed

    Greenberger, Paul A

    2007-05-01

    Idiopathic anaphylaxis is a prednisone-responsive condition without external cause, but it can coexist with food-, medication-, or exercise-induced anaphylaxis. Mast cell activation may occur at night or after foods that have been eaten with impunity many times previously. Idiopathic anaphylaxis can be classified into frequent (if there are six or more episodes per year or two episodes in the last 2 months) or infrequent (if episodes occur less often). Idiopathic anaphylaxis-generalized consists of urticaria or angioedema associated with severe respiratory distress, syncope or hypotension, and gastrointestinal symptoms. Idiopathic anaphylaxis-angioedema consists of massive tongue enlargement or severe pharyngeal or laryngeal swelling with urticaria or peripheral angioedema. The differential diagnosis of idiopathic anaphylaxis is reviewed, and treatment approaches are presented.

  1. Online Training Sessions: Suggested Guidelines.

    ERIC Educational Resources Information Center

    Cabonell, Martha; And Others

    1981-01-01

    These planning and evaluative guidelines for online trainers utilize a sliding scale--from minimal to suggested to optimal--for five types of training sessions: (1) Search Service--Beginning; (2) Search Service--Advanced; (3) Search Service--Subject; (4) Database Producer; and (5) Independent Introductory Workshop. (RAA)

  2. Anaphylaxis-Like Reactions

    MedlinePlus

    ... Home Conditions Anaphylaxis Anaphylaxis-Like Reactions Anaphylaxis-Like Reactions Make an Appointment Refer a Patient Ask a ... exposed to a foreign substance, some people suffer reactions identical to anaphylaxis, but no allergy (IgE antibody) ...

  3. Anaphylaxis-Like Reactions

    MedlinePlus

    ... Home Conditions Anaphylaxis Anaphylaxis-Like Reactions Anaphylaxis-Like Reactions Make an Appointment Refer a Patient Ask a ... exposed to a foreign substance, some people suffer reactions identical to anaphylaxis, but no allergy (IgE antibody) ...

  4. Training Online Faculty: A Phenomenology Study

    ERIC Educational Resources Information Center

    Kang, Haijun

    2012-01-01

    Literature on training faculty to teach online still dwells on the issues explored a decade ago. To make a substantial move in this area, it is necessary to re-evaluate the essence of training in the context of producing qualified online faculty to teach quality online courses. Employing a phenomenological approach, this study examines seven…

  5. Training and administration of epinephrine auto-injectors for anaphylaxis treatment in US schools: results from the EpiPen4Schools® pilot survey

    PubMed Central

    Hogue, Susan L; Goss, Diana; Hollis, Kelly; Silvia, Suyapa; White, Martha V

    2016-01-01

    Background Anaphylaxis is a serious, potentially life-threatening condition. Adequate preparation for anaphylaxis management is imperative for school personnel. This descriptive pilot study assessed preparedness of US schools to manage anaphylactic reactions. Methods An exploratory, cross-sectional, web-based, pilot survey assessed the occurrence and characteristics of anaphylactic events, as well as training provided to school personnel for the recognition and treatment of anaphylaxis. Eligible US schools were participants in the EpiPen4Schools® program during the 2013–2014 school year. EpiPen4Schools provides EpiPen® (epinephrine injection) Auto-Injectors and training materials to qualifying US schools. Survey data were parsed by US Census Bureau region and state and were evaluated using descriptive statistics. Results Schools from all 50 states and the District of Columbia participated in the survey (N=6,019). Among schools that provided information on anaphylactic events, 11% (607/5,683) reported the occurrence of one or more events, with significant variability in incidence across census regions and among states. A total of 5,613 schools provided information regarding which staff members were trained to recognize the signs and symptoms of anaphylaxis. Thirty-six percent of schools (2,022/5,613) indicated that only the school nurse and select staff were trained in anaphylaxis recognition. The proportion of schools in which most or all school staff received such training differed by region/state (range, 13%–100%). A total of 5,578 schools provided information on which staff were permitted to administer epinephrine. The majority of schools (54%; 3,024/5,578) permitted only the school nurse and select staff to administer epinephrine, although percentages varied by region/state (range, 4%–100%). Conclusion Schools differed substantially in their preparedness to manage anaphylaxis, with significant disparities in staff training and permission to treat. Given

  6. Training and administration of epinephrine auto-injectors for anaphylaxis treatment in US schools: results from the EpiPen4Schools(®) pilot survey.

    PubMed

    Hogue, Susan L; Goss, Diana; Hollis, Kelly; Silvia, Suyapa; White, Martha V

    2016-01-01

    Anaphylaxis is a serious, potentially life-threatening condition. Adequate preparation for anaphylaxis management is imperative for school personnel. This descriptive pilot study assessed preparedness of US schools to manage anaphylactic reactions. An exploratory, cross-sectional, web-based, pilot survey assessed the occurrence and characteristics of anaphylactic events, as well as training provided to school personnel for the recognition and treatment of anaphylaxis. Eligible US schools were participants in the EpiPen4Schools(®) program during the 2013-2014 school year. EpiPen4Schools provides EpiPen(®) (epinephrine injection) Auto-Injectors and training materials to qualifying US schools. Survey data were parsed by US Census Bureau region and state and were evaluated using descriptive statistics. Schools from all 50 states and the District of Columbia participated in the survey (N=6,019). Among schools that provided information on anaphylactic events, 11% (607/5,683) reported the occurrence of one or more events, with significant variability in incidence across census regions and among states. A total of 5,613 schools provided information regarding which staff members were trained to recognize the signs and symptoms of anaphylaxis. Thirty-six percent of schools (2,022/5,613) indicated that only the school nurse and select staff were trained in anaphylaxis recognition. The proportion of schools in which most or all school staff received such training differed by region/state (range, 13%-100%). A total of 5,578 schools provided information on which staff were permitted to administer epinephrine. The majority of schools (54%; 3,024/5,578) permitted only the school nurse and select staff to administer epinephrine, although percentages varied by region/state (range, 4%-100%). Schools differed substantially in their preparedness to manage anaphylaxis, with significant disparities in staff training and permission to treat. Given the ramifications of delayed treatment

  7. Cost-Effectiveness of Online Teacher Training

    ERIC Educational Resources Information Center

    Jung, Insung

    2005-01-01

    This study aims to compare the cost-effectiveness of an online teacher training method with a face-to-face training method in teaching "ICT integration in the school curriculum". In addition, the study explores the possibilities of a school-based voluntary training method in supporting other approaches to ICT teacher training. The analyses of…

  8. Group online mindfulness training: proof of concept.

    PubMed

    Kemper, Kathi J; Yun, Jonathan

    2015-01-01

    Mindfulness-based stress reduction training is attractive, but training with an expert teacher is often inconvenient and costly. This proof-of-concept project assessed the feasibility of providing a hybrid of free online mindfulness-based stress reduction training with small group peer facilitation. Six medical students asked a family medicine resident with 5 years of meditation experience but no formal training as a teacher to facilitate 8 weekly group sessions using a free online mindfulness-based stress reduction course. They completed pre- and posttraining questionnaires online. Six of the 7 trainees completed at least half the sessions. Completers and noncompleters had similar age (29 years), gender (about half male), and health status. Changes in the expected direction were observed for perceived stress, mindfulness, resilience, and confidence in providing calm, compassionate care. The hybrid of online mindfulness-based stress reduction training with peer support is feasible. Additional research is warranted to formally evaluate the impact of this approach.

  9. A national survey of Russian physicians' knowledge of diagnosis and management of food-induced anaphylaxis.

    PubMed

    Munblit, Daniel; Treneva, Marina; Korsunskiy, Ilya; Asmanov, Alan; Pampura, Alexander; Warner, John O

    2017-07-20

    Food allergy is an increasing burden worldwide and is a common problem within paediatric populations, affecting 5%-8% of children. Anaphylaxis caused by food proteins is a potentially life-threatening condition and all healthcare practitioners should be aware of its recognition and management. Russia is the largest country in Europe but it is still unknown whether physicians are prepared to diagnose and manage food-induced anaphylaxis effectively. We aimed to examine physicians' knowledge of diagnosis and management of food-induced anaphylaxis. A survey was designed and published online at VrachiRF.ru website (for registered Russian-speaking practicing physicians). We obtained information on respondents' clinical settings, experience and specialty. Survey questions were based on a characteristic clinical scenario of anaphylaxis due to food ingestion. Outcome measures consisted of correct answers to the anaphylaxis diagnosis and management questions. From a total of 707 of physicians accessed in the survey, 315 (45%) responded to the clinical scenario. 16 respondents reported training in allergy-immunology and have been excluded from the analysis, leaving the final sample size of 299. Respondents were paediatricians (68%) and other specialties adult physicians (32%). Overall, 100 (33%) of respondents diagnosed anaphylaxis, but only 29% of those making the correct diagnosis administered adrenalin (1:1000) intramuscular. Respondents working in secondary/tertiary clinics diagnosed anaphylaxis significantly more often (p=0.04) when compared with primary care/private practice physicians. This difference was also apparent as the most important influence on responses in the multivariate analysis. In this national sample of Russian physicians, we found poor knowledge in both anaphylaxis diagnosis and management. Our data show that the chance of being properly diagnosed with anaphylaxis is 33% and being appropriately treated with adrenalin is 10%. These findings highlight

  10. Familial Anaphylaxis after Silkworm Ingestion.

    PubMed

    Gautreau, Marc; Restuccia, Marc; Senser, Kevin; Weisberg, Stacy N

    2017-01-01

    Herein, we present a case of anaphylaxis in multiple family members after ingesting silkworms, an Asian delicacy. While food allergies, including anaphylaxis are unfortunately common, there are no previous reports of multiple family members suffering an anaphylactic reaction after eating silkworms. In addition, both family members required multiple doses of epinephrine and eventually an epinephrine infusion to improve their blood pressures. All interventions, including the epinephrine infusions, were started by emergency medical services (EMS) with on-line medical direction. Both the reaction and the required treatment are not extensively documented in the medical literature.

  11. Involuntary Commitment Application: An Online Training Module

    ERIC Educational Resources Information Center

    Whitfield, Kimberly Y.

    2012-01-01

    The use of Web-based technology has enabled many government and corporate training divisions to reach more learners than ever before. Institutions are restructuring their budgets, obtaining funding from governments and foundations to fund resources needed to increase online learning offerings. While online learning is increasing, questions arise…

  12. Training and Support for Successful Online Instruction

    ERIC Educational Resources Information Center

    Green, Amy

    2012-01-01

    Online education is growing rapidly as colleges seek to increase enrollment without investing in physical infrastructure. To keep up with the increasing demand for courses, some colleges are asking faculty to teach classes online with little training, few resources, and minimal support. The purpose of this study was to determine how the training…

  13. Training Aids for Online Instruction: An Analysis.

    ERIC Educational Resources Information Center

    Guy, Robin Frederick

    This paper describes a number of different types of training aids currently employed in online training: non-interactive audiovisual presentations; interactive computer-based aids; partially interactive aids based on recorded searches; print-based materials; and kits. The advantages and disadvantages of each type of aid are noted, and a table…

  14. Training Aids for Online Instruction: An Analysis.

    ERIC Educational Resources Information Center

    Guy, Robin Frederick

    This paper describes a number of different types of training aids currently employed in online training: non-interactive audiovisual presentations; interactive computer-based aids; partially interactive aids based on recorded searches; print-based materials; and kits. The advantages and disadvantages of each type of aid are noted, and a table…

  15. An Online Training Course to Learn How to Teach Online

    ERIC Educational Resources Information Center

    Bachy, Sylviane; Lebrun, Marcel

    2015-01-01

    This case study deals with the implementation of ongoing training, offered wholly through distance and online learning, and conducted within the framework of an inter-university partnership linking two European countries. The case story relates the experience of several instructional designers (called "Academic Advisors" in this part of…

  16. Anaphylaxis in children and adolescents: The European Anaphylaxis Registry.

    PubMed

    Grabenhenrich, Linus B; Dölle, Sabine; Moneret-Vautrin, Anne; Köhli, Alice; Lange, Lars; Spindler, Thomas; Ruëff, Franziska; Nemat, Katja; Maris, Ioana; Roumpedaki, Eirini; Scherer, Kathrin; Ott, Hagen; Reese, Thomas; Mustakov, Tihomir; Lang, Roland; Fernandez-Rivas, Montserrat; Kowalski, Marek L; Bilò, Maria B; Hourihane, Jonathan O'B; Papadopoulos, Nikolaos G; Beyer, Kirsten; Muraro, Antonella; Worm, Margitta

    2016-04-01

    Anaphylaxis in children and adolescents is a potentially life-threatening condition. Its heterogeneous clinical presentation and sudden occurrence in virtually any setting without warning have impeded a comprehensive description. We sought to characterize severe allergic reactions in terms of elicitors, symptoms, emergency treatment, and long-term management in European children and adolescents. The European Anaphylaxis Registry recorded details of anaphylaxis after referral for in-depth diagnosis and counseling to 1 of 90 tertiary allergy centers in 10 European countries, aiming to oversample the most severe reactions. Data were retrieved from medical records by using a multilanguage online form. Between July 2007 and March 2015, anaphylaxis was identified in 1970 patients younger than 18 years. Most incidents occurred in private homes (46%) and outdoors (19%). One third of the patients had experienced anaphylaxis previously. Food items were the most frequent trigger (66%), followed by insect venom (19%). Cow's milk and hen's egg were prevalent elicitors in the first 2 years, hazelnut and cashew in preschool-aged children, and peanut at all ages. There was a continuous shift from food- to insect venom- and drug-induced anaphylaxis up to age 10 years, and there were few changes thereafter. Vomiting and cough were prevalent symptoms in the first decade of life, and subjective symptoms (nausea, throat tightness, and dizziness) were prevalent later in life. Thirty percent of cases were lay treated, of which 10% were treated with an epinephrine autoinjector. The fraction of intramuscular epinephrine in professional emergency treatment increased from 12% in 2011 to 25% in 2014. Twenty-six (1.3%) patients were either admitted to the intensive care unit or had grade IV/fatal reactions. The European Anaphylaxis Registry confirmed food as the major elicitor of anaphylaxis in children, specifically hen's egg, cow's milk, and nuts. Reactions to insect venom were seen more in

  17. Brief Online Mindfulness Training: Immediate Impact.

    PubMed

    Kemper, Kathi J

    2017-01-01

    Online training is feasible, but the impact of brief mindfulness training on health professionals needs to be better understood. We analyzed data from health professionals and trainees who completed self-reflection exercises embedded in online mindfulness training between May 2014 and September, 2015; their changes in mindfulness were measured using standardized scales. Participants included nurses (34%), physicians (24%), social workers and psychologists (10%), dietitians (8%), and others (25%); 85% were women, and 20% were trainees. The most popular module was Introduction to Mindfulness (n = 161), followed by Mindfulness in Daily Life (n = 146), and Mindful Breathing and Walking (n = 129); most (68%) participants who took 1 module took all 3 modules. There were no differences in participation in any module by gender, trainee status, or profession. Completing modules was associated with small but significant improvements on the Cognitive and Affective Mindfulness Scale-Revised, the Mindful Attention Awareness Scale, and the Five Facet Mindfulness Questionnaire (P < 0.001 for all). Online training reaches diverse health professionals and is associated with immediate improvements in mindfulness. Additional research is warranted to compare the long-term cost-effectiveness of different doses of online and in-person mindfulness training on clinician burnout and quality of care. © The Author(s) 2016.

  18. Prehospital Administration of Epinephrine in Pediatric Anaphylaxis.

    PubMed

    Carrillo, Eli; Hern, H Gene; Barger, Joseph

    2016-01-01

    Anaphylaxis in the pediatric population is both serious and potentially lethal. The incidence of allergic and anaphylactic reactions has been increasing and the need for life saving intervention with epinephrine must remain an important part of Emergency Medical Services (EMS) provider training. Our aim was to characterize dosing and timing of epinephrine, diphenhydramine, and albuterol in the pediatric patient with anaphylaxis. In this retrospective chart review, we studied prehospital medication administration in pediatric patients ages 1 month up to 14 years old classified as having a severe allergic reaction or anaphylaxis. We compared rates of epinephrine, diphenhydramine, and albuterol given to patients with allergic conditions including anaphylaxis. In addition, we calculated the rate of epinephrine administration in cases of anaphylaxis and determined what percentage of time the epinephrine was given by EMS or prior to their arrival. Of the pediatric patient contacts, 205 were treated for allergic complaints. Of those with allergic complaints, 98 of 205 (48%; 95% CI 41%, 55%) had symptoms consistent with anaphylaxis and indications for epinephrine. Of these 98, 53 (54%, 95% CI 44%, 64%) were given epinephrine by EMS or prior to EMS arrival. Among the patients in anaphylaxis not given epinephrine prior to EMS arrival, 6 (12%; 95% CI 3%, 21%) received epinephrine from EMS, 10 (20%; 95% CI 9%, 30%) received diphenhydramine only, 9 (18%, 95% CI 7%-28%) received only albuterol and 17 (33%, 95% CI 20%-46%) received both albuterol and diphenhydramine. 9 patients in anaphylaxis received no treatment prior to arriving to the emergency department (18%, 95% CI 7%-28%). In pediatric patients who met criteria for anaphylaxis and the use of epinephrine, only 54% received epinephrine and the overwhelming majority received it prior to EMS arrival. EMS personnel may not be treating anaphylaxis appropriately with epinephrine.

  19. Online Attention Training for Older Adults.

    PubMed

    Wennberg, Alexandra; Kueider, Alexandra; Spira, Adam; Adams, Gregory; Rager, Robert; Rebok, George

    Evidence suggests that cognitive training interventions can improve older adults' cognitive performance. Successful training programs are adaptable and train multiple cognitive domains to target individual strengths and weaknesses. Computerized training programs are useful because they allow older adults to easily access training. This pilot study used an online attention training program, ATTENTION WORKOUT™, to enhance three aspects of attention- coordination, allocation, and selective focus -in community-dwelling older adults randomized to either an abbreviated (n=13) or an extended (n=17) practice training program over a 6-week period. Participants in the extended practice group significantly improved on selective focus reading distraction tasks with unrelated words (U=39.5; Z=-2.34; p=.02) and blanks (U=26.5; Z=-3.05; p=.002) as well as a matching attributes task (U=49.5; Z=-2.33; p=.02). The extended practice group significantly improved on three tasks of coordinating attention - radio-tuning (U=30; Z=-2.73; p=.01), circuit-breaker resetting (U=46; Z=-2.24; p=.03), and the combination of the two tasks (U=15; Z=-3.51; p<.0001) - as well as a memory generalization task (U=20; Z=-3.27; p=.001). A post-test satisfaction survey found both groups enjoyed the program, but the abbreviated practice group felt the tasks were more difficult. These findings suggest online attention training programs, like ATTENTION WORKOUT, can improve attention-related skills in community-dwelling older adults.

  20. When Should You Offer Online Training?

    ERIC Educational Resources Information Center

    Bandy, Jim

    2010-01-01

    Many companies struggle with the question of when to take a manual training process online. For most, the internal conflict comes from a belief that the course development costs will be astronomical, making the process cost-prohibitive. However, the facilities expense and that of hiring qualified professors, combined with the rising trend of busy…

  1. Anaphylaxis: acute treatment and management.

    PubMed

    Ring, Johannes; Grosber, Martine; Möhrenschlager, Matthias; Brockow, Knut

    2010-01-01

    symptoms are in the focus, inhaled beta(2)-agonists can be tried, also for laryngeal edema. The use of combined H(1)- and H(2)-antagonists has been recommended for prophylaxis prior to application of potentially anaphylaxis-eliciting drugs (e.g. radiographic contrast media). Patients who have survived an anaphylactic reaction have to be thoroughly examined and an allergy diagnosis has to be performed with regard to the eliciting agent and the pathogenic mechanism involved. In cases of clear-cut IgE-mediated anaphylaxis, allergen-specific immunotherapy is available for some allergens and helpful as for example for insect venom anaphylaxis. Furthermore, patients should be trained with regard to the nature of anaphylaxis, the major eliciting agents and the principles of behavior and coping with the situation including the handling of epinephrine autoinjectors and the application of antianaphylactic medication. Educational programs for anaphylaxis have been developed.

  2. Adaptive skin detection based on online training

    NASA Astrophysics Data System (ADS)

    Zhang, Ming; Tang, Liang; Zhou, Jie; Rong, Gang

    2007-11-01

    Skin is a widely used cue for porn image classification. Most conventional methods are off-line training schemes. They usually use a fixed boundary to segment skin regions in the images and are effective only in restricted conditions: e.g. good lightness and unique human race. This paper presents an adaptive online training scheme for skin detection which can handle these tough cases. In our approach, skin detection is considered as a classification problem on Gaussian mixture model. For each image, human face is detected and the face color is used to establish a primary estimation of skin color distribution. Then an adaptive online training algorithm is used to find the real boundary between skin color and background color in current image. Experimental results on 450 images showed that the proposed method is more robust in general situations than the conventional ones.

  3. Anaphylaxis to drugs.

    PubMed

    Kuruvilla, Merin; Khan, David A

    2015-05-01

    Drug-induced anaphylaxis is a common cause of anaphylaxis and a leading cause of fatal anaphylaxis. Antibiotics, radiocontrast, and nonsteroidal anti-inflammatory drugs are commonly implicated drugs. Vocal cord dysfunction can mimic anaphylaxis and is often overlooked. β-Lactams are a common cause of anaphylaxis; however, skin testing and drug challenge can usually determine tolerability of other classes of β-lactams. Nonionic contrast agents cause anaphylaxis less frequently than ionic contrast, and immunoglobulin E-mediated mechanisms may have a role in some of these reactions. Skin testing with radiocontrast may have a role in evaluating patients with anaphylaxis to nonionic contrast. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. An Archival Research Comparing Learning Effectiveness and Training Transfer Perceptions between Classroom Technical Training and Synchronous Online Technical Training

    ERIC Educational Resources Information Center

    Jordan, Charles L.

    2016-01-01

    Synchronous online training has become one of the preferred training modes for organizations. Despite organizations increasing their use of online training, there is still little data to confirm that synchronous online technical training is as effective as classroom technical training for training transfer. Although learning effectiveness between…

  5. An Archival Research Comparing Learning Effectiveness and Training Transfer Perceptions between Classroom Technical Training and Synchronous Online Technical Training

    ERIC Educational Resources Information Center

    Jordan, Charles L.

    2016-01-01

    Synchronous online training has become one of the preferred training modes for organizations. Despite organizations increasing their use of online training, there is still little data to confirm that synchronous online technical training is as effective as classroom technical training for training transfer. Although learning effectiveness between…

  6. Online Attention Training for Older Adults

    PubMed Central

    Wennberg, Alexandra; Kueider, Alexandra; Spira, Adam; Adams, Gregory; Rager, Robert; Rebok, George

    2015-01-01

    Evidence suggests that cognitive training interventions can improve older adults' cognitive performance. Successful training programs are adaptable and train multiple cognitive domains to target individual strengths and weaknesses. Computerized training programs are useful because they allow older adults to easily access training. This pilot study used an online attention training program, ATTENTION WORKOUT™, to enhance three aspects of attention– coordination, allocation, and selective focus –in community-dwelling older adults randomized to either an abbreviated (n=13) or an extended (n=17) practice training program over a 6-week period. Participants in the extended practice group significantly improved on selective focus reading distraction tasks with unrelated words (U=39.5; Z=-2.34; p=.02) and blanks (U=26.5; Z=-3.05; p=.002) as well as a matching attributes task (U=49.5; Z=-2.33; p=.02). The extended practice group significantly improved on three tasks of coordinating attention – radio-tuning (U=30; Z=-2.73; p=.01), circuit-breaker resetting (U=46; Z=-2.24; p=.03), and the combination of the two tasks (U=15; Z=-3.51; p<.0001) – as well as a memory generalization task (U=20; Z=-3.27; p=.001). A post-test satisfaction survey found both groups enjoyed the program, but the abbreviated practice group felt the tasks were more difficult. These findings suggest online attention training programs, like ATTENTION WORKOUT, can improve attention-related skills in community-dwelling older adults. PMID:27057152

  7. Best Practices in the Training of Faculty to Teach Online

    ERIC Educational Resources Information Center

    Wolf, Patricia D.

    2006-01-01

    Distance education is often used as a cost-efficient way to train employees. This research focuses on training for teaching online. A comprehensive literature review revealed the scarcity of scholarly work in this area. To determine best practices in training for teaching online, a faculty training program was examined and experts were…

  8. Best Practices in the Training of Faculty to Teach Online

    ERIC Educational Resources Information Center

    Wolf, Patricia D.

    2006-01-01

    Distance education is often used as a cost-efficient way to train employees. This research focuses on training for teaching online. A comprehensive literature review revealed the scarcity of scholarly work in this area. To determine best practices in training for teaching online, a faculty training program was examined and experts were…

  9. [Anaphylaxis and anaphylactic shock].

    PubMed

    Abi Khalil, Muriel; Damak, Hassen; Décosterd, Dumeng

    2014-08-13

    The anaphylactic shock is an acute, multisystemic and potentially fatal circulatory insufficiency, secondary to an allergic reaction. The prevalence of anaphylaxis is underestimated in the general population. Many studies have reported a prevalence of 0.05-2%. Multiple etiologies are incriminated in the pathogenesis of anaphylaxis, and these etiologies vary depending on age and geographic zones. The clinical manifestations of anaphylaxis are multiple, owing to the multisystemic character of this pathology. The gold standard in management of anaphylaxis is thought to be the rapid and early administration of epinephrine by intra-muscular route. The prevention of anaphylaxis remains the treatment of choice. Educating the patient is an important aspect of anaphylaxis follow-up along with the prescription of epinephrine autoinjectors.

  10. Anaphylaxis and urticaria.

    PubMed

    Williams, Kelli W; Sharma, Hemant P

    2015-02-01

    Anaphylaxis and urticaria are common presenting allergic complaints. Affecting up to 2% of the population, anaphylaxis is a serious, life-threatening allergic reaction. Although not life-threatening, urticaria is a rash of transient, erythematous, pruritic wheals that can be bothersome and affects up to 25% of the population. All cases of anaphylaxis warrant thorough clinical evaluation by the allergist-immunologist, although most cases of urticaria are self-limited and do not require specialist referral. This article offers an overview of our current knowledge on the epidemiology, pathogenesis, triggers, diagnosis, and treatment of anaphylaxis and urticaria.

  11. Peri-operative anaphylaxis

    PubMed Central

    Nel, Linda; Eren, Efrem

    2011-01-01

    Peri-operative anaphylaxis is an important cause for mortality and morbidity associated with anaesthesia. The true incidence is unknown and is most likely under reported. Diagnosis can be difficult, particularly as a number of drugs are given simultaneously and any of these agents can potentially cause anaphylaxis. This review covers the clinical features, differential diagnosis and management of anaphylaxis associated with anaesthesia. The investigations to confirm the clinical suspicion of anaphylaxis and further tests to identify the likely drug(s) are examined. Finally the salient features of common and rare causes including non-drug substances are described. PMID:21235622

  12. Exercise-induced anaphylaxis.

    PubMed

    Feldweg, Anna M

    2015-05-01

    Exercise-induced anaphylaxis is an uncommon disorder in which anaphylaxis occurs in response to physical exertion. Food-dependent exercise-induced anaphylaxis is a disorder with similar symptoms, although symptoms develop only if exercise takes place within a few hours of eating and, in most cases, only if a specific food is eaten. Management includes education about safe conditions for exercise, the importance of ceasing exercise immediately if symptoms develop, appropriate use of epinephrine, and, for patients with food-dependent exercise-induced anaphylaxis, avoidance of the culprit food for at least 4 hours before exercise. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Hospitalizations for pediatric anaphylaxis.

    PubMed

    Calvani, M; Di Lallo, D; Polo, A; Spinelli, A; Zappalà, D; Zicari, A M

    2008-01-01

    The aim of the study is to examine the epidemiology of anaphylaxis in hospitalized children in Lazio (Central Italy) and to evaluate the incidence and case fatality rate. We also verified the concordance of diagnosis between the Emergency Department and Ordinary hospitalizations. In order to obtain these results, we reviewed all ICD-9 codes indicative of anaphylaxis in all primary and secondary diagnoses from 2000 to 2003 in all Emergency Departments, Ordinary Hospitalizations and Day Hospitals in Lazio. We then identified 203 ICD-9 diagnoses of anaphylaxis in children aged between 0 and 17 years. Anaphylactic shock (995.0) accounted for 109 (53.7%) of cases. Food anaphylaxis (995.60 onwards) accounted for 87 (43.0%) of cases. Food anaphylaxis was more frequent in the first years of life. In fact, it decreased from 12.5/100,000 resident children/year in the first year of life to 6.1/100,000 resident children/year in the first two years of life, and less than 3/100,000 resident children/year after the seventh year (p <0.001). Only 12.5% of cases of anaphylaxis diagnosed in Ordinary Hospitalizations were subsequently diagnosed by the Emergency Department as anaphylaxis. Moreover, only 42.3% of the diagnoses of anaphylaxis made in the Emergency Department were later confirmed during ordinary hospitalization. In the four years of study, one child died from anaphylaxis. Thus, mortality was 0.038 cases/100,000 resident children/year. In conclusion, the incidence of hospitalization was highest in the first years of life, during which food anaphylaxis accounted for most hospitalizations. The inconsistency of diagnoses between Emergency Departments and Ordinary Hospitalizations suggests the need to increase awareness of anaphylaxis among health workers.

  14. A Study of Student Engagement with Media in Online Training

    ERIC Educational Resources Information Center

    Rogers, Christian B.

    2013-01-01

    Many studies have been conducted where a face-to-face training environment is compared to an online training environment. While some research has been conducted on the nature of online training in faith-based not-for-profit organizations, little to no research has been found on engagement. The purpose of this study was to determine if the level of…

  15. Anaphylaxis: diagnosis and treatment.

    PubMed

    Bethel, James

    Anaphylaxis is a severe and potentially life-threatening condition that is becoming increasingly prevalent. Healthcare professionals working in a variety of settings need to know how to recognise this condition and the importance of treating it promptly. This article describes the pathophysiology, causes and treatment of anaphylaxis.

  16. The pathophysiology of anaphylaxis.

    PubMed

    Reber, Laurent L; Hernandez, Joseph D; Galli, Stephen J

    2017-08-01

    Anaphylaxis is a severe systemic hypersensitivity reaction that is rapid in onset; characterized by life-threatening airway, breathing, and/or circulatory problems; and usually associated with skin and mucosal changes. Because it can be triggered in some persons by minute amounts of antigen (eg, certain foods or single insect stings), anaphylaxis can be considered the most aberrant example of an imbalance between the cost and benefit of an immune response. This review will describe current understanding of the immunopathogenesis and pathophysiology of anaphylaxis, focusing on the roles of IgE and IgG antibodies, immune effector cells, and mediators thought to contribute to examples of the disorder. Evidence from studies of anaphylaxis in human subjects will be discussed, as well as insights gained from analyses of animal models, including mice genetically deficient in the antibodies, antibody receptors, effector cells, or mediators implicated in anaphylaxis and mice that have been "humanized" for some of these elements. We also review possible host factors that might influence the occurrence or severity of anaphylaxis. Finally, we will speculate about anaphylaxis from an evolutionary perspective and argue that, in the context of severe envenomation by arthropods or reptiles, anaphylaxis might even provide a survival advantage. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  17. Epidemiology of anaphylaxis.

    PubMed

    Tang, Mimi L K; Osborne, Nicholas; Allen, Katrina

    2009-08-01

    The prevalence of allergic disorders has more than doubled in the last two decades leading to increased community concern and anxiety, and unprecedented demand for allergy-specialist services. However, although allergic reactions are common, anaphylaxis is uncommon and fatal anaphylaxis is rare. This review examines recent developments in the epidemiology of anaphylaxis, focusing on new information that may assist in identifying those at increased risk of severe reactions and adverse outcomes. Recent studies suggest an increase in prevalence of anaphylaxis in industrialized countries. Examination of the demographic characteristics of anaphylaxis has revealed potential approaches to better recognize those at greatest risk. Novel laboratory approaches to identify patients at increased risk of severe reactions have been suggested. Increased knowledge of the epidemiology of anaphylaxis has provided insights into the characteristics of those patient groups most at risk of adverse outcomes. However, these characteristics have poor specificity and limited applicability for detection of at-risk individuals in the clinical setting. Further research is required to facilitate more accurate assessment of an individual's risk for anaphylaxis or fatal outcome. This would represent a major advance in clinical management and enable better allocation of existing healthcare resources.

  18. Outpatient Emergencies: Anaphylaxis.

    PubMed

    Commins, Scott P

    2017-05-01

    Anaphylactic fatalities are rare; however, mild reactions can rapidly progress to cardiovascular and respiratory arrest. The clinical course of anaphylaxis can be unpredictable. Prompt and early use of epinephrine should be considered. Most anaphylaxis episodes have an immunologic mechanism involving immunoglobulin E (IgE). Foods are the most common cause in children; medications and insect stings are more common in adults. When the cause is not completely avoidable or cannot be determined, a patient should be supplied with autoinjectable epinephrine and be instructed its use. They should keep the device with them at all times and taught the signs and symptoms of anaphylaxis. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Anaphylaxis to insect stings.

    PubMed

    Golden, David B K

    2015-05-01

    Anaphylaxis to insect stings has occurred in 3% of adults and can be fatal even on the first reaction. Large local reactions are more frequent but rarely dangerous. The chance of a systemic reaction to a sting is 5% to 10% in large local reactors and in children with mild (cutaneous) systemic reactions, and varies between 30% and 65% in adults with previous systemic reactions, depending on the severity of previous sting reactions. Baseline serum tryptase level is increased in many patients with sting anaphylaxis. Venom immunotherapy is 75% to 98% effective in preventing sting anaphylaxis. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Field Instructors and Online Training: An Exploratory Survey

    ERIC Educational Resources Information Center

    Dedman, Denise E.; Palmer, Louann Bierlein

    2011-01-01

    Despite field placement being the signature pedagogy of the social work profession, little research exists regarding methods for training field instructors. This study captures their perceptions regarding the use of online training. An online survey of 642 field instructors from 4 universities produced 208 responses. Less than 4% rejected the idea…

  1. Online Plagiarism Training Falls Short in Biology Classrooms

    ERIC Educational Resources Information Center

    Holt, Emily A.; Fagerheim, Britt; Durham, Susan

    2014-01-01

    Online plagiarism tutorials are increasingly popular in higher education, as faculty and staff try to curb the plagiarism epidemic. Yet no research has validated the efficacy of such tools in minimizing plagiarism in the sciences. Our study compared three plagiarism-avoidance training regimens (i.e., no training, online tutorial, or homework…

  2. E-Basics: Online Basic Training in Program Evaluation

    ERIC Educational Resources Information Center

    Silliman, Ben

    2016-01-01

    E-Basics is an online training in program evaluation concepts and skills designed for youth development professionals, especially those working in nonformal science education. Ten hours of online training in seven modules is designed to prepare participants for mentoring and applied practice, mastery, and/or team leadership in program evaluation.…

  3. Online Plagiarism Training Falls Short in Biology Classrooms

    ERIC Educational Resources Information Center

    Holt, Emily A.; Fagerheim, Britt; Durham, Susan

    2014-01-01

    Online plagiarism tutorials are increasingly popular in higher education, as faculty and staff try to curb the plagiarism epidemic. Yet no research has validated the efficacy of such tools in minimizing plagiarism in the sciences. Our study compared three plagiarism-avoidance training regimens (i.e., no training, online tutorial, or homework…

  4. Field Instructors and Online Training: An Exploratory Survey

    ERIC Educational Resources Information Center

    Dedman, Denise E.; Palmer, Louann Bierlein

    2011-01-01

    Despite field placement being the signature pedagogy of the social work profession, little research exists regarding methods for training field instructors. This study captures their perceptions regarding the use of online training. An online survey of 642 field instructors from 4 universities produced 208 responses. Less than 4% rejected the idea…

  5. E-Basics: Online Basic Training in Program Evaluation

    ERIC Educational Resources Information Center

    Silliman, Ben

    2016-01-01

    E-Basics is an online training in program evaluation concepts and skills designed for youth development professionals, especially those working in nonformal science education. Ten hours of online training in seven modules is designed to prepare participants for mentoring and applied practice, mastery, and/or team leadership in program evaluation.…

  6. Research to practice: developing an integrated anaphylaxis education curriculum for school nurses.

    PubMed

    Cavanaugh, Rebecca; Strickland, C June

    2011-06-01

    The numbers of school-aged children with life-threatening allergies that cause anaphylaxis continues to increase. Many states, including Washington, have responded to this by developing specific guidelines for school districts to follow in order to provide a safe learning environment for children with medical conditions that put them at risk for anaphylaxis. School nurses require resources to assist them in providing health training for school staff on how to manage potentially life-threatening health conditions for children in their school, however, resources to address this training are limited. A search for and content analysis of currently available literature and resources about anaphylaxis and anaphylaxis training curricula revealed a lack of an integrated curriculum to train school staff. This article presents a discussion of the development of a train-the-trainer anaphylaxis education program providing school nurses with curriculum, lesson plans, teaching-learning activities, and resources for anaphylaxis education of all school staff.

  7. Management protocol for anaphylaxis.

    PubMed

    Sharma, Rohit; Sinha, Ramen; Menon, P S; Sirohi, Deepika

    2010-04-01

    There is no universal agreement on the definition of anaphylaxis or the criteria for establishing its diagnosis, although it has been known to the field of emergency medicine for more than 100 years. Two meetings were convened by the National Institute of Allergy and Infectious Disease and Food Allergy and Anaphylaxis Network in April 2004 and July 2005. Representatives from 16 different organizations and government bodies, including representatives from developed nations, continue working toward a universally accepted definition, criteria for diagnosis, and management of anaphylaxis. This article presents the latest concepts on anaphylaxis in the literature including the research needs in this area. 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Preparedness for Students and Staff with Anaphylaxis

    ERIC Educational Resources Information Center

    Morris, Patty; Baker, Dian; Belot, Carol; Edwards, Audrey

    2011-01-01

    Background: Schools are responsible for handling life-threatening events due to a variety of conditions, including anaphylaxis. California is one of a few states that permits school districts to stock emergency epinephrine auto-injectors and to train unlicensed assistive personnel to administer epinephrine for a life-threatening event. We surveyed…

  9. Preparedness for Students and Staff with Anaphylaxis

    ERIC Educational Resources Information Center

    Morris, Patty; Baker, Dian; Belot, Carol; Edwards, Audrey

    2011-01-01

    Background: Schools are responsible for handling life-threatening events due to a variety of conditions, including anaphylaxis. California is one of a few states that permits school districts to stock emergency epinephrine auto-injectors and to train unlicensed assistive personnel to administer epinephrine for a life-threatening event. We surveyed…

  10. Optimizing the clinical identification and management of patients at risk for anaphylaxis.

    PubMed

    Stoloff, Stuart W

    2010-08-01

    Anaphylaxis is a serious, systemic allergic reaction that is rapid in onset and can cause death. Anaphylaxis often occurs in the absence of a health care professional, so it is essential for patients at risk for anaphylaxis to be identified and prepared in the event of an emergency. Identifying at-risk patients goes beyond a history of anaphylaxis; it is important to identify patients who may be at risk for a more severe anaphylactic reaction. Patients at risk for anaphylaxis should be provided an epinephrine auto-injector and appropriately trained in its use in the community setting.

  11. Anaphylaxis and insect allergy.

    PubMed

    Demain, Jeffrey G; Minaei, Ashley A; Tracy, James M

    2010-08-01

    Anaphylaxis is an acute-onset and potentially life-threatening allergic reaction that can be caused by numerous allergic triggers including stinging insects. This review focuses on recent advances, natural history, risk factors and therapeutic considerations. Recent work suggests that concerns over insect allergy diagnosis continue to exist. This is especially true with individuals who have a convincing history of a serious life-threatening anaphylactic event, but lack the necessary diagnostic criteria of venom-specific IgE by skin test or in-vitro diagnostic methods to confirm the diagnosis. The role of occult mastocytosis or increased basophile reactivity may play a role in this subset population. Additionally, epinephrine continues to be underutilized as the primary acute intervention for an anaphylactic reaction in the emergent setting. The incidence of anaphylaxis continues to rise across all demographic groups, especially those less than 20 years of age. Fortunately, the fatalities related to anaphylaxis appear to have decreased over the past decades. Our understanding of various triggers, associated risk factors, as well as an improved understanding and utilization of biological markers such as serum tryptase have improved. Our ability to treat insect anaphylaxis by venom immunotherapy is highly effective. Unfortunately, anaphylaxis continues to be underappreciated and undertreated especially in regard to insect sting anaphylaxis. This includes the appropriate use of injectable epinephrine as the primary acute management tool. These findings suggest that continued education of the general population, primary care healthcare providers and emergency departments is required.

  12. Azithromycin anaphylaxis in children.

    PubMed

    Mori, F; Pecorari, L; Pantano, S; Rossi, M E; Pucci, N; De Martino, M; Novembre, E

    2014-01-01

    Allergic reactions associated to the use of macrolides are uncommon; in particular only two cases of anaphylaxis with erithromycin and clarithromycin have been reported to date. The aim of this study was to investigate macrolide-induced anaphylaxis. Between December 2007 and December 2011, 136 consecutive children were referred to the Allergy Unit of A. Meyer Children's Hospital because of a past history of reactions to macrolides. Allergy work-ups were carried out according to the European Network for Drug Allergy protocol. Anaphylaxis was diagnosed according to the clinical criteria proposed by Sampson et al. and graded according to Brown SGA et al. Sixty-six out of 136 patients completed the allergologic work-up and among them we investigated three cases of anaphylaxis due to azithromycin which included one child with anaphylaxis to both clarithromycin and azithromycin. In two of the children with anaphylaxis, the diagnosis was only confirmed with the skin prick test, the third was positive to the Intradermal Test. The azithromycin allergy shows a surprisingly high sensitivity to the in-vivo tests. Moreover, this study shows that cross-reactivity may occur between different macrolidic molecules; it has even been suggested that macrolide allergies are unlikely to be class allergies.

  13. Exploring Online Graduate Students' Responses to Online Self-Regulation Training

    ERIC Educational Resources Information Center

    Dunn, Karee E.; Rakes, Glenda C.

    2015-01-01

    In this study, online graduate students participated in four brief online self-regulatory trainings for self-efficacy, achievement goal orientation, learning strategies, and attributional thinking. These variables are critical to success in learning environments, but perhaps even more so in the online academic environment (Rakes, Dunn, &…

  14. Exploring Online Graduate Students' Responses to Online Self-Regulation Training

    ERIC Educational Resources Information Center

    Dunn, Karee E.; Rakes, Glenda C.

    2015-01-01

    In this study, online graduate students participated in four brief online self-regulatory trainings for self-efficacy, achievement goal orientation, learning strategies, and attributional thinking. These variables are critical to success in learning environments, but perhaps even more so in the online academic environment (Rakes, Dunn, &…

  15. International survey of knowledge of food-induced anaphylaxis

    PubMed Central

    Wang, Julie; Young, Michael C.; Nowak-Węgrzyn, Anna

    2014-01-01

    Background Studies show that anaphylaxis is under-recognized and epinephrine (adrenaline) is under-used by medical personnel as well as patients and their families. This study assesses the knowledge of food-induced anaphylaxis diagnosis and management across different populations of providers and caregivers and other interested respondents. Methods An online survey embedded in a case discussion food-induced anaphylaxis was distributed by Medscape to registered members. Results 7822 responders who started the activity chose to answer at least some of the questions presented (response rate 39.5%). Over 80% of responders in all groups correctly identified the case of anaphylaxis with prominent skin and respiratory symptoms, however, only 55% correctly recognized the case without skin symptoms as anaphylaxis. Only 23% of responders correctly selected risk factors for anaphylaxis, with physicians significantly more likely to choose the correct answers as compared to allied health, other health professionals and medical students (p<0.001). Ninety five perecnt selected epinephrine (adrenaline) as the most appropriate treatment for anaphylaxis, and 81% correctly indicated that there are no absolute contraindications for epinephrine (adrenaline) in the setting of anaphylaxis. When presented a case of a child with no documented history of allergies who has symptoms of anaphylaxis, more physicians than any other group chose to administer stock epinephrine (adrenaline) (73% vs 60%, p<0.001). Conclusion Specific knowledge deficits for food-induced anaphylaxis persist across all groups. Further educational efforts should be aimed not only at the medical community but also for the entire caregiver community and general public, to optimize care for food allergic individuals. PMID:25263184

  16. Online Training: The Value of Capturing Trainee Reactions

    ERIC Educational Resources Information Center

    Long, Lori K.; DuBois, Cathy Z.; Faley, Robert H.

    2008-01-01

    Purpose: Despite years of advice from researchers that trainee reactions provide training evaluation information that is of very limited use, trainee reactions remain the most commonly used measure of training effectiveness. Because the technology that supports online training facilitates the collection of trainee reaction information during and…

  17. Can Massively Multiplayer Online Gaming Environments Support Team Training?

    ERIC Educational Resources Information Center

    O'Connor, Debra L.; Menaker, Ellen S.

    2008-01-01

    Instructional games are created when training is deliberately added to a gaming environment or when gaming aspects are deliberately incorporated into training. One type of game that is currently attracting the attention of the education and training field is the massively multiplayer online game (MMOG). Because evidence about learning outcomes…

  18. Can Massively Multiplayer Online Gaming Environments Support Team Training?

    ERIC Educational Resources Information Center

    O'Connor, Debra L.; Menaker, Ellen S.

    2008-01-01

    Instructional games are created when training is deliberately added to a gaming environment or when gaming aspects are deliberately incorporated into training. One type of game that is currently attracting the attention of the education and training field is the massively multiplayer online game (MMOG). Because evidence about learning outcomes…

  19. Online Training: The Value of Capturing Trainee Reactions

    ERIC Educational Resources Information Center

    Long, Lori K.; DuBois, Cathy Z.; Faley, Robert H.

    2008-01-01

    Purpose: Despite years of advice from researchers that trainee reactions provide training evaluation information that is of very limited use, trainee reactions remain the most commonly used measure of training effectiveness. Because the technology that supports online training facilitates the collection of trainee reaction information during and…

  20. Highlights in nonhymenoptera anaphylaxis.

    PubMed

    Scherer, Kathrin; Ballmer-Weber, Barbara K; Bircher, Andreas J

    2008-08-01

    The purpose of this review is to summarize new interesting findings in both research and clinical practice of nonhymenoptera anaphylaxis with particular emphasis on food and drug allergy. Recent findings include some aspects of crossreactivity among betalactams, nonsteroidal anti-inflammatory drugs with special attention to an immunogenic metabolite of diclofenac and the mode of diclofenac-induced basophil degranulation. Also, new insights into the sometimes atypical anaphylaxis-like reactions after administration of monoclonal antibodies and the immunologic response to these molecules will be discussed, as well as the role of low-dose pholcodine exposure on the development of sensitization to neuromuscular blocking agents. In food-related anaphylaxis, a significant increase of incidents has been observed over the last few years, especially among children of less than 5 years of age. Unfortunately, the severity of subsequent reactions cannot be predicted from the reaction history. Tree nuts and peanuts are the most important elicitors of fatal food-induced anaphylaxis. In food-related anaphylaxis, prospectively evaluated marker allergens that are indicative of a potential anaphylactic reaction are still lacking. The drug groups covered in this review are of special interest either due to their prominent role as allergens or due to new findings.

  1. Epinephrine (adrenaline) in anaphylaxis.

    PubMed

    Simons, F Estelle R; Simons, Keith J

    2010-01-01

    Epinephrine (adrenaline) is universally recommended as the initial drug of choice for the treatment of anaphylaxis. No other medication has similar life-saving pharmacologic effects in multiple organ systems, including prevention and relief of both upper and lower airway obstruction, and of shock. Failure to inject epinephrine promptly contributes to anaphylaxis fatalities. It is most effective when given immediately after the onset of anaphylaxis symptoms. The initial recommended adult dose is 0.3-0.5 mg, injected intramuscularly in the anterolateral aspect of the mid-thigh. Injected by other routes, epinephrine appears to have a less satisfactory therapeutic window; for example, onset of action is potentially delayed when it is injected subcutaneously, and risk of adverse effects potentially increases when it is injected intravenously. The possibility of randomized, controlled trials of epinephrine in anaphylaxis should be considered. For ethical reasons, these trials will not be placebo-controlled. They might involve comparison of one epinephrine dose versus another, or one route of epinephrine administration versus another. For first-aid treatment of people with anaphylaxis in the community, novel epinephrine formulations are being developed. These include epinephrine autoinjectors that are safer and easier to use, and epinephrine formulations that can be administered through non-invasive routes.

  2. Education, Training and Marketing for Online Information Retrieval Systems.

    ERIC Educational Resources Information Center

    Tedd, Lucy A.

    1979-01-01

    Discusses general aspects of education, training, and marketing techniques for on-line searching, and describes methods adopted by 12 organizations in Norway, the Netherlands, France, Switzerland, Italy, Belgium, and Britain that use computers for their bibliographic information requirements. (CWM)

  3. Online and Onsite Training: When To Mix, When To Match.

    ERIC Educational Resources Information Center

    Barkley, Steve; Bianco, Terri

    2001-01-01

    Discussion of ways to blend onsite and online staff development training focuses on teachers' continuing education needs. Considers theory, modeling, and practice, and describes a collaborative program in a rural area in Ohio that offers a combination of online learning and live instruction that allows for peer interaction and practice. (LRW)

  4. Biphasic anaphylaxis to gemifloxacin.

    PubMed

    Yilmaz, Insu; Doğan, Serkan; Tutar, Nuri; Kanbay, Asiye; Büyükoğlan, Hakan; Demir, Ramazan

    2012-10-01

    Anaphylaxis have been documented as adverse effects of ciprofloxacin, ofloxacin, norfloxacin, levofloxacin, and moxifloxacin. However resistant and biphasic anaphlylactic reactions to gemifloxacin have not been reported to date. Management of severe anaphylaxis in the elderly can be complicated by concurrent medications such as beta (β) adrenergic, alpha (α) adrenergic blockers and angiotensin-converting enzyme (ACE) inhibitors. We report here in the case of a 60-year-old male who was taking on ACE inhibitor, α and β blockers and experienced a severe, resistant and biphasic anaphlylactic reaction to gemifloxacin mesylate.

  5. The Effectiveness and Efficiency of Distributed Online, Regional Online, and Regional Face-to-Face Training for Writing Assessment Raters

    ERIC Educational Resources Information Center

    Wolfe, Edward W.; Matthews, Staci; Vickers, Daisy

    2010-01-01

    This study examined the influence of rater training and scoring context on training time, scoring time, qualifying rate, quality of ratings, and rater perceptions. One hundred twenty raters participated in the study and experienced one of three training contexts: (a) online training in a distributed scoring context, (b) online training in a…

  6. International consensus on (ICON) anaphylaxis

    PubMed Central

    2014-01-01

    ICON: Anaphylaxis provides a unique perspective on the principal evidence-based anaphylaxis guidelines developed and published independently from 2010 through 2014 by four allergy/immunology organizations. These guidelines concur with regard to the clinical features that indicate a likely diagnosis of anaphylaxis -- a life-threatening generalized or systemic allergic or hypersensitivity reaction. They also concur about prompt initial treatment with intramuscular injection of epinephrine (adrenaline) in the mid-outer thigh, positioning the patient supine (semi-reclining if dyspneic or vomiting), calling for help, and when indicated, providing supplemental oxygen, intravenous fluid resuscitation and cardiopulmonary resuscitation, along with concomitant monitoring of vital signs and oxygenation. Additionally, they concur that H1-antihistamines, H2-antihistamines, and glucocorticoids are not initial medications of choice. For self-management of patients at risk of anaphylaxis in community settings, they recommend carrying epinephrine auto-injectors and personalized emergency action plans, as well as follow-up with a physician (ideally an allergy/immunology specialist) to help prevent anaphylaxis recurrences. ICON: Anaphylaxis describes unmet needs in anaphylaxis, noting that although epinephrine in 1 mg/mL ampules is available worldwide, other essentials, including supplemental oxygen, intravenous fluid resuscitation, and epinephrine auto-injectors are not universally available. ICON: Anaphylaxis proposes a comprehensive international research agenda that calls for additional prospective studies of anaphylaxis epidemiology, patient risk factors and co-factors, triggers, clinical criteria for diagnosis, randomized controlled trials of therapeutic interventions, and measures to prevent anaphylaxis recurrences. It also calls for facilitation of global collaborations in anaphylaxis research. In addition to confirming the alignment of major anaphylaxis guidelines, ICON

  7. Training in medical informatics: combining onsite and online instruction.

    PubMed

    Ohno-Machado, L; Marin, H F; Marques, E P; Masssad, E; Greenes, R A

    2001-01-01

    The Internet is promoting active exchange of teaching materials and discussion among geographically distant collaborators. We envision that training in medical informatics can be better achieved if both onsite and online instruction are combined, provided that cultural and technological barriers are anticipated and the training program is prepared accordingly. We describe our Brazil/USA program in medical informatics, which includes components of on-site and online education, and discuss lessons learned during its ongoing implementation. Three onsite courses and one workshop have been planned, and two online courses are being developed.

  8. Marking nut anaphylaxis

    PubMed Central

    Kral, Anita Christine; Hayball, John; Smith, William B

    2016-01-01

    Marking nut Semecarpus anacardium, so-called because it contains a pigment that has been used in the past to mark fabrics, is a known cause of contact hypersensitivity. It may be ingested as an ingredient of some traditional Hindi foods. We describe the first reported case of anaphylaxis to marking nut. PMID:27489793

  9. [Anaphylaxis during anaesthesia].

    PubMed

    Guttormsen, Anne Berit; Harboe, Torkel; Pater, Geert de; Florvaag, Erik

    2010-03-11

    Anaphylaxis is a serious life-threatening generalized or systemic hypersensitivity reaction. The aim of this paper is to provide knowledge on how to diagnose, treat and follow up patients with suspected anaphylaxis during general and local anaesthesia. The article is based on literature identified through a non-systematic search in PubMed, the Scandinavian Guidelines on anaphylaxis during anaesthesia and on own research. Anaphylactic symptoms during anaesthesia vary with respect to severity. Manifestations from skin and the cardiovascular and respiratory systems are present simultaneously in approximately 70 % of patients. Early treatment with adrenaline, fluid and extra oxygen may be vital for survival without sequelae. The following patients should be assessed before anaesthesia: those with moderate or serious reactions or with reactions that raise suspicion of allergy which may cause problems in connection with future treatment. Neuromuscular blocking agents are the main cause of IgE-mediated anaphylaxis during anaesthesia in Norway. New research has shown that allergy towards neuromuscular blocking agents can develop after ingestion of cough syrup containing pholcodine (stimulates asymptomatic production of antibodies). These antibodies cause cross-sensibilisation with neuromuscular blocking agents. The cough syrup Tuxi was withdrawn from the Norwegian market during spring 2007. Allergic reactions during anaesthesia are rare and potentially life-threatening; patients should be followed up and treated in a standardized way.

  10. Anaphylaxis to food.

    PubMed

    Fishbein, Anna B; Makhija, Melanie M; Pongracic, Jacqueline A

    2015-05-01

    This article provides a clinically focused review of food-induced anaphylaxis that includes epidemiology, risk factors, allergens, diagnosis, and management. Currently, there is no treatment for food allergy. Dietary avoidance and emergency preparedness are the cornerstones of management. Effective and safe therapies to reduce the risk of serious food-induced reactions are urgently needed, as are reliable biomarkers to predict severity.

  11. MarylandOnline's Inter-Institutional Project to Train Higher Education Adjunct Faculty to Teach Online

    ERIC Educational Resources Information Center

    Shattuck, Julie; Dubins, Bobbi; Zilberman, Diana

    2011-01-01

    This article reports on an inter-institutional project to design, develop, pilot, and evaluate a state-wide online training course for higher education adjunct faculty who are preparing to teach their first online course. We begin with a brief literature review to contextualize the stated problem the project sought to address: the need for…

  12. Celecoxib-associated anaphylaxis.

    PubMed

    Chamberlin, Kevin W; Silverman, Adam R

    2009-04-01

    To report and discuss a case of anaphylaxis in a young, healthy white male taking celecoxib for intermittent lower back pain. A healthy 27-year-old man with a documented history of anaphylaxis to penicillins and macrolides presented to the emergency department (ED) in anaphylactic shock after ingesting a 200-mg capsule of celecoxib and a cup of orange juice. The patient had been taking celecoxib over the past 6 months, for 1-2 weeks at a time, for low back pain secondary to a pilonidal cyst and an L5/S1 bulging disc. The day of admission was the seventh day of the most recent course of twice-daily celecoxib. The patient initially self-treated the reaction with diphenhydramine and subcutaneous epinephrine that he had at home due to his history of drug- and bee sting-induced anaphylaxis; neither intervention improved his symptoms. He became profoundly diaphoretic and developed systemic swelling, shortness of breath, bradycardia, and hypotension. Emergency medical services transported the patient to the ED, where he was treated appropriately and the symptoms resolved. However, 4 hours later, at time of discharge from the ED, the symptoms recurred. He was admitted to the intensive care unit and monitored for 3 days. Supportive care, steroids, and histamine blockade provided resolution of the symptoms. Cardiac workup was initiated because of the recurrence and severity of bradycardia and hypotension; results of the workup were unremarkable. The patient was discharged in stable condition. This case demonstrates rare anaphylaxis to celecoxib in a patient who had previously taken the drug and who had documented tolerance to sulfonamide antibiotics. Despite this history, our patient developed type V immunoglobulin E-mediated anaphylaxis secondary to the sulfonamide component of celecoxib. This reaction was considered probable according to the Naranjo probability scale. A review of published case reports and related allergy literature for celecoxib allergenicity revealed

  13. The Students' Perspectives of Online Training at Kuwait University

    ERIC Educational Resources Information Center

    Safar, Ammar H.

    2012-01-01

    Computers, the Internet, smartphones, and telecommunication technologies have all changed the way we live--how we think, socialize, entertain, work, teach, learn, and train as well. One of the modern ICT trends of organizations involve the integration of e-learning, in general, and online training systems, in particular, as new methods for…

  14. The Students' Perspectives of Online Training at Kuwait University

    ERIC Educational Resources Information Center

    Safar, Ammar H.

    2012-01-01

    Computers, the Internet, smartphones, and telecommunication technologies have all changed the way we live--how we think, socialize, entertain, work, teach, learn, and train as well. One of the modern ICT trends of organizations involve the integration of e-learning, in general, and online training systems, in particular, as new methods for…

  15. Development Strategies for Online Volunteer Training Modules: A Team Approach

    ERIC Educational Resources Information Center

    Robideau, Kari; Vogel, Eric

    2014-01-01

    Volunteers are central to the delivery of 4-H programs, and providing quality, relevant training is key to volunteer success. Online, asynchronous modules are an enhancement to a training delivery menu for adult volunteers, providing consistent, accessible options traditionally delivered primarily face to face. This article describes how Minnesota…

  16. Learning Experts Examine Shortfalls in Onsite and Online Training.

    ERIC Educational Resources Information Center

    Barkley, Steve; Bianco, Terri

    2001-01-01

    Discusses the need for training to be learner-centered and meaningful to the adult learner and explains that andragogy requires learning to be experiential with immediate application, consequence, and participation. Emphasizes knowing the learning and working styles of participants, discuses training efficiency, and suggests that online training…

  17. Online Plagiarism Training Falls Short in Biology Classrooms

    PubMed Central

    Holt, Emily A.; Fagerheim, Britt; Durham, Susan

    2014-01-01

    Online plagiarism tutorials are increasingly popular in higher education, as faculty and staff try to curb the plagiarism epidemic. Yet no research has validated the efficacy of such tools in minimizing plagiarism in the sciences. Our study compared three plagiarism-avoidance training regimens (i.e., no training, online tutorial, or homework assignment) and their impacts on students’ ability to accurately discriminate plagiarism from text that is properly quoted, paraphrased, and attributed. Using pre- and postsurveys of 173 undergraduate students in three general ecology courses, we found that students given the homework assignment had far greater success in identifying plagiarism or the lack thereof compared with students given no training. In general, students trained with the homework assignment more successfully identified plagiarism than did students trained with the online tutorial. We also found that the summative assessment associated with the plagiarism-avoidance training formats (i.e., homework grade and online tutorial assessment score) did not correlate with student improvement on surveys through time. PMID:24591507

  18. Online plagiarism training falls short in biology classrooms.

    PubMed

    Holt, Emily A; Fagerheim, Britt; Durham, Susan

    2014-01-01

    Online plagiarism tutorials are increasingly popular in higher education, as faculty and staff try to curb the plagiarism epidemic. Yet no research has validated the efficacy of such tools in minimizing plagiarism in the sciences. Our study compared three plagiarism-avoidance training regimens (i.e., no training, online tutorial, or homework assignment) and their impacts on students' ability to accurately discriminate plagiarism from text that is properly quoted, paraphrased, and attributed. Using pre- and postsurveys of 173 undergraduate students in three general ecology courses, we found that students given the homework assignment had far greater success in identifying plagiarism or the lack thereof compared with students given no training. In general, students trained with the homework assignment more successfully identified plagiarism than did students trained with the online tutorial. We also found that the summative assessment associated with the plagiarism-avoidance training formats (i.e., homework grade and online tutorial assessment score) did not correlate with student improvement on surveys through time.

  19. A case of ant anaphylaxis.

    PubMed

    Mehr, Sam; Brown, Simon

    2012-03-01

    A four-year-old girl developed anaphylaxis following ant stings at her parent's property in country New South Wales. The offending insect was identified by an entomologist as the green head ant. Ant sting anaphylactic reactions in Australia, the importance of identifying the offending insect following sting anaphylaxis and the signs of insect sting anaphylaxis are further discussed. © 2010 The Authors. Journal of Paediatrics and Child Health © 2010 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  20. Peanut allergy and anaphylaxis

    PubMed Central

    Finkelman, Fred D.

    2010-01-01

    Summary Peanuts are a frequent cause of food allergy and the most common cause of fatal food-induced anaphylaxis in the U.S. Advances during the past two years have promoted our understanding of peanut allergens and peanut allergy prevalence, etiology, diagnosis and therapy. The advances highlighted in this review include evidence that the peanut allergens most important in disease differ in different parts of the world, that early oral exposure to peanuts may decrease the frequency of peanut allergy, while early non-oral exposure may have the opposite effect, that complement activation by peanut constituents appears to promote peanut-induced anaphylaxis and that oral immunotherapy, anti-IgE antibody and an herbal formulation are promising approaches for treatment of this disorder. PMID:21051210

  1. The Risk of Recurrent Anaphylaxis.

    PubMed

    O'Keefe, Andrew; Clarke, Ann; St Pierre, Yvan; Mill, Jennifer; Asai, Yuka; Eisman, Harley; La Vieille, Sebastien; Alizadehfar, Reza; Joseph, Lawrence; Morris, Judy; Gravel, Jocelyn; Ben-Shoshan, Moshe

    2017-01-01

    To determine the recurrence rate of anaphylaxis in children medically attended in an emergency department (ED), we performed a prospective cohort study to evaluate prehospital and ED management of children with recurrent anaphylaxis and to assess factors associated with recurrent anaphylaxis. As part of the Cross-Canada Anaphylaxis Registry, parents of children with anaphylaxis identified prospectively in 3 EDs and through an emergency medical response service were contacted annually after presentation and queried on subsequent reactions. Cox regression analysis determined factors associated with recurrence. Among 292 children who were registered as having had medical attended anaphylaxis, 68.5% completed annual follow-up questionnaires. Forty-seven patients experienced 65 episodes of anaphylaxis during 369 patient-years of follow-up. Food was the trigger in 84.6% of cases, and epinephrine was used in 66.2%. In 50.8%, epinephrine was used outside the health care facility, and 81.7% were brought to a health care facility for treatment. Asthma, reaction triggered by food, and use of epinephrine during the index episode increased the odds of recurrent reaction. Patients whose initial reaction was triggered by peanut were less likely to have a recurrent reaction. We report a yearly anaphylaxis recurrence rate of 17.6% in children. There is substantial underuse of epinephrine in cases of anaphylaxis. Educational programs that promote effective avoidance strategies and prompt use of epinephrine are required. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Anaphylaxis in the allergy practice.

    PubMed

    Leatherman, Bryan D

    2014-09-01

    Otolaryngologists managing patients with allergic rhinitis are faced with the possibility of anaphylactic reactions in the office, especially when providing allergen immunotherapy. Literature review was performed and recent published articles on anaphylaxis were examined. Details on pathophysiology, incidence, signs/symptoms, and treatment of anaphylaxis are included in this review article. Although anaphylaxis is a rare event with allergy testing and immunotherapy, it can result in fatal consequences. Clinical manifestations of anaphylaxis are rapid, and the upper and lower airways, skin, conjunctiva, and gastrointestinal and cardiovascular systems are often affected, individually or in combination. Treatment of anaphylaxis in the office begins with proper preparation in advance. The most important drug in the treatment of anaphylaxis is epinephrine, which should be administered early during an anaphylactic reaction. Recognition of the risks factors for anaphylaxis, such as uncontrolled asthma, may be helpful in order to prevent anaphylaxis. Fortunately, Anaphylaxis is a rare occurrence in the allergy office if strict attention is paid to proper testing and treatment principles. Maintaining a high level of vigilance and preparedness is important to increase the chances of a favorable outcome should an anaphylactic episode occur. © 2014 ARS-AAOA, LLC.

  3. In utero anaphylaxis.

    PubMed

    MacGinnitie, Andrew

    2011-01-01

    Late fetal demise and hypoxic-ischemic neurologic injury after previously normal in utero development remain devastating outcomes of pregnancy, for which no cause is identified in many cases. Based on a case encountered, I propose that some of these incidents may be due to in utero anaphylaxis to food antigens that cross the placenta. Potential allergens to which pregnant women are exposed can be transported across the placenta, and the fetus is capable of producing IgE, the antibody responsible for anaphylaxis in humans. Whether this IgE is antigen specific is controversial with some studies indicating the ability to generate IgE to food antigens prenatally. Indirect evidence for in utero production of specific IgE is the high percentage of food reactions that occur on the first postnatal exposure to the food. I propose that some cases of stillbirth and prenatal hypoxic-ischemic injury may be due to in utero anaphylaxis. Copyright © 2010 Elsevier Ltd. All rights reserved.

  4. Tryptase genetics and anaphylaxis

    PubMed Central

    Caughey, George H.

    2008-01-01

    Tryptases secreted by tissue mast cells and basophils can enter the bloodstream. In human subjects tryptases are encoded by several genes and alleles, including α, β, γ, and δ. Common variations include complete absence of α genes. Until recently, α tryptase was considered to be the major tryptase secreted at baseline and in mastocytosis. However, lack of α tryptase genes has little effect on circulating tryptase levels, which are now thought mainly to consist of inactive pro-β tryptase secreted constitutively rather than stored in granules with mature tryptases. Pro-β tryptase levels thus might reflect total body mast cell content. In contrast, mature β tryptase can increase transiently in severe systemic anaphylaxis and confirm the diagnosis. However, it might fail to increase in food anaphylaxis or might increase nonspecifically in samples acquired after death. Thus pro- and mature β tryptase measurements are useful but associated with false-negative and false-positive results, which need to be considered in drawing clinical conclusions in cases of suspected anaphylaxis. PMID:16751005

  5. How should occupational anaphylaxis be investigated and managed?

    PubMed

    Quirce, Santiago; Fiandor, Ana

    2016-04-01

    Anaphylaxis is a systemic allergic reaction that can be life-threatening or fatal and can result from work-related exposures. This review study focuses on the assessment, main triggers, and management of occupational anaphylaxis. Exposed workers can be sensitized through inhalation and skin contact, and the risks increase with penetration of the allergen through the skin. The main eliciting agents of occupational anaphylaxis include stinging insects and animal bites, natural rubber latex and other vegetable allergens, food products, and drugs. Workers sensitized to occupational allergens may also develop anaphylaxis outside the work environment from exposure to the same or to cross-reacting allergens. Cofactors at work such as exercise may increase the risk. The relevant medical records and laboratory tests (e.g. tryptase) performed during the episode should be reviewed. It is very important to confirm the diagnosis and to identify the specific trigger of anaphylaxis. Component-resolved diagnosis may help in the identification of primary sensitizers or cross-reactive allergens. Adrenaline must be administered to all patients experiencing anaphylaxis. Removal from exposure is mandatory to prevent further episodes. A written emergency management plan, health and safety education, and training and surveillance should be enforced in occupations at greater risk.

  6. [Exercise-induced anaphylaxis--a review].

    PubMed

    Plavec, Davor; Vuljanko, Ivana Maloca

    2010-01-01

    Exercise-induced anaphylaxis (EIA) is a syndrome in which patients experience the symptoms of anaphylaxis, which occur only after increased physical activity. It is characterised by a gradual development of symptoms: itching, erythema, urticaria, angioedema, anaphylactic shock (hypotension, syncope, loss of consciousness, shortness of breath, wheezing, nausea and vomiting), and at the end of the late phase prolonged urticaria and headache. The triggering factors for EIA are as follows: significant exposure to airborne allergens, insect sting, weather extremes, higher air humidity, taking nonsteroidal anti-inflammatory drugs. The most frequent causative nutritive allergens include wheat, crabs and shells. Prophylactic management for EIA comprises avoding the triggers. Exercise or other physical activity should be performed in proximity of medically trained companion.

  7. The On-Line Experience: The State of Australian On-Line Education and Training Practices. Review of Research.

    ERIC Educational Resources Information Center

    Harper, Barry; Hedberg, John; Bennett, Susan; Lockyer, Lori

    The state of Australian online education and training practices was examined through a literature review and interviews. Special attention was paid to the following aspects of online vocational and technical education (VET) and technical and further education (TAFE): current online implementations; online teaching strategies; issues for online…

  8. The On-Line Experience: The State of Australian On-Line Education and Training Practices. Review of Research.

    ERIC Educational Resources Information Center

    Harper, Barry; Hedberg, John; Bennett, Susan; Lockyer, Lori

    The state of Australian online education and training practices was examined through a literature review and interviews. Special attention was paid to the following aspects of online vocational and technical education (VET) and technical and further education (TAFE): current online implementations; online teaching strategies; issues for online…

  9. Online Manufacturing Training. ToolingU Review (U)

    SciTech Connect

    Montano, Joshua Daniel

    2016-03-23

    The following report is a review of ToolingU, an online manufacturing training website. ToolingU provided the author with a trail account where a number of courses were taken and the overall program was evaluated. A review of the classes revealed that most of the offerings directly align with work at the Laboratory. Ease of use, effectiveness of the system and price all make ToolingU an attractive option for manufacturing training needs.

  10. Anaphylaxis fatalities and admissions in Australia.

    PubMed

    Liew, Woei Kang; Williamson, Elizabeth; Tang, Mimi L K

    2009-02-01

    Detailed data on fatal anaphylaxis are limited, with national anaphylaxis fatality data for the United Kingdom and food-induced anaphylaxis fatality data for the United States. Time trends for anaphylaxis fatalities are not available. We examined causes, demographics, and time trends for anaphylaxis fatalities in Australia between January 1997 and December 2005 and compared these with findings for anaphylaxis admissions. Data on anaphylaxis deaths and hospital admissions were extracted from a national database. Death certificate codes were analyzed to determine the likely cause and associated comorbidities. There were 112 anaphylaxis fatalities in Australia over 9 years. Causes were as follows: food, 7 (6%); drugs, 22 (20%); probable drugs, 42 (38%); insect stings, 20 (18%); undetermined, 15 (13%); and other, 6 (5%). All food-induced anaphylaxis fatalities occurred between 8 and 35 years of age with female preponderance, despite the majority of food-induced anaphylaxis admissions occurring in children less than 5 years of age. Most insect sting-induced anaphylaxis deaths occurred between 35 and 84 years almost exclusively in male subjects, although bee sting-induced admissions peak between 5 and 9 years of age with a male/female ratio of 2.7. However, most drug-induced anaphylaxis deaths occurred between 55 and 85 years with equal sex distribution similar to drug-induced anaphylaxis admissions. There was no evidence of an increase in death rates for food-induced anaphylaxis, despite food-induced anaphylaxis admissions increasing approximately 350%. In contrast, drug-induced anaphylaxis deaths increased approximately 300% compared with an approximately 150% increase in drug-induced anaphylaxis admissions. The demographics for anaphylaxis deaths are different to those for anaphylaxis presentations. Anaphylaxis mortality rates remain low and stable, despite increasing anaphylaxis prevalence, with the exception of drug-induced anaphylaxis deaths, which have increased.

  11. Anaphylaxis across two Canadian pediatric centers: evaluating management disparities

    PubMed Central

    Lee, Alison YM; Enarson, Paul; Clarke, Ann E; La Vieille, Sébastien; Eisman, Harley; Chan, Edmond S; Mill, Christopher; Joseph, Lawrence; Ben-Shoshan, Moshe

    2017-01-01

    differences in hospital management practices. It is crucial to develop training programs that aim to increase epinephrine use in anaphylaxis. PMID:28115856

  12. Evaluation of a newly developed online color training system.

    PubMed

    Chen, Li; Yang, Xu; Tan, Jianguo; Zhou, Jianfeng; Du, Yang; Li, Deli

    2011-01-01

    This study evaluated a newly developed online color training system. The system incorporated basic color training, shade guide matching, and clinical shade selection simulation exercises. Thirty-seven dental students went through baseline Vita-Vita testing with VITA Classical shade guides and then practiced color training exercises with the system for 4 days; the same test was performed after the training program. The average correct match increased from 6.7 (41.88%) to 11.38 (71.13%) using the shade guides (P < .001) and from 9.67 (60.42%) to 13.06 (81.63%) using the color training system (P < .001). The effectiveness of the color training system in improving color-matching quality was confirmed.

  13. On your time: online training for the public health workforce.

    PubMed

    Kenefick, Hope Worden; Ravid, Sharon; MacVarish, Kathleen; Tsoi, Jennifer; Weill, Kenny; Faye, Elizabeth; Fidler, Anne

    2014-03-01

    The need for competency-based training for the public health workforce is well documented. However, human and financial resource limitations within public health agencies often make it difficult for public health practitioners to attend classroom-based training programs. The Internet is an increasingly popular way of extending training beyond the workforce. Although research describes attributes of effective online learning modules, much of the available training delivered via the Internet does not incorporate such attributes. The authors describe the On Your Time training series, an effective distance education program and training model for public health practitioners, which includes a standardized process for development, review, evaluation, and continuous quality improvement. On Your Time is a series of awareness-level (i.e., addressing what practitioners should know), competency-based training modules that address topics related to regulatory responsibilities of public health practitioners (e.g., assuring compliance with codes and regulations governing housing, retail food safety, private water supplies, hazardous and solid waste, on-site wastewater systems, etc.), public health surveillance, case investigation, disease prevention, health promotion, and emergency preparedness. The replicable model incorporates what is known about best practices for online training and maximizes available resources in the interests of sustainability.

  14. Implementing an Online Vocabulary Training Program

    ERIC Educational Resources Information Center

    Robertson, Charles E.

    2015-01-01

    Although vocabulary acquisition research has shed much light on practical methods for increasing lexical knowledge (Nation, 1994), many foreign language teachers hesitate to implement focused vocabulary-training programs in their classrooms. The reasons most often cited for this hesitation are associated with the difficult tasks of creating,…

  15. 10 Things We Know So Far about Online Training.

    ERIC Educational Resources Information Center

    Kiser, Kim

    1999-01-01

    Ten tips for online courses are as follow: (1) provide technical support; (2) plan the program; (3) use it for soft skills; (4) offer training during working hours; (5) keep lessons short; (6) keep traffic moving; (7) avoid using plug-ins; (8) teach the basics; (9) retain the human touch; and (10) realize the Web won't put trainers out of…

  16. Online Training for the End User or Information Consumer.

    ERIC Educational Resources Information Center

    Gordon, Dena W.

    A review of the literature indicates that innovations in technology are making it possible for the consumer of information, the end user, to gather his own information online. The information specialist's role is changing from that of a researcher to a trainer and leader in the information gathering process. Reports on end user training indicate…

  17. 76 FR 17451 - Online OSHA Outreach Training Programs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-29

    ... speak this language. OSHA requires that all information pertinent to the course be submitted in English... information. (e) Training must engage the trainee with frequent interaction techniques and feedback. (i... opportunities and feedback. (iii) OSHA requires a highly interactive, participatory online course....

  18. Training Concerns for an Online Public Access Catalog.

    ERIC Educational Resources Information Center

    Rockman, Ilene F.; Adalian, Paul T., Jr.

    This report is designed to raise issues and concerns which will affect the successful implementation of an education and training program once an online public access catalog (OLPAC) has been installed in the Kennedy Library at California Polytechnic State University (Cal Poly), San Luis Obispo. Information presented in the document was gathered…

  19. The Effects of Online Feedback Training on Students' Text Revision

    ERIC Educational Resources Information Center

    Yang, Yu-Fen; Meng, Wen-Ting

    2013-01-01

    Oftentimes, college students who learn English as a Foreign Language (EFL) provide their peers with incorrect and misleading feedback during text revision. To improve the effectiveness of peer feedback, this study examined the degree to which online feedback training impacted EFL college students' text revisions. A sample of 50 college students…

  20. The Learning Experience: Training Teachers Using Online Synchronous Environments

    ERIC Educational Resources Information Center

    Woodcock, Stuart; Sisco, Ashley; Eady, Michelle

    2015-01-01

    This study examined the effectiveness of an online synchronous platform used for training preservice teachers. A blended learning approach was implemented. Fifty-three students participated in the course. Qualitative interview data and quantitative survey data were collected about students' experiences using the platform, and analyzed via thematic…

  1. Teacher Training, Sexuality Education, and Intellectual Disabilities: An Online Workshop

    ERIC Educational Resources Information Center

    Gonzalez-Acquaro, Katia

    2009-01-01

    The focus of this study was to assess the impact of an online workshop on teachers' knowledge, attitudes, and self-efficacy beliefs toward sexuality education and intellectual disabilities. A pretest-post-test group design was implemented for this study. Sixty-eight teachers were randomly assigned to one of two training conditions or a control…

  2. On-Line Pesticide Training with Narrated Powerpoint Presentations

    ERIC Educational Resources Information Center

    Johnson, Steven B.

    2015-01-01

    UMaine Cooperative Extension is the primary educational delivery organization for pesticide recertification credits in Maine. Shrinking budgets and staff numbers are making traditional face-to-face delivery increasingly difficult to maintain. To address this issue, on-line pesticide applicator recertification training credits were developed. The…

  3. The Effects of Online Feedback Training on Students' Text Revision

    ERIC Educational Resources Information Center

    Yang, Yu-Fen; Meng, Wen-Ting

    2013-01-01

    Oftentimes, college students who learn English as a Foreign Language (EFL) provide their peers with incorrect and misleading feedback during text revision. To improve the effectiveness of peer feedback, this study examined the degree to which online feedback training impacted EFL college students' text revisions. A sample of 50 college students…

  4. Identifying Collaborative Behaviours Online: Training Teachers in Wikis

    ERIC Educational Resources Information Center

    Vinagre Laranjeira, Margarita

    2016-01-01

    In this paper we explore the data gathered from a group of nine in-service teachers who were trained online to become future telecollaborative teachers. Participants from different countries worked in two small groups in a wiki designed specially to facilitate discussion and collaboration. Tasks included reading and reviewing articles on…

  5. On-Line Pesticide Training with Narrated Powerpoint Presentations

    ERIC Educational Resources Information Center

    Johnson, Steven B.

    2015-01-01

    UMaine Cooperative Extension is the primary educational delivery organization for pesticide recertification credits in Maine. Shrinking budgets and staff numbers are making traditional face-to-face delivery increasingly difficult to maintain. To address this issue, on-line pesticide applicator recertification training credits were developed. The…

  6. Peculiarities of US Border Guard Officers' Training at the Federal Law Enforcement Training Center Using Online Campus

    ERIC Educational Resources Information Center

    Bloshchynskyi, Ihor

    2015-01-01

    Professional training of future US border guard officers at the Federal Law Enforcement Training Center using e-FLETC Online Campus has been substantiated in the article. Special attention has been paid to revealing such topical areas of Online Campus computer-based training modules (crime scene, driver training, drugs, firearms, health,…

  7. Peculiarities of US Border Guard Officers' Training at the Federal Law Enforcement Training Center Using Online Campus

    ERIC Educational Resources Information Center

    Bloshchynskyi, Ihor

    2015-01-01

    Professional training of future US border guard officers at the Federal Law Enforcement Training Center using e-FLETC Online Campus has been substantiated in the article. Special attention has been paid to revealing such topical areas of Online Campus computer-based training modules (crime scene, driver training, drugs, firearms, health,…

  8. Online Training: An Evaluation of the Effectiveness and Efficiency of Training Law Enforcement Personnel over the Internet.

    ERIC Educational Resources Information Center

    Schmeeckle, Joyce M.

    2003-01-01

    Study 1 evaluates the effectiveness and efficiency of online training with Nebraska Law Enforcement Training Center's (NLETC's) Jail Management trainees. Results indicate that online training is as effective as and more efficient than classroom training. Study 2 examined learning, instructional time, motivation, and attitude advantages of…

  9. Proceedings of the AMCP Integrated Care Summit: population health and quality improvement in anaphylaxis.

    PubMed

    2014-01-01

    Anaphylaxis is a serious allergic reaction, often caused by food allergies, insect venom, medications, latex, or exercise. The condition is rapid in onset and may cause death. Because of the potential risk of death, it is critical to recognize anaphylaxis quickly and be prepared to treat it appropriately. To review the current trends and challenges related to anaphylaxis management, treatment, and prevention and explore strategies for how to improve access and awareness for patients who are at high risk for anaphylaxis. Fifteen stakeholders gathered on May 22, 2013, in Alexandria, Virginia, for a meeting to discuss population health and quality improvement in anaphylaxis convened by the Academy of Managed Care Pharmacy.Summit participants included managed care leaders, nurses, physicians, and organizations that advocate for consumers. Data on the clinical and financial impact of anaphylaxis are limited and are impacted by under diagnoses, underreporting, and miscoding of anaphylaxis. There is a significant need to increase awareness of the symptoms of anaphylaxis and ensure that patients at risk have access to available treatments. Additional education and training for both patients and health care professionals are needed to recognize the signs and symptoms of anaphylaxis and ensure the appropriate use of epinephrine auto injectors. Managed care companies have a need to better understand how to design and improve health benefits to support patients with anaphylaxis. Summit participants determined that there are opportunities to improve care for patients with anaphylaxis. The availability of epinephrine auto-injectors is not and should not be highly controlled, and the education and training of patients and health care professionals on the appropriate use of these devices are priorities. Attendees discussed numerous strategies that can be implemented by providers, health plans,and hospitals to improve patient care in this disease state.

  10. Customized online and onsite training for rabies-control officers.

    PubMed

    Bourhy, Hervé; Troupin, Cécile; Faye, Ousmane; Meslin, François-Xavier; Abela-Ridder, Bernadette; Sall, Amadou Alpha; Kraehenbuhl, Jean-Pierre

    2015-07-01

    It is difficult to deliver adequate training for people working in rabies control in low and middle-income countries. Popular e-learning systems for low-income settings are not well suited to developing and testing practical skills, including laboratory methods. We customized training in rabies control methods for African professionals and students from different disciplines. Trainees participated in preparatory online sessions, evaluations and exercises before and after a 12-day workshop. Trainees and mentors continued to interact through an online forum up to one year after the workshop. In Africa, 15,000 deaths from rabies occur each year due to a lack of awareness, inaccessibility of post-exposure prophylaxis, inadequate or absent canine rabies-control programmes and lack of governmental financial support. Thirty two trainees - working in health departments, hospitals, veterinary stations and research institutes - were selected to participate; 28 completed the course and passed the final evaluation. Pilot rabies investigation programmes were developed, and two manuscripts submitted for publication. An online forum facilitated further progress for a year after the workshop. A combination of customized online and onsite training is suitable for teaching disease-control personnel in low-income countries. Participation in this course enabled trainees to advocate for the development of national disease-control strategies. Mentoring is needed to develop a strong network of experts in similar settings.

  11. Safety of Adrenaline Use in Anaphylaxis: A Multicentre Register.

    PubMed

    Cardona, Victòria; Ferré-Ybarz, Laia; Guilarte, Mar; Moreno-Pérez, Nuria; Gómez-Galán, Catalina; Alcoceba-Borràs, Eva; Delavalle, Maria Belén; Garriga-Baraut, Teresa

    2017-01-01

    The use of intramuscular adrenaline to treat anaphylaxis is suboptimal, despite being the first-line treatment recommended by national and international anaphylaxis guidelines. Fear of potentially severe side effects may be one of the underlying factors. The aim of this study was to assess the incidence and severity of adverse side effects after the use of adrenaline in anaphylaxis, as well as potential risk factors. Observational study based on a multicenter online registry of cases of adrenaline administration for suspected anaphylaxis. 277 registered valid cases were included: 138 (51.49%) female, median age 29 years (12-47), and 6 children under 2 years with a median age of 9 months (1-21). Side effects occurred in 58 cases (21.64%), with tremors, palpitations, and anxiety being the most frequent. There was a significant association of developing side effects with older age, higher dose of adrenaline, or use of the intravenous route. Potentially severe adverse effects (high blood pressure, chest discomfort, or ECG alterations) occurred only in 8 cases (2.99%); in these cases, no differences were found according to age or adrenaline dose, but again, intravenous administration was associated with more severe adverse events. This study shows that side effects affect less than 1 in 5 patients who receive adrenaline for an anaphylactic reaction, and are usually mild and transient. Therefore, in an emergency situation such as anaphylaxis, restricting adrenaline administration due to potential adverse effects would, in general, not be justified. © 2017 S. Karger AG, Basel.

  12. [Management of anaphylaxis in Latin America: current situation].

    PubMed

    Cardona, Victoria; Álvarez-Perea, Alberto; Ansotegui, Ignacio J; Arias-Cruz, Alfredo; González-Díaz, Sandra Nora; Latour-Staffeld, Patricia; Ivancevich, Juan Carlos; Sánchez-Borges, Mario; Serrano, Carlos; Solé, Dirceu; Tanno, Luciana K

    2017-01-01

    Anaphylaxis is a systemic and severe allergic reaction, which can be fatal. The first-line treatment of choice, according to international guidelines, is intramuscular adrenaline. However, different studies show that the performance of health professionals managing anaphylaxis is often inadequate. To assess the current resources available in Latin American countries for the diagnosis and treatment of anaphylaxis. Online survey promoted by the Latin American Society of Allergy and Immunology to representatives of the national allergy societies of Latin American countries. Responses were received from 10 countries out of the 14 countries invited to participate. Only five of the countries have clinical practice guidelines in anaphylaxis. Adrenaline autoinjectors are available only in two countries, Argentina and Brazil, but are not subsidized by public health systems. In all countries, adrenaline is available in ampoules, which is the presentation usually prescribed to patients for self-administration. The use of adrenaline was estimated to be less than 50 % of cases in five countries, while antihistamines and corticosteroids are almost always used. The determination of serum tryptase is possible in some health centers, often private, in five of the countries surveyed. It is necessary to improve resources related to the diagnosis and management of anaphylaxis in Latin American countries.

  13. Development and psychometric validation of a brief instrument to measure satisfaction with online training.

    PubMed

    Avital, Michel; Atreja, Ashish; Mehta, Neil; Jain, Anil

    2005-01-01

    Nowadays, health care institutions are increasingly challenged with the need for perennial workforce training and documentation for regulatory compliance. Hence, more and more institutions are looking at online training solutions to train their workforce. We developed and validated a brief instrument designed to measure user satisfaction with online training. We present the results of psychometric analysis of our instrument that was validated in an online HIPAA training course by over 13,000 employees of our integrated delivery network.

  14. Anaphylaxis due to head injury.

    PubMed

    Bruner, Heather C; Bruner, David I

    2015-05-01

    Both anaphylaxis and head injury are often seen in the emergency department, but they are rarely seen in combination. We present a case of a 30-year-old woman who presented with anaphylaxis with urticaria and angioedema following a minor head injury. The patient responded well to intramuscular epinephrine without further complications or airway compromise. Prior case reports have reported angioedema from hereditary angioedema during dental procedures and maxillofacial surgery, but there have not been any cases of first-time angioedema or anaphylaxis due to head injury.

  15. Anaphylaxis Due to Head Injury

    PubMed Central

    Bruner, Heather C.; Bruner, David I.

    2015-01-01

    Both anaphylaxis and head injury are often seen in the emergency department, but they are rarely seen in combination. We present a case of a 30-year-old woman who presented with anaphylaxis with urticaria and angioedema following a minor head injury. The patient responded well to intramuscular epinephrine without further complications or airway compromise. Prior case reports have reported angioedema from hereditary angioedema during dental procedures and maxillofacial surgery, but there have not been any cases of first-time angioedema or anaphylaxis due to head injury. PMID:25987924

  16. Training for Online Teachers to Support Student Success: Themes from a Survey Administered to Teachers in Four Online Learning Programs

    ERIC Educational Resources Information Center

    Zweig, Jacqueline S.; Stafford, Erin T.

    2016-01-01

    In addition to teaching the subject matter, online teachers are tasked with supporting students' understanding of the online environment as well as students' progress, engagement, and interactions within the course. Yet only four states and the District of Columbia require teachers to receive training in online instruction prior to teaching a K-12…

  17. The Effect of Online Systems Analysis Training on Aerospace Industry Business Performance: A Qualitative Study

    ERIC Educational Resources Information Center

    Burk, Erlan

    2012-01-01

    Aerospace companies needed additional research on technology-based training to verify expectations when enhancing human capital through online systems analysis training. The research for online systems analysis training provided aerospace companies a means to verify expectations for systems analysis technology-based training on business…

  18. The Effect of Online Systems Analysis Training on Aerospace Industry Business Performance: A Qualitative Study

    ERIC Educational Resources Information Center

    Burk, Erlan

    2012-01-01

    Aerospace companies needed additional research on technology-based training to verify expectations when enhancing human capital through online systems analysis training. The research for online systems analysis training provided aerospace companies a means to verify expectations for systems analysis technology-based training on business…

  19. Managing anaphylaxis in the office setting.

    PubMed

    Cingi, Cemal; Wallace, Dana; Bayar Muluk, Nuray; Ebisawa, Motohiro; Castells, Mariana; Şahin, Ethem; Altıntoprak, Niyazi

    2016-07-01

    Although the definition of anaphylaxis for clinical use may vary by professional health care organizations and individuals, the definition consistently includes the concepts of a serious, generalized or systemic, allergic or hypersensitivity reaction that can be life-threatening or even fatal. In this review, we presented the important topics in the treatment of anaphylaxis in the office setting. This review will discuss triggers and risk factors, clinical diagnosis, and management of anaphylaxis in the office setting. Anaphylaxis in the office setting is a medical emergency. It, therefore, is important to prepare for it, to have a posted, written anaphylaxis emergency protocol, and to rehearse the plan regularly. In this review, we presented the important steps in managing anaphylaxis in the office. Treatment of anaphylaxis should start with epinephrine administered intramuscularly at the first sign of anaphylaxis. Oxygen and intravenous fluids may be needed for moderate-to-severe anaphylaxis or anaphylaxis that is quickly developing or if the patient is unresponsive to the first injection of epinephrine. Antihistamine therapy is considered adjunctive to epinephrine, which mainly relieves itching and urticaria. Corticosteroids, with an onset of action of 4-6 hours, have no immediate effect on anaphylaxis. To prevent near-fatal and fatal reactions from anaphylaxis, the patient, the family, and the physician must remember to follow the necessary steps when treating anaphylaxis. In anaphylaxis, there is no absolute contraindication for epinephrine.

  20. Massive open online courses are relevant for postgraduate medical training.

    PubMed

    Subhi, Yousif; Andresen, Kristoffer; Rolskov Bojsen, Signe; Mørkeberg Nilsson, Philip; Konge, Lars

    2014-10-01

    The CanMEDS framework describes seven roles in postgraduate training, but training and courses relevant to these roles can be limited. Massive open online courses (MOOCs) - free online courses in which anyone can participate, anywhere - may improve course participation. This study investigates the relevance of MOOCs for postgraduate medical training within the CanMEDS framework. We extracted a list of all courses posted by the two largest MOOC providers, Coursera and EdX, and reviewed all course descriptions and categorised each course into one of three categories--"relevant," "possibly relevant" or "not relevant"--reflecting the degree of relevance to each of the seven CanMEDS roles. We also noted course workload, duration and the name of the educational institution. We agreed the most on the role of health advocate (Cronbach's α = 0.85) and the least on the role of collaborator (Cronbach's α = 0.46). After a consensus-building process, 165 courses were found to be relevant or possibly relevant, mostly to the roles as scholar (n = 75) and medical expert (n = 57). The courses had a median duration of seven weeks and a median weekly workload of 4.5 hours, and were predominantly from North American universities. A large number of MOOCs are relevant for postgraduate medical training. A weekly workload of 4.5 hours may enable course participation even for busy clinicians. Physicians should consider these free and universally available courses as relevant and potentially effective means of education. not relevant. not relevant.

  1. History and classification of anaphylaxis.

    PubMed

    Ring, Johannes; Behrendt, Heidrun; de Weck, Alain

    2010-01-01

    Anaphylaxis as the maximal variant of an acute systemic hypersensitivity reaction can involve several organ systems, particularly the skin, respiratory tract, gastrointestinal tract and the cardiovascular system. The severity of anaphylactic reaction is variable and can be classified into severity grades I-IV. Some reactions are fatal. Most frequent elicitors of anaphylaxis are foods in childhood, later insect stings and drugs. The phenomenon itself has been described in ancient medical literature, but was actually recognized and named at the beginning of the 20th century by Charles Richet and Paul Portier. In the course of experiments starting on the yacht of the Prince of Monaco and continued in the laboratory in Paris, they tried to immunize dogs with extracts of Physalia species in an attempt to develop an antitoxin to the venom of the Portuguese man-of-war. While Charles Richet believed that anaphylaxis was a 'lack of protection', it has become clear that an exaggerated immune reaction, especially involving immunoglobulin E antibodies, is the underlying pathomechanism in allergic anaphylaxis besides immune complex reactions. Non-immunologically mediated reactions leading to similar clinical symptomatology have been called 'anaphylactoid' or 'pseudo-allergic'--especially by Paul Kallos--and are now called 'non-immune anaphylaxis' according to a consensus of the World Allergy Organization (WAO). The distinction of different pathophysiological processes is important since non-immune anaphylaxis cannot be detected by skin test or in vitro allergy diagnostic procedures. History and provocation tests are crucial. The intensity of the reaction is not only influenced by the degree of sensitization but also by concomitant other factors as age, simultaneous exposure to other allergens, underlying infection, physical exercise or psychological stress or concomitant medication (e.g. beta-blockers, NSAIDs); this phenomenon has been called augmentation or summation

  2. True rise in anaphylaxis incidence

    PubMed Central

    Yang, Min-Suk; Kim, Ju-Young; Kim, Byung-Keun; Park, Heung-Woo; Cho, Sang-Heon; Min, Kyung-Up; Kang, Hye-Ryun

    2017-01-01

    Abstract The incidence trend of anaphylaxis in Asia is not well investigated. The aim of this study is to estimate the entire population-based incidence of anaphylaxis in Korea using a nationwide administrative database. Data over a 7-year period (2008–2014) was obtained from the Korean National Health Insurance (NHI) claims database which covers 97.9% of the entire Korean population. Using diagnosis codes from the International Classification of Diseases-10 for anaphylaxis (T78.0, T78.2, T80.5, and T88.6), we identified the annual number of patients who had visited any hospital with a primary diagnosis of anaphylaxis. Incidence rates were calculated using the population distribution data of all NHI beneficiaries. The incidence of anaphylaxis in Korea was 32.19 episodes per 100,000 person-years in 2014, which nearly doubled from 2008 (16.02 episodes per 100,000 person-years). The incidence of anaphylaxis increased continuously throughout these years regardless of gender and age groups (P for trend < 0.001). Female was significantly less predisposed than male (adjusted odds ratio [OR], 0.69; 95% confident interval [CI], 0.66–0.72; P < 0.001). The incidence was the lowest in 0 to 19 age group and the highest in 40 to 69 age group (adjusted OR, 2.41; 95% CI, 2.29–2.54; P < 0.001). In conclusion, we report the increasing time trend of anaphylaxis incidence rates using nationwide claims database for the first time in Asia. PMID:28151851

  3. Recognition, assessment and management of anaphylaxis.

    PubMed

    Linton, E; Watson, D

    This article describes the physiological changes that take place during anaphylaxis, explores the ABCDE (airway, breathing, circulation, disability, exposure) approach to patient assessment and discusses the pharmacological interventions required to treat anaphylaxis effectively.

  4. The Effect of Counselling-Based Training on Online Peer Support

    ERIC Educational Resources Information Center

    Lekka, Foteini; Efstathiou, Giorgos; Kalantzi-Azizi, Anastasia

    2015-01-01

    The aim of the current study is to investigate the impact of counselling-based training on online peer support by comparing the interventions of trained peer supporters as opposed to non-trained peer supporters. Two independent raters analysed 746 support posts published during a period of one year at the "Student to Student" online peer…

  5. 75 FR 44265 - Proposed Collection; Comment Request; Online Skills Training for PCPs on Substance Abuse

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-28

    ... Training for PCPs on Substance Abuse SUMMARY: Under the provisions of Section 3506(c)(2)A of the Paperwork... Collection: Title: Online Skills Training for PCPs on Substance Abuse. Type of Information Collection Request... Online Skills Training for PCPs on Substance Abuse, via the Web site SBIRTTraining.com , to...

  6. The Effect of Counselling-Based Training on Online Peer Support

    ERIC Educational Resources Information Center

    Lekka, Foteini; Efstathiou, Giorgos; Kalantzi-Azizi, Anastasia

    2015-01-01

    The aim of the current study is to investigate the impact of counselling-based training on online peer support by comparing the interventions of trained peer supporters as opposed to non-trained peer supporters. Two independent raters analysed 746 support posts published during a period of one year at the "Student to Student" online peer…

  7. Student Training in the Use of an Online Synchronous Conferencing Tool

    ERIC Educational Resources Information Center

    Heiser, Sarah; Stickler, Ursula; Furnborough, Concha

    2013-01-01

    With the increase of online language teaching the training needs of teachers have long been established and researched. However, the training needs of students have not yet been fully acknowledged. This paper focuses on learner training as preparation for language classes where online synchronous conferencing is used. It presents an action…

  8. Student Training in the Use of an Online Synchronous Conferencing Tool

    ERIC Educational Resources Information Center

    Heiser, Sarah; Stickler, Ursula; Furnborough, Concha

    2013-01-01

    With the increase of online language teaching the training needs of teachers have long been established and researched. However, the training needs of students have not yet been fully acknowledged. This paper focuses on learner training as preparation for language classes where online synchronous conferencing is used. It presents an action…

  9. Anaphylaxis to disodium cromoglycate.

    PubMed

    Ibañez, M D; Laso, M T; Martinez-San Irineo, M; Alonso, E

    1996-09-01

    Reports about side effects from cromolyn sodium (DSCG) are few and only a minority of them indicate the possibility of an immediate type I hypersensitivity reaction. We report an 8-year-old boy with a history of seasonal rhinoconjunctivitis and asthma. The patient reported two immediate episodes of acute asthma following inhalation of a cromolyn sodium (DSCG) capsule with an interval of 6 months. The latter occasion was also associated with conjunctivitis and generalized urticaria, requiring emergency treatment. An end-point prick test elicited a 4-mm wheal at 10 mg/mL with DSCG solution for inhalation and DSCG eye drops. An end-point intradermal skin test with DSCG solution for inhalation elicited a 12-mm mean diameter wheal at 10 mg/mL. During the intradermal test, the patient developed conjunctivitis and wheezing with a FEV1 fall of 27% from baseline. Controlled conjunctival and bronchial challenge tests were positive. The bronchial challenge test was repeated 3 years later showing a FEV1 fall of 22% five minutes after inhalation of 1 mg/mL DSCG during one minute. A leukocyte histamine release test performed by an autoanalysis fluorometric procedure, with several dilutions of DSCG, was negative. This case of DSCG anaphylaxis satisfies the criteria for an IgE-mediated reaction. We believe that thought should be given more frequently to this mechanism when patients report adverse reactions to DSCG.

  10. Exercise-induced anaphylaxis.

    PubMed

    Sheffer, A L; Austen, K F

    1980-08-01

    Sixteen patients were seen because of possibly life-threatening exercise-associated symptoms similar to anaphylactic reactions. Asthma attacks, cholinergic urticaria and angioedema, and cardiac arrythmias are recognized as exertion-related phenomena in predisposed patients but are distinct from the syndrome described here. A syndrome characterized by the exertion-related onset of cutaneous pruritus and warmth, the development of generalized urticaria, and the appearance of such additional manifestations as collapse in 12 patients, gastrointestinal tract symptoms in five patients, and upper respiratory distress in 10 patients has been designated exercise-induced anaphylaxis, because of the striking similarity of this symptom complex to the anaphylactic syndrome elicited by ingestion or injection of a foreign antigenic substance. There is a family history of atopic desease for 11 patients and cold urticaria for two others and a personal history of atopy in six. The size of the wheals, the failure to develop an attack with a warm bath or shower or a fever, and the prominence of syncope rule against the diagnosis of conventional cholinergic urticaria. There is no history or evidence of an encounter with an environmental source of antigen during the exercise period.

  11. [Exercise-induced anaphylaxis].

    PubMed

    Gani, Federica; Selvaggi, Lucia; Roagna, Davide

    2008-01-01

    Exercise-induced anaphylaxis (EIA) was defined for the first time in 1980. EIA is associated with different kind of exercise, although jogging is the most frequently reported. The clinical manifestations progress from itching, erythema and urticaria to some combination of cutaneous angioedema, gastrointestinal and laryngeal symptoms and signs of angioedema and vascular collapse. Mast cell participation in the pathogenesis of this syndrome has been proved by the finding of an elevated serum histamine level during experimentally-induced attacks and by cutaneous degranulation of mast cells with elevated serum tryptase after attacks. As predisposing factors of EIA, a specific or even aspecific sensitivity to food has been reported and such cases are called "food-dependent EIA". Many foods are implicated but particularly wheat, vegetables, crustacean. Another precipitating factor includes drugs intake (non steroidal anti-inflammatory drugs), climate variations and menstrual cycle factors. Treatment of an attack should include all the manoeuvres efficacious in the management of conventional anaphylactic syndrome, including the administration of epinephrine and antihistamines. Prevention of the attacks may be achieved with the interruption of the exercise at the appearance of the first premonitory symptoms. To prevent the onset of EIA it is also suitable to delay the exercise practice after at least 4-6 hours from the swallowing of food.

  12. Understanding the mechanisms of anaphylaxis.

    PubMed

    Peavy, Richard D; Metcalfe, Dean D

    2008-08-01

    The present review considers recent reports that identify the roles of key intermediate signaling components and mediators during and after mast cell activation and degranulation leading to anaphylaxis. Mechanisms of anaphylaxis are becoming better understood as the interaction of several regulatory systems in the mast cell activation and degranulation signaling cascade. Multiple tyrosine kinases, activated after immunoglobulin E binding to the high-affinity receptors for immunoglobulin E (FcepsilonRI), exert both positive and negative regulation on the signaling cascade, which may vary with genetic background or mutations in signaling proteins. Calcium influx, the essential, proximal intracellular event leading to mast cell degranulation, is controlled also by both negative and positive regulation through calcium channels. Sphingosine-1-phosphate is emerging as a newly realized mediator of anaphylaxis, acting as a signaling component within the mast cell and as a circulating mediator. Anaphylaxis is a systemic reaction involving multiple organ systems, but it is believed that it may be influenced by cellular events in mast cells and basophils resulting in the release of mediators. Therefore, understanding the mechanisms of mast cell activation and degranulation is critical to understanding the mechanisms of anaphylaxis. Recent reports have identified important regulatory components of the signaling cascade and, consequently, potential targets for therapeutic intervention.

  13. Understanding the mechanisms of anaphylaxis

    PubMed Central

    Peavy, Richard D.; Metcalfe, Dean D.

    2009-01-01

    Purpose of review The present review considers recent reports that identify the roles of key intermediate signaling components and mediators during and after mast cell activation and degranulation leading to anaphylaxis. Recent findings Mechanisms of anaphylaxis are becoming better understood as the interaction of several regulatory systems in the mast cell activation and degranulation signaling cascade. Multiple tyrosine kinases, activated after immunoglobulin E binding to the high-affinity receptors for immunoglobulin E (FcεRI), exert both positive and negative regulation on the signaling cascade, which may vary with genetic background or mutations in signaling proteins. Calcium influx, the essential, proximal intracellular event leading to mast cell degranulation, is controlled also by both negative and positive regulation through calcium channels. Sphingosine-1-phosphate is emerging as a newly realized mediator of anaphylaxis, acting as a signaling component within the mast cell and as a circulating mediator. Summary Anaphylaxis is a systemic reaction involving multiple organ systems, but it is believed that it may be influenced by cellular events in mast cells and basophils resulting in the release of mediators. Therefore, understanding the mechanisms of mast cell activation and degranulation is critical to understanding the mechanisms of anaphylaxis. Recent reports have identified important regulatory components of the signaling cascade and, consequently, potential targets for therapeutic intervention. PMID:18596587

  14. Pancake Syndrome (Oral Mite Anaphylaxis)

    PubMed Central

    2009-01-01

    Oral mite anaphylaxis is a new syndrome characterized by severe allergic manifestations occurring in atopic patients shortly after the intake of foods made with mite-contaminated wheat flour. This clinical entity, observed more frequently in tropical/subtropical environments, is more often triggered by pancakes and for that reason it has been designated "pancake syndrome". Because cooked foods are able to induce the symptoms, it has been proposed that thermoresistant allergens are involved in its production. A novel variety of this syndrome occurs during physical exercise and therefore has been named dust mite ingestion-associated exercise-induced anaphylaxis. To prevent mite proliferation and the production of anaphylaxis, it has been recommended that wheat flour be stored at low temperatures in the refrigerator. PMID:23283016

  15. Delayed Anaphylaxis to Red Meat Masquerading as Idiopathic Anaphylaxis

    PubMed Central

    Tripathi, Anubha; Commins, Scott P.; Heymann, Peter W.; Platts-Mills, Thomas A.E.

    2014-01-01

    Anaphylaxis is traditionally recognized as a rapidly developing combination of symptoms often including hives and hypotension or respiratory symptoms. Furthermore, when a specific cause is identified, exposure to this cause is usually noted to have occurred within minutes to 2 hours before the onset of symptoms. This case is of a 79 year-old female who developed a severe episode of anaphylaxis 3 hours after eating pork. Prior to 2012, she had not experienced any symptoms after ingestion of meat products. Delayed anaphylaxis to mammalian meat has many contrasting features to immediate food-induced anaphylaxis. The relevant IgE antibody is specific for the oligosaccharide galactose-alpha-1,3-galactose (alpha-gal), a blood group substance of non-primate mammals. Evidence from Australia, Sweden, and the U.S. demonstrates that the primary cause of this IgE antibody response is tick bites. These bites characteristically itch for ten days or more. Diagnosis can be made by the presence of specific IgE to beef, pork, lamb, and milk and lack of IgE to chicken, turkey, and fish. Prick skin tests (but not intradermal tests) are generally negative. Management of these cases, now common across the southeastern U.S., consists of education combined with avoidance of both red meat and further tick bites. PMID:24811014

  16. Anaphylaxis: mechanisms of mast cell activation.

    PubMed

    Kalesnikoff, Janet; Galli, Stephen J

    2010-01-01

    Anaphylaxis is a severe systemic allergic response that is rapid in onset and potentially lethal, and that typically is induced by an otherwise innocuous substance. In IgE-dependent and other examples of anaphylaxis, tissue mast cells and circulating basophilic granulocytes (basophils) are thought to represent major (if not the major) sources of the biologically active mediators that contribute to the pathology and, in unfortunate individuals, fatal outcome, of anaphylaxis. In this chapter, we will describe the mechanisms of mast cell (and basophil) activation in anaphylaxis, with a focus on IgE-dependent activation, which is thought to be responsible for most examples of antigen-induced anaphylaxis in humans. We will also discuss the use of mouse models to investigate the mechanisms that can contribute to anaphylaxis in that species in vivo, and the relevance of such mouse studies to human anaphylaxis. Copyright 2010 S. Karger AG, Basel.

  17. The problem of anaphylaxis and mastocytosis.

    PubMed

    Müller, Ulrich R; Haeberli, Gabrielle

    2009-01-01

    Mastocytosis is a rare disease characterized by an elevated whole body mast cell number. Anaphylaxis is a severe, generalized hypersensitivity reaction with rapid onset. The problem of anaphylaxis and mastocytosis is due to strongly increased mediator release from the elevated mast cell number during allergic reactions. This explains the much higher prevalence of anaphylaxis in mastocytosis than in the general population and its severe and sometimes fatal course. Because of the increased risk of anaphylaxis in mastocytosis, all patients with severe or recurrent anaphylaxis should be analyzed for underlying mastocytosis by estimation of baseline serum tryptase. If this is elevated, patients also should be tested via skin examination for cutaneous mastocytosis and with a bone marrow biopsy. All patients with mastocytosis and anaphylaxis must be instructed about avoiding the responsible elicitors and should carry an emergency kit with adrenaline for self-application. In mastocytosis patients with anaphylaxis due to Hymenoptera stings, venom immunotherapy is recommended for life.

  18. Autoinjectors Preferred for Intramuscular Epinephrine in Anaphylaxis and Allergic Reactions

    PubMed Central

    Campbell, Ronna L.; Bellolio, M. Fernanda; Motosue, Megan S.; Sunga, Kharmene L.; Lohse, Christine M.; Rudis, Maria I.

    2016-01-01

    Introduction Epinephrine is the treatment of choice for anaphylaxis. We surveyed emergency department (ED) healthcare providers regarding two methods of intramuscular (IM) epinephrine administration (autoinjector and manual injection) for the management of anaphylaxis and allergic reactions and identified provider perceptions and preferred method of medication delivery. Methods This observational study adhered to survey reporting guidelines. It was performed through a Web-based survey completed by healthcare providers at an academic ED. The primary outcomes were assessment of provider perceptions and identification of the preferred IM epinephrine administration method by ED healthcare providers. Results Of 217 ED healthcare providers invited to participate, 172 (79%) completed the survey. Overall, 82% of respondents preferred the autoinjector method of epinephrine administration. Providers rated the autoinjector method more favorably for time required for training, ease of use, convenience, satisfaction with weight-based dosing, risk of dosing errors, and speed of administration (p<0.001 for all comparisons). However, manual injection use was rated more favorably for risk of provider self-injury and patient cost (p<0.001 for both comparisons). Three participants (2%) reported a finger stick injury from an epinephrine autoinjector. Conclusion ED healthcare providers preferred the autoinjector method of IM epinephrine administration for the management of anaphylaxis or allergic reactions. Epinephrine autoinjector use may reduce barriers to epinephrine administration for the management of anaphylaxis in the ED. PMID:27833688

  19. In vitro diagnosis of anaphylaxis.

    PubMed

    Sanz, María L; Gamboa, P M; García-Figueroa, B E; Ferrer, M

    2010-01-01

    The application and development of new in vitro techniques aims to enable a diagnosis to be reached while incurring no risk for the patient, a situation which is particularly desirable in the case of severe reactions like anaphylaxis. The in vitro diagnosis of anaphylaxis includes, among other aspects, the serial measurement of mediators which are released in the course of an anaphylactic reaction such as tryptase, histamine, chymase, carboxypeptidase A3, platelet-activating factor and other products from mastocytes. The detection of agents which trigger the anaphylactic reaction can be made with the use of serologic methods: serum-specific IgE or with cellular tests which measure the release of basophil mediators (leukotrienes, histamine) or with the analysis of the expression of basophil markers, a technique known as the basophil activation test. These techniques offer interesting alternatives in the diagnosis of anaphylaxis. The basophil activation test provides important advantages in patients with anaphylaxis to beta-lactams, non-steroidal anti-inflammatory drugs, neuromuscular blocking agents and drugs where there is no technique to measure specific IgE. Copyright 2010 S. Karger AG, Basel.

  20. The Effects of Technical Difficulties on Learning and Attrition during Online Training

    ERIC Educational Resources Information Center

    Sitzmann, Traci; Ely, Katherine; Bell, Bradford S.; Bauer, Kristina N.

    2010-01-01

    Although online instruction has many potential benefits, technical difficulties are one drawback to the increased use of this medium. A repeated measures design was used to examine the effect that technical difficulties have on learning and attrition from voluntary online training. Adult learners (N = 530) were recruited online and volunteered to…

  1. The Use of Online Surveys to Measure Satisfaction in Job Training and Workforce Development

    ERIC Educational Resources Information Center

    Schmidt, Steve; Strachota, Elaine; Conceicao, Simone

    2006-01-01

    This paper examines two empirical studies that used online surveys to collect data to measure satisfaction in job training and workforce development. A description of each study, findings related to response rate, the processes used in online survey development and implementation, as well as recommendations for the future use of online surveys…

  2. The Practical Aspects of Online Counseling: Ethics, Training, Technology, and Competency

    ERIC Educational Resources Information Center

    Mallen, Michael J.; Vogel, David L.; Rochlen, Aaron B.

    2005-01-01

    This article addresses the practical aspects of online counseling, including ethics, training, supervision, technology, and competency issues. The authors discuss online counseling's strengths and limitations and present guidelines for what types of clients and counseling psychologists may be appropriate for online counseling. To illustrate the…

  3. The Effects of Technical Difficulties on Learning and Attrition during Online Training

    ERIC Educational Resources Information Center

    Sitzmann, Traci; Ely, Katherine; Bell, Bradford S.; Bauer, Kristina N.

    2010-01-01

    Although online instruction has many potential benefits, technical difficulties are one drawback to the increased use of this medium. A repeated measures design was used to examine the effect that technical difficulties have on learning and attrition from voluntary online training. Adult learners (N = 530) were recruited online and volunteered to…

  4. Online Problem-Based and Enquiry-Based Learning in the Training of Educational Psychologists

    ERIC Educational Resources Information Center

    Bozic, Nick; Williams, Huw

    2011-01-01

    Over the past 40 years, problem-based learning (PBL) and enquiry-based learning (EBL) approaches have been used in a variety of professional training courses. More recently online versions of these pedagogies have been developed. This paper explains how online PBL and EBL activities have been incorporated into the professional training of…

  5. TMOC: A Model for Lecturers' Training to Management of Online Courses in Higher-Education

    ERIC Educational Resources Information Center

    Ghilay, Yaron; Ghilay, Ruth

    2014-01-01

    The study examined a new model called TMOC: Training to Management of Online Courses. The model is designed to train lecturers in higher-education to successfully create, deliver and develop online courses. The research was based on a sample of lecturers, who studied in a course based on the new model at the Mofet Institute in Tel-Aviv (n = 20).…

  6. 75 FR 74738 - Proposed Collection; Comment Request; Online Skills Training for PCPs on Substance Abuse

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-01

    ... Training for PCPs on Substance Abuse SUMMARY: Under the provisions of Section 3507(a)(1)(D) of the... research will evaluate the effectiveness of the Online Skills Training for PCPs on Substance Abuse, via the... clinical skills of primary care physicians in the US who treat substance abuse patients. The Online...

  7. Determining Best Practices for Training Instructors to Teach in the Online Environment

    ERIC Educational Resources Information Center

    Downing, Marie Antoinette

    2013-01-01

    Researchers have indicated that the number of online courses will continue to grow in the coming years, resulting in an increased need for online course facilitators. Often these facilitators have transitioned without receiving adequate training. The purpose of this qualitative case study was to explore the training requirements and future faculty…

  8. Training Therapists to Work Effectively Online and Offline within Digital Culture

    ERIC Educational Resources Information Center

    Anthony, Kate

    2015-01-01

    The speed at which technology evolves, and therefore the speed at which online mental health services evolve and the training required to keep up with them, has become a real concern for the profession. The need for training in transferring face-to-face skills to the online environment has been recognised for some years by leading professional…

  9. Relating Training to Job Satisfaction: A Survey of Online Faculty Members

    ERIC Educational Resources Information Center

    Hoekstra, Brian

    2013-01-01

    As the online education market continues to mature, institutions of higher education will respond to student demand by employing quality faculty members. Faculty members need unique training to successfully teach online. While the effect of training on job satisfaction has been investigated in the realm of business, it has not been tested…

  10. A Case Study Analysis of Factors that Influence Attrition Rates in Voluntary Online Training Programs

    ERIC Educational Resources Information Center

    Long, Lori; Dubois, Cathy; Faley, Robert

    2009-01-01

    This article examines utilization of online training courses in a Midwest-based landscaping company in the United States. The company had implemented online training to facilitate employee development for their 5,000 employees who were in locations throughout the United States. The courses had been in place for about a decade before the…

  11. Online Synchronous vs. Asynchronous Software Training through the Behavioral Modeling Approach: A Longitudinal Field Experiment

    ERIC Educational Resources Information Center

    Chen, Charlie C.; Shaw, Ruey-shiang

    2006-01-01

    The continued and increasing use of online training raises the question of whether the most effective training methods applied in live instruction will carry over to different online environments in the long run. Behavior Modeling (BM) approach--teaching through demonstration--has been proven as the most effective approach in a face-to-face (F2F)…

  12. A Preliminary Evaluation of Instructional Effectiveness of Online Training Implemented at a Government Agency in Thailand

    ERIC Educational Resources Information Center

    Supanakorn-Davila, Supawan; Bolliger, Doris U.

    2012-01-01

    Online training has become popular in the professional development of government employees in Thailand. One large government agency developed an online program to provide training to its employees across the country using two systems: an Internet and Intranet-based system. With the new program implemented, the evaluation of the instructional…

  13. Researching the Size and Scope of Online Usage in the Vocational Education and Training Sector.

    ERIC Educational Resources Information Center

    Hill, Robyn; Malone, Peter; Markham, Selby; Sharma, Renu; Sheard, Judithe; Young, Graeme

    The size and scope of online usage in Australia's vocational education and training sector were examined in a four-stage study that included the numerous data collection activities, including the following: a literature review; interviews with 85 institutes; interviews with 10 training organizations and 20 organizations using online learning;…

  14. Changing College Students' Conceptions of Autism: An Online Training to Increase Knowledge and Decrease Stigma

    ERIC Educational Resources Information Center

    Gillespie-Lynch, Kristen; Brooks, Patricia J.; Someki, Fumio; Obeid, Rita; Shane-Simpson, Christina; Kapp, Steven K.; Daou, Nidal; Smith, David Shane

    2015-01-01

    College students with autism may be negatively impacted by lack of understanding about autism on college campuses. Thus, we developed an online training to improve knowledge and decrease stigma associated with autism among college students. Participants (N = 365) completed a pre-test, online training, and post-test. Women reported lower stigma…

  15. Relating Training to Job Satisfaction: A Survey of Online Faculty Members

    ERIC Educational Resources Information Center

    Hoekstra, Brian

    2013-01-01

    As the online education market continues to mature, institutions of higher education will respond to student demand by employing quality faculty members. Faculty members need unique training to successfully teach online. While the effect of training on job satisfaction has been investigated in the realm of business, it has not been tested…

  16. The Impact of Fluency Strategy Training on Iranian EFL Learners' Speech under Online Planning Conditions

    ERIC Educational Resources Information Center

    Seifoori, Zohreh; Vahidi, Zahra

    2012-01-01

    The research findings reported on here confirm the facilitative role of pre-task planning on fluency and of online task planning on accuracy of speech. This quasi-experimental research was conducted to examine whether learners could be trained to attend to the fluency of their speech while planning online and whether such training might compensate…

  17. Changing College Students' Conceptions of Autism: An Online Training to Increase Knowledge and Decrease Stigma

    ERIC Educational Resources Information Center

    Gillespie-Lynch, Kristen; Brooks, Patricia J.; Someki, Fumio; Obeid, Rita; Shane-Simpson, Christina; Kapp, Steven K.; Daou, Nidal; Smith, David Shane

    2015-01-01

    College students with autism may be negatively impacted by lack of understanding about autism on college campuses. Thus, we developed an online training to improve knowledge and decrease stigma associated with autism among college students. Participants (N = 365) completed a pre-test, online training, and post-test. Women reported lower stigma…

  18. He Asked Me What!?--Using Shared Online Accounts as Training Tools for Distance Learning Librarians

    ERIC Educational Resources Information Center

    Robinson, Kelly; Casey, Anne Marie; Citro, Kathleen

    2017-01-01

    This study explores the idea of creating a knowledge base from shared online accounts to use in training librarians who perform distance reference services. Through a survey, follow-up interviews and a case study, the investigators explored current and potential use of shared online accounts as training tools. This study revealed that the…

  19. A Preliminary Evaluation of Instructional Effectiveness of Online Training Implemented at a Government Agency in Thailand

    ERIC Educational Resources Information Center

    Supanakorn-Davila, Supawan; Bolliger, Doris U.

    2012-01-01

    Online training has become popular in the professional development of government employees in Thailand. One large government agency developed an online program to provide training to its employees across the country using two systems: an Internet and Intranet-based system. With the new program implemented, the evaluation of the instructional…

  20. A Case Study Analysis of Factors that Influence Attrition Rates in Voluntary Online Training Programs

    ERIC Educational Resources Information Center

    Long, Lori; Dubois, Cathy; Faley, Robert

    2009-01-01

    This article examines utilization of online training courses in a Midwest-based landscaping company in the United States. The company had implemented online training to facilitate employee development for their 5,000 employees who were in locations throughout the United States. The courses had been in place for about a decade before the…

  1. Online Synchronous vs. Asynchronous Software Training through the Behavioral Modeling Approach: A Longitudinal Field Experiment

    ERIC Educational Resources Information Center

    Chen, Charlie C.; Shaw, Ruey-shiang

    2006-01-01

    The continued and increasing use of online training raises the question of whether the most effective training methods applied in live instruction will carry over to different online environments in the long run. Behavior Modeling (BM) approach--teaching through demonstration--has been proven as the most effective approach in a face-to-face (F2F)…

  2. Training Therapists to Work Effectively Online and Offline within Digital Culture

    ERIC Educational Resources Information Center

    Anthony, Kate

    2015-01-01

    The speed at which technology evolves, and therefore the speed at which online mental health services evolve and the training required to keep up with them, has become a real concern for the profession. The need for training in transferring face-to-face skills to the online environment has been recognised for some years by leading professional…

  3. Determining Best Practices for Training Instructors to Teach in the Online Environment

    ERIC Educational Resources Information Center

    Downing, Marie Antoinette

    2013-01-01

    Researchers have indicated that the number of online courses will continue to grow in the coming years, resulting in an increased need for online course facilitators. Often these facilitators have transitioned without receiving adequate training. The purpose of this qualitative case study was to explore the training requirements and future faculty…

  4. Paediatric anaphylaxis: a 5 year retrospective review.

    PubMed

    de Silva, I L; Mehr, S S; Tey, D; Tang, M L K

    2008-08-01

    To describe the demographic characteristics, clinical features, causative agents, settings and administered therapy in children presenting with anaphylaxis. This was a retrospective case note study of children presenting with anaphylaxis over a 5-year period to the Emergency Department (ED) at the Royal Children's Hospital, Melbourne. One-hundred and twenty-three cases of anaphylaxis in 117 patients were included. There was one death. The median age of presentation was 2.4 years. Home was the most common setting (48%) and food (85%) the most common trigger. Peanut (18%) and cashew nut (13%) were the most common cause of anaphylaxis. The median time from exposure to anaphylaxis for all identifiable agents was 10 min. The median time from onset to therapy was 40 min. Respiratory features were the principal presenting symptoms (97%). Seventeen per cent of subjects had experienced anaphylaxis previously. This is the largest study of childhood anaphylaxis reported. Major findings are that most children presenting to the ED with anaphylaxis are first-time anaphylactic reactions and the time to administration of therapy is often significantly delayed. Most reactions occurred in the home. Peanut and cashew nut were the most common causes of anaphylaxis in this study population, suggesting that triggers for anaphylaxis in children have not changed significantly over the last decade.

  5. Intraoperative medications associated with hemodynamically significant anaphylaxis.

    PubMed

    Freundlich, Robert E; Duggal, Neal M; Housey, Michelle; Tremper, Tyler T; Engoren, Milo C; Kheterpal, Sachin

    2016-12-01

    To facilitate the identification of drugs and patient factors associated with hemodynamically significant anaphylaxis. Using an existing database containing complete perioperative records, instances of hemodynamically significant anaphylaxis were identified using a physiologic and treatment-based screening algorithm. All cases were manually reviewed by 2 clinicians, with a third adjudicating disagreements, and confirmed cases were matched 3:1 with control cases. Intraoperative medications given in instances of hemodynamically significant anaphylaxis and patient risk factors were compared with control cases. University of Michigan Hospital, a large, tertiary care hospital. All adult patients undergoing surgery between January 1, 2004, and January 5, 2015. None. Incidence of hemodynamically significant anaphylaxis during anesthesia. Patient risk factors and intraoperative medications associated with hemodynamically significant anaphylaxis. Hemodynamically significant anaphylaxis occurred in 55 of 461 986 cases (1 in 8400). Hemodynamically significant anaphylaxis occurred in 52 patients, with 1 patient experiencing 3 instances and another patient 2 instances. Only 1 drug was associated with an increased risk of hemodynamically significant anaphylaxis: protamine (odds ratio, 11.78; 95% confidence interval, 1.40-99.26; P=.0233). No category of drugs was associated with increased risk. Of patient risk factors, only personal history of anaphylaxis was associated with an increased risk (odds ratio, 77.1; 95% confidence interval, 10.46-567.69; P=<.0001). Postoperative follow-up and evaluation of patients were low at our institution. A serum tryptase level was sent in only 49% of cases, and 41% of levels were positive, an overall positive rate of 20% of cases. Following instances of hemodynamically significant anaphylaxis, only 29% of patients were seen and evaluated by an allergist at our institution. Hemodynamically significant anaphylaxis is a rare complication of

  6. Anaphylaxis treatment: ergonomics of epinephrine autoinjector design.

    PubMed

    Dennerlein, Jack T

    2014-01-01

    Epinephrine administration is a critical component of individualized emergency action plans for patients at risk for anaphylaxis. Fundamental ergonomic principles can be used to facilitate rapid and effective use of an epinephrine autoinjector when appropriate. Specific patient characteristics, including age and strength, that impact physical and cognitive capabilities, should be considered when choosing an epinephrine autoinjector. Considerations in the optimal functioning of an autoinjector include the device being portable, identifiable, safe, and effective. Size, shape, coloring, and labeling of the device all contribute to the device being portable and identifiable. Trigger-lock features, designs resistant to physical perturbations, and safety technology to prevent injury after use contribute to safety and reliability. Optimal grip designs, tailored in size and/or shape to specific patient types, contribute to reliability and effectiveness. After selection of the most appropriate autoinjector, hands-on training, practice, and drills should be implemented. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Primary school teachers' knowledge about and attitudes toward anaphylaxis.

    PubMed

    Ercan, Hulya; Ozen, Ahmet; Karatepe, Hande; Berber, Mustafa; Cengizlier, Reha

    2012-08-01

    One in 10,000 children experiences an anaphylactic attack, every year. It has been demonstrated that 82% of these attacks occur in children of school age and that most of the attack-related deaths have occurred in schools. In this study, we aimed to investigate primary school teachers' knowledge about and attitudes toward anaphylaxis. A total of 237 teachers were questioned: 91 working in elementary state schools and 146 in private schools. A questionnaire was completed to obtain data on their knowledge of anaphylaxis and the availability of emergency treatment facilities in schools. Fifty-two percent of the teachers knew which students had an allergic disease. When questioned about agents that can potentially cause anaphylaxis, the most significant causes were thought to be pollen by 54% of the teachers, food by 47%, mites by 40%, and drugs by 30%. Of foods, eggs (30.4%) and strawberries (25.3%) were thought to be the two leading causes. The teachers' responses on what would be their initial reaction in the event of an anaphylactic reaction were: he/she would give first aid in 24.3%, notify the school nurse in 39.7%, and call the emergency services in 19.8%. Only 10% were aware of an epinephrine autoinjector, and only 4% knew where to apply it. While 28% of the teachers reported that they had been informed about anaphylaxis previously, most had formed their ideas from brochures or the media. While 25% of the teachers knew all of the symptoms of anaphylaxis, 54% knew some, and 21% none. Only 6% of the teachers reported that there was a management plan for anaphylaxis in their schools. This study shows that primary school teachers are not well informed about anaphylaxis. Teachers should be given training on the subject, and there should be a re-evaluation of school and health policies with a wider global perspective. There is an urgent need to inquire into the allergy management plans and policies in schools and to develop teacher education organizations on the

  8. eGTTP - bridging distances with online training

    NASA Astrophysics Data System (ADS)

    Doran, Rosa

    2015-08-01

    The Galileo Teacher Training Program vision is to empower teachers on the use of modern tools and resources for astronomy education. Bringing modern astronomy to the hands of students all over the world represents much more than providing pieces of knowledge. It represents the construction of the building blocks of awareness about our place in the cosmos and our role as specie. In the era of fast track for information exchange, there are still some severe limitations on the provision of equal opportunities to all. Overcoming these limits is the goal of the eGTTP for Portuguese speaking countries. The aim of the project is to provide online training to teachers in the Portuguese speaking countries. With support from the Office of Astronomy for Development we are building experience on how to provide effective support to educators in several countries with different settings, experiences, barriers and needs. In this presentation we hope to share our success stories and set the road for a sustainable continuation of this effort.

  9. Identifying Training Needs of Novice Online English Language Tutors

    ERIC Educational Resources Information Center

    Rodriguez Buitrago, Carolina

    2013-01-01

    Online and blended learning are of growing interest in the English language learning community. In Colombia, national initiatives and policies promote online educational programs and online English courses specifically. As a result, new online tutors are constantly needed for new programs and courses offered by institutions as well as by private…

  10. Online colour training system for dental students: a comprehensive assessment of different training protocols.

    PubMed

    Liu, M; Chen, L; Liu, X; Yang, Y; Zheng, M; Tan, J

    2015-04-01

    The purpose of this study was to evaluate the training effect and to determine the optimal training protocol for a recently developed online colour training system. Seventy students participated in the evaluation. They first completed a baseline test with shade guides (SGT) and the training system (TST), and then trained with one of the three system training methods (Basic colour training for group E1, Vitapan Classical for E2, and Vitapan 3D-Master for E3) or shade guides (group C1) for 4 days. The control group (C2) received no training. The same test was performed after training and they finally completed a questionnaire. The correct matches after training increased in three experimental groups and group C1. Among experimental groups, the greatest improvement of correct matching number was achieved by group E3 (4·00 ± 1·88 in SGT, 4·29 ± 2·73 in TST), followed by E2 (2·29 ± 2·73 in SGT, 3·50 ± 3·03 in TST) and E1 (2·00 ± 2·60 in SGT, 1·93 ± 2·96 in TST). The difference between E3 and E1 was statistically significant (P = 0·036 in SGT, 0·026 in TST). The total average training time was shorter in group E2 (15·39 ± 4·22 min) and E3 (17·63 ± 5·22 min), with no significant difference between them. Subjective evaluations revealed that self-confidence in colour matching were improved greater in group C1 and E3. In conclusion, all tested sections of the system effectively improved students' colour-matching ability. Among system training methods, Vitapan 3D-Master showed the best performance; it enabled greater shade-matching improvement, it saved time and was superior in subjective evaluations. © 2014 John Wiley & Sons Ltd.

  11. Online training delivery in meteorological continued education and training: Eumetcal experiences & plans

    NASA Astrophysics Data System (ADS)

    Siili, Tero; Haga, Lisa; Neitiniemi-Upola, Leena

    2013-04-01

    Eumetcal is the Education and Training (E & T) project of EUMETNET - the collaboration organ­isation of European National Meteorological and Hydrological Services (NMHSs) - with emphasis on Computer Assisted Learning (CAL) from the project's inception in 2002. Finnish Meteorological Institute has been assigned to manage the Eumetcal project since the onset of the project's pilot phase. Participat­ing NMHSs cover most of Europe, their number exceeds 20 and the scales and scopes of their in-house E & T activities vary widely. Eumetcal also collaborates with a number of E & T organisations in Europe and worldwide. Eumetcal's target group includes the meteorological staff and E & T personnel of the participant NMHSs; the target group is hence geographically widely distributed. The subject matters covered include not only scientific and technical skills and competencies, but also other types of competen­cies relevant to NMHSs' staff. Eumetcal's goal and task is to supplement the E & T activities of the participants through collabora­tion and networking, both between project participants and with other E & T organisations. The project also utilises Information and Communications Technologies extensively in delivery of E & T events and materials: Eumetcal is a Virtual Training Organisation and emphasises online and blended E & T events. In the last five years the project has organised or contributed to at least 2-4 E & T events per year. This presentation a) gives an overview of the Eumetcal project and its place among meteorological E & T organisations in Europe and globally, as well as b) describes the E & T events the project has delivered or contributed to in the last years and plans to deliver in 2013. Emphasis will be on the online and blended events and lessons learned from designing and implementing these events and the benefits of using online training.

  12. Recognition, treatment, and prevention of anaphylaxis.

    PubMed

    Moore, Lindsey E; Kemp, Ann M; Kemp, Stephen F

    2015-05-01

    Anaphylaxis is an acute and potentially lethal multisystem allergic reaction that occurs in a variety of clinical scenarios and is almost unavoidable. Immunologic reactions to medications, foods, and insect stings cause most episodes, but virtually any substance capable of inducing systemic degranulation of mast cells and basophils can produce anaphylaxis. All health care professionals must be able to recognize anaphylaxis promptly, be prepared to treat it appropriately, and be able to provide preventive recommendations. Similarly, at-risk individuals must be prepared to self-treat anaphylaxis promptly if prevention fails. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Learning and Treatment of Anaphylaxis by Laypeople: A Simulation Study Using Pupilar Technology

    PubMed Central

    Fernandez-Mendez, Felipe; Barcala-Furelos, Roberto; Padron-Cabo, Alexis; Garcia-Magan, Carlos; Moure-Gonzalez, Jose; Contreras-Jordan, Onofre; Rodriguez-Nuñez, Antonio

    2017-01-01

    An anaphylactic shock is a time-critical emergency situation. The decision-making during emergencies is an important responsibility but difficult to study. Eye-tracking technology allows us to identify visual patterns involved in the decision-making. The aim of this pilot study was to evaluate two training models for the recognition and treatment of anaphylaxis by laypeople, based on expert assessment and eye-tracking technology. A cross-sectional quasi-experimental simulation study was made to evaluate the identification and treatment of anaphylaxis. 50 subjects were randomly assigned to four groups: three groups watching different training videos with content supervised by sanitary personnel and one control group who received face-to-face training during paediatric practice. To evaluate the learning, a simulation scenario represented by an anaphylaxis' victim was designed. A device capturing eye movement as well as expert valuation was used to evaluate the performance. The subjects that underwent paediatric face-to-face training achieved better and faster recognition of the anaphylaxis. They also used the adrenaline injector with better precision and less mistakes, and they needed a smaller number of visual fixations to recognise the anaphylaxis and to make the decision to inject epinephrine. Analysing the different video formats, mixed results were obtained. Therefore, they should be tested to evaluate their usability before implementation. PMID:28758128

  14. Utilization of Online Training for On-Site Clinical Supervisors: One University's Approach.

    ERIC Educational Resources Information Center

    Getz, Hildy G.; Schnurman-Crook, Abrina

    2001-01-01

    The need to train on-site clinical supervisors often clashes with the practicality of time constraints of a variety of counseling professionals, as well as a significant geographical separation. This article is an overview of how one university developed online training to provide supervision training to clinical supervisors unable to attend live…

  15. Anaphylaxis: guidelines from the European Academy of Allergy and Clinical Immunology.

    PubMed

    Muraro, A; Roberts, G; Worm, M; Bilò, M B; Brockow, K; Fernández Rivas, M; Santos, A F; Zolkipli, Z Q; Bellou, A; Beyer, K; Bindslev-Jensen, C; Cardona, V; Clark, A T; Demoly, P; Dubois, A E J; DunnGalvin, A; Eigenmann, P; Halken, S; Harada, L; Lack, G; Jutel, M; Niggemann, B; Ruëff, F; Timmermans, F; Vlieg-Boerstra, B J; Werfel, T; Dhami, S; Panesar, S; Akdis, C A; Sheikh, A

    2014-08-01

    Anaphylaxis is a clinical emergency, and all healthcare professionals should be familiar with its recognition and acute and ongoing management. These guidelines have been prepared by the European Academy of Allergy and Clinical Immunology (EAACI) Taskforce on Anaphylaxis. They aim to provide evidence-based recommendations for the recognition, risk factor assessment, and the management of patients who are at risk of, are experiencing, or have experienced anaphylaxis. While the primary audience is allergists, these guidelines are also relevant to all other healthcare professionals. The development of these guidelines has been underpinned by two systematic reviews of the literature, both on the epidemiology and on clinical management of anaphylaxis. Anaphylaxis is a potentially life-threatening condition whose clinical diagnosis is based on recognition of a constellation of presenting features. First-line treatment for anaphylaxis is intramuscular adrenaline. Useful second-line interventions may include removing the trigger where possible, calling for help, correct positioning of the patient, high-flow oxygen, intravenous fluids, inhaled short-acting bronchodilators, and nebulized adrenaline. Discharge arrangements should involve an assessment of the risk of further reactions, a management plan with an anaphylaxis emergency action plan, and, where appropriate, prescribing an adrenaline auto-injector. If an adrenaline auto-injector is prescribed, education on when and how to use the device should be provided. Specialist follow-up is essential to investigate possible triggers, to perform a comprehensive risk assessment, and to prevent future episodes by developing personalized risk reduction strategies including, where possible, commencing allergen immunotherapy. Training for the patient and all caregivers is essential. There are still many gaps in the evidence base for anaphylaxis. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Reducing Hospitalization Rates for Children With Anaphylaxis.

    PubMed

    Farbman, Karen S; Michelson, Kenneth A; Neuman, Mark I; Dribin, Timothy E; Schneider, Lynda C; Stack, Anne M

    2017-06-01

    Most children with anaphylaxis in the emergency department (ED) are hospitalized. Opportunities exist to safely reduce the hospitalization rate for children with anaphylaxis by decreasing unnecessary hospitalizations. A quality improvement (QI) intervention was conducted to improve care and reduce hospitalization rates for children with anaphylaxis. We used the Model for Improvement and began with development and implementation in 2011 of a locally developed evidence-based guideline based on national recommendations for the management of anaphylaxis. Guideline adoption and adherence were supported by interval reminders and feedback to providers. Patients from 2008 to 2014 diagnosed with anaphylaxis were identified, and statistical process control methods were used to evaluate change in hospitalization rates over time. The balancing measure was any return visit to the ED within 72 hours. To control for secular trends, hospitalization rates for anaphylaxis at 34 US children's hospitals over the same time period were analyzed. Over the study period, there were 1169 visits for children with anaphylaxis, of which 731 (62%) occurred after the QI implementation. The proportion of children hospitalized decreased from 54% to 36%, with no increase in the 72-hour ED revisit rate. The hospitalization rate across 34 other US pediatric hospitals remained static at 52% over the study period. We safely reduced unnecessary hospitalizations for children with anaphylaxis and sustained the change over 3 years by using a QI initiative that included evidence-based guideline development and implementation, reinforced by provider reminders and structured feedback. Copyright © 2017 by the American Academy of Pediatrics.

  17. Education and Training for On-Line Use of Data Bases

    ERIC Educational Resources Information Center

    Williams, Martha E.

    1977-01-01

    This paper discusses vehicles for education and training, tools and techniques for promotion, and details the information requirements of the processors, service managers, searchers, and end users of on-line data bases. (Author/KP)

  18. Recognition and management of food induced anaphylaxis

    PubMed Central

    Keet, Corinne

    2011-01-01

    Synopsis Food-induced anaphylactic reactions are common and increasing in frequency. Despite the existence of a consensus definition of anaphylaxis, many cases are missed, recommended treatments are not given and follow-up is inadequate. New aspects of its pathophysiology and causes, including atypical food-induced causes., are still being uncovered. Epinephrine remains the cornerstone for successfully treating anaphylaxis; H1 and H2 antihistamines, glucocorticoids and β-agonists are ancillary medications that may be used in some cases in addition to epinephrine. However, the added utility of these secondary medications in anaphylaxis has not been conclusively demonstrated. Early recognition of anaphylaxis, appropriate emergency treatment and follow-up, including prescription of self-injectable epinephrine, are essential to prevent death and significant morbidity from anaphylaxis. PMID:21453808

  19. What Is the Impact of Online Training in Mind-Body Skills?

    PubMed

    Kemper, Kathi J; Lynn, Joanne; Mahan, John D

    2015-10-01

    Mind-body skills (MBS) training is popular, but in-person training can be inconvenient and costly. We assessed the impact of online MBS training on clinicians' and trainees' stress, mindfulness, and confidence in providing calm, compassionate care. This was a prospective cohort trial. Trainees entering medical school; graduate programs in nursing, social work, and dietetics; and residencies in family medicine and pediatrics at a large Midwestern academic health center were invited to complete online surveys before and 12 weeks after enrolling in online elective integrative health courses on MBS training or not. The elective offered no course credit and had no mandated deadlines for completion. At baseline, the 60 who engaged in MBS training were similar to the 43 who did not in terms of profession, gender, perceived stress levels, mindfulness, resilience, and compassion. MBS participants engaged in a median of 3 of 12 available modules with a bimodal distribution peaking at 1 to 2 and 12 modules. Twelve weeks later, those who participated in MBS showed significantly greater improvements in measures of stress, mindfulness, and confidence in providing calm, compassionate care than those who did not. Online elective training offers a feasible strategy to improve mindfulness, stress, and confidence in providing calm, compassionate care. Additional studies are needed to determine the impact of required versus elective courses, the optimal dosage and content of training, and the costs and benefits of online versus in-person training. © The Author(s) 2015.

  20. Exploring the Acceptability of Online Learning for Continuous Professional Development at Kenya Medical Training Colleges

    ERIC Educational Resources Information Center

    Kyalo, Isaac William; Hopkins, Sandra

    2013-01-01

    This study explores the acceptance of online learning (OL) for continuous professional development among lecturers at Kenya Medical Training College in 2009. The large and multi-campus College faces logistical and cost challenges in ensuring that its 700 lecturing staff have access to continuous professional development. Online learning…

  1. Instructor Training and Instructional Design in Online Courses Using Group Work

    ERIC Educational Resources Information Center

    Gibson, Patricia K.

    2013-01-01

    The purpose of this exploratory multi-case study was to examine the role of instructional design and instructor training on student learning outcomes and student satisfaction within the online class using group work, a form of collaborative learning. Group work has been strongly recommended for online classes. Data allowing insight into…

  2. UCF's Support for Teaching and Learning Online: CD-ROM Development, Faculty Development, and Statewide Training.

    ERIC Educational Resources Information Center

    Truman-Davis, Barbara; Futch, Linda; Thompson, Kelvin; Yonekura, Francisca

    The University of Central Florida (UCF) has developed an award winning faculty development program providing experiential, collaborative learning for instructors to build online programs. A project is now underway to extend training throughout the state of Florida. Supporting students is also essential to the success of teaching online. The…

  3. Relating Training to Job Satisfaction: A Survey of Online Faculty Members

    ERIC Educational Resources Information Center

    Hoekstra, Brian

    2014-01-01

    The purpose of this study was to determine whether training affected the job satisfaction reported by online faculty members. A convenience sample of 492 Iowa Community College Online Consortium (ICCOC) faculty members were invited to participate in a quantitative survey, and 148 responded. Overall Job Satisfaction was operationalized through the…

  4. A Randomized-Controlled Trial of the Effects of Online Training on Implementation Fidelity

    ERIC Educational Resources Information Center

    Drake, Pamela M.; Firpo-Triplett, Regina; Glassman, Jill R.; Ong, Seow Ling; Unti, Lisa

    2015-01-01

    The effectiveness of evidence-based programs can be compromised if the program is not implemented with fidelity. This article describes the evaluation of an online training to improve implementation fidelity to an evidence-based HIV prevention curriculum, Reducing the Risk, through online skills-based instruction and support. Educators were…

  5. E-Business and Online Learning: Connections and Opportunities for Vocational Education and Training.

    ERIC Educational Resources Information Center

    Mitchell, John

    Australian vocational education and training (VET) providers show increasing interest in using electronic technology to provide online learning, student services, and business functions, according to a study that included a literature review, Internet search, interviews with organizations that use e-business models for online learning, analysis of…

  6. Online versus Face-to-Face Training of Critical Time Intervention: A Matching Cluster Randomized Trial

    ERIC Educational Resources Information Center

    Olivet, Jeffrey; Zerger, Suzanne; Greene, R. Neil; Kenney, Rachael R.; Herman, Daniel B.

    2016-01-01

    This study examined the effectiveness of online education to providers who serve people experiencing homelessness, comparing online and face-to-face training of Critical Time Intervention (CTI), an evidence-based case management model. The authors recruited 184 staff from nineteen homeless service agencies to participate in one of two training…

  7. From E-Training to E-Performance: Putting Online Learning To Work.

    ERIC Educational Resources Information Center

    Bernardez, Mariano

    2003-01-01

    Discusses corporate electronic learning and describes three different operative and business paradigms: electronic training, that replaces face-to-face interaction and reduces costs; electronic learning, that measures learning outcomes and considers technological barriers, learning to learn online, and installing an online culture; and electronic…

  8. Digital Learning in Higher Education: A Training Course for Teaching Online--Universidade Aberta, Portugal

    ERIC Educational Resources Information Center

    Moreira, José António; José António, Susana; Goulão, Maria de Fátima; Barros, Daniela

    2017-01-01

    This paper uses qualitative evidence to describe, explore and discuss the progress of the online teaching training course taught at the Universidade Aberta to Portuguese and foreign professors of higher education institutions. As this is an entirely online course, its pedagogical design results from the combination of the basics of open distance…

  9. Instructor Training and Instructional Design in Online Courses Using Group Work

    ERIC Educational Resources Information Center

    Gibson, Patricia K.

    2013-01-01

    The purpose of this exploratory multi-case study was to examine the role of instructional design and instructor training on student learning outcomes and student satisfaction within the online class using group work, a form of collaborative learning. Group work has been strongly recommended for online classes. Data allowing insight into…

  10. CLSI On-Line Public Catalog Keyboard Terminal Manual: Training Manual.

    ERIC Educational Resources Information Center

    California State Univ., Chico.

    This training manual developed by the Public Access Subcommittee of the Reference Department of Meriam Library (California State University, Chico) provides instructions for using the library's online public catalog by means of a keyboard terminal. An introduction describes the Boolean searching capability of the online catalog and gives examples…

  11. CLSI On-Line Public Catalog Keyboard Terminal Manual: Training Manual.

    ERIC Educational Resources Information Center

    California State Univ., Chico.

    This training manual developed by the Public Access Subcommittee of the Reference Department of Meriam Library (California State University, Chico) provides instructions for using the library's online public catalog by means of a keyboard terminal. An introduction describes the Boolean searching capability of the online catalog and gives examples…

  12. E-Business and Online Learning: Connections and Opportunities for Vocational Education and Training.

    ERIC Educational Resources Information Center

    Mitchell, John

    Australian vocational education and training (VET) providers show increasing interest in using electronic technology to provide online learning, student services, and business functions, according to a study that included a literature review, Internet search, interviews with organizations that use e-business models for online learning, analysis of…

  13. Online versus Face-to-Face Training of Critical Time Intervention: A Matching Cluster Randomized Trial

    ERIC Educational Resources Information Center

    Olivet, Jeffrey; Zerger, Suzanne; Greene, R. Neil; Kenney, Rachael R.; Herman, Daniel B.

    2016-01-01

    This study examined the effectiveness of online education to providers who serve people experiencing homelessness, comparing online and face-to-face training of Critical Time Intervention (CTI), an evidence-based case management model. The authors recruited 184 staff from nineteen homeless service agencies to participate in one of two training…

  14. Mandatory Online Training: Transmissive Learning, Issues of Abuse and Hidden Agendas

    ERIC Educational Resources Information Center

    Barratt-Pugh, Llandis; Bahn, Susanne; Scholz, Alex

    2011-01-01

    This paper is based on two studies of mandatory online learning which although unrelated and conducted eight years apart nevertheless provide an illuminating comparison of mandatory training delivered online. The first study was carried out in 2002 in a state government department and the second in 2010 with the commercial construction industry,…

  15. Anaphylaxis in referred pediatric patients: demographic and clinical features, triggers, and therapeutic approach.

    PubMed

    De Swert, Liliane F A; Bullens, Dominique; Raes, Marc; Dermaux, Anna-Maria

    2008-11-01

    Anaphylaxis remains under-diagnosed and under-treated. A better knowledge of patterns and triggers of anaphylaxis might contribute to a better management. In this study we evaluated the demographic and clinical features of anaphylaxis in pediatric patients, as well as its triggers and therapeutic approach. From May 1st 2004 until April 30th 2006 we prospectively collected data on all patients referred for investigation of anaphylaxis to the pediatric department of the University Hospital Gasthuisberg Leuven and to two private pediatric practices. Data were stored in a MYSQL database by use of an online encrypted web form. Sixty-four cases of anaphylaxis occurred in 48 children, aged 6 months to 14.8 years. Twenty-seven episodes (42.2%) occurred at home. The symptoms were dermatologic in 62 (96.9%) episodes, respiratory in 57 (89.1%), gastrointestinal in 19 (29.7%), cardiovascular in 14 (21.8%), and neurological or behavioural in 19 (29.7%). Antihistamines were administered in 41/57 (71.9%) cases, corticosteroids in 26/57 (45.6%), beta-2-mimetics in 14/57 (24.6%), and adrenaline in 11/57 (19.3%). Out of nine cases where Epipen was available at the moment of anaphylaxis, it was administered in one case only. Food was the cause of anaphylaxis in 42/55 (76.4%) cases with identified trigger, while medication, insect stings, latex, and birch pollen triggered 5 (9.1%), 4 (7.3%), 3 (5.5%), and 1 (1.8%) case(s), respectively. Allergy to the trigger was known prior to anaphylaxis in 19/55 (34.5%) cases. In conclusion, anaphylaxis in pediatric patients generally presents with dermatologic and respiratory symptoms, while in 1/5 episodes cardiovascular symptoms occur. Food is by far the most frequent trigger. Allergy to the trigger is known in 1/3 cases only. Anaphylaxis is under-treated, even when appropriate medication is available.

  16. Comparing Attitudes of Online Instructors and Online College Students: Quantitative Results for Training, Evaluation and Administration

    ERIC Educational Resources Information Center

    Eskey, Michael T.; Schulte, Marthann

    2012-01-01

    The past decade has witnessed an explosion in online learning opportunities for post-secondary students throughout the United States. The university has developed a Faculty Online Observation (FOO) model to allow for an annual observation of online adjunct faculty with a focus on five major areas of facilitation. To test the effectiveness and…

  17. Idiopathic cold urticaria and anaphylaxis.

    PubMed

    Işk, Sakine; Arkan-Ayyldz, Zeynep; Sozmen, Sule Caglayan; Karaman, Özkan; Uzuner, Nevin

    2014-01-01

    Cold urticaria (CU) is a subtype of physical urticaria characterized by the development of urticaria and angioedema after cold exposure. Symptoms typically occur minutes after skin exposure to cold air, liquids, and objects. Most common method to confirm the diagnosis of CU is through ice cube challenge test, but 20% of patients with CU have negative ice cube challenge test results. The greatest risk with this kind of urticaria is the development of systemic reaction resulting in a hemodynamic collapse during generalized cold exposure. We report a case of a patient who developed CU and anaphylaxis during swimming and diving in the sea.

  18. Online Distance Learning and Music Training: Benefits, Drawbacks and Challenges

    ERIC Educational Resources Information Center

    Koutsoupidou, Theano

    2014-01-01

    This study examines online distance learning (ODL) as applied in music and music education programmes at different educational levels with a special focus on the digital tools employed in such programmes. It aims to provide an up-to-date snapshot of the current online courses focusing on the potential benefits and drawbacks of ODL from the…

  19. Using Online Discussion Groups in a CALL Teacher Training Course

    ERIC Educational Resources Information Center

    Son, Jeong-Bae

    2006-01-01

    This paper reports the results of a study that examined an online discussion group established for a computer-assisted language learning (CALL) course and investigated patterns of interactions generated through the online discussion and participants' attitudes toward the computer-mediated communication (CMC) activity. The participants in the study…

  20. The Evolution of Peer Driven Training for Teaching Online Courses

    ERIC Educational Resources Information Center

    Shapiro, Peter J.

    2006-01-01

    Online courses at Bergen Community College (BCC) began in the late 1990's with an imperative from the college President to develop online courses. Senior faculty members who dared to experiment with this new mode of teaching had to learn how to design a course and how to use WebCT, a new course management system, on their own. As these faculty…

  1. Online Leader Training Course: Nebraska Equine Extension Leader Certification

    ERIC Educational Resources Information Center

    Cottle, Lena; D'Angelo, Nicole

    2015-01-01

    The Nebraska Equine Advancement Level Leader Certification Program is an online learning tool that clarifies principles of the Nebraska 4-H Equine Advancement Programs. Through an online Moodle course through eXtension.org, 4-H leaders and Extension educators are able to fulfill the certification requirement from any location before allowing youth…

  2. Online Leader Training Course: Nebraska Equine Extension Leader Certification

    ERIC Educational Resources Information Center

    Cottle, Lena; D'Angelo, Nicole

    2015-01-01

    The Nebraska Equine Advancement Level Leader Certification Program is an online learning tool that clarifies principles of the Nebraska 4-H Equine Advancement Programs. Through an online Moodle course through eXtension.org, 4-H leaders and Extension educators are able to fulfill the certification requirement from any location before allowing youth…

  3. The Evolution of Peer Driven Training for Teaching Online Courses

    ERIC Educational Resources Information Center

    Shapiro, Peter J.

    2006-01-01

    Online courses at Bergen Community College (BCC) began in the late 1990's with an imperative from the college President to develop online courses. Senior faculty members who dared to experiment with this new mode of teaching had to learn how to design a course and how to use WebCT, a new course management system, on their own. As these faculty…

  4. Online Distance Learning and Music Training: Benefits, Drawbacks and Challenges

    ERIC Educational Resources Information Center

    Koutsoupidou, Theano

    2014-01-01

    This study examines online distance learning (ODL) as applied in music and music education programmes at different educational levels with a special focus on the digital tools employed in such programmes. It aims to provide an up-to-date snapshot of the current online courses focusing on the potential benefits and drawbacks of ODL from the…

  5. Serious Shortcomings in the Management of Children with Anaphylaxis in Scottish Schools

    PubMed Central

    Rankin, Kirsty E; Sheikh, Aziz

    2006-01-01

    Background The United Kingdom incidence of anaphylaxis has increased very sharply over the last decade, with the highest rates of hospital admissions occurring in school-aged children. This raises concerns about the extent to which schools are aware of approaches to the prevention and treatment of anaphylaxis. Methods and Findings We undertook a national postal survey of 250 Scottish schools enquiring about approaches to managing children considered to be at risk of anaphylaxis. We obtained responses from 148 (60%) schools, 90 (61%) of which reported having at least one at risk child. Most (80%) schools with children considered to be at risk reported having personalised care plans and invariably reported having at least one member of staff trained in the emergency treatment of anaphylaxis. Access to adrenaline was available on-site in 97% of these schools. However, significantly fewer schools without children considered to be at risk reported having a trained member of staff (48%, p < 0.001), with access to adrenaline being very poor (12%, p < 0.001). Overall, 59% of respondents did not feel confident in their school's ability to respond in an emergency situation. Conclusions Most schools with children considered to be at risk of anaphylaxis report using personal care plans and having a member of staff trained in the use of, and with access to, adrenaline. The picture is, however, less encouraging in schools without known at risk children, both in relation to staff training and access to adrenaline. The majority of schools with at risk children have poorly developed strategies for preventing food-triggered anaphylaxis reactions. There is a need for detailed national guidelines for all schools, which the Scottish Executive must now ensure are developed and implemented. PMID:16933965

  6. Measuring local anaphylaxis in mice.

    PubMed

    Evans, Holly; Killoran, Kristin E; Mitre, Edward

    2014-10-14

    Allergic responses are the result of the activation of mast cells and basophils, and the subsequent release of vasoactive and proinflammatory mediators. Exposure to an allergen in a sensitized individual can result in clinical symptoms that vary from minor erythema to life threatening anaphylaxis. In the laboratory, various animal models have been developed to understand the mechanisms driving allergic responses. Herein, we describe a detailed method for measuring changes in vascular permeability to quantify localized allergic responses. The local anaphylaxis assay was first reported in the 1920s, and has been adapted from the technique published by Kojima et al. in 2007(1). In this assay, mice sensitized to OVA are challenged in the left ear with vehicle and in the right ear with OVA. This is followed by an intravenous injection of Evans Blue dye. Ten min after injecting Evans Blue, the animal is euthanized and the dye that has extravasated into the ears is extracted overnight in formamide. The absorbance of the extracted dye is then quantified with a spectrophotometer. This method reliably results in a visual and quantifiable manifestation of a local allergic response.

  7. [Anaphylaxis in children: What pediatricians should know].

    PubMed

    Pouessel, G; Deschildre, A

    2016-12-01

    Anaphylaxis is a severe potentially life-threatening allergic emergency that has been increasing over the last two decades, especially in young children. Anaphylaxis deaths remain rare, in particular in children, and their frequency is stable during this period. Food is the main anaphylaxis trigger in children, notably to cow's milk, peanuts, and tree nuts. In infants, the recognition of anaphylaxis may be difficult. Vomiting, urticaria, and laryngeal edema are more frequent at this age. Cardiovascular involvement is rare, most often encountered in adolescence. A history of asthma or atopy, allergy to particular foods such as peanuts and tree nuts, and adolescence are some risk factors for anaphylaxis and more severe reactions. First-line treatment is intramuscular adrenaline for all patients experiencing anaphylaxis. There are no absolute contra-indications. Guidelines for the prescription of the adrenaline auto-injector and for establishing a personalized care project in allergic children at school have recently been updated. Recognition of anaphylaxis and treatment should also be improved. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  8. Mechanisms of Anaphylaxis Beyond IgE.

    PubMed

    Muñoz-Cano, R; Picado, C; Valero, A; Bartra, J

    2016-01-01

    Anaphylaxis is an acute, life-threatening, multisystem syndrome resulting from the sudden release of mediators derived from mast cells and basophils. Food allergens are the main triggers of anaphylaxis, accounting for 33%-56% of all cases and up to 81% of cases of anaphylaxis in children. Human anaphylaxis is generally thought to be mediated by IgE, with mast cells and basophils as key players, although alternative mechanisms have been proposed. Neutrophils and macrophages have also been implicated in anaphylactic reactions, as have IgG-dependent, complement, and contact system activation. Not all allergic reactions are anaphylactic, and the presence of the so-called accompanying factors (cofactors or augmenting factors) may explain why some conditions lead to anaphylaxis, while in other cases the allergen elicits a milder reaction or is even tolerated. In the presence of these factors, allergic reactions may be induced at lower doses of allergen or become more severe. Cofactors are reported to be relevant in up to 30% of anaphylactic episodes. Nonsteroidal anti-inflammatory drugs and exercise are the best-documented cofactors, although estrogens, angiotensin-converting enzyme inhibitors, β-blockers, lipid-lowering drugs, and alcohol have also been involved. The mechanisms underlying anaphylaxis are complex and involve several interrelated pathways. Some of these pathways may be key to the development of anaphylaxis, while others may only modulate the severity of the reaction. An understanding of predisposing and augmenting factors could lead to the development of new prophylactic and therapeutic approaches.

  9. Anaphylaxis: a ten years inpatient retrospective study.

    PubMed

    Techapornroong, Malee; Akrawinthawong, Krittapoom; Cheungpasitporn, Wisit; Ruxrungtham, Kiat

    2010-12-01

    The actual incidence of anaphylaxis is unknown. Periodical study of the anaphylaxis in different countries will raise the awareness to improve further the prevention and care. To investigate anaphylaxis among inpatients in the previous decade, we conducted a retrospective study of adult patients between 1992 and 2001 at a tertiary care center in Bangkok. Of 448,211 admissions, 80 events of anaphylaxis in 79 patients (0.017%) were found. The incidence had increased from 2.6 to 46 per 100,000 inpatients. Mean age +/- SD was 36 +/- 16 years-old, with an equal male:female ratio. Drugs, mainly antibiotics and nonsteroidal anti-inflammatory agents, (48%) and food (31%) were the most common causes. Over-the-counter medication and multiple drug use were responsible for up to a half of the unspecified drug causes. There was no fatality. 84% received epinephrine, but in only 7% it was given intramuscularly. Fifteen cases (20%) had a history of prior anaphylaxis, nonetheless only one had received prefilled epinephrine. The rise in the incidence of anaphylaxis over the two decades of the study period is alarming. Raising the awareness of anaphylaxis management among healthcare providers and the public is warranted.

  10. Anaphylaxis: Recent advances in assessment and treatment.

    PubMed

    Simons, F Estelle R

    2009-10-01

    The incidence rate of anaphylaxis is increasing, particularly during the first 2 decades of life. Common triggers include foods, medications, and insect stings. Clinical diagnosis is based on a meticulous history of an exposure or event preceding characteristic symptoms and signs, sometimes but not always supported by a laboratory test such as an elevated serum total tryptase level. Physician-initiated investigation of patients with anaphylaxis whose symptoms and signs are atypical sometimes leads to important insights into previously unrecognized triggers and mechanisms. In idiopathic anaphylaxis, in which no trigger can be confirmed by means of skin testing or measurement of specific IgE, the possibility of mastocytosis or a clonal mast cell disorder must be considered in addition to the possibility of a previously unrecognized trigger. Long-term risk reduction in patients with anaphylaxis focuses on optimal management of relevant comorbidities such as asthma and other respiratory diseases, cardiovascular disease, and mastocytosis or a clonal mast cell disorder; avoidance of the relevant confirmed allergen trigger; and relevant immunomodulation such as medication desensitization, venom immunotherapy, and possibly in the future, immunotherapy with food. Emergency preparedness for recurrence of anaphylaxis in community settings includes having epinephrine (adrenaline) autoinjectors available, knowing when and how to use them, and having a written, personalized anaphylaxis emergency action plan and up-to-date medical identification. Randomized controlled trials of the pharmacologic interventions used in an acute anaphylaxis episode are needed.

  11. Anaphylaxis following quadrivalent human papillomavirus vaccination.

    PubMed

    Brotherton, Julia M L; Gold, Mike S; Kemp, Andrew S; McIntyre, Peter B; Burgess, Margaret A; Campbell-Lloyd, Sue

    2008-09-09

    In 2007, Australia implemented the National human papillomavirus (HPV) Vaccination Program, which provides quadrivalent HPV vaccine free to all women aged 12-26 years. Following notification of 7 presumptive cases of anaphylaxis in the state of New South Wales, Australia, we verified cases and compared the incidence of anaphylaxis following HPV vaccination to other vaccines in comparable settings. We contacted all patients with suspected anaphylaxis and obtained detailed histories from telephone interviews and a review of medical records. A multidisciplinary team determined whether each suspected case met the standardized Brighton definition. Some participants also received skin-prick allergy testing for common antigens and components of the HPV vaccine. Of 12 suspected cases, 8 were classified as anaphylaxis. Of these, 4 participants had negative skin-prick test results for intradermal Gardasil. From the 269 680 HPV vaccine doses administered in schools, 7 cases of anaphylaxis were identified, which represents an incidence rate of 2.6 per 100 000 doses (95% CI 1.0-5.3 per 100 000). In comparison, the rate of identified anaphylaxis was 0.1 per 100 000 doses (95% CI 0.003-0.7) for conjugated meningococcal C vaccination in a 2003 school-based program. Based on the number of confirmed cases, the estimated rate of anaphylaxis following quadrivalent HPV vaccine was significantly higher than identified in comparable school-based delivery of other vaccines. However, overall rates were very low and managed appropriately with no serious sequelae.

  12. Human IgE-independent systemic anaphylaxis.

    PubMed

    Finkelman, Fred D; Khodoun, Marat V; Strait, Richard

    2016-06-01

    Anaphylaxis is a rapidly developing, life-threatening, generalized or systemic allergic reaction that is classically elicited by antigen crosslinking of antigen-specific IgE bound to the high-affinity IgE receptor FcεRI on mast cells and basophils. This initiates signals that induce cellular degranulation with release and secretion of vasoactive mediators, enzymes, and cytokines. However, IgE-independent mechanisms of anaphylaxis have been clearly demonstrated in experimental animals. These include IgG-dependent anaphylaxis, which involves the triggering of mediator release by IgG/antigen complex crosslinking of FcγRs on macrophages, basophils, and neutrophils; anaphylaxis mediated by binding of the complement-derived peptides C3a and C5a to their receptors on mast cells, basophils, and other myeloid cells; and direct activation of mast cells by drugs that interact with receptors on these cells. Here we review the mechanisms involved in these IgE-independent forms of anaphylaxis and the clinical evidence for their human relevance. We conclude that this evidence supports the existence of all 3 IgE-independent mechanisms as important causes of human disease, although practical and ethical considerations preclude their demonstration to the degree of certainty possible with animal models. Furthermore, we cite evidence that different clinical situations can suggest different mechanisms as having a primal role in anaphylaxis and that IgE-dependent and distinct IgE-independent mechanisms can act together to increase anaphylaxis severity. As specific agents become available that can interfere with mechanisms involved in the different types of anaphylaxis, recognition of specific types of anaphylaxis is likely to become important for optimal prophylaxis and therapy. Published by Elsevier Inc.

  13. A Preliminary Evaluation of a Short Online Training Workshop for TPACK Development

    ERIC Educational Resources Information Center

    Alsofyani, Mohammed Modeef; bin Aris, Baharuddin; Eynon, Rebecca

    2013-01-01

    National plans in higher education institutions are being developed in various aspects of the academic world for technology integration. Short online training has the potential for accelerating and facilitating the implementation of those plans. So far, a little is known about the suitability of this mode of training for faculty members'…

  14. Basic Botany On-Line: A Training Tool for the Master Gardener Program.

    ERIC Educational Resources Information Center

    VanDerZanden, Ann Marie; Rost, Bob; Eckel, Rick

    2002-01-01

    A noncredit, online training module on botany was offered to participants in the Oregon Master Gardener program. The 48 participants felt the module was a useful training tool. They also noted that the convenience of completing the material at their own pace and during a time that fit into their schedule. (SK)

  15. A National Study of Training Content and Activities for Faculty Development for Online Teaching

    ERIC Educational Resources Information Center

    Meyer, Katrina A.; Murrell, Vicki S.

    2014-01-01

    This article presents the results of a national study of 39 higher education institutions that collected information about their practices for faculty development for online teaching and particularly the content and training activities used during 2011-2012. This study found that the most frequently offered training content (97% of the…

  16. Independence at the Terminal: Training Student End Users to Do Online Literature Searching.

    ERIC Educational Resources Information Center

    Friend, Linda

    1985-01-01

    Describes program of end user training designed to teach students rudiments of searching using Bibliographic Retrieval Service/After Dark. Results of participant responses to post-search questionnaire are reported, including suggestions of what to cover in basic training, problems of end users, and developing role of online searcher as consultant.…

  17. Basic Botany On-Line: A Training Tool for the Master Gardener Program.

    ERIC Educational Resources Information Center

    VanDerZanden, Ann Marie; Rost, Bob; Eckel, Rick

    2002-01-01

    A noncredit, online training module on botany was offered to participants in the Oregon Master Gardener program. The 48 participants felt the module was a useful training tool. They also noted that the convenience of completing the material at their own pace and during a time that fit into their schedule. (SK)

  18. Dispositional Employability and Online Training Purchase. Evidence from Employees' Behavior in Spain

    PubMed Central

    Torrent-Sellens, Joan; Ficapal-Cusí, Pilar; Boada-Grau, Joan

    2016-01-01

    This article explores the relationship between dispositional employability and online training purchase. Through a sample of 883 employees working for enterprises in Spain, and a using principal component analysis and binomial logit probabilistic models, the research revealed two main results. First, it was found that dispositional employability is characterized by five factors: “openness to changes at work,” “career motivation and work resilience,” “work and career proactivity,” “optimism and engagement at work,” and “work identity.” Second, the research also found a double causality in the relationship analysis between dispositional employability and online training purchase. However, this causality is not direct. In explaining dispositional employability, certain motivations and types of behavior of employees participating in online training are significant. In particular, greater sensitivity toward career-related personal empowerment, a greater predisposition toward developing new experiences at work, and a greater awareness of the fact that positive job outcomes are related to preparation conscientiousness. In explaining online training purchase, employees who are more motivated and who better identify with their jobs are more likely to pay. Moreover, employees who spend more time on training and have less contact with new trends in their jobs, find it hard to keep calm in difficult situations, and have a greater predisposition toward effort, and preference for novelty, variety and challenges at work are more likely to purchase online training. PMID:27313557

  19. Dispositional Employability and Online Training Purchase. Evidence from Employees' Behavior in Spain.

    PubMed

    Torrent-Sellens, Joan; Ficapal-Cusí, Pilar; Boada-Grau, Joan

    2016-01-01

    This article explores the relationship between dispositional employability and online training purchase. Through a sample of 883 employees working for enterprises in Spain, and a using principal component analysis and binomial logit probabilistic models, the research revealed two main results. First, it was found that dispositional employability is characterized by five factors: "openness to changes at work," "career motivation and work resilience," "work and career proactivity," "optimism and engagement at work," and "work identity." Second, the research also found a double causality in the relationship analysis between dispositional employability and online training purchase. However, this causality is not direct. In explaining dispositional employability, certain motivations and types of behavior of employees participating in online training are significant. In particular, greater sensitivity toward career-related personal empowerment, a greater predisposition toward developing new experiences at work, and a greater awareness of the fact that positive job outcomes are related to preparation conscientiousness. In explaining online training purchase, employees who are more motivated and who better identify with their jobs are more likely to pay. Moreover, employees who spend more time on training and have less contact with new trends in their jobs, find it hard to keep calm in difficult situations, and have a greater predisposition toward effort, and preference for novelty, variety and challenges at work are more likely to purchase online training.

  20. Training Substance Use Disorder Counselors in Cognitive Behavioral Therapy for Depression: Development and Initial Exploration of an Online Training Program.

    PubMed

    Curran, Geoffrey M; Woo, Stephanie M; Hepner, Kimberly A; Lai, Wen Pin; Kramer, Teresa L; Drummond, Karen L; Weingardt, Ken

    2015-11-01

    Evidence based psychotherapies (EBPs) remain underutilized. Models for EBP training and implementation that are cost-effective, minimally disruptive, and sufficiently flexible are needed. Internet-based technology is a promising platform, but questions remain about how this technology can address the barriers to implementation. We developed and examined the implementation of an online training for the Building Recovery by Improving Goals, Habits, and Thoughts (BRIGHT) intervention-a manualized, sixteen-session group depression treatment for individuals with substance use disorders (SUDs). We explored the feasibility of replacing in-person BRIGHT training with a self-paced, online training. A highly partnered and iterative process was followed to translate the written BRIGHT manual and associated didactic training materials into a media rich, interactive, and detailed (12-16 h) online training. Subsequently, 8 volunteer counselors across 7 Veterans' Affairs SUD programs completed the training. Semi-structured interviews focused on the counselors' experiences and their plans for implementing BRIGHT groups. A template approach, using a mixture of deductive and inductive coding, was used for data analyses. The most important barrier to completing training was a lack of protected time. Most counselors were not afforded protected time and reported a sometimes frustrating and fragmented training experience. Many used personal time at work and at home to complete the work. Facilitators to completing the training included positive reactions/attitudes towards the training modules, supervisor support, counselor dedication, and strong beliefs supporting providing services for depression. Many counselors were also concerned about the feasibility of fitting 16 group sessions (2h each) into their program's clinical schedule, but many had devised potential solutions or "work-arounds" to accommodate or approximate the recommended treatment course (e.g., using lunch times, reducing

  1. Comparing School Environments With and Without Legislation for the Prevention and Management of Anaphylaxis

    PubMed Central

    Cicutto, Lisa; Julien, Brianna; Li, Nancy Y.; Nguyen-Luu, Nha Uyen; Butler, Janice; Clarke, Ann; Elliott, Susan J.; Harada, Laurie; McGhan, Shawna; Stark, Donald; Vander Leek, Timothy K.; Waserman, Susan

    2011-01-01

    Background School personnel in contact with students with life-threatening allergies often lack necessary supports, creating a potentially dangerous situation. Sabrina’s Law, the first legislation in the world designed to protect such children, requires all Ontario public schools to have a plan to protect children at risk. Though it has captured international attention, the differences a legislative approach makes have not been identified. Our study compared the approaches to anaphylaxis prevention and management in schools with and without legislation. Methods Legislated (Ontario) and non-legislated (Alberta, British Columbia, Newfoundland and Labrador, and Quebec) environments were compared. School board anaphylaxis policies were assessed for consistency with Canadian anaphylaxis guidelines. Parents of at-risk children and school personnel were surveyed to determine their perspectives on school practices. School personnel’s EpiPen technique was assessed. Results Consistency of school board policies with anaphylaxis guidelines was significantly better in a legislated environment (p=0.009). Parents in a legislated environment reported more comprehensive anaphylaxis emergency forms (p< 0.001), while school personnel in non-legislated environments reported more comprehensive forms (p=0.004). Despite school personnel in both environments receiving EpiPen training (>80%), suboptimal technique was commonly observed. However, school personnel in the legislated environment had better technique (p < 0.001). Conclusion Our results suggest that school boards in legislated environments have made greater efforts to support students at-risk for anaphylaxis compared to non-legislated environments. However, significant gaps exist in both environments, especially with respect to EpiPen administration, content and distribution of anaphylaxis emergency forms, and awareness of school procedures by school personnel and parents. PMID:21951319

  2. Adrenaline in anaphylaxis treatment and self-administration: experience from an inner city emergency department.

    PubMed

    Mostmans, Y; Grosber, M; Blykers, M; Mols, P; Naeije, N; Gutermuth, J

    2017-03-01

    Anaphylaxis is a life-threatening emergency of which reliable epidemiological data are lacking. This study aimed to analyze how quickly patients presenting with anaphylaxis were treated in emergency and whether treatment followed the European Academy of Allergy and Clinical Immunology (EAACI) guidelines. Patient data were collected between April 2009 and April 2013. Emergency doctors completed a questionnaire for adult patients presenting at the emergency department (ED) of the St. Pierre hospital in Brussels with anaphylaxis. Inclusion criteria were based on the Sampson criteria of anaphylaxis. Data were analyzed using a Microsoft Excel database. About 0.04% (100/230878) of all emergency visits in adults presented with anaphylaxis. 64% of patients received their first medical help later than 30 min after symptom onset. 67% of patients received adrenaline, 85% oral antihistamines, and 89% received IV glucocorticosteroids. 46/100 patients were discharged directly from the ED, of which 87% received further medical prescriptions for self-administration: 67% corticosteroids, 83% antihistamines, and 9% intramuscular adrenaline. 74% were instructed to consult an allergologist for adequate diagnosis. 54/100 patients were hospitalized. The majority of patients were treated according to the EAACI guidelines for management of anaphylaxis, but only a minority received the recommended adrenaline auto-injector for self-administration at discharge. Because the majority of patients received medical help later than 30 min after symptom onset, adrenaline auto-injector prescription is a necessity. The low rate of doctors prescribing adrenaline auto-injectors in the ED setting underlines the need to train doctors of various backgrounds in prevention and treatment of anaphylaxis and the close collaboration with allergologists. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. A Security Framework for Online Distance Learning and Training.

    ERIC Educational Resources Information Center

    Furnell, S. M.; Onions, P. D.; Bleimann, U.; Gojny, U.; Knahl, M.; Roder, H. F.; Sanders, P. W.

    1998-01-01

    Presents a generic reference model for online distance learning and discusses security issues for each stage (enrollment, study, completion, termination, suspension). Discusses a security framework (authentication and accountability, access control, intrusion detection, network communications, nonrepudiation, learning resources provider…

  4. A Security Framework for Online Distance Learning and Training.

    ERIC Educational Resources Information Center

    Furnell, S. M.; Onions, P. D.; Bleimann, U.; Gojny, U.; Knahl, M.; Roder, H. F.; Sanders, P. W.

    1998-01-01

    Presents a generic reference model for online distance learning and discusses security issues for each stage (enrollment, study, completion, termination, suspension). Discusses a security framework (authentication and accountability, access control, intrusion detection, network communications, nonrepudiation, learning resources provider…

  5. Satellite Television and Training for On-line Computer Searching.

    ERIC Educational Resources Information Center

    Simmons, Peter

    1979-01-01

    Describes an eight-week continuing education program which used the Canadian Communications Technology Satellite to provide interactive educational television in the teaching of online computer retrieval techniques to librarians in remote areas. (FM)

  6. Satellite Television and Training for On-line Computer Searching.

    ERIC Educational Resources Information Center

    Simmons, Peter

    1979-01-01

    Describes an eight-week continuing education program which used the Canadian Communications Technology Satellite to provide interactive educational television in the teaching of online computer retrieval techniques to librarians in remote areas. (FM)

  7. A case of anaphylaxis to oral minocycline.

    PubMed

    Jang, Ji Woong; Bae, Yun-Jeong; Kim, Yong Giun; Jin, Young-Joo; Park, Kyung Sun; Cho, You Sook; Moon, Hee-Bom; Kim, Tae-Bum

    2010-08-01

    Minocycline is a semisynthetic tetracycline derivative that is often used in the treatment of acne vulgaris. To date, there has been only one case report of anaphylaxis to minocycline. We report here a case of anaphylaxis to oral minocycline. A 56-yr-old woman visited our hospital after three episodes of recurrent anaphylaxis. We performed an oral challenge test, the standard method for diagnosing drug allergies, with minocycline, one of the drugs she had taken previously. She developed urticaria, angioedema, nausea, vomiting, hypotension, and dyspnea within 4 min and was treated with intramuscular epinephrine, intravenous antihistamine and systemic corticosteroid. However, she presented similar symptoms at 50 min and at 110 min. In prescribing oral minocycline, physicians should consider the possibility of serious adverse reactions, such as anaphylaxis.

  8. Prevention of anaphylaxis in healthcare settings.

    PubMed

    Worth, Allison; Sheikh, Aziz

    2013-09-01

    In this paper, we review recent evidence on preventing anaphylaxis in healthcare settings and contexts where the risk of developing anaphylaxis is known to be increased. These include investigation units in which patients are undergoing challenge testing, outpatient clinics undertaking immunotherapy and vaccination, inpatient settings in which patients receive antibiotics, non-steroidal anti-inflammatory drugs, opiates and biological agents and operating theatres in which patients receive general anesthetics. Anaphylaxis may however develop unpredictably in any patient exposed to a wide range of drugs, food and other triggers (e.g., latex, iodinated contrast media and exercise), so it is important that all healthcare professionals and systems have effective, well-rehearsed protocols for risk assessment and management of this allergic emergency. Where available, we consider evidence for the effectiveness of interventions aiming to reduce the risk of developing anaphylaxis.

  9. Enhancing communication skills for pediatric visits through on-line training using video demonstrations.

    PubMed

    Kemper, Kathi J; Foy, Jane M; Wissow, Larry; Shore, Steve

    2008-02-11

    Training in communication skills for health professionals is important, but there are substantial barriers to individual in-person training for practicing clinicians. We evaluated the feasibility and desirability of on-line training and sought suggestions for future courses. Based on successful in-person curricula for communication skills and our previous on-line curricula, we created an on-line course consisting of 28 modules (4.75 hours CME credit) about communication skills during pediatric visits that included a mental health concern; each module included a brief case, a multiple choice question, an explanation, and a 1-2 minute video demonstrating key skills. Specific communication skills included: greeting, setting an agenda, discussing diagnosis and treatment, and managing negative interactions. The course was announced by emails in spring, 2007; the course was available on-line for 60 days; we aimed to enroll 50 clinicians. Outcomes were analyzed for those who evaluated the course within 75 days of its initial availability. Overall, 61 clinicians registered, of whom most were nurses (N = 24), physicians (N = 22), or psychologists or social workers (N = 12). Of the 36 (59%) clinicians who evaluated the course, over 85% agreed that all course objectives had been met; over 90% reported greater confidence in greetings and agenda-setting; and over 80% reported greater confidence in discussing diagnosis and treatment and managing negative interactions. Nearly all, 97% would recommend the course to other clinicians and trainees. Suggestions for improvement included a library of additional video vignettes and written materials to accompany the on-line training. On-line training in communication skills for pediatric mental health visits is feasible, desirable and associated with increased confidence in key skills. Positive feedback from clinicians suggests that a comparison of on-line versus in-person training is warranted.

  10. Anaphylaxis

    MedlinePlus

    ... After being exposed to a substance such as bee sting venom, the person's immune system becomes sensitized ... person. If the allergic reaction is from a bee sting, scrape the stinger off the skin with ...

  11. Anaphylaxis

    MedlinePlus

    ... peanuts), medications, and stinging insects. Other causes include exercise and exposure to latex. Sometimes no cause can be found. It can affect many organs: Skin - itching, hives, redness, swelling Nose - sneezing, stuffy nose, ...

  12. Anaphylaxis

    MedlinePlus

    ... themselves epinephrine if needed. The medicine comes in auto-injector syringes to make this easier. Epinephrine should ... any medicine, even aspirin and other nonsteroidal anti-inflammatory drugs, have the potential to cause severe reactions. ...

  13. Recognition and treatment of anaphylaxis in hospital.

    PubMed

    Jevon, Phil

    Anaphylaxis is a life-threatening, generalized or systemic hypersensitivity reaction characterized by rapidly developing airway, and/or breathing, and/or circulation compromise, usually associated with skin and mucosal changes. Summoning expert help, positioning the patient appropriately, administering high-flow oxygen, and administering adrenaline by intramuscular injection are the key initial treatment and management options. This article draws on the literature, including published guidelines, to discuss the recognition and treatment of anaphylaxis in hospital.

  14. Cholinergic urticaria and exercise-induced anaphylaxis.

    PubMed

    Montgomery, Stefan L

    2015-01-01

    In this article, we will present the physical manifestations of two similar conditions. The first is cholinergic urticaria. This is chronic urticaria precipitated by an elevated body temperature. The second is exercise-induced anaphylaxis. Anaphylaxis can be idiopathic, a result of a specific allergenic trigger (food, medication, or insect sting), or exercise induced. We will focus on the third subtype. We describe the causes, symptoms, pathophysiology, testing, treatment, and prognosis of these two conditions.

  15. [Emergency treatment and management of anaphylaxis].

    PubMed

    Brockow, K; Ring, J

    2013-02-01

    Anaphylaxis, the maximal manifestation of an immediate allergic reaction, is a life-threatening systemic reaction. The immediate therapy is chosen according to the clinical manifestations and new German guidelines are in preparation. Required measures include immediate removal of allergen, adequate positioning, assessment of severity and organ involvement and activation of emergency medical services. In anaphylaxis with primarily cardiovascular involvement, epinephrine is the treatment of choice and given together with volume substitution, oxygen, H(1)-antihistamines and corticosteroids. Obstruction of the airways is treated with intramuscular and inhaled epinephrine, or alternatively β(2)-sympathicomimetics, and oxygen. Abdominal or cutaneous involvement, such as generalized urticaria, usually can be treated with intravenous H(1)-antihistamines, glucocorticoids and surveillance. In patients with anaphylaxis, the elicitor of the reaction has to be diagnosed by allergy testing. Patients with sustained risk for anaphylaxis should receive a self-medication kit and should be educated about behavioral patterns needed for prophylaxis and therapy of anaphylactic reactions. Patient educational intervention increases knowledge about anaphylaxis, and practical competence and thus, is a basis of a successful management of anaphylaxis.

  16. Glucocorticoids for the treatment of anaphylaxis.

    PubMed

    Choo, Karen Jui Lin; Simons, F Estelle R; Sheikh, Aziz

    2010-03-17

    Anaphylaxis is a serious hypersensitivity reaction that is rapid in onset and may result in death. Anaphylaxis guidelines recommend glucocorticoids for the treatment of people experiencing anaphylaxis. We sought to assess the benefits and harms of glucocorticoid treatment during episodes of anaphylaxis. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2009, Issue 3), MEDLINE (Ovid) (1966 to September 2009), EMBASE (Ovid) (1988 to September 2009), CINAHL (EBSCOhost) (to September 2009) and The Science Citation Index Expanded (SCI-EXPANDED) (1945 to September 2009). We also searched the UK National Research Register and websites listing ongoing trials, and contacted international experts in anaphylaxis in an attempt to locate unpublished material. We included randomized and quasi-randomized controlled trials comparing glucocorticoids with any control (either placebo, adrenaline (epinephrine), an antihistamine, or any combination of these). Two authors independently assessed articles for inclusion. We found no studies that satisfied the inclusion criteria. We are, based on this review, unable to make any recommendations for the use of glucocorticoids in the treatment of anaphylaxis.

  17. [Approach and Registry of Anaphylaxis in Portugal].

    PubMed

    Mota, Inês; Pereira, Ana Margarida; Pereira, Celso; Tomaz, Elza; Ferreira, Manuel Branco; Sabino, Filipa; Coelho, Anabela; Santos, Anabela; Martins, Henrique; Morais-Almeida, Mário

    2015-01-01

    Anaphylaxis has a growing incidence, especially in children. It represents a medical emergency and its successful therapy depends on early and proper intervention. Intramuscular epinephrine, with dose adjustment according to weight and age, is the drug of choice for anaphylaxis treatment. After resolution of the acute reaction, the patient should be kept under clinical surveillance for 6 to 24 hours, due to possible biphasic reactions. Prescription of an epinephrine auto injectable device should be considered in all patients with diagnosed or suspected anaphylaxis; additionally these patients should always be referred to an Immunoallergy consultation, to perform adequate investigation and management in order to reduce future risk. All anaphylaxis episodes must be recorded in The Portuguese Catalogue of Allergies and other Adverse Reactions (Catálogo Português de Alergias e outras Reações Adversas, CPARA), which represents a fundamental tool to share clinical information within the Health System. The present manuscript intends to disclose the most recent Portuguese guidelines for the diagnosis and treatment of anaphylaxis, making its clinical approach more effective and homogeneous, and to promote the use of The Portuguese Catalogue of Allergies and other Adverse Reactions as an essential tool to register and share information on anaphylaxis in Portugal.

  18. Sugammadex and rocuronium-induced anaphylaxis.

    PubMed

    Takazawa, Tomonori; Mitsuhata, Hiromasa; Mertes, Paul Michel

    2016-04-01

    Perioperative anaphylaxis is a life-threatening clinical condition that is typically the result of drugs or substances used for anesthesia or surgery. The most common cause of anaphylaxis during anesthesia is reportedly neuromuscular blocking agents. Of the many muscle relaxants that are clinically available, rocuronium is becoming popular in many countries. Recent studies have demonstrated that succinylcholine (but also rocuronium use) is associated with a relatively high rate of IgE-mediated anaphylaxis compared with other muscle relaxant agents. Sugammadex is widely used for reversal of the effects of steroidal neuromuscular blocking agents, such as rocuronium and vecuronium. Confirmed cases of allergic reactions to clinical doses of sugammadex have also been recently reported. Given these circumstances, the number of cases of hypersensitivity to either sugammadex or rocuronium is likely to increase. Thus, anesthesiologists should be familiar with the epidemiology, mechanisms, and clinical presentations of anaphylaxis induced by these drugs. In this review, we focus on the diagnosis and treatment of anaphylaxis to sugammadex and neuromuscular blocking agents. Moreover, we discuss recent studies in this field, including the diagnostic utility of flow cytometry and improvement of rocuronium-induced anaphylaxis with the use of sugammadex.

  19. Effectiveness of online simulation training: Measuring faculty knowledge, perceptions, and intention to adopt.

    PubMed

    Kim, Sujeong; Park, Chang; O'Rourke, Jennifer

    2017-04-01

    Best practice standards of simulation recommend standardized simulation training for nursing faculty. Online training may offer an effective and more widely available alternative to in-person training. Using the Theory of Planned Behavior, this study evaluated the effectiveness of an online simulation training program, examining faculty's foundational knowledge of simulation as well as perceptions and intention to adopt. One-group pretest-posttest design. A large school of nursing with a main campus and five regional campuses in the Midwestern United States. Convenience sample of 52 faculty participants. Knowledge of foundational simulation principles was measured by pre/post-training module quizzes. Perceptions and the intention to adopt simulation were measured using the Faculty Attitudes and Intent to Use Related to the Human Patient Simulator questionnaire. There was a significant improvement in faculty knowledge after training and observable improvements in attitudes. Attitudes significantly influenced the intention to adopt simulation (B=2.54, p<0.001). Online simulation training provides an effective alternative for training large numbers of nursing faculty who seek to implement best practice of standards within their institutions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Assess the impact of an online tobacco prevention training program on teachers and their students.

    PubMed

    Chen, W William; Sheu, Jiunn-Jye; Weng, Chung-Bang

    2013-01-01

    School-based tobacco prevention programs have been proven effective in reducing tobacco use. This evaluation aimed to assess the impact of an online tobacco prevention teacher training program on teachers and their students in Florida schools. A total of 344 teachers, including 72 K-3 grade teachers, 44 4th-5th grade teachers, and 228 6th-12th grade teachers completed the online training program and 323 (93.9%) were followed up to assess impacts on their 6,490 students. Results suggested that the online tobacco prevention education program for teachers was effective with high satisfaction and the impact on students was significant in improving knowledge and attitude about tobacco use and in increasing the proportion of 6-12th grade students who decided not to use tobacco. The evaluation study recommended the online education program be continued and expanded in the future.

  1. Acute Effects of Online Mind-Body Skills Training on Resilience, Mindfulness, and Empathy.

    PubMed

    Kemper, Kathi J; Khirallah, Michael

    2015-10-01

    Some studies have begun to show benefits of brief in-person mind-body skills training. We evaluated the effects of 1-hour online elective mind-body skills training for health professionals on mindfulness, resilience, and empathy. Between May and November, 2014, we described enrollees for the most popular 1-hour modules in a new online mind-body skills training program; compared enrollees' baseline stress and burnout to normative samples; and assessed acute changes in mindfulness, resilience, and empathy. The 513 enrollees included dietitians, nurses, physicians, social workers, clinical trainees, and health researchers; about 1/4 were trainees. The most popular modules were the following: Introduction to Stress, Resilience, and the Relaxation Response (n = 261); Autogenic Training (n = 250); Guided Imagery and Hypnosis for Pain, Insomnia, and Changing Habits (n = 112); Introduction to Mindfulness (n = 112); and Mindfulness in Daily Life (n = 102). Initially, most enrollees met threshold criteria for burnout and reported moderate to high stress levels. Completing 1-hour modules was associated with significant acute improvements in stress (P < .001), mindfulness (P < .001), empathy (P = .01), and resilience (P < .01). Online mind-body skills training reaches diverse, stressed health professionals and is associated with acute improvements in stress, mindfulness, empathy, and resilience. Additional research is warranted to compare the long-term cost-effectiveness of different doses of online and in-person mind-body skills training for health professionals. © The Author(s) 2015.

  2. The Physiotherapy eSkills Training Online resource improves performance of practical skills: a controlled trial.

    PubMed

    Preston, Elisabeth; Ada, Louise; Dean, Catherine M; Stanton, Rosalyn; Waddington, Gordon; Canning, Colleen

    2012-11-26

    E-learning is a common and popular mode of educational delivery, but little is known about its effectiveness in teaching practical skills. The aim of this study was to determine whether the Physiotherapy eSkills Training Online resource in addition to usual teaching improved the performance of practical skills in physiotherapy students. This study was a non-randomised controlled trial. The participants were graduate entry physiotherapy students enrolled in consecutive semesters of a neurological physiotherapy unit of study. The experimental group received the Physiotherapy eSkills Training Online resource as well as usual teaching. The Physiotherapy eSkills Training Online resource is an online resource incorporating (i) video-clips of patient-therapist simulations; (ii) supportive text describing the aim, rationale, equipment, key points, common errors and methods of progression; and (iii) a downloadable PDF document incorporating the online text information and a still image of the video-clip for each practical skill. The control group received usual teaching only. The primary outcomes were the overall performance of practical skills as well as their individual components, measured using a practical examination. The implementation of the Physiotherapy eSkills Training Online resource resulted in an increase of 1.6 out of 25 (95% CI -0.1 to 3.3) in the experimental group compared with the control group. In addition, the experimental group scored 0.5 points out of 4 (95% CI 0 to 1.1) higher than the control group for 'effectiveness of the practical skill' and 0.6 points out of 4 (95% CI 0.1 to 1.1) higher for 'rationale for the practical skill'. There was improvement in performance of practical skills in students who had access to the Physiotherapy eSkills Training Online resource in addition to usual teaching. Students considered the resource to be very useful for learning.

  3. EPA'S ON-LINE CALCULATORS AND TRAINING COURSE

    EPA Science Inventory

    EPA has developed a suite of on-line calculators called "OnSite" for assessing transport of environmental contaminants int the subsurface. The calculators are available on the Internet at http://www.epa.gov/athens/onsite, and are divided into four categories: Parameter Estimate...

  4. EPA'S ON-LINE CALCULATORS AND TRAINING COURSE

    EPA Science Inventory

    EPA has developed a suite of on-line calculators called "OnSite" for assessing transport of environmental contaminants int the subsurface. The calculators are available on the Internet at http://www.epa.gov/athens/onsite, and are divided into four categories: Parameter Estimate...

  5. Using Online Delivery for Workplace Training in Healthcare

    ERIC Educational Resources Information Center

    Bryce, Elizabeth; Choi, Peter; Landstrom, Margaret; LoChang, Justin

    2008-01-01

    The potential impact of on-line learning in health care is significant. By providing access to educational material from an internet-connected computer anytime and anywhere, healthcare workers (HCWs), whose workload demands are often changing and somewhat unpredictable, have increased ability to self-educate. For example, the growing recognition…

  6. Evaluation of an online training program in eating disorders for health professionals in Australia.

    PubMed

    Brownlow, Rachel S; Maguire, Sarah; O'Dell, Adrienne; Dias-da-Costa, Catia; Touyz, Stephen; Russell, Janice

    2015-01-01

    Early detection and treatment of eating disorders is instrumental in positive health outcomes for this serious public health concern. As such, workforce development in screening, diagnosis and early treatment of eating disorders is needed. Research has demonstrated both high rates of failure to accurately diagnose and treat cases early and low levels of perceived access to training in eating disorders by health professionals-representing an urgent need for clinician training in this area. However, significant barriers to the access of evidence-based training programs exist, including availability, cost and time, particularly when large geographic distances are involved. Online learning presents a solution to workforce challenges, as it can be delivered anywhere, at a fraction of the cost of traditional training, timing is user controlled, and a growing body of research is demonstrating it as effective as face-to-face training. The Centre for Eating and Dieting Disorders in Australia has developed an Online Training Program In Eating Disorders, to educate health professionals in the nature, identification, assessment and management of eating disorders. The aim of the current study was to evaluate the ability of this online learning course to improve clinician levels of knowledge, skill and confidence to treat eating disorders. As well as its effect on stigmatised beliefs about eating disorders known to effect treatment delivery. One-hundred-eighty-seven health professionals participated in the program. A pre training questionnaire and a post training evaluation examined participants' levels of knowledge, skill and confidence to treat eating disorders, as well attitudes and beliefs about people with eating disorders. Significant improvements in knowledge, skill, and confidence to treat eating disorders was found between pre and post program assessment in health professionals who completed the course, along with a significant decrease in stigmatised beliefs about

  7. Developing and testing an online breastfeeding training among undergraduate nursing students.

    PubMed

    Cianelli, Rosina; Villegas, Natalia; Azaiza, Khitam; Henderson, Shakira; Hooshmand, Mary; Peragallo, Nilda

    2015-01-01

    The benefits of breastfeeding for mothers and babies have been well documented in the scientific literature, with new evidence about the benefits continuing to emerge. The Surgeon General's call to action to support breastfeeding recommends mandatory breastfeeding education and training for all healthcare providers that deliver care to mothers and babies. The purpose of this study is to analyze the development of an online computer based breastfeeding training (BT) and the preliminary outcomes of this training. The development of this training included consultation with content and technology experts. The collection of preliminary outcomes related to breastfeeding knowledge data and evaluation of the online BT was pre and posttest study. Eighty six undergraduate nursing students completed the online BT using Blackboard Learn. The online component of the BT consisted of five modules with a combined length of approximately 16 hours. After the completion of the modules, the students increased their levels of knowledge related to breastfeeding and the majority believed that they were fully able to perform skills to support breastfeeding. The results of this study indicate that a successful BT for nursing students can be effectively designed, which can in the future be disseminated to other healthcare providers and students. In addition, this online BT was cost-efficient and effective in improving students' knowledge and skills to support breastfeeding.

  8. Developing and testing an online breastfeeding training among undergraduate nursing students

    PubMed Central

    Cianelli, Rosina; Villegas, Natalia; Azaiza, Khitam; Henderson, Shakira; Hooshmand, Mary; Peragallo, Nilda

    2016-01-01

    The benefits of breastfeeding for mothers and babies have been well documented in the scientific literature, with new evidence about the benefits continuing to emerge. The Surgeon General’s call to action to support breastfeeding recommends mandatory breastfeeding education and training for all healthcare providers that deliver care to mothers and babies. The purpose of this study is to analyze the development of an online computer based breastfeeding training (BT) and the preliminary outcomes of this training. The development of this training included consultation with content and technology experts. The collection of preliminary outcomes related to breastfeeding knowledge data and evaluation of the online BT was pre and posttest study. Eighty six undergraduate nursing students completed the online BT using Blackboard Learn. The online component of the BT consisted of five modules with a combined length of approximately 16 hours. After the completion of the modules, the students increased their levels of knowledge related to breastfeeding and the majority believed that they were fully able to perform skills to support breastfeeding. The results of this study indicate that a successful BT for nursing students can be effectively designed, which can in the future be disseminated to other healthcare providers and students. In addition, this online BT was cost-efficient and effective in improving students’ knowledge and skills to support breastfeeding. PMID:27766266

  9. Developing Asthma-Friendly Childcare Centers with Online Training and Evaluation.

    PubMed

    Nowakowski, Alexandra Catherine Hayes; Carretta, Henry Joseph; Pineda, Nicole; Dudley, Julie Kurlfink; Forrest, Jamie R

    2016-01-01

    In 2011, the Florida Asthma Coalition (FAC) began offering its Asthma-Friendly Childcare Center (AFCC) training online. This course teaches childcare center employees the fundamentals of effective asthma management. It covers basic asthma physiology, ways to recognize asthma attacks, techniques to help children experiencing attacks, and strategies to create healthy environments for asthmatics. A team of health services researchers evaluated both years of the online training. Evaluators used a quasi-experimental design with pretest, posttest, and follow-up assessment. Questions measured knowledge gain and retention, user satisfaction, and implementation of management strategies. Over 650 people from nearly all 67 Florida counties took AFCC training online between 2011 and 2013. Test scores improved by a minimum of 11% points in all program years evaluated. Gains in both knowledge and confidence were substantial and highly significant across years. While individual trainees did forget some content on follow-up, they seemed to retain the specific messages most relevant for their own workplaces. Most trainees also planned to implement multiple management strategies recommended by the training. A large majority of participants rated the training as excellent on all quality metrics, including relevance of content and time efficiency of the online format. Nearly all respondents perceived the training as useful for both providing improved care and fulfilling licensure or certification requirements. Many participants also indicated that their centers would pursue formal certification as AFCCs via the program offered by FAC. The online AFCC course performed strongly in its first years, yielding both high participant satisfaction and substantial improvement in workplace asthma management activity. This training holds promise for introducing and improving multidimensional asthma management strategies at childcare facilities nationwide.

  10. Teaching citizen science skills online: Implications for invasive species training programs

    USGS Publications Warehouse

    Newman, G.; Crall, A.; Laituri, M.; Graham, J.; Stohlgren, T.; Moore, J.C.; Kodrich, K.; Holfelder, K.A.

    2010-01-01

    Citizen science programs are emerging as an efficient way to increase data collection and help monitor invasive species. Effective invasive species monitoring requires rigid data quality assurances if expensive control efforts are to be guided by volunteer data. To achieve data quality, effective online training is needed to improve field skills and reach large numbers of remote sentinel volunteers critical to early detection and rapid response. The authors evaluated the effectiveness of online static and multimedia tutorials to teach citizen science volunteers (n = 54) how to identify invasive plants; establish monitoring plots; measure percent cover; and use Global Positioning System (GPS) units. Participants trained using static and multimedia tutorials provided less (p <.001) correct species identifications (63% and 67%) than did professionals (83%) across all species, but they did not differ (p =.125) between each other. However, their ability to identify conspicuous species was comparable to that of professionals. The variability in percent plant cover estimates between static (??10%) and multimedia (??13%) participants did not differ (p =.86 and.08, respectively) from those of professionals (??9%). Trained volunteers struggled with plot setup and GPS skills. Overall, the online approach used did not influence conferred field skills and abilities. Traditional or multimedia online training augmented with more rigorous, repeated, and hands-on, in-person training in specialized skills required for more difficult tasks will likely improve volunteer abilities, data quality, and overall program effectiveness. ?? Taylor & Francis Group, LLC.

  11. The effects of technical difficulties on learning and attrition during online training.

    PubMed

    Sitzmann, Traci; Ely, Katherine; Bell, Bradford S; Bauer, Kristina N

    2010-09-01

    Although online instruction has many potential benefits, technical difficulties are one drawback to the increased use of this medium. A repeated measures design was used to examine the effect that technical difficulties have on learning and attrition from voluntary online training. Adult learners (N = 530) were recruited online and volunteered to participate in a 4-hr training program on using computer spreadsheets. Technical difficulties were inserted in some of the training modules in the form of error messages. Using multilevel modeling, the results indicated that the presence of these technical difficulties impaired learning, such that test scores were lower in modules where trainees encountered technical difficulties than in modules where they did not encounter technical difficulties. Furthermore, the effect on learning was greater among trainees who eventually withdrew from the course than among trainees who completed the course. With regards to attrition, pretraining motivation provided a buffer against dropping out, especially when trainees encountered technical difficulties. Learning also predicted attrition from the subsequent module, such that attrition was higher among trainees with low test scores in the previous module. The current study disentangles some of the implications of technical difficulties and suggests that organizations should provide trainees with the technical support required to overcome technical difficulties in training. Furthermore, the findings contribute to our theoretical understanding of the implications of interruptions on performance in online training.

  12. Training end-users: An on-line help package

    SciTech Connect

    Waite, M.

    1992-03-01

    No matter how wonderful your INGRES application, if the end users don`t know how to use the application it will not be utilized. This paper discusses an on-line help package implemented in our manufacturing database application in order to help our user community use the application. The Materials Fabrication Division (MFD) of Mechanical Engineering is a series of machining shops that do production jobs for the Laboratory. The Fabrication Control System (FCS) is the user interface to an INGRES database. FCS tracks jobs as they traverse the machine shops and FCS maintains the employee payroll. This interface consists of VIFRED forms, menus and EQUEL Fortran code. The on-line help package is an interactive system that responds to the users ``single key stroke`` request for information. The information retrieved is based upon which help key is used and the form or menu from which the request is generated.

  13. A Structured Educational Curriculum Including Online Training Positively Impacts American Board of Surgery In-Training Examination Scores.

    PubMed

    Kelly, Dympna M; London, Daniel A; Siperstein, Allan; Fung, John J; Walsh, Matthew R

    2015-01-01

    To assess the effect of a structured postgraduate year 1 educational curriculum, including online surgical training, on American Board of Surgery In-Training Examination (ABSITE) scores. This was a retrospective cohort study. The study was performed in an academic surgical residency program in a tertiary care hospital, Cleveland Clinic Foundation, Cleveland, Ohio. The participants were 140 surgical postgraduate year 1 residents from 2000 to 2009. Interns from 2000 to 2004 were grouped together and completed a self-directed learning curriculum. Interns from 2005 to 2009 participated in a structured educational curriculum that included lectures and the use of an online program. Lectures were based on the American College of Surgeons curriculum. The online program consisted of 8 to 12 hours of assigned tutorials and quizzes that corresponded to the lectures and 3 multiple-choice (MC) examinations. Use of a structured educational curriculum led to improved ABSITE scores (66 ± 9%) compared with that of those who had no curriculum (55 ± 10%, p < 0.001). Several variables positively correlated with the ABSITE score: United States Medical Licensing Examination step 1 score (p < 0.001), monthly quiz scores (p = 0.003), average MC examination scores (p = 0.005), lecture attendance (p = 0.02), and time spent online (p = 0.04). Multivariable analysis demonstrated that the step 1 United States Medical Licensing Examination score, time spent online, and MC examination score are predictive of total the ABSITE score. When ABSITE subscores (basic science and clinical science) were compared, the online curriculum had a greater effect on basic science subscores, whereas lectures had a greater effect on clinical science subscores. Providing surgery residents a structured curriculum with lectures and an online component positively impacts ABSITE scores. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  14. Food anaphylaxis in antiphospholipid syndrome and thrombosis.

    PubMed

    Armentia, A; Mazón, A; Pineda, F; Palacios, R; Crespo, J; Inglada, L; Martín-Santos, J M; García-Frade, J; Martín-Armentia, B

    2011-01-01

    We have observed that some cases of food anaphylaxis were followed by severe thrombosis associated to anticardiolipin antibodies. Food anaphylaxis associated with antiphospholipid syndrome has seldom been published. The aims were: 1) to test anticardiolipin antibodies in an important number of patients with anaphylaxis due to vegetal foods and their relationship with possible thrombosis; and 2) to study seed and fruit hypersensitivity in patients with previous thrombotic events associated with antiphospholipid antibodies (aCL). We included 30 patients diagnosed of thrombosis associated with aCL, 52 patients who suffered from anaphylaxis due to seeds or fruits, and 120 control patients. Haematological, cardiopulmonary vascular and rheumatologic studies had been performed as needed. In vivo and in vitro allergy tests with a large battery of vegetal allergens were carried out in all the patients. Measurement of IgG aCL antibodies and specific IgE to vegetal food was done by ELISA and CAP-FEIA (Phadia). Immunodetection and inhibitions with lipoproteins belonging to seeds were performed. Seventy-five percent of the patients diagnosed as having antiphospholipid primary syndrome had specific IgE against different proteins from different vegetable allergens, most of them seeds, and clearly against lipoproteins that were also recognised by the patients with food anaphylaxis but not by the control cases. Among the patients with anaphylaxis, 28% had anticardiolipin antibodies and 17.3% thrombosis. Our study suggests that seed lipoproteins which cause severe food anaphylaxis might have a potential role in the antiphospholipid syndrome and related thrombosis. Copyright © 2010 SEICAP. Published by Elsevier Espana. All rights reserved.

  15. Online Public Health Preparedness Training Programs: An Evaluation of User Experience with the Technological Environment

    PubMed Central

    Nambisan, Priya

    2010-01-01

    Objectives: Several public health education programs and government agencies across the country have started offering virtual or online training programs in emergency preparedness for people who are likely to be involved in managing or responding to different types of emergency situations such as natural disasters, epidemics, bioterrorism, etc. While such online training programs are more convenient and cost-effective than traditional classroom-based programs, their success depends to a great extent on the underlying technological environment. Specifically, in an online technological environment, different types of user experiences come in to play—users’ utilitarian or pragmatic experience, their fun or hedonic experience, their social experience, and most importantly, their usability experience—and these different user experiences critically shape the program outcomes, including course completion rates. This study adopts a multi-disciplinary approach and draws on theories in human computer interaction, distance learning theories, usability research, and online consumer behavior to evaluate users’ experience with the technological environment of an online emergency preparedness training program and discusses its implications for the design of effective online training programs. . Methods: Data was collected using a questionnaire from 377 subjects who had registered for and participated in online public health preparedness training courses offered by a large public university in the Northeast. Results: Analysis of the data indicates that as predicted, participants had higher levels of pragmatic and usability experiences compared to their hedonic and sociability experiences. Results also indicate that people who experienced higher levels of pragmatic, hedonic, sociability and usability experiences were more likely to complete the course(s) they registered for compared to those who reported lower levels. Discussion: The study findings hold important

  16. Online public health preparedness training programs: an evaluation of user experience with the technological environment.

    PubMed

    Nambisan, Priya

    2010-01-01

    Several public health education programs and government agencies across the country have started offering virtual or online training programs in emergency preparedness for people who are likely to be involved in managing or responding to different types of emergency situations such as natural disasters, epidemics, bioterrorism, etc. While such online training programs are more convenient and cost-effective than traditional classroom-based programs, their success depends to a great extent on the underlying technological environment. Specifically, in an online technological environment, different types of user experiences come in to play-users' utilitarian or pragmatic experience, their fun or hedonic experience, their social experience, and most importantly, their usability experience-and these different user experiences critically shape the program outcomes, including course completion rates. This study adopts a multi-disciplinary approach and draws on theories in human computer interaction, distance learning theories, usability research, and online consumer behavior to evaluate users' experience with the technological environment of an online emergency preparedness training program and discusses its implications for the design of effective online training programs. . Data was collected using a questionnaire from 377 subjects who had registered for and participated in online public health preparedness training courses offered by a large public university in the Northeast. Analysis of the data indicates that as predicted, participants had higher levels of pragmatic and usability experiences compared to their hedonic and sociability experiences. Results also indicate that people who experienced higher levels of pragmatic, hedonic, sociability and usability experiences were more likely to complete the course(s) they registered for compared to those who reported lower levels. The study findings hold important implications for the design of effective online emergency

  17. Evaluating an Online Cognitive Training Platform for Older Adults: User Experience and Implementation Requirements.

    PubMed

    Haesner, Marten; Steinert, Anika; O'Sullivan, Julie Lorraine; Weichenberger, Markus

    2015-08-01

    Decline of cognitive function is a part of aging. However, intensive cognitive training can improve important cognitive functions, such as attention and working memory. Because existing systems are not older adult-friendly and are usually not based on scientific evidence, an online platform was developed for cognitive training with information and communication features and evaluated in an 8-week field test. In a randomized clinical trial with 80 older adults, findings from log data analysis and questionnaires revealed a good use of the online platform. Communication or assistive features were not used often. Good usability ratings were given to the cognitive exercises. Subjective improvements of cognitive functions due to the training were reported. The current article presents concrete requirements and recommendations for deploying cognitive training software in older adult residential homes. Copyright 2015, SLACK Incorporated.

  18. Online real AdaBoost with co-training for object tracking

    NASA Astrophysics Data System (ADS)

    Jin, Lizuo; Bian, Zhiguo; Li, Xiaobing; Pan, Hong; Xia, Siyu

    2009-10-01

    One of the major challenges of object tracking is to tackle appearance variations, possibly caused by the change of object postures, size, and occlusions. In this paper an adaptive tracking system is presented, which integrates online semisupervised classification and particle filter efficiently. To identify object pixels from background accurately, classifiers are trained online using real Adaboost which performs much better than its discrete version. In the system, uncorrelated features, color and texture are adopt to train two classifiers separately; the classifiers fused by voting generate confidence score for each pixel measuring its belonging to object or background in candidate regions; accumulated scores in each region are feed to particle filter for estimating object states; pixels with high scores augment the training set mutually and further classifiers are updated by co-training. The system is applied to vehicle and pedestrian tracking in real world scenarios and the experimental results show its robustness to large appearance variations and severe occlusions.

  19. Integration of Instructional Design Principles to Online Courses and Faculty Training in Three Puerto Rican Institutions of Higher Education

    ERIC Educational Resources Information Center

    Perez, Wanda W.

    2011-01-01

    Research on how the principles of instructional design are taught in faculty training courses for online teaching and how faculty members incorporate these principles into their online courses is limited. This gap in the research literature is especially pronounced when considering the relatively new online learning context of Puerto Rico's higher…

  20. Online Versus In-Person Screening, Brief Intervention, and Referral to Treatment Training in Pediatrics Residents

    PubMed Central

    Giudice, Erin L.; Lewin, Linda O.; Welsh, Christopher; Crouch, Taylor Berens; Wright, Katherine S.; Delahanty, Janine; DiClemente, Carlo C.

    2015-01-01

    Background Pediatricians underestimate the prevalence of substance misuse among children and adolescents and often fail to screen for and intervene in practice. The American Academy of Pediatrics recommends training in Screening, Brief Intervention, and Referral to Treatment (SBIRT), but training outcomes and skill acquisition are rarely assessed. Objective We compared the effects of online versus in-person SBIRT training on pediatrics residents' knowledge, attitudes, behaviors, and skills. Methods Forty pediatrics residents were randomized to receive either online or in-person training. Skills were assessed by pre- and posttraining standardized patient interviews that were coded for SBIRT-adherent and -nonadherent behaviors and global skills by 2 trained coders. Thirty-two residents also completed pre- and postsurveys of their substance use knowledge, attitudes, and behaviors (KABs). Two-way repeated measures multivariate analyses of variance (MANOVAs) and analyses of variance (ANOVAs) estimates were used to assess group differences in skill acquisition and KABs. Results Findings indicated that both groups demonstrated skill improvement from pre- to postassessment. Results indicated that both groups increased their knowledge, self-reported behaviors, confidence, and readiness with no significant between-group differences. Follow-up univariate analyses indicated that, while both groups increased their SBIRT-adherent skills, the online training group displayed more “undesirable” behaviors posttraining. Conclusions The current study indicates that brief training, online or in-person, can increase pediatrics residents' SBIRT skills, knowledge, self-reported behaviors, confidence, and readiness. The findings further indicate that in-person training may have incremental benefit in teaching residents what not to do. PMID:26217423

  1. [Suspected anaphylaxis by wound treatment with polyhexanide derivate wound products].

    PubMed

    Schrøder, Morten A; Kirketerp-Møller, Klaus; Winther, Lone

    2014-12-15

    Only four cases of anaphylaxis triggered by polyhexanide have been reported in the literature. We report a case of anaphylaxis in a Danish patient treated with polyhexanide derivate (Prontosan) wound products. We emphasise the importance of intramuscular injection of adrenaline as part of the treatment protocol in the initial phase of anaphylaxis and stress the importance of being aware of polyhexanide as a potential trigger of anaphylaxis.

  2. Professional Experiences of Online Teachers in Wisconsin: Results from a Survey about Training and Challenges. REL 2016-110

    ERIC Educational Resources Information Center

    Zweig, Jacqueline; Stafford, Erin; Clements, Margaret; Pazzaglia, Angela M.

    2015-01-01

    REL Midwest, in partnership with the Midwest Virtual Education Research Alliance, analyzed the results of a survey administered to Wisconsin Virtual School teachers about the training in which they participated related to online instruction, the challenges they encounter while teaching online, and the type of training they thought would help them…

  3. Anaphylaxis in children: clinical and allergologic features.

    PubMed

    Novembre, E; Cianferoni, A; Bernardini, R; Mugnaini, L; Caffarelli, C; Cavagni, G; Giovane, A; Vierucci, A

    1998-04-01

    Despite the importance of anaphylaxis, little information is available on its clinical features. To evaluate the clinical and allergologic features of anaphylaxis in children referred to the allergology and immunology unit of A. Meyer Children's Hospital (Florence, Italy) from 1994 to 1996. Ninety-five episodes of anaphylaxis occurred in 76 children (50 boys and 26 girls). Sixty-six children (87%) had only one episode of anaphylaxis, while 10 (13%) had two or more episodes. Sixty-two (82%) of the 76 patients had a personal history of atopic symptoms, although 14 (18%) did not. Sixty (79%) of the 76 children studied had at least one positive skin prick test to one or more of the common inhalant and/or food allergens. Children with venom-induced anaphylaxis usually had negative skin tests to the allergens tested. A younger age and eczema were more frequent among children with food-dependent anaphylaxis, whereas an older age together with urticaria-angioedema were common among those with exercise-induced anaphylaxis. The mean latent period (+/-SD) of the anaphylaxis episodes was 15.4 +/- 27.5 minutes. Skin and respiratory manifestations had an earlier onset and were more common than the gastrointestinal and cardiovascular ones. The most frequent clinical manifestation in children with food anaphylaxis was gastrointestinal symptoms, whereas cardiovascular symptoms were rare. The most probable causative agents in the 95 episodes described were foods (57%), drugs (11%), hymenoptera venom (12%), exercise (9%), additives (1%), specific immunotherapy (1%), latex (1%), and vaccines (2%), but in 6 cases (6%) the agent was never determined. Among the foods, seafood and milk were the most frequently involved. As for location, 57% of the anaphylactic events occurred in the home (54/95), 12% outdoors (11/95); 5% in restaurants (5/95); 3% in the doctor's office (3/95); 3% in hospitals (3/95); 3% on football fields (3/95); 2% on the beach (2/95); 1% in the gym (1/95); 1% at school

  4. [Anaphylaxis caused by royal jelly].

    PubMed

    Roger, A; Rubira, N; Nogueiras, C; Guspi, R; Baltasar, M; Cadahia, A

    1995-01-01

    Royal jelly is the food on which are fed and which causes them to develop into queen bees. It is claimed to have rejuvenating virtues for human beings. This report describes a 15-year-old atopic woman who presented, 15 minutes after the intake of royal jelly, local angioedema, generalised urticaria, dysphonia and bronchospasm. She was given antihistaminics and corticoesteroids and responded well. The ingested product contains royal jelly, lactose and potassium sorbate. No anaphylactic reactions to lactose and sorbates have been described previously. Prick test to common food allergens hymenoptera venoms and pollens were negative. RAST to meletin was also negative. Blood eosinophils were 600 and total IgE 465. Non-commercial prepared specific IgE to royal jelly was positive (0.8 KU/l). Prick by prick was positive to 1/10 dilution, being negative in controls (undiluted). No oral provocation test was performed due to the risk of anaphylaxis. No reported cases of royal jelly allergy were founded in a review of the medical literature. Concluding, it is the first described case of IgE anaphylactic reaction due to royal jelly.

  5. Vaccination and anaphylaxis: a forensic perspective

    PubMed Central

    Palmiere, Cristian; Tettamanti, Camilla; Scarpelli, Maria Pia

    2017-01-01

    Aim To review the available literature pertaining to fatalities following vaccine administration and, in particular, cases of vaccine-related fatal anaphylaxis. Method The MEDLINE database was systematically searched up to March 2016 to identify all relevant articles pertaining to fatal cases of anaphylaxis following vaccine administration. Results Six papers pertaining to fatal anaphylaxis following vaccination were found relevant. Mast cell tryptase and total IgE concentration was assessed exclusively in one case. Laryngeal edema was not detected in any of these cases, whereas eosinophil or mast cell infiltration was observed in lymphoid organs. In one case, immunohistochemical investigations using anti-tryptase antibodies allowed pulmonary mast cells and degranulating mast cells with tryptase-positive material outside to be identified. Conclusion In any suspected IgE-mediated fatal anaphylactic cases, biochemical investigations should be systematically performed for forensic purposes. Splenic tissue should be routinely sampled for immunohistochemical investigations in all suspected anaphylaxis-related deaths and mast cell/eosinophil infiltrations should be systematically sought out in the spleen, myocardium, and coronary artery wall. The hypothesis of fatal anaphylaxis following vaccination should be formulated exclusively when circumstantial data, available medical records, laboratory investigations, and autopsy or histology findings converge in a consistent pattern. The reasonable exclusion of alternative causes of death after all postmortem investigations is also imperative in order to establish or rule out a cause-and-effect relationship between vaccine administration and any presumptive temporarily-related death. PMID:28252871

  6. Enabling SMEs to Deliver Synchronous Online Training--Practical Guidelines

    ERIC Educational Resources Information Center

    Taran, Carmen

    2006-01-01

    Purpose: While synchronous and asynchronous distance education options have fulfilled the promise to reduce travel costs and decrease the number of human resources necessary for training delivery, many corporations are faced with the need to produce learning even at a faster pace in order to gain and sustain competitive advantage. This means a…

  7. Incentive Styles, Asynchronous Online Discussion, and Vocational Training

    ERIC Educational Resources Information Center

    Lin, Shinyi; Chiu, Chou-Kang

    2008-01-01

    Vocational education and training (VET) is intended to prepare adult learners for careers that are based on practical activities. With the underlying constructivist andragogy, this study intended to examine the effects of computer-mediated group collaboration in vocational education, and how that affects the associated learning outcomes. For…

  8. Incentive Styles, Asynchronous Online Discussion, and Vocational Training

    ERIC Educational Resources Information Center

    Lin, Shinyi; Chiu, Chou-Kang

    2008-01-01

    Vocational education and training (VET) is intended to prepare adult learners for careers that are based on practical activities. With the underlying constructivist andragogy, this study intended to examine the effects of computer-mediated group collaboration in vocational education, and how that affects the associated learning outcomes. For…

  9. On-line Naval Engineering Skills Supplemental Training Program

    DTIC Science & Technology

    2010-01-01

    systems such as Sharefast ( Kazuo Heikata, 2007) that highlight learning engineering design by workflow. Investigation into a partnership with an...Training and Development: http://www.astd.org/LC/2009/0809_kapp.htm Kazuo Heikata, H. Y. (2007). Design engineering Educational Framework Using

  10. Improving the Campus Climate for Students with Disabilities through the Use of Online Training

    ERIC Educational Resources Information Center

    Junco, Reynol; Salter, Daniel W.

    2004-01-01

    As one strategy to improve the campus climate for students with disabilities, the Project Opportunity and Access online training program was evaluated for its ability to change the attitudes of faculty and student affairs staff. The Attitudes Towards Disabled Persons Scale was used to measure attitudes towards individuals with disabilities.…

  11. Utilizing Online Training for Child Sexual Abuse Prevention: Benefits and Limitations

    ERIC Educational Resources Information Center

    Paranal, Rechelle; Thomas, Kiona Washington; Derrick, Christina

    2012-01-01

    The prevalence of child sexual abuse demands innovative approaches to prevent further victimization. The online environment provides new opportunities to expand existing child sexual abuse prevention trainings that target adult gatekeepers and allow for large scale interventions that are fiscally viable. This article discusses the benefits and…

  12. An Evaluation System for the Online Training Programs in Meteorology and Hydrology

    ERIC Educational Resources Information Center

    Wang, Yong; Zhi, Xiefei

    2009-01-01

    This paper studies the current evaluation system for the online training program in meteorology and hydrology. CIPP model that includes context evaluation, input evaluation, process evaluation and product evaluation differs from Kirkpatrick model including reactions evaluation, learning evaluation, transfer evaluation and results evaluation in…

  13. An Evaluation of a Training Program to Prepare Faculty for Online Instruction

    ERIC Educational Resources Information Center

    McGee-Swope, Kinyata

    2010-01-01

    The expansion of distance education makes it necessary for many faculty to take on the role of online instructor. As a result, higher education institutions face the challenge of training their faculty to make a shift from teaching in traditional to virtual environments. The Higher Learning Commission's Best Practices for Electronically Offered…

  14. Utilizing Online Training for Child Sexual Abuse Prevention: Benefits and Limitations

    ERIC Educational Resources Information Center

    Paranal, Rechelle; Thomas, Kiona Washington; Derrick, Christina

    2012-01-01

    The prevalence of child sexual abuse demands innovative approaches to prevent further victimization. The online environment provides new opportunities to expand existing child sexual abuse prevention trainings that target adult gatekeepers and allow for large scale interventions that are fiscally viable. This article discusses the benefits and…

  15. Investigating Real-Time Predictors of Engagement: Implications for Adaptive Video Games and Online Training

    ERIC Educational Resources Information Center

    Sharek, David J.

    2012-01-01

    Engagement is a worthwhile psychological construct to examine in the context of online training and video games. In this context, previous research suggests that the more engaged a person is, the more likely they are to experience overall positive affect while performing at a high level. This research builds on theories of engagement, Flow Theory,…

  16. A Preliminary Evaluation of Short Blended Online Training Workshop for TPACK Development Using Technology Acceptance Model

    ERIC Educational Resources Information Center

    Alsofyani, Mohammed Modeef; Aris, Baharuddin bin; Eynon, Rebecca; Majid, Norazman Abdul

    2012-01-01

    The use of Short Blended Online Training (SBOT) for the development of Technological Pedagogical and Content Knowledge (TPACK) is a promising approach to facilitate the use of e-learning by academics. Adult learners prefer the blend of pedagogies such as the presentation, demonstration, practice and feedback if they are structured and…

  17. Evaluating Online Instruction: Adapting a Training Model to E-Learning in Higher Education.

    ERIC Educational Resources Information Center

    Hallett, Karen; Essex, Christopher

    This paper presents a model for the evaluation of postsecondary online distance education courses and programs. To better address the unique nature and audience for these courses and programs, and the related institutional needs for assessing their success or failure, the focus is on a model from corporate training that provides a comprehensive,…

  18. Florida Public Health Training Center: Evidence-Based Online Mentor Program

    ERIC Educational Resources Information Center

    Frahm, Kathryn A.; Alsac-Seitz, Biray; Mescia, Nadine; Brown, Lisa M.; Hyer, Kathy; Liburd, Desiree; Rogoff, David P.; Troutman, Adewale

    2013-01-01

    This article describes an Online Mentor Program (OMP) designed to support and facilitate mentorships among and between Florida Department of Health (FDOH) employees and USF College of Public Health students using a Web-based portal. The Florida Public Health Training Center (FPHTC) at the University of South Florida (USF) College of Public Health…

  19. Supporting Online AP Students: The Rural Facilitator and Considerations for Training

    ERIC Educational Resources Information Center

    Hendrix, Nicole; Degner, Katherine

    2016-01-01

    Online courses supplemented by on-site facilitators help many rural students pursue advanced coursework, but research is warranted to better understand facilitator role and training needs. This study examined facilitation experiences, demographic characteristics, and professional development activities of rural on-site facilitators associated with…

  20. Investigating Real-Time Predictors of Engagement: Implications for Adaptive Video Games and Online Training

    ERIC Educational Resources Information Center

    Sharek, David J.

    2012-01-01

    Engagement is a worthwhile psychological construct to examine in the context of online training and video games. In this context, previous research suggests that the more engaged a person is, the more likely they are to experience overall positive affect while performing at a high level. This research builds on theories of engagement, Flow Theory,…

  1. Assess the Impact of an Online Tobacco Prevention Training Program on Teachers and Their Students

    ERIC Educational Resources Information Center

    Chen, W. William; Sheu, Jiunn-Jye; Weng, Chung-Bang

    2013-01-01

    School-based tobacco prevention programs have been proven effective in reducing tobacco use. This evaluation aimed to assess the impact of an online tobacco prevention teacher training program on teachers and their students in Florida schools. A total of 344 teachers, including 72 K-3 grade teachers, 44 4th-5th grade teachers, and 228 6th-12th…

  2. Assess the Impact of an Online Tobacco Prevention Training Program on Teachers and Their Students

    ERIC Educational Resources Information Center

    Chen, W. William; Sheu, Jiunn-Jye; Weng, Chung-Bang

    2013-01-01

    School-based tobacco prevention programs have been proven effective in reducing tobacco use. This evaluation aimed to assess the impact of an online tobacco prevention teacher training program on teachers and their students in Florida schools. A total of 344 teachers, including 72 K-3 grade teachers, 44 4th-5th grade teachers, and 228 6th-12th…

  3. Online Academic-Integrity Mastery Training May Improve Students' Awareness of, and Attitudes toward, Plagiarism

    ERIC Educational Resources Information Center

    Curtis, Guy J.; Gouldthorp, Bethanie; Thomas, Emma F.; O'Brien, Geraldine M.; Correia, Helen M.

    2013-01-01

    Some evidence has emerged in recent years that plagiarism can be reduced through the use of online mastery tests that are designed to train introductory psychology students in awareness of academic integrity and referencing conventions. Although these studies demonstrated a reduction in incidents of plagiarism they did not directly examine whether…

  4. Teachers' Views on the Potential Use of Online In-Service Education and Training Activities

    ERIC Educational Resources Information Center

    Kokoc, Mehmet; Ozlu, Aysenur; Cimer, Atilla; Karal, Hasan

    2011-01-01

    This study examined teacher's views on the potential use of online in-service education and training (INSET) activities. The study used a qualitative approach. A total of 13 in-service teachers from primary school, vocational school, science and art center, high school in Trabzon (on the Black Sea coast of Turkey) participated in the study. To…

  5. Online Academic-Integrity Mastery Training May Improve Students' Awareness of, and Attitudes toward, Plagiarism

    ERIC Educational Resources Information Center

    Curtis, Guy J.; Gouldthorp, Bethanie; Thomas, Emma F.; O'Brien, Geraldine M.; Correia, Helen M.

    2013-01-01

    Some evidence has emerged in recent years that plagiarism can be reduced through the use of online mastery tests that are designed to train introductory psychology students in awareness of academic integrity and referencing conventions. Although these studies demonstrated a reduction in incidents of plagiarism they did not directly examine whether…

  6. Does Powerful Language Training Affect Student Participation, Impression Formation, and Gender Communication in Online Discussions?

    ERIC Educational Resources Information Center

    Thomas, Crystal Ann

    2012-01-01

    The purpose of this dissertation was to investigate whether powerful language training affected student participation, impression formation, and gender communication style in online discussions. Powerful language was defined as a lack of the use of powerless language. Participants in this study were 507 freshmen taking a first-year college…

  7. Online Teacher Training in a Context of Forced Immobility: The Case of Gaza, Palestine

    ERIC Educational Resources Information Center

    Fassetta, Giovanna; Imperiale, Maria Grazia; Frimberger, Katja; Attia, Mariam; Al-Masri, Nazmi

    2017-01-01

    This article discusses an action research study that involved the design and delivery of an online training course for teachers of Arabic to speakers of other languages in the Gaza Strip (Palestine). Grounded in Freirean pedagogy, the course aimed to respond to the employment needs of university graduates by creating opportunities for online…

  8. All That Glitters Is Not Gold: Online Delivery of Education and Training. Review of Research.

    ERIC Educational Resources Information Center

    Brennan, Ros; McFadden, Mark; Law, Elizabeth

    This consolidation study concentrates on major questions about effectiveness of online delivery of education and training in Australia through the literature that describes effects of these new forms of delivery on the learner/user and provider/practitioner. Chapter 1 focuses on sources of data used in the literature review, defines online…

  9. Applying Multimedia Learning Theories to the Redesign of Residence Life Online Training Modules

    ERIC Educational Resources Information Center

    Kaliher, Licinia Barrueco

    2010-01-01

    The purpose of this Executive Position Paper (EPP) is to develop a model for improving the online training modules utilized by a mid-Atlantic Residence Life department. The complexity of the Residence Life staff positions, coupled with demands from other university departments and the need to provide as much information as possible, resulted in an…

  10. Florida Public Health Training Center: Evidence-Based Online Mentor Program

    ERIC Educational Resources Information Center

    Frahm, Kathryn A.; Alsac-Seitz, Biray; Mescia, Nadine; Brown, Lisa M.; Hyer, Kathy; Liburd, Desiree; Rogoff, David P.; Troutman, Adewale

    2013-01-01

    This article describes an Online Mentor Program (OMP) designed to support and facilitate mentorships among and between Florida Department of Health (FDOH) employees and USF College of Public Health students using a Web-based portal. The Florida Public Health Training Center (FPHTC) at the University of South Florida (USF) College of Public Health…

  11. Improved Processing Speed: Online Computer-Based Cognitive Training in Older Adults

    ERIC Educational Resources Information Center

    Simpson, Tamara; Camfield, David; Pipingas, Andrew; Macpherson, Helen; Stough, Con

    2012-01-01

    In an increasingly aging population, a number of adults are concerned about declines in their cognitive abilities. Online computer-based cognitive training programs have been proposed as an accessible means by which the elderly may improve their cognitive abilities; yet, more research is needed in order to assess the efficacy of these programs. In…

  12. CLSI On-Line Public Catalog Touch Terminal Manual: Training Manual.

    ERIC Educational Resources Information Center

    California State Univ., Chico.

    This training manual developed by the Public Access Subcommittee of the Reference Department of Meriam Library (California State University, Chico) provides instructions for using the library's online public catalog by means of a touch terminal which accepts commands in the form of a touch on a particular part of the terminal screen. Author and…

  13. Teaching Citizen Science Skills Online: Implications for Invasive Species Training Programs

    ERIC Educational Resources Information Center

    Newman, Greg; Crall, Alycia; Laituri, Melinda; Graham, Jim; Stohlgren, Tom; Moore, John C.; Kodrich, Kris; Holfelder, Kirstin A.

    2010-01-01

    Citizen science programs are emerging as an efficient way to increase data collection and help monitor invasive species. Effective invasive species monitoring requires rigid data quality assurances if expensive control efforts are to be guided by volunteer data. To achieve data quality, effective online training is needed to improve field skills…

  14. Supporting Online AP Students: The Rural Facilitator and Considerations for Training

    ERIC Educational Resources Information Center

    Hendrix, Nicole; Degner, Katherine

    2016-01-01

    Online courses supplemented by on-site facilitators help many rural students pursue advanced coursework, but research is warranted to better understand facilitator role and training needs. This study examined facilitation experiences, demographic characteristics, and professional development activities of rural on-site facilitators associated with…

  15. Designing the Right Blend: Combining Online and Onsite Training for Optimal Results.

    ERIC Educational Resources Information Center

    Rowley, Kurt; Bunker, Ellen; Cole, David

    2002-01-01

    Describes two decisions in the development of effective blended instruction: selecting the instructional approach and selecting the development approach. Examines a successful training design and development case at a military continuing education college and analyzes it as an application of a blended onsite-online approach to human performance…

  16. CLSI On-Line Public Catalog Touch Terminal Manual: Training Manual.

    ERIC Educational Resources Information Center

    California State Univ., Chico.

    This training manual developed by the Public Access Subcommittee of the Reference Department of Meriam Library (California State University, Chico) provides instructions for using the library's online public catalog by means of a touch terminal which accepts commands in the form of a touch on a particular part of the terminal screen. Author and…

  17. Improved Processing Speed: Online Computer-Based Cognitive Training in Older Adults

    ERIC Educational Resources Information Center

    Simpson, Tamara; Camfield, David; Pipingas, Andrew; Macpherson, Helen; Stough, Con

    2012-01-01

    In an increasingly aging population, a number of adults are concerned about declines in their cognitive abilities. Online computer-based cognitive training programs have been proposed as an accessible means by which the elderly may improve their cognitive abilities; yet, more research is needed in order to assess the efficacy of these programs. In…

  18. Teaching Citizen Science Skills Online: Implications for Invasive Species Training Programs

    ERIC Educational Resources Information Center

    Newman, Greg; Crall, Alycia; Laituri, Melinda; Graham, Jim; Stohlgren, Tom; Moore, John C.; Kodrich, Kris; Holfelder, Kirstin A.

    2010-01-01

    Citizen science programs are emerging as an efficient way to increase data collection and help monitor invasive species. Effective invasive species monitoring requires rigid data quality assurances if expensive control efforts are to be guided by volunteer data. To achieve data quality, effective online training is needed to improve field skills…

  19. Dynamical and stationary properties of on-line learning from finite training sets.

    PubMed

    Luo, Peixun; Wong, K Y Michael

    2003-01-01

    The dynamical and stationary properties of on-line learning from finite training sets are analyzed by using the cavity method. For large input dimensions, we derive equations for the macroscopic parameters, namely, the student-teacher correlation, the student-student autocorrelation and the learning force fluctuation. This enables us to provide analytical solutions to Adaline learning as a benchmark. Theoretical predictions of training errors in transient and stationary states are obtained by a Monte Carlo sampling procedure. Generalization and training errors are found to agree with simulations. The physical origin of the critical learning rate is presented. Comparison with batch learning is discussed throughout the paper.

  20. Dynamical and stationary properties of on-line learning from finite training sets

    NASA Astrophysics Data System (ADS)

    Luo, Peixun; Michael Wong, K. Y.

    2003-01-01

    The dynamical and stationary properties of on-line learning from finite training sets are analyzed by using the cavity method. For large input dimensions, we derive equations for the macroscopic parameters, namely, the student-teacher correlation, the student-student autocorrelation and the learning force fluctuation. This enables us to provide analytical solutions to Adaline learning as a benchmark. Theoretical predictions of training errors in transient and stationary states are obtained by a Monte Carlo sampling procedure. Generalization and training errors are found to agree with simulations. The physical origin of the critical learning rate is presented. Comparison with batch learning is discussed throughout the paper.

  1. Recurrent postpartum anaphylaxis with breast-feeding.

    PubMed

    Shank, Jessica J; Olney, Stacey C; Lin, Fang L; McNamara, Michael F

    2009-08-01

    Anaphylaxis associated with breast-feeding is a rare but potentially life-threatening event. This woman reported anaphylaxis with three previous pregnancies while breast-feeding. With her fourth pregnancy she was treated with corticosteroids and antihistamines after delivery. Despite treatment, she developed urticaria, facial edema, and throat tightening, less severe than prior episodes. Her symptoms resolved with epinephrine and antihistamine but recurred with subsequent breast-feeding. On postpartum day 4 she had no symptoms while breast-feeding. Three cases of postpartum breast-feeding anaphylaxis have been reported. Although the pathophysiology is unclear, it may involve the decrease in progesterone and rise of prolactin causing mast cell degranulation. Avoidance of nonsteroidal antiinflammatories and prophylaxis with corticosteroids and antihistamines may offer the best protection.

  2. Anaphylaxis Conundrum: A Trojan Horse Phenomenon.

    PubMed

    Esquivel, Ann; Busse, William W

    Anaphylaxis is a serious and potentially life-threatening allergic reaction that may follow the ingestion of foods. Although these reactions usually follow a common clinical pattern and often demonstrate IgE sensitization to the antigen in question, both the clinical presentation and causative allergen may be atypical, surprising, and difficult to identify. Failure to identify the actual cause of the reaction can compromise treatment and complicate long-term care. Here, we present a patient who had symptoms of anaphylaxis after eating salmon, but confirmation of the causative allergen was not readily apparent. This particular case serves as an insightful lesson for patients undergoing evaluation for anaphylaxis and also provides a framework for navigating through a case involving identification of an underlying allergen.

  3. Jackfruit anaphylaxis in a latex allergic patient.

    PubMed

    Wongrakpanich, Supakanya; Klaewsongkram, Jettanong; Chantaphakul, Hiroshi; Ruxrungtham, Kiat

    2015-03-01

    Several fruits have been reported to crossreact with latex antigen in latex allergy patients but little is known regarding tropical fruits in particular. Here we report the case of a 34-year old nurse who developed anaphylaxis following the ingestion of dried jackfruit (Artocarpus heterophyllus). The patient had a history of chronic eczema on both hands resulting from a regular wear of latex gloves. She and her family also had a history of atopy (allergic rhinitis and/or atopic dermatitis). The results of skin prick tests were positive for jackfruit, latex glove, kiwi and papaya, but the test was negative for banana. While we are reporting the first case of jackfruit anaphylaxis, further research needs to be conducted to identify the mechanisms underlying it. In particular, in-vitro studies need to be designed to understand if the anaphylaxis we describe is due to a cross reactivity between latex and jackfruit or a coincidence of allergy to these 2 antigens.

  4. Online PTSD Diagnosis and Treatment Training for Primary Care Physicians

    DTIC Science & Technology

    2013-03-01

    Eligible participants were English-speaking PCPs, including licensed physicians (internists, family practitioners , pediatricians), nurse practitioners ...sample, 69% were female and were primarily physicians (60%) and nurse practitioners (18%). The majority (81%) had completed their clinical training and...31.5% Female 50 68.5% Profession Nurse Practitioner 13 17.8% Family Practice 20 27.4% Internal Medicine 21 28.8% Pediatrics 3 4.1

  5. A Comparative Study of Classroom and Online Distance Modes of Official Vocational Education and Training

    PubMed Central

    López Soblechero, Miguel Vicente; González Gaya, Cristina; Hernández Ramírez, Juan José

    2014-01-01

    The study discussed in this paper had two principal objectives. The first was to evaluate the distance model of official vocational education and training offered by means of a virtual learning platform. The second was to establish that both on-site classroom and online distance modes of vocational education and training can be seen as complementary in terms of responding to the majority of modern educational needs. We performed a comparative study using data and results gathered over the course of eleven academic years for 1,133 of our students enrolled in an official vocational education and training program, leading to the awarding of a certificate as an Administrative Management Expert. The classes were offered by the Alfonso de Avellaneda Vocational Education and Training School, located in the city of Alcalá de Henares near Madrid, Spain. We offered classes both in traditional classroom mode and through online distance learning. This paper begins with a descriptive analysis of the variables we studied; inferential statistical techniques are subsequently applied in order to study the relationships that help form the basis for the conclusions reached. This study’s results provide evidence that a broad offering of vocational education and training opportunities will facilitate access to such learning for students who require it, regardless of their age, employment status, or personal circumstances, with the online distance mode playing a fundamental role while also yielding results equivalent to those observed for classroom instruction. PMID:24788543

  6. A comparative study of classroom and online distance modes of official vocational education and training.

    PubMed

    López Soblechero, Miguel Vicente; González Gaya, Cristina; Hernández Ramírez, Juan José

    2014-01-01

    The study discussed in this paper had two principal objectives. The first was to evaluate the distance model of official vocational education and training offered by means of a virtual learning platform. The second was to establish that both on-site classroom and online distance modes of vocational education and training can be seen as complementary in terms of responding to the majority of modern educational needs. We performed a comparative study using data and results gathered over the course of eleven academic years for 1,133 of our students enrolled in an official vocational education and training program, leading to the awarding of a certificate as an Administrative Management Expert. The classes were offered by the Alfonso de Avellaneda Vocational Education and Training School, located in the city of Alcalá de Henares near Madrid, Spain. We offered classes both in traditional classroom mode and through online distance learning. This paper begins with a descriptive analysis of the variables we studied; inferential statistical techniques are subsequently applied in order to study the relationships that help form the basis for the conclusions reached. This study's results provide evidence that a broad offering of vocational education and training opportunities will facilitate access to such learning for students who require it, regardless of their age, employment status, or personal circumstances, with the online distance mode playing a fundamental role while also yielding results equivalent to those observed for classroom instruction.

  7. School nurse online emergency preparedness training: an analysis of knowledge, skills, and confidence.

    PubMed

    Elgie, Robert; Sapien, Robert; Fullerton, Lynne; Moore, Brian

    2010-10-01

    The objective of this study was to evaluate the effectiveness of a computer-assisted emergency preparedness course for school nurses. Participants from a convenience sample (52) of school nurses from New Mexico were randomly assigned to intervention or control groups in an experimental after-only posttest design. Intervention group participants completed 15 online emergency preparedness training modules followed by posttests, and control group participants completed the posttests without taking the training modules. Tests measured emergency preparedness with written exams, confidence surveys, and skills performance in videotaped scenarios; the videotaped scenarios were scored by Pediatric Emergency Medicine physicians blinded to whether the participants were in the intervention or control group. The intervention group participants scored significantly higher in tests of knowledge and skills than control group participants. Confidence Survey scores did not differ significantly. The online training modules are a valuable resource for improving school nurse emergency preparedness knowledge and skills but may not affect participants' confidence.

  8. The development of a TED-Ed online resident research training program

    PubMed Central

    Moreau, Katherine A.; Pound, Catherine M.; Peddle, Beth; Tokarewicz, Jaclyn; Eady, Kaylee

    2014-01-01

    Background Pediatric health research is important for improving the health and well-being of children and their families. To foster the development of physicians’ research competencies, it is vital to integrate practical and context-specific research training into residency programs. Purpose To describe the development of a resident research training program at one tertiary care pediatric academic health sciences center in Ontario, Canada. Methods We surveyed residents and pediatricians/research staff to establish the need and content for a resident research training program. Results Residents and resident research supervisors agreed or strongly agreed that research training is important for residents. However, few residents and supervisors believed that their academic health sciences center provided adequate training and resources to support resident research. As such, an online resident research training program was established. Residents and supervisors agreed that the program should focus on the following topics: 1) critically evaluating research literature, 2) writing a research proposal, 3) submitting an application for research funding, and 4) writing a manuscript. Discussion This highly accessible, context-specific, and inexpensive online program model may be of interest and benefit to other residency programs as a means to enhance residents’ scholarly roles. A formal evaluation of the research training program is now underway. PMID:25526717

  9. The development of a TED-Ed online resident research training program.

    PubMed

    Moreau, Katherine A; Pound, Catherine M; Peddle, Beth; Tokarewicz, Jaclyn; Eady, Kaylee

    2014-01-01

    Pediatric health research is important for improving the health and well-being of children and their families. To foster the development of physicians' research competencies, it is vital to integrate practical and context-specific research training into residency programs. To describe the development of a resident research training program at one tertiary care pediatric academic health sciences center in Ontario, Canada. We surveyed residents and pediatricians/research staff to establish the need and content for a resident research training program. Residents and resident research supervisors agreed or strongly agreed that research training is important for residents. However, few residents and supervisors believed that their academic health sciences center provided adequate training and resources to support resident research. As such, an online resident research training program was established. Residents and supervisors agreed that the program should focus on the following topics: 1) critically evaluating research literature, 2) writing a research proposal, 3) submitting an application for research funding, and 4) writing a manuscript. This highly accessible, context-specific, and inexpensive online program model may be of interest and benefit to other residency programs as a means to enhance residents' scholarly roles. A formal evaluation of the research training program is now underway.

  10. The development of a TED-Ed online resident research training program.

    PubMed

    Moreau, Katherine A; Pound, Catherine M; Peddle, Beth; Tokarewicz, Jaclyn; Eady, Kaylee

    2014-01-01

    Background Pediatric health research is important for improving the health and well-being of children and their families. To foster the development of physicians' research competencies, it is vital to integrate practical and context-specific research training into residency programs. Purpose To describe the development of a resident research training program at one tertiary care pediatric academic health sciences center in Ontario, Canada. Methods We surveyed residents and pediatricians/research staff to establish the need and content for a resident research training program. Results Residents and resident research supervisors agreed or strongly agreed that research training is important for residents. However, few residents and supervisors believed that their academic health sciences center provided adequate training and resources to support resident research. As such, an online resident research training program was established. Residents and supervisors agreed that the program should focus on the following topics: 1) critically evaluating research literature, 2) writing a research proposal, 3) submitting an application for research funding, and 4) writing a manuscript. Discussion This highly accessible, context-specific, and inexpensive online program model may be of interest and benefit to other residency programs as a means to enhance residents' scholarly roles. A formal evaluation of the research training program is now underway.

  11. A comparison of online versus on-site training in health research methodology: a randomized study.

    PubMed

    Aggarwal, Rakesh; Gupte, Nikhil; Kass, Nancy; Taylor, Holly; Ali, Joseph; Bhan, Anant; Aggarwal, Amita; Sisson, Stephen D; Kanchanaraksa, Sukon; McKenzie-White, Jane; McGready, John; Miotti, Paolo; Bollinger, Robert C

    2011-06-17

    Distance learning may be useful for building health research capacity. However, evidence that it can improve knowledge and skills in health research, particularly in resource-poor settings, is limited. We compared the impact and acceptability of teaching two distinct content areas, Biostatistics and Research Ethics, through either on-line distance learning format or traditional on-site training, in a randomized study in India. Our objective was to determine whether on-line courses in Biostatistics and Research Ethics could achieve similar improvements in knowledge, as traditional on-site, classroom-based courses. Volunteer Indian scientists were randomly assigned to one of two arms. Students in Arm 1 attended a 3.5-day on-site course in Biostatistics and completed a 3.5-week on-line course in Research Ethics. Students in Arm 2 attended a 3.5-week on-line course in Biostatistics and 3.5-day on-site course in Research Ethics. For the two course formats, learning objectives, course contents and knowledge tests were identical. Improvement in knowledge immediately and 3-months after course completion, compared to baseline. Baseline characteristics were similar in both arms (n = 29 each). Median knowledge score for Biostatistics increased from a baseline of 49% to 64% (p < 0.001) 3 months after the on-site course, and from 48% to 63% (p = 0.009) after the on-line course. For the on-site Research Ethics course, median score increased from 69% to 83% (p = 0.005), and for the on-line Research Ethics course from 62% to 80% (p < 0.001). Three months after the course, median gains in knowledge scores remained similar for the on-site and on-line platforms for both Biostatistics (16% vs. 12%; p = 0.59) and Research Ethics (17% vs. 13%; p = 0.14). On-line and on-site training formats led to marked and similar improvements of knowledge in Biostatistics and Research Ethics. This, combined with logistical and cost advantages of on-line training, may make on-line courses particularly

  12. Online Training in Mind-Body Therapies: Different Doses, Long-term Outcomes.

    PubMed

    Kemper, Kathi J; Rao, Nisha; Gascon, Gregg; Mahan, John D

    2017-01-01

    There is a high rate of burnout among health professionals, driving diverse attempts to promote resilience and well-being to counter this trend. The purpose of this project was to assess the dose-response relationship between the number of hours of online mind-body skills training for health professionals and relevant outcomes a year later. Among 1438 registrants for online training (including up to 12 hours of training on mind-body practices) between December 2013 and November 2015, we analyzed responses from the first 10% who responded to an anonymous online survey between December 1, 2015 and February 1, 2016. Questions included the type and frequency of mind-body practice in the past 30 days and whether the online training had any impact on personal life or professional practice. Standardized measures were used to assess stress, mindfulness, confidence in providing compassionate care, and burnout. The 149 respondents represented a variety of ages and health professions; 55% completed one or more mind-body training modules an average of 14 months previously. Most (78%) engaged in one or more mind-body practices in the 30 days before the survey; 79% reported changes in self-care and 71% reported changes in the care of others as a result of participating. Increasing number of hours of training were significantly associated with practicing mind-body skills more frequently; increasing practice frequency was associated with less stress and burnout, which were associated with missing less work. Greater practice frequency was also associated with improvements in stress, mindfulness, and resilience, which were associated with increased confidence in providing compassionate care. Online training in mind-body therapies is associated with changes in self-reported behavior one year later; increasing doses of training are associated with more frequent practice which is associated with less stress, burnout, and missing work, and higher levels of mindfulness, resilience, and

  13. An unexpected cause of anaphylaxis: potato.

    PubMed

    Eke Gungor, H; Uytun, S; Murat Sahiner, U; Altuner Torun, Y

    2016-07-01

    Immediate reactions against contact to raw potato has been reported in adults with generally being in the form of an oral contact dermatitis or contact urticaria, but it may also manifest as rhinitis symptoms, wheezing or even anaphylaxis. Cooked or raw potato allergy has been rarely reported in children as some is being immediate and others being late reactions, and it usually results from ingestion. Herein, we report two cases with a background of allergic diseases developed anaphylaxis one with cooked potato and the other one with raw potato.

  14. Mast cell activation syndromes presenting as anaphylaxis.

    PubMed

    Akin, Cem

    2015-05-01

    Anaphylaxis results from severe systemic mast cell activation. In addition to IgE-mediated and physical triggers, it may occur with a clonal mast cell disease and in an idiopathic fashion without clear provoking factors. Disorders of mast cell activation are classified into primary (clonal), secondary, and idiopathic. Mast cell activation syndrome (MCAS) is a multisystem disorder characterized by objective documentation of elevated mast cell mediators during attacks and a favorable response to antimediator therapy. It should be considered in the differential diagnosis of patients presenting with recurrent anaphylaxis without a clear cause. This article discusses the diagnosis of MCAS.

  15. Anaphylaxis avoidance and management: educating patients and their caregivers

    PubMed Central

    Järvinen, Kirsi M; Celestin, Jocelyn

    2014-01-01

    Anaphylaxis is an increasingly prevalent problem in westernized countries. Therefore, it is of utmost importance that the increasing numbers of patients at risk for anaphylaxis receive proper education on the etiology and risk factors as well as appropriate treatment of anaphylaxis with epinephrine. The physician’s role is crucial in order to educate the patients and care takers on effective measures to prevent anaphylaxis and empower them to take charge of early recognition and proper management of an anaphylactic reaction to prevent poor outcomes. This review summarizes the clinical presentation, triggers, avoidance, and management of anaphylaxis. PMID:25031541

  16. The Effect of an Online Cognitive Training Package in Healthy Older Adults: An Online Randomized Controlled Trial.

    PubMed

    Corbett, Anne; Owen, Adrian; Hampshire, Adam; Grahn, Jessica; Stenton, Robert; Dajani, Said; Burns, Alistair; Howard, Robert; Williams, Nicola; Williams, Gareth; Ballard, Clive

    2015-11-01

    Cognitive training (CT) offers a potential approach for dementia prevention and maintenance of cognitive function in older adults. Online delivery provides a cost-effective means of implementing CT compared with in-person interventions, with the potential of providing an effective public health intervention for risk reduction. A double-blind 6-month online randomized controlled trial in adults older than 50 randomized to General CT, Reasoning CT, or control. The primary outcome was instrumental activities of daily living (IADL) in adults older than 60. Secondary outcomes were reasoning, verbal short-term memory, spatial working memory, verbal learning (VL), and digit vigilance in adults older than 50. Secondary analyses were performed with a group defined as showing age-associated impairment in reasoning according to baseline scores in this domain. A total of 2912 adults older than 60 (6742 > 50) participated. General and reasoning packages conferred benefit to IADL (P = .008, P = .011), reasoning (P < 0.0001, P < .0001), and VL (P = .007, P = .008) at 6 months. Benefit in reasoning was evident from 6 weeks. Other benefits developed over 6 months. Analysis of participants with age-associated impairment also showed the same pattern of benefit. A clear dose-response effect was seen. Online CT confers significant benefit to cognition and function in older adults, with benefit favoring the Reasoning package. Scale of benefit is comparable with in-person training, indicating its potential as a public health intervention. Impact on the group with age-associated impairment indicates a particular sensitivity to this at-risk group, which merits further investigation. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  17. Innovative Practices for Innovators: Walking the Talk Online Training for Online Teaching.

    ERIC Educational Resources Information Center

    Crichton, Susan; LaBonte, Randy

    2003-01-01

    Reports on inservice opportunities provided by the Canadian company Odyssey Learning Systems Inc. (Odyssey) and critically assesses how that training mirrored the learning environment created through use of its product in educational settings with students. Suggests that changes to a learning environment provided through technology will not occur…

  18. Clinical Effectiveness of Online Training in Palliative Care of Primary Care Physicians

    PubMed Central

    Perez-Hoyos, Santiago; Agra-Varela, Yolanda

    2013-01-01

    Abstract Background Primary care physicians (PCPs) have a major responsibility in the management of palliative patients. Online palliative care (PC) education has not been shown to have a clinical impact on patients that is equal or different to traditional training. Objective This study tested the clinical effectiveness of online PC education of physicians through impact on symptom control, quality of life (QOL), caregiver satisfaction, and knowledge-attitude of physicians at 18 months of the intervention. Methods We conducted a randomized clinical trial. Subjects were 169 physicians randomly assigned to receive the online model or traditional training. Consecutive patients with advanced cancer requiring PC were included. Physicians and patients completed the Palliative Care Outcome Scale (POS), and patients the Brief Pain Inventory (BPI) and the Rotterdam Symptom Checklist (RSCL) twice, 7 to 10 days apart. Caregivers completed the SERVQUAL. Physicians' level of knowledge-attitude was measured at 18 months. Results Sixty-seven physicians enrolled 117 patients. The intervention group had reduced scores for pain, symptoms, and family anxiety. The global RSCL scale showed a difference between groups. There was no significant difference in the questionnaires used. Caregiver satisfaction was comparable between groups. Physicians in the intervention group significantly increased their knowledge without any differences in attitude. Online training was completed by 86.6% in the intervention group, whereas 13.4% in the control group accessed traditional training. Conclusions Participation in an online PC education program by PCPs improved patient scores for some symptoms and family anxiety on the POS and also showed improved global QOL. Significant differences were found in physicians' knowledge at short and long term. PMID:23987657

  19. Review and evaluation of online tobacco dependence treatment training programs for health care practitioners.

    PubMed

    Selby, Peter; Goncharenko, Karina; Barker, Megan; Fahim, Myra; Timothy, Valerie; Dragonetti, Rosa; Kemper, Katherine; Herie, Marilyn; Hays, J Taylor

    2015-04-17

    Training health care professionals is associated with increased capacity to deliver evidence-based smoking cessation interventions and increased quit rates among their patients. Online training programs hold promise to provide training but questions remain regarding the quality and usability of available programs. The aim was to assess the quality of English-language online courses in tobacco dependence treatment using a validated instrument. An environmental scan was conducted using the Google search engine to identify available online tobacco dependence treatment courses. The identified courses were then evaluated using the Peer Review Rubric for Online Learning, which was selected based on its ability to evaluate instructional design. It also has clear and concise criteria descriptions to ensure uniformity of evaluations by trained experts. A total of 39 courses were identified, of which 24 unique courses were assessed based on their accessibility and functionality during the period of evaluation. Overall, the course ratings indicated that 17 of 24 courses evaluated failed to meet minimal quality standards and none of the courses evaluated could be ranked as superior. However, many excelled in providing effective navigation, course rationale, and content. Many were weak in the use of instructional design elements, such as teaching effectiveness, learning strategies, instructor's role, and assessment and evaluation. Evaluation results and suggestions for improvement were shared with course administrators. Based on the courses evaluated in this review, course developers are encouraged to employ best practices in instructional design, such as cohesiveness of material, linearity of design, practice exercises, problem solving, and ongoing evaluation to improve existing courses and in the design of new online learning opportunities.

  20. A novel, online social cognitive training program for young adults with schizophrenia: A pilot study

    PubMed Central

    Nahum, Mor; Fisher, Melissa; Loewy, Rachel; Poelke, Gina; Ventura, Joseph; Nuechterlein, Keith H.; Hooker, Christine I.; Green, Michael F.; Merzenich, Mike; Vinogradov, Sophia

    2014-01-01

    Background Pervasive social cognition deficits are evident early in the course of schizophrenia and are directly linked to functional outcome, making them an important target for intervention. Here, we tested the feasibility of use, and initiated the evaluation of efficacy, of a novel, neuroplasticity-based online training program (SocialVille) in young adults with schizophrenia. Methods Schizophrenia patients (n=17) completed 24 hours of online SocialVille game play either from home or at a clinic, over a 6-10 week period. We examined training feasibility, gains on the SocialVille exercises relative to matched healthy controls (n=17), and changes on measures of social cognition, social functioning, global functioning and motivation. Results Subjects adhered to training requirements, and rated SocialVille in the medium to high range in satisfaction, enjoyment, and ease of use. Subjects demonstrated significant, large improvements on the speeded SocialVille tasks, and small to moderate improvements on the working memory tasks. Post-training performance on the SocialVille tasks were similar to initial performance of the healthy controls. Subjects also showed improvements on standard measures of social cognition, social functioning, and motivation. No improvements were recorded for emotion recognition indices on the MSCEIT, or on quality of life scales. Conclusion This study provides an initial proof of concept for online social cognition training in schizophrenia. This form of training demonstrated feasibility and resulted in within-subject gains in social functioning and motivation. This pilot study represents a first step towards validating this training approach; randomized controlled trials, now underway, are designed to confirm and extend these findings. PMID:25267937

  1. Constructing distributed Hippocratic video databases for privacy-preserving online patient training and counseling.

    PubMed

    Peng, Jinye; Babaguchi, Noboru; Luo, Hangzai; Gao, Yuli; Fan, Jianping

    2010-07-01

    Digital video now plays an important role in supporting more profitable online patient training and counseling, and integration of patient training videos from multiple competitive organizations in the health care network will result in better offerings for patients. However, privacy concerns often prevent multiple competitive organizations from sharing and integrating their patient training videos. In addition, patients with infectious or chronic diseases may not want the online patient training organizations to identify who they are or even which video clips they are interested in. Thus, there is an urgent need to develop more effective techniques to protect both video content privacy and access privacy . In this paper, we have developed a new approach to construct a distributed Hippocratic video database system for supporting more profitable online patient training and counseling. First, a new database modeling approach is developed to support concept-oriented video database organization and assign a degree of privacy of the video content for each database level automatically. Second, a new algorithm is developed to protect the video content privacy at the level of individual video clip by filtering out the privacy-sensitive human objects automatically. In order to integrate the patient training videos from multiple competitive organizations for constructing a centralized video database indexing structure, a privacy-preserving video sharing scheme is developed to support privacy-preserving distributed classifier training and prevent the statistical inferences from the videos that are shared for cross-validation of video classifiers. Our experiments on large-scale video databases have also provided very convincing results.

  2. Online games training aging brains: limited transfer to cognitive control functions

    PubMed Central

    van Muijden, Jesse; Band, Guido P. H.; Hommel, Bernhard

    2011-01-01

    The prevalence of age-related cognitive decline will increase due to graying of the global population. The goal of the present study was to test whether playing online cognitive training games can improve cognitive control (CC) in healthy older adults. Fifty-four older adults (age 60–77) played five different cognitive training games online for 30 min a day over a period of seven weeks (game group). Another group of 20 older adults (age 61–73) instead answered quiz questions about documentaries online (documentary group). Transfer was assessed by means of a cognitive test battery administered before and after the intervention. The test battery included measures of working memory updating, set shifting, response inhibition, attention, and inductive reasoning. Compared with the documentary group, the game group showed larger improvement of inhibition (Stop-Signal task) and inductive reasoning (Raven-SPM), whereas the documentary group showed more improvement in selective attention (UFoV-3). These effects qualify as transfer effects, because response inhibition, inductive reasoning and selective attention were not targeted by the interventions. However, because seven other indicators of CC did not show benefits of game training and some of those that did suffered from potential baseline differences, the study as a whole provides only modest support for the potential of videogame training to improve CC in healthy older adults. PMID:22912609

  3. The Feasibility and Effectiveness of Online Guided Imagery Training for Health Professionals.

    PubMed

    Rao, Nisha; Kemper, Kathi J

    2017-01-01

    This study evaluated the feasibility and impact of brief online guided imagery training (up to 3 hours) for health professionals. Paired t tests were used to measure pre-to-post-training changes in stress (Perceived Stress Scale,), anxiety (Patient Reported Outcomes Measurement Information System-Anxiety Scale), empathy (Empathic Concern Scale, and Perspective-taking Scale), and self-efficacy (Self-Efficacy in providing Non-Drug Therapies Scale). Online guided imagery training attracted diverse health professionals and trainees (n = 273; 14% trainees; 34% registered nurses, 20% physicians, 14% social workers, 5% registered dititians, and 27% others). Participants reported small but significant pre-to-post-module improvements in stress (17.8 to 13.5), anxiety (T-scores 56.4 to 54.3), empathy (both empathic concern, 29.8 to 30.7, and perspective taking, 28.0 to 29.4), and self-efficacy in providing nondrug therapies for common symptoms (58.5 to 77.0) (P < .001 for all). Future studies will need to examine the clinical impact of online guided imagery training for health professionals.

  4. Online games training aging brains: limited transfer to cognitive control functions.

    PubMed

    van Muijden, Jesse; Band, Guido P H; Hommel, Bernhard

    2012-01-01

    The prevalence of age-related cognitive decline will increase due to graying of the global population. The goal of the present study was to test whether playing online cognitive training games can improve cognitive control (CC) in healthy older adults. Fifty-four older adults (age 60-77) played five different cognitive training games online for 30 min a day over a period of seven weeks (game group). Another group of 20 older adults (age 61-73) instead answered quiz questions about documentaries online (documentary group). Transfer was assessed by means of a cognitive test battery administered before and after the intervention. The test battery included measures of working memory updating, set shifting, response inhibition, attention, and inductive reasoning. Compared with the documentary group, the game group showed larger improvement of inhibition (Stop-Signal task) and inductive reasoning (Raven-SPM), whereas the documentary group showed more improvement in selective attention (UFoV-3). These effects qualify as transfer effects, because response inhibition, inductive reasoning and selective attention were not targeted by the interventions. However, because seven other indicators of CC did not show benefits of game training and some of those that did suffered from potential baseline differences, the study as a whole provides only modest support for the potential of videogame training to improve CC in healthy older adults.

  5. Epidemiology of severe anaphylaxis: can we use population-based data to understand anaphylaxis?

    PubMed

    Turner, Paul J; Campbell, Dianne E

    2016-10-01

    The observed increase in incidence of allergic disease in many regions over the past 3 decades has intensified interest in understanding the epidemiology of severe allergic reactions. We discuss the issues in collecting and interpreting these data and highlight current deficiencies in the current methods of data gathering. Anaphylaxis, as measured by hospital admission rates, is not uncommon and has increased in the United Kingdom, the United States, Canada, and Australia over the last 10-20 years. All large datasets are hampered by a large proportion of uncoded, 'unspecified' causes of anaphylaxis. Fatal anaphylaxis remains a rare event, but appears to be increasing for medication in Australia, Canada, and the United States. The rate of fatal food anaphylaxis is stable in the United Kingdom and the United States, but has increased in Australia. The age distribution for fatal food anaphylaxis is different to other causes, with data suggesting an age-related predisposition to fatal outcomes in teenagers and adults to the fourth decade of life. The increasing rates of food and medication allergy (the latter exacerbated by an ageing population) has significant implications for future fatality trends. An improved ability to accurately gather and analyse population-level anaphylaxis data in a harmonized fashion is required, so as to ultimately minimize risk and improve management.

  6. Enhancing Cognitive Abilities with Comprehensive Training: A Large, Online, Randomized, Active-Controlled Trial

    PubMed Central

    Hardy, Joseph L.; Nelson, Rolf A.; Thomason, Moriah E.; Sternberg, Daniel A.; Katovich, Kiefer; Farzin, Faraz; Scanlon, Michael

    2015-01-01

    Background A variety of studies have demonstrated gains in cognitive ability following cognitive training interventions. However, other studies have not shown such gains, and questions remain regarding the efficacy of specific cognitive training interventions. Cognitive training research often involves programs made up of just one or a few exercises, targeting limited and specific cognitive endpoints. In addition, cognitive training studies typically involve small samples that may be insufficient for reliable measurement of change. Other studies have utilized training periods that were too short to generate reliable gains in cognitive performance. Methods The present study evaluated an online cognitive training program comprised of 49 exercises targeting a variety of cognitive capacities. The cognitive training program was compared to an active control condition in which participants completed crossword puzzles. All participants were recruited, trained, and tested online (N = 4,715 fully evaluable participants). Participants in both groups were instructed to complete one approximately 15-minute session at least 5 days per week for 10 weeks. Results Participants randomly assigned to the treatment group improved significantly more on the primary outcome measure, an aggregate measure of neuropsychological performance, than did the active control group (Cohen’s d effect size = 0.255; 95% confidence interval = [0.198, 0.312]). Treatment participants showed greater improvements than controls on speed of processing, short-term memory, working memory, problem solving, and fluid reasoning assessments. Participants in the treatment group also showed greater improvements on self-reported measures of cognitive functioning, particularly on those items related to concentration compared to the control group (Cohen’s d = 0.249; 95% confidence interval = [0.191, 0.306]). Conclusion Taken together, these results indicate that a varied training program composed of a number of

  7. Enhancing Cognitive Abilities with Comprehensive Training: A Large, Online, Randomized, Active-Controlled Trial.

    PubMed

    Hardy, Joseph L; Nelson, Rolf A; Thomason, Moriah E; Sternberg, Daniel A; Katovich, Kiefer; Farzin, Faraz; Scanlon, Michael

    2015-01-01

    A variety of studies have demonstrated gains in cognitive ability following cognitive training interventions. However, other studies have not shown such gains, and questions remain regarding the efficacy of specific cognitive training interventions. Cognitive training research often involves programs made up of just one or a few exercises, targeting limited and specific cognitive endpoints. In addition, cognitive training studies typically involve small samples that may be insufficient for reliable measurement of change. Other studies have utilized training periods that were too short to generate reliable gains in cognitive performance. The present study evaluated an online cognitive training program comprised of 49 exercises targeting a variety of cognitive capacities. The cognitive training program was compared to an active control condition in which participants completed crossword puzzles. All participants were recruited, trained, and tested online (N = 4,715 fully evaluable participants). Participants in both groups were instructed to complete one approximately 15-minute session at least 5 days per week for 10 weeks. Participants randomly assigned to the treatment group improved significantly more on the primary outcome measure, an aggregate measure of neuropsychological performance, than did the active control group (Cohen's d effect size = 0.255; 95% confidence interval = [0.198, 0.312]). Treatment participants showed greater improvements than controls on speed of processing, short-term memory, working memory, problem solving, and fluid reasoning assessments. Participants in the treatment group also showed greater improvements on self-reported measures of cognitive functioning, particularly on those items related to concentration compared to the control group (Cohen's d = 0.249; 95% confidence interval = [0.191, 0.306]). Taken together, these results indicate that a varied training program composed of a number of tasks targeted to different cognitive

  8. Anaphylaxis: How Do You Live with It?

    ERIC Educational Resources Information Center

    Mandell, Deena; Curtis, Ruth; Gold, Milton; Hardie, Susan

    2005-01-01

    This article reports on a study of the needs of families coping with life-threatening allergies in a child. Due to the scarcity of publications on the psychosocial dimensions of anaphylaxis, the authors draw on selected literature on family coping with chronic illness, asthma, and allergy to provide a conceptual context for the research and…

  9. Role for basophils in systemic anaphylaxis.

    PubMed

    Karasuyama, Hajime; Tsujimura, Yusuke; Obata, Kazushige; Mukai, Kaori

    2010-01-01

    For more than 100 years since the discovery of basophils by Paul Ehrlich, the functional significance of this rare leukocyte as compared to mast cells has remained an enigma. Studies on basophils have long been hampered by their rarity (less than 1% of peripheral blood leukocytes) and the lack of useful analytical tools such as model animals deficient only in basophils. Recent studies have now defined previously-unrecognized roles for basophils in both allergic responses and immune regulation, and markedly changed our image of basophils, from a neglected minority to a key player in the immune system. We have recently demonstrated that basophils and mast cells play distinct roles in systemic anaphylaxis in mice. Basophils are dispensable for IgE-mediated systemic anaphylaxis unlike mast cells. Instead, basophils play the major role in IgG-mediated systemic anaphylaxis. In vivo depletion of basophils protects mice from anaphylactic death. Upon capture of IgG-allergen complexes, basophils release platelet-activating factor that increases vascular permeability, leading to anaphylactic shock. Thus, there are two major, distinct pathways to allergen-induced systemic anaphylaxis: one mediated by basophils, IgG and platelet-activating factor, and the other 'classical' pathway mediated by mast cells, IgE and histamine. Copyright 2010 S. Karger AG, Basel.

  10. Anaphylaxis: How Do You Live with It?

    ERIC Educational Resources Information Center

    Mandell, Deena; Curtis, Ruth; Gold, Milton; Hardie, Susan

    2005-01-01

    This article reports on a study of the needs of families coping with life-threatening allergies in a child. Due to the scarcity of publications on the psychosocial dimensions of anaphylaxis, the authors draw on selected literature on family coping with chronic illness, asthma, and allergy to provide a conceptual context for the research and…

  11. [Anaphylaxis caused by human seminal fluid].

    PubMed

    Rubira, N; Roger, A; Nogueiras, C; Server, T; Guspi, R; Cadahia, A

    1995-01-01

    Anaphylaxis to human seminal fluid (HSF) is rare. We present an atopic woman with postcoital cutaneous and respiratory symptoms. Prick by prick to HSF was positive. CAP to FSH was also positive (4 KU/l). The clinical findings, differential diagnosis and different treatments are discussed.

  12. Addressing barriers to emergency anaphylaxis care: from emergency medical services to emergency department to outpatient follow-up.

    PubMed

    Fineman, Stanley M; Bowman, Steven H; Campbell, Ronna L; Dowling, Paul; O'Rourke, Dianne; Russell, W Scott; Sublett, J Wesley; Wallace, Dana

    2015-10-01

    Anaphylaxis is a systemic life-threatening allergic reaction that presents unique challenges for emergency care practitioners. Allergists and emergency physicians have a history of collaborating to promote an evidence-based, multidisciplinary approach to improve the emergency management and follow-up of patients with or at risk of anaphylaxis. To review recent scientific literature about anaphylaxis, discuss barriers to care, and recommend strategies to support improvement in emergency anaphylaxis care. An expert panel of allergists and emergency physicians was convened by the American College of Allergy, Asthma and Immunology in November 2014 to discuss current knowledge about anaphylaxis, identify opportunities for emergency practitioners and allergists to partner to address barriers to care, and recommend strategies to improve medical management of anaphylaxis along the continuum of care: from emergency medical systems and emergency department practitioners for acute management through appropriate outpatient follow-up with allergists to confirm diagnosis, identify triggers, and plan long-term care. The panel identified key barriers to anaphylaxis care, including difficulties in making an accurate diagnosis, low rates of epinephrine administration during acute management, and inadequate follow-up. Strategies to overcome these barriers were discussed and recommendations made for future allergist/emergency physician collaborations, and key messages to be communicated to emergency practitioners were proposed. The panel recommended that allergists and emergency physicians continue to work in partnership, that allergists be proactive in outreach to emergency care practitioners, and that easy-to-access educational programs and materials be developed for use by emergency medical systems and emergency department practitioners in the training environment and in practice. Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All

  13. Robot-assisted humanized passive rehabilitation training based on online assessment and regulation.

    PubMed

    Pan, Lizheng; Song, Aiguo; Duan, Suolin; Xu, Baoguo

    2015-01-01

    Robot-assisted rehabilitation has been developed and proved effective for motion function recovery. Humanization is one of the crucial issues in the designing of robot-based rehabilitation system. However, most of the previous investigations focus on the simplex position control when comes to the control system design of robot-assisted passive training, and pay little attention to the dynamic adjustment according to the patient's performances. This paper presents a novel method to design the passive training system using a developed assessing-and-regulating section to online assess the subject's performances. The motion regulating mechanism is designed to dynamically adjust the training range and motion speed according to the actual performances, which is helpful to improve the humanization of the rehabilitation training. Moreover, position-based impedance control is adopted to achieve compliant trajectory tracking movement. Experimental results demonstrate that the proposed method presents good performances not only in motion control but also in humanization.

  14. Transcranial direct current stimulation versus user training on improving online myoelectric control for amputees

    NASA Astrophysics Data System (ADS)

    Pan, Lizhi; Zhang, Dingguo; Jiang, Ning; Sheng, Xinjun; Zhu, Xiangyang

    2017-08-01

    Objective. Transcranial direct current stimulation (tDCS) and user training (UT) are two types of methods to improve myoelectric control performance for amputees. In this study, we compared the independent effect between tDCS and UT, and investigated the combined effect of tDCS and UT. Approach. An online paradigm of simultaneous and proportional control (SPC) based on electromyography (EMG) was adopted. The proposed experiments were conducted on six naïve unilateral trans-radial amputees. The subjects each received three types of 20 min interventions: active tDCS with motor training (tDCS  +  UT), active tDCS with quiet sitting (tDCS), and sham tDCS with motor training (UT). The interventions were applied at one week intervals in a randomized order. The subjects performed online control of a feedback arrow with two degrees of freedom (DoFs) to accomplish target reaching motor tasks in pre-sessions and post-sessions. We compared the performance, measured by completion rate, completion time, and efficiency coefficient, between pre-sessions and post-sessions. Main results. The results showed that the intervention tDCS  +  UT and tDCS significantly improved the online SPC performance (i.e. improved the completion rate; reduced the completion time; and improved the efficiency coefficient), while intervention UT did not significantly change the performance. The results also showed that the online SPC performance after intervention tDCS  +  UT and tDCS was not significantly different, but both were significantly better than that after intervention UT. Significance. tDCS could be an effective intervention to improve the online SPC performance in a short time.

  15. Training

    EPA Pesticide Factsheets

    The Drinking Water Academy provides online training and information to ensure that water professionals, public officials, and involved citizens have the knowledge and skills necessary to protect our drinking water supply.

  16. Transdisciplinary training in reproductive health through online multidisciplinary problem-solving: a proof of concept.

    PubMed

    Lambert, Raymond D; Monnier-Barbarino, Patricia

    2005-11-01

    The problem of iatrogenic multiple pregnancies has been addressed through an online multidisciplinary discussion forum with the primary aim of developing a transdisciplinary research and training tool. The pedagogical approach was divided in three phases, unidisciplinary, multidisciplinary and multi/transdisciplinary. Evaluation of the level of transdisciplinarity reached by each of the students was based on their capacity to translate disciplinary knowledge, to establish a frank dialogue, to cross disciplinary barriers, to detach from their initial opinion, and to develop curiosity for others' perspectives and concerns. Translation of disciplinary knowledge and frank dialogue were easily performed by all. Most students showed curiosity towards the others' point of view and started to be preoccupied with the concerns of other students. Online discussion forum is a particularly well-adapted tool for transdisciplinary research and training.

  17. Training pi-sigma network by online gradient algorithm with penalty for small weight update.

    PubMed

    Xiong, Yan; Wu, Wei; Kang, Xidai; Zhang, Chao

    2007-12-01

    A pi-sigma network is a class of feedforward neural networks with product units in the output layer. An online gradient algorithm is the simplest and most often used training method for feedforward neural networks. But there arises a problem when the online gradient algorithm is used for pi-sigma networks in that the update increment of the weights may become very small, especially early in training, resulting in a very slow convergence. To overcome this difficulty, we introduce an adaptive penalty term into the error function, so as to increase the magnitude of the update increment of the weights when it is too small. This strategy brings about faster convergence as shown by the numerical experiments carried out in this letter.

  18. Engaging clinicians in motivational interviewing: Comparing online with face-to-face post-training consolidation.

    PubMed

    Clancy, Richard; Taylor, Andrew

    2016-02-01

    Motivational interviewing (MI) is an evidence-based intervention that has been widely recommended in clinical settings where consumer behaviour change is a goal of treatment. Training clinicians in MI, as with other translational endeavours, does not always result in changes to clinical practice. The present study compares two post-training approaches to consolidate MI skills following a training workshop. We randomly assigned 63 clinicians working in mental health or drug and alcohol services to receive either face-to-face group consolidation sessions or to access a series of online consolidation resources. We compared clinician engagement and devised a new instrument to measure clinician outcomes. Participants who completed follow-up consolidation retained knowledge, attitudes, and practices, regardless of consolidation method. Face-to-face consolidation sessions were superior to online materials in engaging participants (mean sessions attended was 2.1 (maximum possible = 3) compared to a mean of 1.38 sessions, respectively (t(61) = -2.73, P = 0.008, d = 0.72, 95% confidence interval: 0.19-1.25). Engagement to the completion of consolidation sessions was also influenced by previous training in MI. For every additional hour of previous MI training, there was a 10% increase in the odds that the participant would complete the final consolidation session. © 2016 Australian College of Mental Health Nurses Inc.

  19. Evaluation of a combined online and in person training in the use of buprenorphine.

    PubMed

    Gunderson, Erik W; Fiellin, David A; Levin, Frances R; Sullivan, Lynn E; Kleber, Herbert D

    2006-09-01

    To evaluate buprenorphine training methodology, we surveyed physicians who had completed a combined online and in person buprenorphine curriculum. Of 53/70 (76%) survey respondents, 57% were psychiatrists and 40% generalists. On a scale of 1 (very poor) to 7 (superlative), the overall training rated a mean of 5.8. The online course (5.0) rated lower than in person training components (p < .001) except for material that addressed the logistics of office practice. The in person patient interview received the highest rating (mean 6.3, p < .001). The 67% of physicians who intended to prescribe buprenorphine after the training were more likely than hesitant physicians to agree that the course provided enough information (p < .05) and that telephone access to experienced providers would improve their confidence (p < .05). Physicians hesitant to prescribe cited lack of experience as the main barrier (41%), with 24% concerned about induction difficulty and reimbursement. Overall, physicians preferred in person instruction and may benefit from additional experiential training and support after curriculum participation.

  20. Evaluation of a Combined Online and In Person Training in the Use of Buprenorphine

    PubMed Central

    Gunderson, Erik W.; Fiellin, David A.; Levin, Frances R.; Sullivan, Lynn E.; Kleber, Herbert D.

    2013-01-01

    To evaluate buprenorphine training methodology, we surveyed physicians who had completed a combined online and in person buprenorphine curriculum. Of 53/70 (76%) survey respondents, 57% were psychiatrists and 40% generalists. On a scale of 1 (very poor) to 7 (superlative), the overall training rated a mean of 5.8. The online course (5.0) rated lower than in person training components (p<.001) except for material that addressed the logistics of office practice. The in person patient interview received the highest rating (mean 6.3, p<.001). The 67% of physicians who intended to prescribe buprenorphine after the training were more likely than hesitant physicians to agree that the course provided enough information (p<.05) and that telephone access to experienced providers would improve their confidence (p<.05). Physicians hesitant to prescribe cited lack of experience as the main barrier (41%), with 24% concerned about induction difficulty and reimbursement. Overall, physicians preferred in person instruction and may benefit from additional experiential training and support after curriculum participation. PMID:17135179

  1. Training in outbreak investigation through use of an online discussion group.

    PubMed

    Stehr-Green, Jeanette; Gathany, Nancy

    2005-11-01

    Distance learning has been found to be effective for continuing public health training. The authors undertook a six-week pilot to teach skills in outbreak investigation through the combination of a self-instructional, interactive, computer-based case study and online discussions led by two instructors. Participants were public health practitioners with knowledge of basic epidemiology and public health. Eighteen public health practitioners participated. Overall, participants posted 113 messages to the online discussions, with a median of 5.5 messages per participant (range: 0-16). The number of postings was higher for participants who had taken part in an outbreak investigation before the pilot test than for those who had not. In general, participants enjoyed the experience and believed that the online discussions added value to the self-instructional case study. The authors conclude that the combination of the case study and the online discussions was a positive learning experience. They encourage others to consider this format for training.

  2. Massive Multiplayer Online Gaming: A Research Framework for Military Training and Education

    DTIC Science & Technology

    2005-03-01

    cultivating communities of practice in the business world (Wenger, McDermott, & Snyder, 2002) as well as learning communities in education, research on the... Learning communities have a number of common principles. Chao (2001) and Bonk et al. (in press) note that online learning communities require...Technology in Training. Hyderabad, India: ICFAI Press. Bonk, C. J., Wisher, R. A., & Nigrelli, M. L. (in press). Learning communities , communities

  3. Video Tutorials and Interactive Online Resources for Multibeam Sonar Software Training

    NASA Astrophysics Data System (ADS)

    Sautter, L. R.; Mode, J.; Duguid, P.

    2010-12-01

    For the past 5 years, undergraduate students at the College of Charleston (CofC) have had the opportunity to sail aboard the NOAA Ship Nancy Foster to collect multibeam sonar data for use in the Seafloor Mapping (SeaMap) Program. SeaMap is offered as an Academic Partnership with the CARIS software company, to train students to process and render multibeam bathymetric data using CARIS' HIPS and SIPS 7.0 software. During the semester-long program, students embellish their training by conducting independent research using sonar data provided by many NOAA and USGS collaborating scientists. Students create research posters to present at the annual CofC School of Science and Mathematics poster session and at professional meetings. To promote development of the SeaMap Program at CofC and other Academic Partner institutions, new approaches to training are being developed using online resources. This endeavor is part of the new CARIS Education Program and will incorporate bathymetric post processing using HIPS and SIPS 7.0. The HIPS Bathymetry Module consists of thirteen thematic units, each of which contains a suite of short online video tutorials focused on specific HIPS operations, with complementing interactive exercises and assessments. Students will convene for a weekend workshop for hands-on training with both a CARIS Instructor and the institution's professor. The workshop is followed by several laboratory sessions during which students practice their new skills using sample datasets. HIPS Bathymetry Module's online resources will be used throughout the program, and will be available afterwards, allowing students to revisit and supplement their learning. The Module will also be tested as a self-paced online course that will not necessitate a classroom presence. A demonstration of a thematic unit will be included in the presentation.

  4. Epinephrine and its use in anaphylaxis: current issues.

    PubMed

    Simons, Keith J; Simons, F Estelle R

    2010-08-01

    Epinephrine is a life-saving medication in the treatment of anaphylaxis, in which it has multiple beneficial pharmacologic effects. Here, we examine the evidence base for its primary role in the treatment of anaphylaxis episodes in community settings. We review the practical pharmacology of epinephrine in anaphylaxis, its intrinsic limitations, and the pros and cons of different routes of administration. We provide a new perspective on the adverse effects of epinephrine, including its cardiac effects. We describe the evidence base for the use of epinephrine in anaphylaxis. We discuss the role of epinephrine auto-injectors for treatment of anaphylaxis in community settings, including identification of patients who need an auto-injector prescription, current use of auto-injectors, and advances in auto-injector design. We list reasons why physicians fail to prescribe epinephrine auto-injectors for patients with anaphylaxis, and reasons why patients fail to self-inject epinephrine in anaphylaxis. We emphasize the primary role of epinephrine in the context of emergency preparedness for anaphylaxis in the community. Epinephrine is the medication of choice in the first-aid treatment of anaphylaxis in the community. For ethical reasons, it is not possible to conduct randomized, placebo-controlled trials of epinephrine in anaphylaxis; however, continued efforts are needed towards improving the evidence base for epinephrine injection in this potentially fatal disease.

  5. Pharmacologic treatment of anaphylaxis: can the evidence base be strengthened?

    PubMed

    Simons, F Estelle R

    2010-08-01

    To evaluate the evidence base for the pharmacologic treatment of anaphylaxis. In this review, we focus on four classes of medications (the alpha/beta-agonist epinephrine (adrenaline), H1-antihistamines, H2-antihistamines, and glucocorticoids) that are used in healthcare settings for the initial treatment of anaphylaxis. Epinephrine and many H1-antihistamines and glucocorticoids were introduced before the era of randomized controlled trials and before the era of evidence-based medicine. In anaphylaxis, no randomized controlled trials that are free from methodological problems and meet current standards have been performed with these medications, or with H2-antihistamines. The evidence base for epinephrine injection is stronger than the evidence base for use of other medications in anaphylaxis. Guidelines unanimously recommend prompt injection of epinephrine as the life-saving first-line medication in anaphylaxis; however, they differ in their recommendations for H1-antihistamines, H2-antihistamines, and glucocorticoids. Epinephrine is the only medication that is universally available for anaphylaxis treatment in healthcare settings worldwide. Paradoxically, it is underused in anaphylaxis treatment. For ethical reasons, there should never be a placebo-controlled trial of epinephrine in anaphylaxis. We discuss why the possibility of conducting randomized placebo-controlled trials with H1-antihistamines, H2-antihistamines, and particularly with glucocorticoids in anaphylaxis should be considered in order to improve the evidence base for treatment and guide clinical decision-making. We also describe the precautions that will be needed if randomized controlled trials are conducted in anaphylaxis.

  6. Research on Linear Wireless Sensor Networks Used for Online Monitoring of Rolling Bearing in Freight Train

    NASA Astrophysics Data System (ADS)

    Nan, Wang; Qingfeng, Meng; Bin, Zheng; Tong, Li; Qinghai, Ma

    2011-07-01

    This paper presents a Wireless Sensor Networks (WSNs) technique for the purpose of on-line monitoring of rolling bearing in freight train. A new technical scheme including the arrangements of sensors, the design of sensor nodes and base station, routing protocols, signal acquirement, processing and transmission is described, and an on-line monitoring system is established. Considering the approximately linear arrangements of cars and the running state of freight train, a linear topology structure of WSNs is adopted and five linear routing protocols are discussed in detail as to obtain the desired minimum energy consumption of WSNs. By analysing the simulation results, an optimal multi-hop routing protocol named sub-section routing protocol according to equal distance is adopted, in which all sensor nodes are divided into different groups according to the equal transmission distance, the optimal transmission distance and number of hops of routing protocol are also studied. We know that the communication consumes significant power in WSNs, so, in order to save the limit power supply of WSNs, the data compression and coding scheme based on lifting integer wavelet and embedded zerotree wavelet (EZW) algorithms is studied to reduce the amounts of data transmitted. The experimental results of rolling bearing have been given at last to verify the effectiveness of data compression algorithm. The on-line monitoring system of rolling bearing in freight train will be applied to actual application in the near future.

  7. User patterns and satisfaction with on-line trainings completed on the North Carolina Center for Public Health Preparedness Training Web Site.

    PubMed

    Horney, Jennifer A; MacDonald, Pia; Rothney, Erin E; Alexander, Lorraine K

    2005-11-01

    Short online training modules have been developed by the North Carolina Center for Public Health Preparedness (NCCPHP) and provided to registered users for free on its Training Web Site. Use of these modules can improve the knowledge, skills, and awareness of public health professionals in topics related to public health preparedness. According to the results of a survey implemented in October 2004, the NCCPHP Training Web Site is effectively reaching its target audience of local and state public health workers. The utilization of distance learning technology allows for broad distribution of training materials, with registered users in all 50 US states and 122 foreign countries. In addition, the NCCPHP Training Web Site is providing training materials in topics most requested by the public health workforce. According to the findings of this survey, online training in public health preparedness and response is an efficient way to improve the knowledge and skills of our public health workforce to increase competency.

  8. What are the 'ideal' features of an adrenaline (epinephrine) auto-injector in the treatment of anaphylaxis?

    PubMed

    Frew, A J

    2011-01-01

    Anaphylaxis is a systemic allergic reaction that often involves respiratory symptoms and cardiovascular collapse, which are potentially life-threatening if not treated promptly with intramuscular adrenaline. Owing to the unpredictable nature of anaphylaxis and accidental exposure to allergens (such as peanuts and shellfish), patients should be prescribed intramuscular adrenaline auto-injectors and carry these with them at all times. Patients also need to be able to use their auto-injectors correctly while under high stress, when an anaphylactic attack occurs. Despite this, an alarming number of patients fail to carry their auto-injectors and many patients, carers of children with known anaphylaxis and healthcare professionals do not know how to use the device correctly, despite having had training. Currently available auto-injector devices have various limitations that may impede their use in the management of anaphylaxis. There is also a lack of validated assessment criteria and regulatory requirements for new devices. This review describes the different delivery systems used in currently available auto-injectors and discusses the key barriers to the use of adrenaline auto-injectors, with the goal of identifying the 'ideal' features/characteristics of such devices in the emergency treatment of anaphylaxis that will ensure ease of use, portability and accurate delivery of a life-saving drug.

  9. Learning the Discourse of Quality Assurance: A Case of Workplace Learning in Online In-Service Training

    ERIC Educational Resources Information Center

    Lundin, Mona; Lundin, Johan

    2016-01-01

    Purpose: In this study, online in-service training for people employed in the food production industry is scrutinized. The purpose of this study is to analyse how the participants adapt to such online environments in terms of the kind of discussions they establish. The more specific interest relates to how the participants discuss current work…

  10. Learning the Discourse of Quality Assurance: A Case of Workplace Learning in Online In-Service Training

    ERIC Educational Resources Information Center

    Lundin, Mona; Lundin, Johan

    2016-01-01

    Purpose: In this study, online in-service training for people employed in the food production industry is scrutinized. The purpose of this study is to analyse how the participants adapt to such online environments in terms of the kind of discussions they establish. The more specific interest relates to how the participants discuss current work…

  11. Reviewing the Content and Design of Anaphylaxis Management Plans Published in English.

    PubMed

    Mercer, Rory D; Jones, Christina J; Smith, Helen E

    Guidelines recommend that patients at risk of anaphylaxis are given an anaphylaxis management plan (AMP) providing advice on symptom recognition and emergency management. However, the format and content of plans is not standardized. The objective of this study was to review the design and contents of different AMPs available in English. A systematic internet search identified AMPs published online. Each plan was analyzed for design and content (including signs and symptoms indicative of anaphylaxis and the actions to be taken). The content was compared with an e-Delphi-derived statement of the key characteristics of an AMP. The systematic search identified 41 plans from 29 different sources. The majority of plans identified were personalized management plans for individuals (78%); the others were designed for institutions. Most AMPs addressed both mild/moderate and severe allergic reactions and had different instructions related to the degree of severity. Thirty-seven individual symptoms were mentioned as indicators of anaphylaxis. Only 55% of plans that recommended the administration of an adrenaline autoinjector gave further instructions on how to do this. Only 17% of plans contained comprehensive instructions on safe patient positioning. There are a wide variety of AMPs in English available online. Plans are similar in design, but differ in content. None of the currently available plans contain all the desirable components recommended in the literature. Because of the variation between plans, when practitioners select an AMP for their patient, they need to be attentive to the content of the plan and its appropriateness for that individual. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  12. Guidance on Completing a Written Allergy and Anaphylaxis Emergency Plan.

    PubMed

    Wang, Julie; Sicherer, Scott H

    2017-03-01

    Anaphylaxis is a potentially life-threatening, severe allergic reaction. The immediate assessment of patients having an allergic reaction and prompt administration of epinephrine, if criteria for anaphylaxis are met, promote optimal outcomes. National and international guidelines for the management of anaphylaxis, including those for management of allergic reactions at school, as well as several clinical reports from the American Academy of Pediatrics, recommend the provision of written emergency action plans to those at risk of anaphylaxis, in addition to the prescription of epinephrine autoinjectors. This clinical report provides information to help health care providers understand the role of a written, personalized allergy and anaphylaxis emergency plan to enhance the care of children at risk of allergic reactions, including anaphylaxis. This report offers a comprehensive written plan, with advice on individualizing instructions to suit specific patient circumstances. Copyright © 2017 by the American Academy of Pediatrics.

  13. Anaphylaxis: implications of monoclonal antibody use in oncology.

    PubMed

    Gleich, Gerald J; Leiferman, Kristin M

    2009-02-01

    Anaphylaxis is currently classified as an immunologically triggered response with reactions that are IgE-mediated and reactions that are not IgE-mediated. This immunologically mediated phenomenon can result in various clinical manifestations, including decreased blood pressure, generalized skin inflammation, such as hives and pruritus, and respiratory symptoms, such as wheezing or bronchospasm. The severity of anaphylaxis can range from a mild allergic reaction to a potentially fatal anaphylactic shock. Numerous causative agents trigger anaphylactic reactions, and some of the best described include food and bee sting allergens. Monoclonal antibodies, which are increasingly used in the treatment of various malignancies, also can cause anaphylaxis. In this review, the mechanisms governing anaphylaxis along with treatment strategies are reviewed. Diagnostic aids for anaphylaxis are also discussed. Increased awareness of the mechanisms, symptoms, and treatment of anaphylaxis can aid caregivers to make informed decisions when new agents, such as monoclonal antibodies, are introduced into the clinic.

  14. Temporal Pattern of Online Communication Spike Trains in Spreading a Scientific Rumor: How Often, Who Interacts with Whom?

    NASA Astrophysics Data System (ADS)

    Sanli, Ceyda; Lambiotte, Renaud

    2015-09-01

    We study complex time series (spike trains) of online user communication while spreading messages about the discovery of the Higgs boson in Twitter. We focus on online social interactions among users such as retweet, mention, and reply, and construct different types of active (performing an action) and passive (receiving an action) spike trains for each user. The spike trains are analyzed by means of local variation, to quantify the temporal behavior of active and passive users, as a function of their activity and popularity. We show that the active spike trains are bursty, independently of their activation frequency. For passive spike trains, in contrast, the local variation of popular users presents uncorrelated (Poisson random) dynamics. We further characterize the correlations of the local variation in different interactions. We obtain high values of correlation, and thus consistent temporal behavior, between retweets and mentions, but only for popular users, indicating that creating online attention suggests an alignment in the dynamics of the two interactions.

  15. Risk of anaphylaxis after vaccination in children and adults

    PubMed Central

    McNeil, Michael M.; Weintraub, Eric S.; Duffy, Jonathan; Sukumaran, Lakshmi; Jacobsen, Steven J.; Klein, Nicola P.; Hambidge, Simon J.; Lee, Grace M.; Jackson, Lisa A.; Irving, Stephanie A.; King, Jennifer P.; Kharbanda, Elyse O.; Bednarczyk, Robert A.; DeStefano, Frank

    2015-01-01

    Background Anaphylaxis is a potentially life-threatening allergic reaction. The risk of anaphylaxis after vaccination has not been well described in adults or with newer vaccines in children. Objective We sought to estimate the incidence of anaphylaxis after vaccines and describe the demographic and clinical characteristics of confirmed cases of anaphylaxis. Methods Using health care data from the Vaccine Safety Datalink, we determined rates of anaphylaxis after vaccination in children and adults. We first identified all patients with a vaccination record from January 2009 through December 2011 and used diagnostic and procedure codes to identify potential anaphylaxis cases. Medical records of potential cases were reviewed. Confirmed cases met the Brighton Collaboration definition for anaphylaxis and had to be determined to be vaccine triggered. We calculated the incidence of anaphylaxis after all vaccines combined and for selected individual vaccines. Results We identified 33 confirmed vaccine-triggered anaphylaxis cases that occurred after 25,173,965 vaccine doses. The rate of anaphylaxis was 1.31 (95% CI, 0.90-1.84) per million vaccine doses. The incidence did not vary significantly by age, and there was a nonsignificant female predominance. Vaccine-specific rates included 1.35 (95% CI, 0.65-2.47) per million doses for inactivated trivalent influenza vaccine (10 cases, 7,434,628 doses given alone) and 1.83 (95% CI, 0.22-6.63) per million doses for inactivated monovalent influenza vaccine (2 cases, 1,090,279 doses given alone). The onset of symptoms among cases was within 30 minutes (8 cases), 30 to less than 120 minutes (8 cases), 2 to less than 4 hours (10 cases), 4 to 8 hours (2 cases), the next day (1 case), and not documented (4 cases). Conclusion Anaphylaxis after vaccination is rare in all age groups. Despite its rarity, anaphylaxis is a potentially life-threatening medical emergency that vaccine providers need to be prepared to treat. PMID:26452420

  16. Risk of anaphylaxis after vaccination in children and adults.

    PubMed

    McNeil, Michael M; Weintraub, Eric S; Duffy, Jonathan; Sukumaran, Lakshmi; Jacobsen, Steven J; Klein, Nicola P; Hambidge, Simon J; Lee, Grace M; Jackson, Lisa A; Irving, Stephanie A; King, Jennifer P; Kharbanda, Elyse O; Bednarczyk, Robert A; DeStefano, Frank

    2016-03-01

    Anaphylaxis is a potentially life-threatening allergic reaction. The risk of anaphylaxis after vaccination has not been well described in adults or with newer vaccines in children. We sought to estimate the incidence of anaphylaxis after vaccines and describe the demographic and clinical characteristics of confirmed cases of anaphylaxis. Using health care data from the Vaccine Safety Datalink, we determined rates of anaphylaxis after vaccination in children and adults. We first identified all patients with a vaccination record from January 2009 through December 2011 and used diagnostic and procedure codes to identify potential anaphylaxis cases. Medical records of potential cases were reviewed. Confirmed cases met the Brighton Collaboration definition for anaphylaxis and had to be determined to be vaccine triggered. We calculated the incidence of anaphylaxis after all vaccines combined and for selected individual vaccines. We identified 33 confirmed vaccine-triggered anaphylaxis cases that occurred after 25,173,965 vaccine doses. The rate of anaphylaxis was 1.31 (95% CI, 0.90-1.84) per million vaccine doses. The incidence did not vary significantly by age, and there was a nonsignificant female predominance. Vaccine-specific rates included 1.35 (95% CI, 0.65-2.47) per million doses for inactivated trivalent influenza vaccine (10 cases, 7,434,628 doses given alone) and 1.83 (95% CI, 0.22-6.63) per million doses for inactivated monovalent influenza vaccine (2 cases, 1,090,279 doses given alone). The onset of symptoms among cases was within 30 minutes (8 cases), 30 to less than 120 minutes (8 cases), 2 to less than 4 hours (10 cases), 4 to 8 hours (2 cases), the next day (1 case), and not documented (4 cases). Anaphylaxis after vaccination is rare in all age groups. Despite its rarity, anaphylaxis is a potentially life-threatening medical emergency that vaccine providers need to be prepared to treat. Published by Elsevier Inc.

  17. Epinephrine for First-aid Management of Anaphylaxis.

    PubMed

    Sicherer, Scott H; Simons, F Estelle R

    2017-03-01

    Anaphylaxis is a severe, generalized allergic or hypersensitivity reaction that is rapid in onset and may cause death. Epinephrine (adrenaline) can be life-saving when administered as rapidly as possible once anaphylaxis is recognized. This clinical report from the American Academy of Pediatrics is an update of the 2007 clinical report on this topic. It provides information to help clinicians identify patients at risk of anaphylaxis and new information about epinephrine and epinephrine autoinjectors (EAs). The report also highlights the importance of patient and family education about the recognition and management of anaphylaxis in the community. Key points emphasized include the following: (1) validated clinical criteria are available to facilitate prompt diagnosis of anaphylaxis; (2) prompt intramuscular epinephrine injection in the mid-outer thigh reduces hospitalizations, morbidity, and mortality; (3) prescribing EAs facilitates timely epinephrine injection in community settings for patients with a history of anaphylaxis and, if specific circumstances warrant, for some high-risk patients who have not previously experienced anaphylaxis; (4) prescribing epinephrine for infants and young children weighing <15 kg, especially those who weigh 7.5 kg and under, currently presents a dilemma, because the lowest dose available in EAs, 0.15 mg, is a high dose for many infants and some young children; (5) effective management of anaphylaxis in the community requires a comprehensive approach involving children, families, preschools, schools, camps, and sports organizations; and (6) prevention of anaphylaxis recurrences involves confirmation of the trigger, discussion of specific allergen avoidance, allergen immunotherapy (eg, with stinging insect venom, if relevant), and a written, personalized anaphylaxis emergency action plan; and (7) the management of anaphylaxis also involves education of children and supervising adults about anaphylaxis recognition and first

  18. The gaps in anaphylaxis diagnosis and management by French physicians.

    PubMed

    Pouessel, G; Galand, J; Beaudouin, E; Renaudin, J M; Labreuche, J; Moneret-Vautrin, D A; Deschildre, A

    2017-02-08

    Several studies have assessed the knowledge of health professionals in recognition and treatment of anaphylaxis using case-based surveys with conflicting results [1-3]. The proportion of responders able to recognize anaphylaxis and treat with appropriate adrenaline ranged from 56% to 95% [1, 3]. The causes for this under optimal management are not clearly understood. In this context, EAACI anaphylaxis guidelines were recently updated. This article is protected by copyright. All rights reserved.

  19. Online video-based resistance training improves the physical capacity of junior basketball athletes.

    PubMed

    Klusemann, Markus J; Pyne, David B; Fay, Tristan S; Drinkwater, Eric J

    2012-10-01

    Junior basketball athletes require a well-designed resistance training program to improve their physical development. Lack of expert supervision and resistance training in junior development pathways may be overcome by implementing an online video-based program. The aim of this study was to compare the magnitude of improvement (change) in physical performance and strength and functional movement patterns of junior basketball athletes using either a fully supervised or an online video-based resistance training program. Thirty-eight junior basketball athletes (males, n = 17; age, 14 ± 1 year; height, 1.79 ± 0.10 m; mass, 67 ± 12 kg; females, n = 21; age, 15 ± 1 year; height, 1.70 ± 0.07 m; mass, 62 ± 8 kg) were randomly assigned into a supervised resistance training group (SG, n = 13), video training group (VG, n = 13) or control group (CG, n = 12) and participated in a 6-week controlled experimental trial. Pre- and posttesting included measures of physical performance (20-m sprint, step-in vertical jump, agility, sit and reach, line drill, and Yo-Yo intermittent recovery level 1), strength (15 s push-up and pull-up), and functional movement screening (FMS). Both SG and VG achieved 3-5% ± 2-4% (mean ± 90% confidence limits) greater improvements in several physical performance measures (vertical jump height, 20-m sprint time, and Yo-Yo endurance performance) and a 28 ± 21% greater improvement in push-up strength compared with the CG. The SG attained substantially larger gains in FMS scores over both the VG (12 ± 10%) and CG (13 ± 8%). Video-based training appears to be a viable option to improve physical performance and strength in junior basketball athletes. Qualified supervision is recommended to improve functional movement patterns in junior athletes.

  20. Two cases of anaphylaxis after laminaria insertion.

    PubMed Central

    Kim, Sang-Hoon; Chang, Yun-Hae; Kim, Woo-Kyoung; Kim, Yoon-Keun; Cho, Sang-Heon; Kim, You-Young; Min, Kyung-Up

    2003-01-01

    Anaphylaxis following laminaria insertion rarely occurs but may be a life-threatening condition. Laminaria tents, prepared from natural sea kelp, are commonly used prior to elective termination of pregnancy to achieve cervical dilatation. We report herein two cases of anaphylaxis caused by IgE-mediated hypersensitivity to laminaria. Two women, each of whom had undergone at least one previous abortion where a laminaria had been utilized, developed anaphylactic reaction following laminaria insertion. The reaction included urticaria, nausea, breathing difficulty, and hypotension. The patients subsequently underwent skin testing and measurement of serum specific IgE level to laminaria extract, and were shown to elicit positive responses to laminaria. The implication and impact of laminaria allergy on gynecologic procedures are significant and this allergy should be included in the list of differential diagnoses for hypersensitive reaction in gynecologic procedures. PMID:14676449

  1. A case of famotidine-induced anaphylaxis.

    PubMed

    Kim, Y I; Park, C K; Park, D J; Wi, J O; Han, E R; Koh, Y I

    2010-01-01

    Famotidine is considered to be safe, causing very few adverse events. We describe a case of famotidine-induced anaphylaxis in a 23-year-old man who presented with dyspnea, seizure-like activity, and comatose mental state immediately after an intravenous injection of cefazedone and famotidine for the preoperative preparation of left varicocele. He completely recovered with epinephrine, fluid replacement, and corticosteroids. Skin tests with cefazedone and other beta-lactam antibiotics were all negative but skin tests with famotidine showed a clear positive immediate reaction. Interestingly, we also observed clear positive skin reactions to other H2-receptor antagonists such as nizatidine and ranitidine, which have similar side chains to the ring structures. Our case suggests that famotidine may induce immunoglobulin E-mediated anaphylaxis and have cross-reactivity with nizatidine and ranitidine. Clinicians should therefore be aware of possible life-threatening adverse reactions to commonly used H2-receptor antagonists such as famotidine.

  2. Selective anaphylaxis to paracetamol in a child.

    PubMed

    Couto, M; Gaspar, A; Morais-Almeida, M

    2012-08-01

    Paracetamol anaphylaxis is a very rare event, with only a few cases described in literature and even less reported in children. We report the case of a 15-year-old boy, referred to Immunoallergy Department due to four reproducible episodes of anaphylaxis after paracetamol administration, since the age of 8 years. The most severe episode occurred at 12 years, characterized by glottis edema with respiratory distress, hypotension, generalized urticaria and facial edema, immediately after intravenous administration of paracetamol during a post-operatory recovery. He had always and still tolerates ibuprofen; an oral challenge test with meloxicam was negative. Skin prick and intradermal tests with paracetamol were negative. Serum-specific IgE and CAST to paracetamol were also negative. This report provides an alert to health-care professionals regarding the potential severity of reactions occurring within the therapeutic range of this widely used drug.

  3. Anaphylaxis: epidemiology, aetiology and relevance for the clinic.

    PubMed

    Dhami, Sangeeta; Sheikh, Aziz

    2017-09-01

    Anaphylaxis is responsible for considerable morbidity and may in some cases prove fatal. Areas covered: This review summarises the findings from recent studies on the epidemiology and aetiology of anaphylaxis and draws on the insights from this work and recent international guidelines to consider the implications for clinical care. Acute management of anaphylaxis is centred on early recognition, treatment with adrenaline (epinephrine) and other essential life-support measures. The importance of longer-term care of patients with a history of or at risk of anaphylaxis are also considered with a view to minimising the risk of further reactions. Tailored individual anaphylaxis management plans should be a routine component of this longer-term care with provision of adrenaline auto-injectors to those at risk of further episodes of anaphylaxis. More generally, there is a need to ensure that there are standard protocols in place to ensure that risks of triggering anaphylaxis are minimised and appropriate acute and long-term care are provided if reactions occur. Expert commentary: It is important to be aware that anaphylaxis may occur in patients of any age, sex or ethnicity. Early recognition and prompt treatment with adrenaline are potentially life-saving. Careful assessment of risk and appropriate long-term management are key to improving long-term outcomes in those at risk of repeat episodes of anaphylaxis.

  4. Hypothesis: Hemolytic Transfusion Reactions Represent an Alternative Type of Anaphylaxis

    PubMed Central

    Hod, Eldad A.; Sokol, Set A.; Zimring, James C.; Spitalnik, Steven L.

    2009-01-01

    Classical anaphylaxis is the most severe, and potentially fatal, type of allergic reaction, manifested by hypotension, bronchoconstriction, and vascular permeability. Similarly, a hemolytic transfusion reaction (HTR) is the most feared consequence of blood transfusion. Evidence for the existence of an alternative, IgG-mediated pathway of anaphylaxis may be relevant for explaining the pathophysiology of IgG-mediated-HTRs. The purpose of this review is to summarize the evidence for this alternative pathway of anaphylaxis and to present the hypothesis that an IgG-mediated HTR is one example of this type of anaphylaxis. PMID:18830382

  5. Computer Vision Based Method and System for Online Measurement of Geometric Parameters of Train Wheel Sets

    PubMed Central

    Zhang, Zhi-Feng; Gao, Zhan; Liu, Yuan-Yuan; Jiang, Feng-Chun; Yang, Yan-Li; Ren, Yu-Fen; Yang, Hong-Jun; Yang, Kun; Zhang, Xiao-Dong

    2012-01-01

    Train wheel sets must be periodically inspected for possible or actual premature failures and it is very significant to record the wear history for the full life of utilization of wheel sets. This means that an online measuring system could be of great benefit to overall process control. An online non-contact method for measuring a wheel set’s geometric parameters based on the opto-electronic measuring technique is presented in this paper. A charge coupled device (CCD) camera with a selected optical lens and a frame grabber was used to capture the image of the light profile of the wheel set illuminated by a linear laser. The analogue signals of the image were transformed into corresponding digital grey level values. The ‘mapping function method’ is used to transform an image pixel coordinate to a space coordinate. The images of wheel sets were captured when the train passed through the measuring system. The rim inside thickness and flange thickness were measured and analyzed. The spatial resolution of the whole image capturing system is about 0.33 mm. Theoretic and experimental results show that the online measurement system based on computer vision can meet wheel set measurement requirements. PMID:22368472

  6. Is Online Learning a Viable Training Option for Teaching Sexual Assault Forensic Examiners?

    PubMed

    Patterson, Debra; Resko, Stella M

    2015-01-01

    This study assessed knowledge attainment of healthcare professionals who participated in a nationwide sexual assault forensic examiner training program developed by the International Association of Forensic Nursing. A comprehensive curriculum was divided into 12 modules that students accessed through an online learning management system. Using a one-group pretest-posttest design, we assessed students' knowledge attainment for all 12 online modules. The results showed that the mean posttest scores were significantly greater than the mean pretest scores for all 12 online modules. On over 40% of the modules, the students exhibited at least a 25% knowledge gain. This study also examined the predictors of knowledge attainment. Using a multiple linear regression model, we found that knowledge attainment was positively associated with a reliable Internet connection, students who were drawn to the training because it was of no cost to them, and those students with higher levels of motivation. By contrast, lower knowledge gains were significantly related to students who reported more work/personal barriers and those who were drawn to sexual assault forensic examiner practice because they, or someone close to them, have personal experience with sexual assault.

  7. Anaphylaxis caused by honey: a case report

    PubMed Central

    Duarte, Fátima Cabral; Mendes, Ana; Bartolomé, Borja; Barbosa, Manuel Pereira

    2017-01-01

    Honey allergy is a very rare, but serious health condition. In this study, we presented 1 patient who had anaphylaxis after the honey allergological investigation with skin prick-prick test with honey. Honey as a food has been associated to allergic reactions and as the increased consumption of honey in health food may increase the incidence of honey-related allergic reactions. PMID:28154806

  8. Exercise-induced anaphylaxis: A clinical view

    PubMed Central

    2012-01-01

    Exercise-induced anaphylaxis (EIA) is a distinct form of physical allergy. The development of anaphylaxis during exertion often requires the concomitant exposure to triggering factors such as intake of foods (food dependent exercise-induced anaphylaxis) or drugs prior to exercise, extreme environmental conditions. EIA is a rare, but serious disorder, which is often undetected or inadequately treated. This article summarizes current evidences on pathophysiology, diagnosis and management. We reviewed recent advances in factors triggering the release of mediators from mast cells which seems to play a pathogenetic role. A correct diagnosis is essential to avoid unnecessary restricted diet, to allow physical activity in subjects with EIA dependent from triggering factors such as food, and to manage attacks. An algorithm for diagnosing EIA based on medical history, IgE tests and exercise challenge test has been provided. In the long-term management of EIA, there is a need for educating patients and care-givers to avoid exposure to precipitating factors and to recognize and treat episodes. Future researches on existing questions are discussed. PMID:22980517

  9. [Cereal-dependent exercise-induced anaphylaxis].

    PubMed

    Seoane-Rodríguez, Marta; Caralli, María Elisa; Morales-Cabeza, Cristina; Micozzi, Sarah; De Barrio-Fernández, Manuel; Rojas Pérez-Ezquerra, Patricia

    2016-01-01

    Wheat-dependent exercise-induced anaphylaxis (WDEIA) is increasing. In vitro test such as omega-5-gliadin levels are useful in the diagnosis, while oral single blind challenge tests (OCT) with wheat plus exercise continuous being the gold standard diagnostic method. This paper reports the case of a 38-year-old woman, with several episodes of anaphylaxis after eating different foods and doing exercise after ingestion. An allergy study was performed with positive skin prick tests for wheat, barley and rye. Total IgE 238.0KU/L, positive specific IgE (>100KU/L) to wheat, barley and rye, and negative to rTri-a-19 omega-5 gliadin. OCT with bread and exercise was positive. In this case of wheat-dependent exerciseinduced anaphylaxis (WDEIA) with negative serum specific IgE to omega-5-gliadin, negative results with gamma, alpha, bheta y omega-gliadin doesn't exclude the diagnosis of WDEIA.

  10. Anaphylaxis: clinical concepts and research priorities.

    PubMed

    Brown, Simon G A

    2006-04-01

    Anaphylaxis is a severe immediate-type hypersensitivity reaction characterized by life-threatening upper airway obstruction bronchospasm and hypotension. Although many episodes are easy to diagnose by the combination of characteristic skin features with other organ effects, this is not always the case and a workable clinical definition of anaphylaxis and useful biomarkers of the condition have been elusive. A recently proposed consensus definition is ready for prospective validation. The cornerstones of management are the supine position, adrenaline and volume resuscitation. An intramuscular dose of adrenaline is generally recommended to initiate treatment. If additional adrenaline is required, then a controlled intravenous infusion might be more efficacious and safer than intravenous bolus administration. Additional bronchodilator treatment with continuous salbutamol and corticosteroids are used for severe and/or refractory bronchospasm. Aggressive volume resuscitation, selective vasopressors, atropine (for bradycardia), inotropes that bypass the beta-adrenoreceptor and bedside echocardiographic assessment should be considered for hypotension that is refractory to treatment. Management guidelines continue to be opinion- and consensus-based, with retrospective studies accounting for the vast majority of clinical research papers on the topic. The clinical spectrum of anaphylaxis including major disease subgroups requires clarification, and validated scoring systems and outcome measures are needed to enable good-quality prospective observational studies and randomized controlled trials. A systematic approach with multicentre collaboration is required to improve our understanding and management of this disease.

  11. Enhancing Learners' Self-Directed Use of Technology for Language Learning: The Effectiveness of an Online Training Platform

    ERIC Educational Resources Information Center

    Lai, Chun; Shum, Mark; Tian, Yan

    2016-01-01

    Enhancing self-directed use of technology for language learning is essential for maximizing the potential of technology for language learning. Understanding how to construct learner training to promote this critical competency is of great significance. This study examined the effectiveness of an online training platform aimed at enhancing the…

  12. Measuring the Effects of an On-Line Training Module for School Psychologists Working with Traumatized Children: A Pilot Study

    ERIC Educational Resources Information Center

    Dezen, Kristin

    2012-01-01

    The present study was designed to address the current lack of trauma training provided to school psychologists. Specifically, this study employed a randomized, controlled design to test the efficacy of an on-line training targeting school psychology graduate student trainees' awareness of the signs and symptoms of child abuse as well as their…

  13. 76 FR 1622 - Submission for OMB Review; Comment Request; Online Skills Training for PCPs on Substance Abuse

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-11

    ... Training for PCPs on Substance Abuse SUMMARY: Under the provisions of Section 3507(a)(1)(D) of the... research will evaluate the effectiveness of the Online Skills Training for PCPs on Substance Abuse, via the... clinical skills of primary care physicians in the U.S. who treat substance abuse patients. The...

  14. Measuring the Effects of an On-Line Training Module for School Psychologists Working with Traumatized Children: A Pilot Study

    ERIC Educational Resources Information Center

    Dezen, Kristin

    2012-01-01

    The present study was designed to address the current lack of trauma training provided to school psychologists. Specifically, this study employed a randomized, controlled design to test the efficacy of an on-line training targeting school psychology graduate student trainees' awareness of the signs and symptoms of child abuse as well as their…

  15. A Theoretical Model and Analysis of the Effect of Self-Regulation on Attrition from Voluntary Online Training

    ERIC Educational Resources Information Center

    Sitzmann, Traci

    2012-01-01

    A theoretical model is presented that examines self-regulatory processes and trainee characteristics as predictors of attrition from voluntary online training in order to determine who is at risk of dropping out and the processes that occur during training that determine when they are at risk of dropping out. Attrition increased following declines…

  16. Teacher Training in a Synchronous Cyber Face-to-Face Classroom: Characterizing and Supporting the Online Teachers' Learning Process

    ERIC Educational Resources Information Center

    Wang, Yuping; Chen, Nian-Shing; Levy, Mike

    2010-01-01

    This article discusses the learning process undertaken by language teachers in a cyber face-to-face teacher training program. Eight tertiary Chinese language teachers attended a 12-week training program conducted in an online synchronous learning environment characterized by multimedia-based, oral and visual interaction. The term "cyber…

  17. Corporate Sector Practice Informs Online Workforce Training for Australian Government Agencies: Towards Effective Educational-Learning Systems Design

    ERIC Educational Resources Information Center

    McKay, Elspeth; Vilela, Cenie

    2011-01-01

    The purpose of this paper is to outline government online training practice. We searched individual research domains of the human-dimensions of Human Computer Interaction (HCI), information and communications technologies (ICT) and instructional design for evidence of either corporate sector or government training practices. We overlapped these…

  18. Enhancing Learners' Self-Directed Use of Technology for Language Learning: The Effectiveness of an Online Training Platform

    ERIC Educational Resources Information Center

    Lai, Chun; Shum, Mark; Tian, Yan

    2016-01-01

    Enhancing self-directed use of technology for language learning is essential for maximizing the potential of technology for language learning. Understanding how to construct learner training to promote this critical competency is of great significance. This study examined the effectiveness of an online training platform aimed at enhancing the…

  19. A Theoretical Model and Analysis of the Effect of Self-Regulation on Attrition from Voluntary Online Training

    ERIC Educational Resources Information Center

    Sitzmann, Traci

    2012-01-01

    A theoretical model is presented that examines self-regulatory processes and trainee characteristics as predictors of attrition from voluntary online training in order to determine who is at risk of dropping out and the processes that occur during training that determine when they are at risk of dropping out. Attrition increased following declines…

  20. Teacher Training in a Synchronous Cyber Face-to-Face Classroom: Characterizing and Supporting the Online Teachers' Learning Process

    ERIC Educational Resources Information Center

    Wang, Yuping; Chen, Nian-Shing; Levy, Mike

    2010-01-01

    This article discusses the learning process undertaken by language teachers in a cyber face-to-face teacher training program. Eight tertiary Chinese language teachers attended a 12-week training program conducted in an online synchronous learning environment characterized by multimedia-based, oral and visual interaction. The term "cyber…

  1. Meeting a Growing Demand: Texas A&M AgriLife Extension Service's Early Childhood Educator Online Training Program

    ERIC Educational Resources Information Center

    Green, Stephen

    2013-01-01

    Demand for professional development training in the early childhood field has grown substantially in recent years. To meet the demand, Texas A&M AgriLife Extension Service's Family Development and Resource Management unit developed the Early Childhood Educator Online Training Program, a professional development system that currently offers…

  2. Online training on fetal alcohol spectrum disorders for court-appointed special advocates volunteers.

    PubMed

    Pomeroy, Elizabeth C; Parrish, Danielle E

    2013-08-01

    Fetal alcohol spectrum disorders (FASDs) are a leading cause of developmental disabilities. Children within the child welfare system are five to 10 times more likely than other children to experience these symptoms. Court Appointed Special Advocates (CASA) volunteers are uniquely positioned to identify these children and refer them for assessment and services. This study used a one-group pretest-posttest design to assess the impact of a three-hour online FASDs training on CASA workers' knowledge of FASDs and their comfort and confidence in identifying children with FASDs for referral, advocating for them, and linking them to services. The training and assessment measures were completed by 338 CASA volunteers and staff from 55 CASA locations in Texas. Wilcoxon matched-pairs tests and paired t tests were used to assess change in each of the dependent measures. All comfort and confidence items showed significant improvement from pretest to posttest; there was also a significant improvement in knowledge. These results support the potential of this online training to enhance CASA volunteers' ability to help children with FASDs.

  3. Use of Entertainment Elements in an Online Video Mini-Series to Train Pharmacy Preceptors

    PubMed Central

    Cheon, Jongpil; Crooks, Steven M.; Lee, Jaehoon; Curtis, Jacob D.

    2017-01-01

    Objective. To create an entertaining approach to training pharmacy preceptors. Design. A training program was developed to provide an innovative, entertaining, and flexible continuing education program for pharmacy preceptors. Three instructional design principles – providing an authentic context, offering a diversity of content, and engaging and maintaining attention – were foundational to this concept. The mini-series consisted of 12 online video episodes. Participants completed three reflective questions and one evaluation after watching each episode. Three months following completion of the training, a survey was distributed to analyze the long-term impact of the mini-series on precepting skills. Assessment. Two hundred two participants completed all 12 episodes. After completing the training series, the participants’ confidence level in their knowledge pertaining to the objectives was significantly greater than before they started. Among the 32% of participants who responded to the three-month follow-up survey, the mean score for precepting confidence was 6.8 on a scale of 1 to 10 on which 1=no increase to 10=big increase. Also, 99% of participants indicated they would complete a similar training program and recommend to others. Conclusions. Feedback from the mini-series provides evidence of the effectiveness of its delivery format and use as a preceptor learning tool. PMID:28289302

  4. Factors that determine parents' perception of their child's risk of life-threatening food-induced anaphylaxis.

    PubMed

    Ogg, Jennifer; Wong, Jayne; Wan, Ming Wai; Davis, Naomi; Arkwright, Peter D

    2017-01-01

    Although food allergy is known to be associated with increased disease burden, factors that shape parents' perception of their child's risk of future severe or fatal anaphylaxis are poorly understood. This study aimed to evaluate factors associated with parents' perceived risk of food-induced anaphylaxis. A questionnaire-based survey of 202 parents was conducted in a single specialist center outpatient clinic that treats children with food allergies. Parents' perceived risk of their child experiencing further food-induced anaphylaxis was assessed by using a validated food allergy independent measure. Demographic data as well as parents' anxiety and depression scores were assessed by using the Hospital Anxiety and Depression score. Nineteen percent of parents believed that their child had a moderate-to-high chance of dying from food-induced anaphylaxis. A lack of a university education, higher anxiety score, and, particularly, possession of an epinephrine autoinjector (relative risk 9.9 [95% confidence interval, 3.3-30]) were key factors associated with heightened risk perception. Caring for a child with multiple food allergies was the main factor associated with parents feeling less able to manage future reactions (relative risk 9.5 [95% confidence interval, 1.7-53]). Parents' risk perception of fatal anaphylaxis correlated with anxiety and mood scores. Parents' education, affect, and possession of an epinephrine autoinjector were associated with a heightened perceived risk of future anaphylaxis. Clinicians should consider not only the child's needs but should also provide counseling for parents, particularly those who possess autoinjectors. Parents of children with multiple food allergies may need additional education and training to help them cope with future reactions.

  5. 3D Online Visualization and Synergy of NASA A-Train Data Using Google Earth

    NASA Technical Reports Server (NTRS)

    Chen, Aijun; Kempler, Steven; Leptoukh, Gregory; Smith, Peter

    2010-01-01

    This poster presentation reviews the use of Google Earth to assist in three dimensional online visualization of NASA Earth science and geospatial data. The NASA A-Train satellite constellation is a succession of seven sun-synchronous orbit satellites: (1) OCO-2 (Orbiting Carbon Observatory) (will launch in Feb. 2013), (2) GCOM-W1 (Global Change Observation Mission), (3) Aqua, (4) CloudSat, (5) CALIPSO (Cloud-Aerosol Lidar & Infrared Pathfinder Satellite Observations), (6) Glory, (7) Aura. The A-Train makes possible synergy of information from multiple resources, so more information about earth condition is obtained from the combined observations than would be possible from the sum of the observations taken independently

  6. [Incidence and clinical features of anaphylaxis during general anesthesia].

    PubMed

    Nabatame, Maki; Mori, Masanobu; Ikeda, Yoshikazu; Matsushita, Mitsuji; Tsujimura, Shigehisa

    2010-02-01

    Anaphylaxis is an acute life-threatening systematic reaction, and it requires early diagnosis and correct management to save the patients. The true incidence of anaphylaxis during general anesthesia is unknown. Although anaphylaxis is a rare intraoperative complication, most drugs used in the perioperative period can lead to anaphylaxis. All patients who had received operations under general anesthesia in our hospital were covered in this study during the 5-year period. We searched for the incidence and clinical features of anaphylaxis retrospectively. Seven cases in 9,844 patients were recognized. Various drugs were suspected as causal agents, but they were all nonanesthesia related drugs. The diagnosis of anaphylaxis relied on the history and clinical course of each patient. There was no reliable diagnostic testing such as serum tryptase and skin test. So we could not determine whether the reaction was IgE-mediated or not. Immediate discontinuation of causal drugs and early administration of epinephrine are cornerstones of treatment. More specific diagnostic tests are required for correct identification of causal drugs. To reduce the risk of anaphylaxis during anesthesia, we hope practical data bases and guidelines for anaphylaxis related to anesthesia will be published in the future.

  7. Suspected Intraoperative Anaphylaxis to Gelatin Absorbable Hemostatic Sponge

    PubMed Central

    Ji, Joonyoung; Barrett, Edward J.

    2015-01-01

    Anaphylaxis under anesthesia is a life-threatening medical emergency that requires rapid identification and treatment. Allergies to agents with which the general population are likely to come into contact are usually identified, but patients are exposed to uncommon agents during anesthesia and surgery. Here, we describe a case of anaphylaxis under anesthesia implicating Gelfoam sponges. PMID:25849471

  8. Demonstration of an aberrant mast-cell population with clonal markers in a subset of patients with "idiopathic" anaphylaxis.

    PubMed

    Akin, Cem; Scott, Linda M; Kocabas, Can N; Kushnir-Sukhov, Nataliya; Brittain, Erica; Noel, Pierre; Metcalfe, Dean D

    2007-10-01

    Idiopathic anaphylaxis remains a perplexing disorder in which existing prophylactic therapy is inadequate. In this prospective study, we sought to determine whether patients with idiopathic anaphylaxis might have evidence for a clonal disorder of mast cells related to mastocytosis and for which novel targeted therapies might be considered. We report 12 patients with "idiopathic" anaphylaxis who did not exhibit either urticaria pigmentosa or the characteristic bone marrow biopsy finding of multifocal mast-cell aggregates observed in systemic mastocytosis. Of these 12 patients, 5 had evidence of 1 or more minor criteria for mastocytosis. C-KIT mutational analysis was positive for the 816D>V activating mutation in 3 of 3 patients in CD25(+) bone marrow cells where the analysis was performed. These results demonstrate the presence of an aberrant mast-cell population carrying clonal markers in a subset of patients diagnosed with "idiopathic" anaphylaxis, who may respond to inhibitors targeting mutated C-KIT. This intramural clinical trial was conducted in 2003 and 2004 and was registered at (http://clinicalcenter.nih.gov) with a study number 03-I-0010. Since the study is now closed, it is no longer available online.

  9. Anaphylaxis in an urban Belgian emergency department: epidemiology and aetiology.

    PubMed

    Mostmans, Y; Blykers, M; Mols, P; Gutermuth, J; Grosber, M; Naeije, N

    2016-04-01

    Anaphylaxis is an emergency condition of which reliable epidemiological data are lacking. This study focusses on epidemiology and aetiology of anaphylactic reactions in an urban Belgian emergency department (ED). Patient data were collected from 04/2009 to 04/2013.During this period, emergency doctors completed a questionnaire for adult patients (>15 years) with anaphylaxis presenting at the ED. Inclusion criteria were based on the Sampson criteria of anaphylaxis. Data were analysed using a Microsoft Excel database. Anaphylaxis accounted for 0.04% of all emergency visits in this 4-year period. In both women and men, dyspnoea and urticaria were noted most frequently. 51.7% of cases were possibly elicited by foods, 46.1% by drugs and 3.4% by hymenoptera stings. Women more often reported allergic diseases in their personal history. 55.7% of patients, who had a history of allergy, reported a suspected food-related allergy, 24.6% a drug-related allergy and 8.2% a hymenoptera venom-related allergy. In 76.5% of patients who reported a history of food allergy, food was the presumed elicitor of anaphylaxis. For patients with history of drug allergy, 88.2% had a presumed drug anaphylaxis at the time of presentation at the ED. 81% of cases presented with grade 4 or 5 anaphylaxis. With increasing age, the severity of anaphylaxis increased. Higher tryptase levels correlated with a higher grade of anaphylaxis. In this Belgian urban population, foods and drugs were by far the most common suspected elicitors of anaphylaxis. Personal history of allergic diseases was present in more than half of the cases.

  10. Anaphylaxis After Immunization of Children and Adolescents in Germany.

    PubMed

    Oberle, Doris; Pavel, Jutta; Rieck, Thorsten; Weichert, Stefan; Schroten, Horst; Keller-Stanislawski, Brigitte; Tenenbaum, Tobias

    2016-05-01

    Anaphylaxis is a life-threatening event. The aim of this study was to estimate the annual frequency of anaphylaxis after immunization in individuals younger than 18 years in Germany leading to hospitalization. All suspected cases of postvaccination anaphylaxis involving individuals aged 0-17 years reported to the German surveillance unit for rare pediatric diseases (Erhebungseinheit für seltene pädiatrische Erkrankungen in Deutschland) from June 2008 through May 2010, and all suspected cases of anaphylaxis as an adverse event following immunization in the same age group reported to the Paul-Ehrlich-Institut during the observational period were classified according to the Brighton collaboration case definition. Only hospitalized cases of anaphylaxis fulfilling Brighton collaboration case definition level 1-3 criteria were eligible. Estimates for the annual frequency were calculated by using capture-recapture methods. A total of 22 reports were eligible. Median age of the affected individuals (13 males, 9 females) was 7.0 years (range: 2 months to 17 years). Anaphylaxis occurred most frequently after administration of AS03 adjuvanted A/H1N1 pandemic influenza vaccine (n = 8). The annual frequency of anaphylaxis after vaccination (excluding pandemic influenza vaccine as well as monovalent measles and rubella vaccines) was estimated to be 6.8 (95% confidence interval: 6.1-10.9). The estimated incidence of anaphylaxis after administration of specific vaccines ranged from 0.4 to 127.6 cases per 1,000,000 doses administered. This study confirms that anaphylaxis after immunization in children and adolescents is a rare event. AS03 adjuvanted A/H1N1 pandemic influenza vaccine seems to be associated with a higher risk of anaphylaxis when compared with other vaccines.

  11. Appropriateness of epinephrine use in ED patients with anaphylaxis.

    PubMed

    Baalmann, Damian V; Hagan, John B; Li, James T C; Hess, Erik P; Campbell, Ronna L

    2016-02-01

    Studies have demonstrated low rates of emergency department (ED) epinephrine administration for anaphylaxis patients, suggestive of ED undertreatment of anaphylaxis. Our study assessed the appropriateness of ED epinephrine administration in anaphylaxis management. A prospective observational study was conducted involving ED patients presenting with possible allergic reactions. Patients and ED providers completed questionnaires regarding the suspected trigger, signs and symptoms, and prehospital treatment. Two board-certified allergists-immunologists independently reviewed the questionnaires, as well as electronic health records, to determine whether the cases represented anaphylaxis and whether ED epinephrine administration was appropriate. Among 174 patients enrolled in the study, 61 (35%) were confirmed to have anaphylaxis. Overall, 47 anaphylaxis patients (77%) received epinephrine either before ED arrival or in the ED. In the latter situation, 24 anaphylaxis patients (39%) received epinephrine and 37 (61%) did not. Of the patients who received ED epinephrine, the allergists-immunologists determined that its administration was appropriate in all cases (95% confidence interval [CI], 83%-100%). Among the 37 patients who did not receive ED epinephrine, the allergists-immunologists determined that nonadministration of epinephrine was appropriate in 36 patients (97%; 95% CI, 84%-100%). The allergists-immunologists determined that overall, ED management was appropriate for 60 (98%) of 61 patients with anaphylaxis (95% CI, 90%-100%). Although more than 60% of anaphylaxis patients did not receive epinephrine in the ED, the allergists-immunologists deemed ED management appropriate in 98% of total cases. Previous retrospective studies may underestimate the appropriateness of ED anaphylaxis management, particularly when prehospital epinephrine administration is not reported. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Effects of online palliative care training on knowledge, attitude and satisfaction of primary care physicians

    PubMed Central

    2011-01-01

    Background The Spanish Palliative Care Strategy recommends an intermediate level of training for primary care physicians in order to provide them with knowledge and skills. Most of the training involves face-to-face courses but increasing pressures on physicians have resulted in fewer opportunities for provision of and attendance to this type of training. The effectiveness of on-line continuing medical education in terms of its impact on clinical practice has been scarcely studied. Its effect in relation to palliative care for primary care physicians is currently unknown, in terms of improvement in patient's quality of life and main caregiver's satisfaction. There is uncertainty too in terms of any potential benefits of asynchronous communication and interaction among on-line education participants, as well as of the effect of the learning process. The authors have developed an on-line educational model for palliative care which has been applied to primary care physicians in order to measure its effectiveness regarding knowledge, attitude towards palliative care, and physician's satisfaction in comparison with a control group. The effectiveness evaluation at 18 months and the impact on the quality of life of patients managed by the physicians, and the main caregiver's satisfaction will be addressed in a different paper. Methods Randomized controlled educational trial to compared, on a first stage, the knowledge and attitude of primary care physicians regarding palliative care for advanced cancer patients, as well as satisfaction in those who followed an on-line palliative care training program with tutorship, using a Moodle Platform vs. traditional education. Results 169 physicians were included, 85 in the intervention group and 84 in the control group, of which five were excluded. Finally 82 participants per group were analyzed. There were significant differences in favor of the intervention group, in terms of knowledge (mean 4.6; CI 95%: 2.8 to 6.5 (p = 0

  13. Effects of online palliative care training on knowledge, attitude and satisfaction of primary care physicians.

    PubMed

    Pelayo, Marta; Cebrián, Diego; Areosa, Almudena; Agra, Yolanda; Izquierdo, Juan Vicente; Buendía, Félix

    2011-05-23

    The Spanish Palliative Care Strategy recommends an intermediate level of training for primary care physicians in order to provide them with knowledge and skills. Most of the training involves face-to-face courses but increasing pressures on physicians have resulted in fewer opportunities for provision of and attendance to this type of training. The effectiveness of on-line continuing medical education in terms of its impact on clinical practice has been scarcely studied. Its effect in relation to palliative care for primary care physicians is currently unknown, in terms of improvement in patient's quality of life and main caregiver's satisfaction. There is uncertainty too in terms of any potential benefits of asynchronous communication and interaction among on-line education participants, as well as of the effect of the learning process.The authors have developed an on-line educational model for palliative care which has been applied to primary care physicians in order to measure its effectiveness regarding knowledge, attitude towards palliative care, and physician's satisfaction in comparison with a control group.The effectiveness evaluation at 18 months and the impact on the quality of life of patients managed by the physicians, and the main caregiver's satisfaction will be addressed in a different paper. Randomized controlled educational trial to compared, on a first stage, the knowledge and attitude of primary care physicians regarding palliative care for advanced cancer patients, as well as satisfaction in those who followed an on-line palliative care training program with tutorship, using a Moodle Platform vs. traditional education. 169 physicians were included, 85 in the intervention group and 84 in the control group, of which five were excluded. Finally 82 participants per group were analyzed. There were significant differences in favor of the intervention group, in terms of knowledge (mean 4.6; CI 95%: 2.8 to 6.5 (p = 0.0001), scale range 0-33), confidence

  14. Allergists' self-reported adherence to anaphylaxis practice parameters and perceived barriers to care: an American College of Allergy, Asthma, and Immunology member survey.

    PubMed

    Fineman, Stanley; Dowling, Paul; O'Rourke, Dianne

    2013-12-01

    Anaphylaxis is life-threatening and requires rapid medical intervention. Knowledge of treatment guidelines and addressing barriers to care are essential for appropriate management. To investigate allergists' self-reported practices in managing patients at risk for anaphylaxis, specifically in following practice parameters for diagnosis, treatment, and appropriate use of epinephrine, and to identify perceived barriers to care. Online questionnaires were distributed to members of the American College of Allergy, Asthma, and Immunology. The US physicians who self-identified as "allergist/immunologist" were eligible to participate. The first 500 completed questionnaires were analyzed. Nearly all (≥95%) reported adherence to practice parameters in prescribing an epinephrine auto-injector and instructing patients on its use, taking a detailed allergy history, counseling patients on avoidance measures, and educating patients on the signs and symptoms of anaphylaxis. More than 90% stated they determined the best diagnostic procedures to identify triggers and coordinated laboratory and allergy testing. Adherence to practice parameters was less robust for providing patients with written action plans and in-office anaphylaxis preparedness. Perceived barriers to care included a significant proportion of patients who were uncomfortable using epinephrine auto-injectors and inadequate knowledge of anaphylaxis among referral physicians. Allergists overwhelmingly adhere to practice parameter recommendations for the treatment and management of anaphylaxis, including appropriate use of epinephrine as first-line treatment, educating patients, and testing to diagnose anaphylaxis and identify its triggers. Opportunities for improvement include preparing staff and patients for anaphylactic events, providing written action plans, and improving knowledge of referring physicians. Copyright © 2013 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights

  15. A case of anaphylaxis to peppermint

    PubMed Central

    2014-01-01

    Background Anaphylaxis, a form of IgE mediated hypersensitivity, arises when mast cells and possibly basophils are provoked to secrete mediators with potent vasoactive and smooth muscle contractile activities that evoke a systemic response. We report a case of IgE mediated anaphylaxis to peppermint (Mentha piperita) in a male shortly after sucking on a candy. Case presentation A 69 year old male developed sudden onset of lip and tongue swelling, throat tightness and shortness of breath within five minutes of sucking on a peppermint candy. He denied lightheadedness, weakness, nausea, vomiting, or urticaria. He took 25 mg of diphenhydramine, but his symptoms progressed to onset of cough, wheeze and difficulty with talking and swallowing. He was rushed to the nearest emergency department, where he was treated with intramuscular epinephrine, antihistamines and steroids. On history, he reported recent onset of mouth itchiness and mild tongue and lip swelling after using Colgate peppermint toothpaste. He denied previous history of asthma, allergic rhinitis, food or drug allergies. His past medical history was remarkable for hypercholesterolemia, gastroesophageal reflux and gout. He was on simvastatin, omeprazole, aspirin, and was carrying a self-injectable epinephrine device. He moved to current residence three years ago and cultivated mint plants in his backyard. He admitted to develop nasal congestion, cough and wheeze when gardening. Physical examination was unremarkable apart from slightly swollen pale inferior turbinates. Skin prick test (SPT) was strongly positive to a slurry of peppermint candy and fresh peppermint leaf, with appropriate controls. Same tests performed on five healthy volunteers yielded negative results. Skin testing to common inhalants including molds and main allergenic foods was positive to dust mites. Strict avoidance of mint containing items was advised. Upon reassessment, he had removed mint plants from his garden which led to resolution of

  16. A case of anaphylaxis to peppermint.

    PubMed

    Bayat, Roian; Borici-Mazi, Rozita

    2014-01-28

    Anaphylaxis, a form of IgE mediated hypersensitivity, arises when mast cells and possibly basophils are provoked to secrete mediators with potent vasoactive and smooth muscle contractile activities that evoke a systemic response. We report a case of IgE mediated anaphylaxis to peppermint (Mentha piperita) in a male shortly after sucking on a candy. A 69 year old male developed sudden onset of lip and tongue swelling, throat tightness and shortness of breath within five minutes of sucking on a peppermint candy. He denied lightheadedness, weakness, nausea, vomiting, or urticaria. He took 25 mg of diphenhydramine, but his symptoms progressed to onset of cough, wheeze and difficulty with talking and swallowing. He was rushed to the nearest emergency department, where he was treated with intramuscular epinephrine, antihistamines and steroids. On history, he reported recent onset of mouth itchiness and mild tongue and lip swelling after using Colgate peppermint toothpaste. He denied previous history of asthma, allergic rhinitis, food or drug allergies. His past medical history was remarkable for hypercholesterolemia, gastroesophageal reflux and gout. He was on simvastatin, omeprazole, aspirin, and was carrying a self-injectable epinephrine device. He moved to current residence three years ago and cultivated mint plants in his backyard. He admitted to develop nasal congestion, cough and wheeze when gardening. Physical examination was unremarkable apart from slightly swollen pale inferior turbinates. Skin prick test (SPT) was strongly positive to a slurry of peppermint candy and fresh peppermint leaf, with appropriate controls. Same tests performed on five healthy volunteers yielded negative results. Skin testing to common inhalants including molds and main allergenic foods was positive to dust mites. Strict avoidance of mint containing items was advised. Upon reassessment, he had removed mint plants from his garden which led to resolution of symptoms when gardening. Ig

  17. Anaphylaxis after accidental ingestion of kiwi fruit

    PubMed Central

    Różalska, Anna; Ukleja-Sokołowska, Natalia; Żbikowska-Gotz, Magdalena; Bartuzi, Zbigniew

    2013-01-01

    Numerous cases of anaphylaxis after ingestion of kiwi fruit, after the skin tests and during oral immunotherapy were described. The article describes the case of severe anaphylactic reaction that occurred in a 55-year-old patient after accidental ingestion of kiwi. Allergy to kiwi fruit was confirmed by a native test with fresh kiwi fruit. After the test, the patient experienced generalized organ response in the form of headache, general weakness and rashes on the neck and breast, and dyspnea. The patient had significantly elevated levels of total IgE and IgE specific to kiwi fruit. PMID:24278073

  18. Allergen-Specific Immunotherapy in Food Anaphylaxis

    PubMed Central

    2008-01-01

    Specific immunotherapy (SIT) protocols for nutritional allergens have only recently been established with a focus on oral allergy syndrome because of pollen cross-reacting antibodies. For these patients, a substantial number of studies have been published suggesting benefits from SIT. The situation in true anaphylaxis to food allergens such as peanut allergy is more complex, and therapeutic strategies are based on individual protocols rather than controlled studies. However, in defined cases, SIT represents a promising approach for a durable protection from life-threatening risks after accidental ingestion. PMID:23283385

  19. Anaphylaxis after accidental ingestion of kiwi fruit.

    PubMed

    Gawrońska-Ukleja, Ewa; Różalska, Anna; Ukleja-Sokołowska, Natalia; Zbikowska-Gotz, Magdalena; Bartuzi, Zbigniew

    2013-06-01

    Numerous cases of anaphylaxis after ingestion of kiwi fruit, after the skin tests and during oral immunotherapy were described. The article describes the case of severe anaphylactic reaction that occurred in a 55-year-old patient after accidental ingestion of kiwi. Allergy to kiwi fruit was confirmed by a native test with fresh kiwi fruit. After the test, the patient experienced generalized organ response in the form of headache, general weakness and rashes on the neck and breast, and dyspnea. The patient had significantly elevated levels of total IgE and IgE specific to kiwi fruit.

  20. Clinical immunology review series: an approach to the patient with anaphylaxis.

    PubMed

    El-Shanawany, T; Williams, P E; Jolles, S

    2008-07-01

    Anaphylaxis is a severe, life-threatening, generalized or systemic hypersensitivity reaction. While there is agreement as to this definition of anaphylaxis, the clinical presentation is often variable and it is not uncommon for there to be debate after the event as to whether anaphylaxis had actually occurred. The management of anaphylaxis falls into two distinct phases: (1) emergency treatment and resuscitation of a patient with acute anaphylaxis and (2) the search for a cause for the event and the formulation of a plan to prevent and treat possible further episodes of anaphylaxis. Both aspects are important in preventing death from anaphylaxis and are covered in this review.

  1. Development of online conferencing and web-based in-service modules for preceptor training.

    PubMed

    Conway-Klaassen, Janice M; Brennecke, Patricia J; Wiesner, Stephen M; Spannaus-Martin, Donna J

    2012-01-01

    Over the past five years our clinical laboratory sciences (CLS) program more than doubled student enrollment to help address the workforce shortages in our state. At the same time, medical laboratory technician programs were also increasing enrollment, putting significant pressure on the already limited number of clinical training spaces. To help alleviate the impact on clinical sites, major changes were made to the traditional clinical rotation model; shifting from a clinical training to a clinical experience and a simultaneous decrease in length from 22 to 12 weeks. This change required extensive in-service training for clinical preceptors including rationale for the new clinical experience model, review of student campus education, expectations for preceptors and students, as well as developing and implementing new evaluation methods of student performance. Through funding from the Department of Labor, online interactive modules introducing the concepts of new clinical experience module for both preceptors and for students were developed. To provide a more in-depth and specific in-service for the preceptors, web-conferences were held to describe the students' didactic and laboratory educational background and to discuss the expectations and evaluations of students. Two course management system sites were developed, one for preceptors and one for students, so they could access clinical experience information and materials at any time and from any location. These course sites also allowed us to convert evaluation processes to an online format. Survey feedback from preceptors indicates that this system was well received providing a cost-effective method for preceptor education and communication.

  2. Knowledge of asthma and anaphylaxis among teachers in Spanish schools.

    PubMed

    Juliá-Benito, J C; Escarrer-Jaume, M; Guerra-Pérez, M T; Contreras-Porta, J; Tauler-Toro, E; Madroñero-Tentor, A; Cerdá-Mir, J C

    Allergic diseases affect 15-20% of the paediatric population in the industrialised world. Most educational centres in Spain do not have health professionals among their staff, and the teachers are in charge of child care in school. The advisability of specific training of the teaching staff should be considered, with the introduction of concrete intervention plans in the event of life-threatening emergencies in schools. Evaluation of the training needs constitutes the first step in planning an educational project. In this regard, the Health Education Group of the Spanish Society of Clinical Immunology, Allergology and Paediatric Asthma (Grupo de Educación Sanitaria de la Sociedad Española de Inmunología Clínica, Alergología y Asma Pediátrica [SEICAAP]) assessed the knowledge of teachers in five Spanish Autonomous Communities, using a self-administered questionnaire specifically developed for this study. The data obtained were analysed using the SPSS statistical package. A total of 2479 teachers completed the questionnaire. Most of them claimed to know what asthma is, and almost one half considered that they would know how to act in the event of an asthma attack. This proportion was higher among physical education teachers. Most would not know how to act in the case of anaphylaxis or be able to administer the required medication. In general, the teachers expressed interest in receiving training and in having an interventional protocol applicable to situations of this kind. It is important to know what the training requirements are in order to develop plans for intervention in the event of an emergency in school. Teachers admit a lack of knowledge on how to deal with these disorders, but express a wish to receive training. Copyright © 2017 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  3. School personnel's self-efficacy in managing food allergy and anaphylaxis.

    PubMed

    Polloni, Laura; Baldi, Ileana; Lazzarotto, Francesca; Bonaguro, Roberta; Toniolo, Alice; Celegato, Nicolò; Gregori, Dario; Muraro, Antonella

    2016-06-01

    Food allergy affects up to 4-7% European schoolchildren. Studies identified important shortcomings on food allergy and anaphylaxis management in schools. In social cognitive theory, personal beliefs in own capabilities influence choices, effort levels, perseverance and performance accomplishments. This study aimed to investigate school personnel's self-efficacy in managing food allergy and anaphylaxis, providing a valid instrument to deeply understand how to support schools to effectively manage students at risk of food reactions. A total of 440 schoolteachers and caretakers from north-east Italy completed a questionnaire assessing self-efficacy in managing food allergy and anaphylaxis at school. Exploratory factor analysis was performed. Factors' internal consistency was evaluated using Cronbach's alpha. Factors' scores were estimated using Bartlett approach, and kernel density estimate of distributions was provided. Descriptive statistics explored school personnel's self-efficacy. A regression model assessed the influence of gender, school, job and previous experience. Two factors emerged from exploratory factor analysis related to anaphylaxis management (AM) and food allergy management (FAM). The two subscales both showed good internal consistency. School personnel showed lower self-efficacy in recognizing symptoms, administering drugs and guaranteeing full participation to extra-curricular activities to food-allergic students. Participants who previously had food-allergic students showed a significantly increased self-efficacy in AM and a significantly decreased self-efficacy in FAM. The study supports the use of self-efficacy scale to identify specific areas where teachers' confidence in their ability to care for food-allergic students is especially weak. This would empower the development of training programs specifically tailored to the needs of teachers and caregivers. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Learner Attrition in an Advanced Vocational Online Training: The Role of Computer Attitude, Computer Anxiety, and Online Learning Experience

    ERIC Educational Resources Information Center

    Stiller, Klaus D.; Köster, Annamaria

    2016-01-01

    Online learning has gained importance in education over the last 20 years, but the well-known problem of high dropout rates still persists. According to the multi-dimensional learning tasks model, the cognitive (over)load of learners is essential to attrition when dealing with five challenges (e.g. technology, user interface) of an online training…

  5. Coexistent anaphylaxis to Diptera and Hymenoptera.

    PubMed

    Freye, H B; Litwin, C

    1996-03-01

    Anaphylaxis to the bite of Diptera and specifically the bite of the Tabanidae family (horsefly) have been sparsely documented. The coexistent hypersensitivity to both the order Diptera and Hymenoptera has not been documented. We present a patient who experienced anaphylaxis to both insect species. Venom skin testing and RAST revealed sensitivity to several members of the Hymenoptera order. Prick, intradermal and RAST with whole body extracts of Tabanidae species is also documented in this patient. Twenty patients who are sensitive to Hymenoptera and have been bitten by horseflies but have had no reaction to the horsefly bite were used as controls. An anaphylactic reaction to horsefly bite has been documented in a 56-year-old white male. This patient also demonstrated evidence of anaphylactic reaction to Hymenoptera envenomation. In controls consisting of 20 patients with Hymenoptera sensitivity, there was no clinical history of reaction to horsefly bite despite the presence of positive prick and/or positive intradermal tests and/or positive RAST to mixed Tabanidae species extract. Skin testing to horsefly by prick and/or intradermal testing using whole body insect extract is not useful in making a diagnosis of Tabanidae hypersensitivity. RAST using Tabanidae species as antigen is similarly useless in making a diagnosis of Tabanidae hypersensitivity. In vivo and in vitro diagnosis of horsefly hypersensitivity may be achieved when the salivary gland antigen of the horsefly becomes available.

  6. Clinical Characteristics of Inpatients with Anaphylaxis in China

    PubMed Central

    Tang, Rui; Xu, Han-Yi; Chen, Shi; Sun, Jin-Lu; Hu, Hong; Li, Hai-Chao; Diao, Ying; Li, Zhi

    2015-01-01

    Objective. To analyze the clinical characteristics of inpatients with anaphylaxis and the factors that influenced those characteristics. Methods. Using the patient records from 1990 to 2013 from three highly ranked Chinese hospitals, we retrospectively analyzed the characteristics of 108 inpatients with anaphylaxis (not anaphylaxis admitted). Results. The mean patient age was 42 ± 20 years old and male-to-female ratio was 1 : 1.3. The number of patients with anaphylaxis increased gradually, and cases diagnosed after 2005 accounted for 68.5% of the 108 total cases. The most common trigger was medications. The most common clinical manifestations included cutaneous, nervous, respiratory, circulatory, and digestive signs and symptoms. Male patients were more likely to experience loss of consciousness. Multisystem involvement was more likely to develop in patients with low BP, whereas it was uncommon in those with anaphylaxis induced by antibiotics or anesthetics. Epinephrine was used as the first-line treatment for 56 cases. Conclusions. Inpatient with anaphylaxis was more common in female patients and the number increased gradually during the study period. The most common trigger was medications. Patients with low BP were prone to having multisystem involvement, whereas the cases of anaphylaxis induced by antibiotics and anesthetics were less likely to involve multiple organ systems. PMID:26064911

  7. Anaphylaxis: a history with emphasis on food allergy

    PubMed Central

    Boden, Stephen R.; Burks, A. Wesley

    2011-01-01

    Summary In the century since Paul Portier and Charles Richet described their landmark findings of severe fatal reactions in dogs re-exposed to venom after vaccination with sea anemone venom, treatment for anaphylaxis continues to evolve. The incidence of anaphylaxis continues to be difficult to measure. Underreporting due to patients not seeking medical care as well as failure to identify anaphylaxis affects our understanding of the magnitude of the disease. Treatment with intramuscular epinephrine continues to be the recommended first line therapy although studies indicate that education of both the patients and the medical community is needed. Adverse food reactions continue to be the leading cause of anaphylaxis presenting for emergency care. Current therapy for food-induced anaphylaxis is built on the foundation of strict dietary avoidance, rapid access to injectable epinephrine, and education to recognize signs and symptoms of anaphylaxis. Investigation into therapy with oral and sublingual immunotherapy as well as other modalities holds hope for improved treatment of food-induced anaphylaxis. PMID:21682750

  8. A review of perioperative anaphylaxis at a Singapore tertiary hospital.

    PubMed

    Chen, Xuanxuan; Thong, Sze Ying; Chong, Yong Yeow; Ng, Shin Yi

    2016-03-01

    Perioperative anaphylaxis is an anaesthetic emergency, but its incidence is not well described in the local literature. This retrospective study aims to look at a group of patients who had perioperative anaphylaxis in our institution. We conducted a retrospective review of electronic databases and clinical case sheets, and identified 34 patients who had possible perioperative anaphylaxis during anaesthesia in our institution between 1 January 2007 and 30 April 2012. After reviewing clinical and biochemical data, we found that 16 out of 151,876 patients who underwent surgery had confirmed perioperative anaphylaxis, an incidence of 1:10,000. Neuromuscular blockers were identified as the most common causative agent for perioperative anaphylaxis. The offending agent could not be identified in seven patients. To the best of our knowledge, this is the first study in Southeast Asia on the incidence of perioperative anaphylaxis. Having a preoperative history of allergy did not seem to predispose patients to the subsequent development of perioperative anaphylaxis. Copyright: © Singapore Medical Association.

  9. A review of perioperative anaphylaxis at a Singapore tertiary hospital

    PubMed Central

    Chen, Xuanxuan; Thong, Sze Ying; Chong, Yong Yeow; Ng, Shin Yi

    2016-01-01

    INTRODUCTION Perioperative anaphylaxis is an anaesthetic emergency, but its incidence is not well described in the local literature. This retrospective study aims to look at a group of patients who had perioperative anaphylaxis in our institution. METHODS We conducted a retrospective review of electronic databases and clinical case sheets, and identified 34 patients who had possible perioperative anaphylaxis during anaesthesia in our institution between 1 January 2007 and 30 April 2012. RESULTS After reviewing clinical and biochemical data, we found that 16 out of 151,876 patients who underwent surgery had confirmed perioperative anaphylaxis, an incidence of 1:10,000. Neuromuscular blockers were identified as the most common causative agent for perioperative anaphylaxis. The offending agent could not be identified in seven patients. CONCLUSION To the best of our knowledge, this is the first study in Southeast Asia on the incidence of perioperative anaphylaxis. Having a preoperative history of allergy did not seem to predispose patients to the subsequent development of perioperative anaphylaxis. PMID:26996282

  10. Food-induced anaphylaxis: who, what, why, and where?

    PubMed

    Shah, Ekta; Pongracic, Jacqueline

    2008-08-01

    Food-induced anaphylaxis is a leading cause of anaphylaxis treated in emergency departments and hospitals around the world. Peanuts, tree nuts, fish, and shellfish are the most commonly implicated foods. Food-induced anaphylaxis may occur in any age group and with any food. However, food-induced anaphylaxis fatalities disproportionately affect adolescents and young adults with peanut and tree nut allergy. Individuals who have both IgE-mediated food allergy and asthma are at a higher risk for food-induced anaphylaxis fatality. Delayed administration of epinephrine is also associated with fatal outcome. Often, in fatal reactions, the food allergen is unknowingly ingested away from home, in settings such as restaurants and schools. Although avoidance of food allergens is critical, timely administration of epinephrine is also of great importance in the treatment of food-induced anaphylaxis. Patients, families, and caregivers must be well educated regarding the signs, symptoms and risk factors for anaphylaxis. They must also be counseled on the importance of strict food avoidance of the implicated food allergens, compliance with having self-injectable epinephrine available at all times, and the importance of timely administration of epinephrine, even when cutaneous symptoms are lacking.

  11. Ingested allergens must be absorbed systemically to induce systemic anaphylaxis

    PubMed Central

    Strait, Richard T.; Mahler, Ashley; Hogan, Simon; Khodoun, Marat; Shibuya, Akira; Finkelman, Fred D.

    2011-01-01

    Background IgE-mediated food allergy is a common cause of enteric disease and is responsible for approximately 100 systemic anaphylaxis deaths in the USA each year. IgG antibodies can protect against IgE-mediated systemic anaphylaxis induced by injected antigens by neutralizing antigens before they can bind to mast cell-associated IgE. Objective We have investigated whether IgA and IgG antibodies can similarly protect against systemic, IgE-mediated anaphylaxis induced by ingested antigens and, if so, whether IgA and IgG antibodies protect by neutralizing antigens before or after their systemic absorption. Methods Murine passive and active anaphylaxis models were used to study the abilities of serum vs. gut lumenal IgA antibodies and serum IgG antibodies to inhibit systemic anaphylaxis induced by ingested allergens in normal mice, mice deficient in the ability to secrete IgA into the intestines, and mice in which intestinal IL-9 overexpression has induced intestinal mastocytosis and increased intestinal permeability. Results IgE-mediated systemic anaphylaxis and mast cell degranulation induced by antigen ingestion are suppressed by both serum antigen-specific IgA and IgG, but not by IgA within the gut lumen. Conclusion Systemic, rather than enteric antibodies protect against systemic anaphylaxis induced by ingested antigen. This implies that ingested antigens must be absorbed systemically to induce anaphylaxis and suggests that immunization protocols that increase serum levels of antigen-specific, non-IgE antibodies should protect against severe food allergy. Clinical Implications Induction of a systemic IgG or IgA antibody response against a food allergen should protect against induction of systemic anaphylaxis by ingestion of that allergen. PMID:21354602

  12. Paediatric emergency department anaphylaxis: different patterns from adults

    PubMed Central

    Braganza, S C; Acworth, J P; Mckinnon, D R L; Peake, J E; Brown, A F T

    2006-01-01

    Background and Aims Data on acute paediatric anaphylaxis presentations to the emergency department (ED) are limited. All allergic presentations to one Australian paediatric ED were studied to determine epidemiological, clinical, and outcome data. Methods Retrospective, case based study of patients under 16 years attending one metropolitan, paediatric teaching hospital ED in Australia over three years. The medical records of patients presenting with generalised allergic reactions and anaphylaxis satisfying relevant ICD‐9‐CM diagnostic codes were studied. The incidence, age, sex ratio, co‐morbidities, likely aetiology, clinical features, management, and disposal were determined. Results A total of 526 children with generalised allergic reactions, and 57 with anaphylaxis were included in the study. This represented incidences of 9.3:1000 ED presentations for generalised allergic reactions and 1:1000 for anaphylaxis. There were no fatalities. In anaphylaxis cases, a cause was recognised in 68.4%. Cutaneous features were present in 82.5%. A past history of asthma was reported in 36.8%. Adrenaline was used in 39.3% of severe anaphylaxis cases. The ED alone definitively cared for 97.8% of all patients. Follow up was inadequate in cases of anaphylaxis. Conclusions This is the first reported incidence figure for paediatric anaphylaxis ED presentations in Australia, and is less than that reported in adults in the same local population. However, the incidence of generalised allergic reactions of 9.3:1000 was greater than in the adults. Virtually all paediatric allergic cases may be managed in the ED alone, provided that the importance of specialist follow up, particularly for severe anaphylaxis, is recognised. PMID:16308410

  13. Management of anaphylaxis in primary care: Canadian expert consensus recommendations.

    PubMed

    Waserman, S; Chad, Z; Francoeur, M J; Small, P; Stark, D; Vander Leek, T K; Kaplan, A; Kastner, M

    2010-09-01

    Anaphylaxis is often managed inadequately. We used findings from a systematic review of gaps in anaphylaxis management to develop evidence-based recommendations for gaps rated as clinically important by a panel of Canadian allergy experts. The nominal group technique (NGT) consensus methodology was used to develop evidence-based recommendations for the management of anaphylaxis in primary care. Physician-specific gaps from our systematic review were prioritized by consensus meeting participants in two rounds, which involved the rating, discussion, and re-rating of gaps. Using current anaphylaxis guidelines, recommendations were then developed for each category of gaps that were identified by the panel as clinically important. Thirty unique physician gaps from the systematic review were categorized according to gaps of knowledge and anaphylaxis practice behaviors. The panel rated diagnosis of anaphylaxis, and when and how to use epinephrine auto-injectors as clinically important knowledge gaps; and rated infrequent or delayed epinephrine administration, low rate of auto-injector prescription, and infrequent or no referrals to allergy specialists after a reaction as important practice behavior gaps. Evidence from four guidelines was used to support the consensus recommendation statements for three resulting categories of gap themes: anaphylaxis management, epinephrine use, and follow-up care. We used an NGT consensus methodology to develop an educational resource for primary care physicians and allergists to better understand how to manage patients with anaphylaxis. Next steps include testing our findings against observed data in primary care settings and to develop other strategies or tools to overcome gaps in anaphylaxis management.

  14. Cholinergic Urticaria with Anaphylaxis: An Underrecognized Clinical Entity.

    PubMed

    Vadas, Peter; Sinilaite, Angela; Chaim, Marcus

    2016-01-01

    Cholinergic urticaria is a form of physical urticaria triggered by high ambient temperature, strenuous physical activity, and strong emotion. These same triggers may cause multisystem reactions that can be life-threatening. A study of patients with cholinergic urticaria with anaphylaxis was undertaken to describe the demographic and clinical features of this form of anaphylaxis. To describe a cohort of patients with anaphylaxis triggered by high ambient temperature, exertion, and stress. Patients from an academic allergy practice in a university teaching hospital were identified by retrospective chart review. A total of 19 patients with recurrent episodes of anaphylaxis due to cholinergic triggers were identified. The female:male ratio was 15:4 (79% females). The mean age of onset was 27.5 years. Patients experienced a mean of 9.41 episodes per year. All 19 patients (100%) reported anaphylaxis triggered by high ambient temperature, 89.5% reported anaphylaxis triggered by strenuous exertion, and 78.9% reported anaphylaxis triggered by stress. Cutaneous involvement was present in 94.7%; 78.9% had upper airway obstructive symptoms, 78.9% had lower airway involvement, 57.9% had gastrointestinal involvement, and 78.9% had cardiovascular manifestations. Anaphylaxis severity scores were grade 1 (mild) in 11.1%, grade 2 (moderate) in 44.4%, and grade 3 (severe) in 44.4%. Baseline tryptase levels were normal in all but 1 patient. Anaphylaxis due to cholinergic triggers is underreported, with only several case reports in the literature. Reactions are multisystem with cutaneous, upper and lower airway, and cardiovascular involvement in most patients. Manifestations may be life-threatening, and reactions are often severe. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  15. Online Video-Based Training in the Use of Hydrologic Models: A Case Example Using SWAT

    NASA Astrophysics Data System (ADS)

    Frankenberger, J.

    2009-12-01

    , and posing questions to the web-based group. Although excellent model documentation is available (http://www.brc.tamus.edu/swat/), the extent to which users conduct careful study to ensure that their understanding goes beyond the superficial level is unknown. Online video-on-demand technology provides a way for users to learn consistent content while saving travel resources, and allows for training to fit into people’s schedule. Online videos were created to teach the basics of setting up the model, acquiring input data, parameterizing, calibrating and evaluating model results, and analyzing outputs, as well as model science, uncertainty, and appropriate use. Feedback was sought from the SWAT modeling community to determine typical backgrounds of model users and how the video training fits into the available means of learning SWAT. Evaluation is being undertaken to assess results. The processes used in developing and evaluating the online SWAT training could be applied to other computer models for which use among broader groups of people is increasing or has the potential to grow.

  16. Type 1 Kounis Syndrome in Patient with Idiopathic Anaphylaxis

    PubMed Central

    Makuc, Jana; Sekavčnik, Gregor

    2017-01-01

    Kounis syndrome represents the concurrence of acute coronary syndromes or anginal pain with allergic, hypersensitivity, and anaphylactic reactions. It can be associated with normal coronary angiogram or preexistent coronary pathology. Idiopathic anaphylaxis is defined as anaphylaxis without any identifiable precipitating agent or event. We present a case of male who experienced attacks of dyspnoea, hypoxemia, hypotension, purple-red skin, and chest pain over several years. He was diagnosed with idiopathic anaphylaxis. Based on the pattern of chest pain of ischemic origin during the attacks he was retrospectively diagnosed with Kounis syndrome. PMID:28255467

  17. Inhaled sevoflurane for lower gastrointestinal endoscopy with possible propofol anaphylaxis

    PubMed Central

    Ye, Ling; Liu, Yun-Fei; Zhu, Tao

    2014-01-01

    Sedation with propofol is widely used for the outpatient examination. Although anaphylaxis to propofol is rare, there were some reports of anaphylaxis following propofol administration. We present a case of female patient under sedation for lower gastrointestinal endoscopy with possible propofol anaphylaxis. Then sevoflurane was successfully used for the examination and the following surgery. We discussed the possible feasibility of sevoflurane for the examination of lower gastrointestinal endoscopy. Propofol is widely used for the sedation of outpatient with lower gastrointestinal endoscopy. But it may cause some allergic reaction. Inhaled sevoflurane may provide a satisfactory and safe alternative for adult outpatients’ endoscopy. PMID:25419408

  18. The Additive Effects of Values Clarification Training to an Online Goal-Setting Procedure on Measures of Student Retention and Performance

    ERIC Educational Resources Information Center

    Chase, Jared A.

    2010-01-01

    The purpose of this study was to provide individuals with online tutorials to help participants generate strategies to achieve their academic goals and clarify their academic values to assess the additive effects of values clarification training to an online goal-setting training procedure on (1) measures of academic performance and (2) student…

  19. The Additive Effects of Values Clarification Training to an Online Goal-Setting Procedure on Measures of Student Retention and Performance

    ERIC Educational Resources Information Center

    Chase, Jared A.

    2010-01-01

    The purpose of this study was to provide individuals with online tutorials to help participants generate strategies to achieve their academic goals and clarify their academic values to assess the additive effects of values clarification training to an online goal-setting training procedure on (1) measures of academic performance and (2) student…

  20. An analysis of online courses in research ethics in the Fogarty-sponsored bioethics training programs.

    PubMed

    Silverman, Henry; Strosberg, Martin; Luna, Florencia; Philpott, Sean; Hemmerle, Cheryl A

    2013-12-01

    Several training programs sponsored by the NIH/Fogarty International Center's International Research Ethics Education and Curriculum Development Program offer online graduate-level courses in research ethics to participants in lowand middle-income countries. This paper describes the evaluation of four of these online courses and recommendations for improvements to achieve the highest-quality design and delivery. We used an evaluation matrix consisting of 95 criteria based on recommended best practices in eLearning. Our results showed that these courses are developing or meeting nearly 73% of the criteria, while they are not meeting approximately 21% of the criteria. Together, one or more of the courses are developing or meeting 89 of the 95 criteria. These results suggest that the necessary skills and expertise exist in these programs to bring all of the eLearning courses close to 100% proficiency by sharing a common set of best practices. This paper is part of a collection of articles analyzing the Fogarty International Center's International Research Ethics Education and Curriculum Development Program.

  1. An Analysis of Online Courses in Research Ethics in the Fogarty-Sponsored Bioethics Training Programs

    PubMed Central

    Silverman, Henry; Strosberg, Martin; Luna, Florencia; Philpott, Sean; Hemmerle, Cheryl A.

    2014-01-01

    Several training programs sponsored by the NIH/Fogarty International Center’s International Research Ethics Education and Curriculum Development Program offer online graduate-level courses in research ethics to participants in low- and middle-income countries. This paper describes the evaluation of four of these online courses and recommendations for improvements to achieve the highest-quality design and delivery. We used an evaluation matrix consisting of 95 criteria based on recommended best practices in eLearning. Our results showed that these courses are developing or meeting nearly 73% of the criteria, while they are not meeting approximately 21% of the criteria. Together, one or more of the courses are developing or meeting 89 of the 95 criteria. These results suggest that the necessary skills and expertise exist in these programs to bring all of the eLearning courses close to 100% proficiency by sharing a common set of best practices. This paper is part of a collection of articles analyzing the Fogarty International Center’s International Research Ethics Education and Curriculum Development Program. PMID:24384517

  2. Simulating on-line dynamic voltages of multiple trains under real operating conditions for AC railways

    SciTech Connect

    Hsi, P.H.; Chen, S.L.; Li, R.J.

    1999-05-01

    The analysis of Railway Power Supplies (RPS) presents a unique type of load flow problem which is characterized by its constant moving loads, dynamically changing load types (constant current/constant power), and its specialized network structure. When multiple trains and the capacitors for power factor correction are also involved, the analysis of this special kind of power system can be very complicated and time consuming which will prevent on-line state analysis from becoming possible. This paper presents a novel and extremely efficient algorithm to solve this special kind of power flow problem with high precision. By first decoupling the Autotransformer (AT) current into 2 equal phasor components and then applying an iteration-based circuit-analysis approach, the RPS power flow problem can be solved in an accurate but extremely efficient manner. An on-line Railway Power-Supply State Analyzer (RPSA) based on this approach is presented in this paper while the extension of using this approach to perform power factor corrector (PFC) simulation is also presented.

  3. Effectiveness of an online Problem-Based learning curriculum for training family medical doctors in Brazil.

    PubMed

    Tomaz, Jose Batista Cisne; Mamede, Silvia; Filho, Joao Macedo Coelho; Roriz Filho, Jarbas de S; van der Molen, Henk T

    2015-01-01

    Problem-based learning (PBL) and distance education (DE) have been combined as educational approaches in higher education. This combination has been called distributed PBL. In health professions education it has been called online PBL (OPBL). However, more research on the effectiveness of OPBL is needed. The present study aims at evaluating the effectiveness of an OPBL curriculum for training family medical doctors in Brazil. We used a pretest-posttest control group design in this study. Thirty family physician participants were non-randomly assigned to the experimental group and the same number to the control group. Three instruments for collecting data were used: A multiple choice question knowledge test, an Objective Structural Clinical Examination (OSCE) for assessing the ability to apply the Mini Mental State Exam (MMSE) and a test based on clinical cases for assessing the ability to make an adequate differential diagnosis of dementia. Multivariate Analysis of Variance (MANOVA) and univariate tests were conducted to see if the difference between the two groups was significant. The effect size was measured by Cohen's d. A total of 50 participants completed the study. The results show significant effects of the course on participants' knowledge and diagnostic skills. The results may indicate that innovative pedagogical approaches such as PBL can be effective in an online environment in a low-resources context, with the advantages of DE approach.

  4. Integrative medicine in residency education: developing competency through online curriculum training.

    PubMed

    Lebensohn, Patricia; Kligler, Benjamin; Dodds, Sally; Schneider, Craig; Sroka, Selma; Benn, Rita; Cook, Paula; Guerrera, Mary; Low Dog, Tieraona; Sierpina, Victor; Teets, Raymond; Waxman, Dael; Woytowicz, John; Weil, Andrew; Maizes, Victoria

    2012-03-01

    The Integrative Medicine in Residency (IMR) program, a 200-hour Internet-based, collaborative educational initiative was implemented in 8 family medicine residency programs and has shown a potential to serve as a national model for incorporating training in integrative/complementary/alternative medicine in graduate medical education. The curriculum content was designed based on a needs assessment and a set of competencies for graduate medical education developed following the Accreditation Council for Graduate Medical Education outcome project guidelines. The content was delivered through distributed online learning and included onsite activities. A modular format allowed for a flexible implementation in different residency settings. TO ASSESS THE FEASIBILITY OF IMPLEMENTING THE CURRICULUM, A MULTIMODAL EVALUATION WAS UTILIZED, INCLUDING: (1) residents' evaluation of the curriculum; (2) residents' competencies evaluation through medical knowledge testing, self-assessment, direct observations, and reflections; and (3) residents' wellness and well-being through behavioral assessments. The class of 2011 (n  =  61) had a high rate of curriculum completion in the first and second year (98.7% and 84.2%) and course evaluations on meeting objectives, clinical utility, and functioning of the technology were highly rated. There was a statistically significant improvement in medical knowledge test scores for questions aligned with content for both the PGY-1 and PGY-2 courses. The IMR program is an advance in the national effort to make training in integrative medicine available to physicians on a broad scale and is a success in terms of online education. Evaluation suggests that this program is feasible for implementation and acceptable to residents despite the many pressures of residency.

  5. Humanized mouse model of mast cell-mediated passive cutaneous anaphylaxis and passive systemic anaphylaxis.

    PubMed

    Bryce, Paul J; Falahati, Rustom; Kenney, Laurie L; Leung, John; Bebbington, Christopher; Tomasevic, Nenad; Krier, Rebecca A; Hsu, Chia-Lin; Shultz, Leonard D; Greiner, Dale L; Brehm, Michael A

    2016-09-01

    Mast cells are a critical component of allergic responses in humans, and animal models that allow the in vivo investigation of their contribution to allergy and evaluation of new human-specific therapeutics are urgently needed. To develop a new humanized mouse model that supports human mast cell engraftment and human IgE-dependent allergic responses. This model is based on the NOD-scid IL2rg(null)SCF/GM-CSF/IL3 (NSG-SGM3) strain of mice engrafted with human thymus, liver, and hematopoietic stem cells (termed Bone marrow, Liver, Thymus [BLT]). Large numbers of human mast cells develop in NSG-SGM3 BLT mice and populate the immune system, peritoneal cavity, and peripheral tissues. The human mast cells in NSG-SGM3 BLT mice are phenotypically similar to primary human mast cells and express CD117, tryptase, and FcεRI. These mast cells undergo degranulation in an IgE-dependent and -independent manner, and can be readily cultured in vitro for additional studies. Intradermal priming of engrafted NSG-SGM3 mice with a chimeric IgE containing human constant regions resulted in the development of a robust passive cutaneous anaphylaxis response. Moreover, we describe the first report of a human mast cell antigen-dependent passive systemic anaphylaxis response in primed mice. NSG-SGM3 BLT mice provide a readily available source of human mast cells for investigation of mast cell biology and a preclinical model of passive cutaneous anaphylaxis and passive systemic anaphylaxis that can be used to investigate the pathogenesis of human allergic responses and to test new therapeutics before their advancement to the clinic. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  6. Online Equivalence-Based Instruction about Statistical Inference Using Written Explanation Instead of Match-to-Sample Training

    ERIC Educational Resources Information Center

    Critchfield, Thomas S.

    2014-01-01

    Equivalence-based instruction of college students was adapted for use in a commercial online course-delivery system, with written explanation replacing match-to-sample training. Outcomes rivaled those of previous studies in which students were taught in low-distraction settings through match-to-sample procedures that were controlled by custom…

  7. Online Equivalence-Based Instruction about Statistical Inference Using Written Explanation Instead of Match-to-Sample Training

    ERIC Educational Resources Information Center

    Critchfield, Thomas S.

    2014-01-01

    Equivalence-based instruction of college students was adapted for use in a commercial online course-delivery system, with written explanation replacing match-to-sample training. Outcomes rivaled those of previous studies in which students were taught in low-distraction settings through match-to-sample procedures that were controlled by custom…

  8. A Universal Anaphylaxis Emergency Care Plan: Introducing the New Allergy and Anaphylaxis Care Plan From the American Academy of Pediatrics.

    PubMed

    Pistiner, Michael; Mattey, Beth

    2017-09-01

    Anaphylaxis is a life-threatening emergency. In the school setting, school nurses prepare plans to prevent an emergency, educating staff and students on life-threatening allergies. A critical component of any emergency plan is a plan of care in the event of accidental ingestion or exposure to an antigen to prevent the sequelae of untreated anaphylaxis. A universal anaphylaxis emergency care plan developed by the American Academy of Pediatrics and reviewed by NASN offers an opportunity for schools, family, and health care providers to use one standard plan and avoid confusion. The plan and benefits of use are described in this article.

  9. Managing anxiety related to anaphylaxis in childhood: a systematic review.

    PubMed

    Manassis, Katharina

    2012-01-01

    Objectives. This paper reviews the relationship between anxiety and anaphylaxis in children and youth, and principles for managing anxiety in the anaphylactic child and his or her parents. Methods. A review of the medical literature (Medline) was done using the keywords "anxiety," "anaphylaxis," and "allergy," limited to children and adolescents. Findings were organized into categories used in the treatment of childhood anxiety disorders, then applied to managing anxiety in the anaphylactic child. Results. Twenty-four relevant papers were identified. These varied widely in methodology. Findings emphasized included the need to distinguish anxiety-related and organic symptoms, ameliorate the anxiety-related impact of anaphylaxis on quality of life, and address parental anxiety about the child. Conclusion. Children with anaphylaxis can function well despite anxiety, but the physical, cognitive, and behavioral aspects of anxiety associated with anaphylactic risk must be addressed, and parents must be involved in care in constructive ways.

  10. Abdominal anaphylaxis presenting as trauma: a recipe for delayed diagnosis.

    PubMed

    Rankins, Kevin B; McGovern, Robert; Winston, Eleanor S; Al-Dulaimy, Khaldoon; Pope, J Hector

    2012-10-01

    Successful shock management requires prompt identification, classification, and treatment; however, the triage of patients with non-hemorrhagic shock to the trauma room can lead to delayed diagnosis with increased morbidity and mortality. Our goal is to emphasize the importance of shock identification and classification to facilitate the delivery of the appropriate and timely therapy, no matter how the patient is triaged. We describe a patient triaged as a trauma patient with suspected hemorrhagic shock yet who was found to have anaphylaxis as the etiology of his condition. Abdominal anaphylaxis, a less recognized presentation of anaphylaxis, is reviewed and discussed. We hope to increase awareness of a less common presentation of anaphylaxis and discuss its management. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Postmortem diagnostics of assumed food anaphylaxis in an unexpected death.

    PubMed

    Unkrig, S; Hagemeier, L; Madea, B

    2010-05-20

    Diagnosis of lethal anaphylaxis is known to be difficult to establish in forensic autopsy. Cases of anaphylactic shock have to be dealt with in forensic medicine comparatively frequently as death due to anaphylaxis is likely to occur rapidly and without warning in seemingly healthy subjects. Autopsy findings might hint at allergic reaction, but classic manifestations can also be completely absent. A case of suspected food anaphylaxis in a middle-aged woman is presented. The deceased had been known to suffer from multiple allergies. Death came about after an evening meal with friends. Dyspnoea was reported to have been followed by collapse, unconsciousness and death within minutes. The course of further analysis undertaken (toxicology, biochemistry, immunohistochemistry) is examplarily described. By means of the results presented we discuss problems and possibilities of postmortem diagnostics of food induced anaphylaxis.

  12. Anaphylaxis and mast cell disease: what is the risk?

    PubMed

    Akin, Cem

    2010-01-01

    Mastocytosis is a proliferative disorder of the hematopoietic mast cell progenitor that results from expansion of a clone carrying the D816V c-kit mutation. Based on the dramatic increase in incidence of anaphylaxis in patients with mastocytosis, recent studies analyzed the presence of clonal mast cell markers, including D816V c-kit mutation, in patients with recurrent IgE- and non-IgE-mediated anaphylaxis. These studies demonstrated the presence of an aberrant mast cell clone in a significant proportion of patients with unexplained anaphylaxis, or anaphylaxis due to hymenoptera venom. Clonal mast cell disease should be suspected in particular in patients presenting with profound cardiovascular manifestations such as hypotension and syncope in the absence of urticaria.

  13. On-line node fault injection training algorithm for MLP networks: objective function and convergence analysis.

    PubMed

    Sum, John Pui-Fai; Leung, Chi-Sing; Ho, Kevin I-J

    2012-02-01

    Improving fault tolerance of a neural network has been studied for more than two decades. Various training algorithms have been proposed in sequel. The on-line node fault injection-based algorithm is one of these algorithms, in which hidden nodes randomly output zeros during training. While the idea is simple, theoretical analyses on this algorithm are far from complete. This paper presents its objective function and the convergence proof. We consider three cases for multilayer perceptrons (MLPs). They are: (1) MLPs with single linear output node; (2) MLPs with multiple linear output nodes; and (3) MLPs with single sigmoid output node. For the convergence proof, we show that the algorithm converges with probability one. For the objective function, we show that the corresponding objective functions of cases (1) and (2) are of the same form. They both consist of a mean square errors term, a regularizer term, and a weight decay term. For case (3), the objective function is slight different from that of cases (1) and (2). With the objective functions derived, we can compare the similarities and differences among various algorithms and various cases.

  14. Understanding visual search patterns of dermatologists assessing pigmented skin lesions before and after online training.

    PubMed

    Krupinski, Elizabeth A; Chao, Joseph; Hofmann-Wellenhof, Rainer; Morrison, Lynne; Curiel-Lewandrowski, Clara

    2014-12-01

    The goal of this investigation was to explore the feasibility of characterizing the visual search characteristics of dermatologists evaluating images corresponding to single pigmented skin lesions (PSLs) (close-ups and dermoscopy) as a venue to improve training programs for dermoscopy. Two Board-certified dermatologists and two dermatology residents participated in a phased study. In phase I, they viewed a series of 20 PSL cases ranging from benign nevi to melanoma. The close-up and dermoscopy images of the PSL were evaluated sequentially and rated individually as benign or malignant, while eye position was recorded. Subsequently, the participating subjects completed an online dermoscopy training module that included a pre- and post-test assessing their dermoscopy skills (phase 2). Three months later, the subjects repeated their assessment on the 20 PSLs presented during phase I of the study. Significant differences in viewing time and eye-position parameters were observed as a function of level of expertise. Dermatologists overall have more efficient search than residents generating fewer fixations with shorter dwells. Fixations and dwells associated with decisions changing from benign to malignant or vice versa from photo to dermatoscopic viewing were longer than any other decision, indicating increased visual processing for those decisions. These differences in visual search may have implications for developing tools to teach dermatologists and residents about how to better utilize dermoscopy in clinical practice.

  15. Measuring sense of presence and user characteristics to predict effective training in an online simulated virtual environment.

    PubMed

    De Leo, Gianluca; Diggs, Leigh A; Radici, Elena; Mastaglio, Thomas W

    2014-02-01

    Virtual-reality solutions have successfully been used to train distributed teams. This study aimed to investigate the correlation between user characteristics and sense of presence in an online virtual-reality environment where distributed teams are trained. A greater sense of presence has the potential to make training in the virtual environment more effective, leading to the formation of teams that perform better in a real environment. Being able to identify, before starting online training, those user characteristics that are predictors of a greater sense of presence can lead to the selection of trainees who would benefit most from the online simulated training. This is an observational study with a retrospective postsurvey of participants' user characteristics and degree of sense of presence. Twenty-nine members from 3 Air Force National Guard Medical Service expeditionary medical support teams participated in an online virtual environment training exercise and completed the Independent Television Commission-Sense of Presence Inventory survey, which measures sense of presence and user characteristics. Nonparametric statistics were applied to determine the statistical significance of user characteristics to sense of presence. Comparing user characteristics to the 4 scales of the Independent Television Commission-Sense of Presence Inventory using Kendall τ test gave the following results: the user characteristics "how often you play video games" (τ(26)=-0.458, P<0.01) and "television/film production knowledge" (τ(27)=-0.516, P<0.01) were significantly related to negative effects. Negative effects refer to adverse physiologic reactions owing to the virtual environment experience such as dizziness, nausea, headache, and eyestrain. The user characteristic "knowledge of virtual reality" was significantly related to engagement (τ(26)=0.463, P<0.01) and negative effects (τ(26)=-0.404, P<0.05). Individuals who have knowledge about virtual environments and

  16. Anaphylaxis from atracurium without skin manifestation

    PubMed Central

    Maitra, Souvik; Sen, Suvadeep; Kundu, Sudeshna (Bhar); Pal, Sugata

    2014-01-01

    Anaphylaxis is an acute, potentially fatal allergic reaction involving multi organ system that is triggered by a wide range of antigens with a subsequent release of chemical mediators from mast cells and basophils. Diagnosis is primarily clinical though laboratory studies are helpful in further confirmation. Anaphylactic reactions during anesthesia are rare, but can be fatal if not promptly recognized and treated. Among all drugs commonly used in anesthesia, muscle relaxants are the most notorious to trigger anaphylactic reactions and benzylisoquinolinium group of drugs are known to be less common an offender than the steroidal compounds. We report severe anaphylactic reaction after administration of atracurium that was promptly diagnosed and managed without any further morbidity. PMID:24574606

  17. Polyethylene glycol as a cause of anaphylaxis.

    PubMed

    Wylon, Katharina; Dölle, Sabine; Worm, Margitta

    2016-01-01

    Polyethylene glycols (PEGs) or macrogols are polyether compounds and are widely used as additives in pharmaceuticals, cosmetics, and food. We report on a Caucasian patient experiencing recurrent severe allergic reactions to several drugs. An extensive diagnostic workup including skin prick tests, intradermal tests (IDT) and a double-blind oral challenge was performed to identify the trigger of anaphylaxis. In the present case hypersensitivity to the additive polyethylene glycol was confirmed by an IDT suggesting an Immunoglobulin E-dependent mechanism as a cause of the reaction. Potential life-threatening hypersensitivity reactions to hidden molecules like macrogol may be underdiagnosed. Cases of immediate-type PEG hypersensitivity were reported with increasing frequency. The awareness regarding the allergenic potential of PEG should be raised and a proper product labelling is crucial to prevent PEG mediated hypersensitivity.

  18. Food allergy and anaphylaxis in pediatrics: update 2010-2012.

    PubMed

    Santos, Alexandra F; Lack, Gideon

    2012-12-01

    This review highlights the progress made in food allergy (FA) and anaphylaxis research in pediatrics published in the journal Pediatric Allergy and Immunology since 2010. Putative risk factors for FA are as follows: a family history of allergic disease, particularly in the mother, low birth order, season of birth, and severe atopic eczema. Obstetric practices, antibiotic use, and home environment are factors deserving further research. Diagnostic decision levels and component-specific IgE are useful in the diagnosis of FA; however, oral food challenges remain the gold standard and may also be a means to reduce parental anxiety and to improve education. Oral immunotherapy studies show promise in increasing the threshold of reactivity of allergic patients and therefore improving their quality of life. In single-nut-allergic patients, introduction of other nuts allows broadening the diet and thus reducing the psychological impact of allergen avoidance. Nutritional deficiencies are not uncommon in food-allergic children and should be specifically assessed. The prescription of injectable adrenaline is still insufficient and not consistent among practitioners, requiring improved training and implementation of guidelines. Current research into the epidemiology and immunological mechanisms of FA and tolerance will enable us to devise strategies to both prevent and treat food allergies.

  19. An Online Approach for Training International Climate Scientists to Use Computer Models

    NASA Astrophysics Data System (ADS)

    Yarker, M. B.; Mesquita, M. D.; Veldore, V.

    2013-12-01

    With the mounting evidence by the work of IPCC (2007), climate change has been acknowledged as a significant challenge to Sustainable Development by the international community. It is important that scientists in developing countries have access to knowledge and tools so that well-informed decisions can be made about the mitigation and adaptation of climate change. However, training researchers to use climate modeling techniques and data analysis has become a challenge, because current capacity building approaches train researchers to use climate models through short-term workshops, which requires a large amount of funding. It has also been observed that many participants who recently completed capacity building courses still view climate and weather models as a metaphorical 'black box', where data goes in and results comes out; and there is evidence that these participants lack a basic understanding of the climate system. Both of these issues limit the ability of some scientists to go beyond running a model based on rote memorization of the process. As a result, they are unable to solve problems regarding run-time errors, thus cannot determine whether or not their model simulation is reasonable. Current research in the field of science education indicates that there are effective strategies to teach learners about science models. They involve having the learner work with, experiment with, modify, and apply models in a way that is significant and informative to the learner. It has also been noted that in the case of computational models, the installation and set up process alone can be time consuming and confusing for new users, which can hinder their ability to concentrate on using, experimenting with, and applying the model to real-world scenarios. Therefore, developing an online version of capacity building is an alternative approach to the workshop training programs, which makes use of new technologies and it allows for a long-term educational process in a way

  20. Clinical diagnosis and management of anaphylaxis in infancy.

    PubMed

    Dibek Misirlioglu, Emine; Vezir, Emine; Toyran, Müge; Capanoglu, Murat; Guvenir, Hakan; Civelek, Ersoy; Kocabas, Can Naci

    2017-01-01

    Anaphylaxis is increasingly reported in infancy. Diagnosis and management of anaphylaxis is difficult, and data are limited in infants. The aim of the present study was to determine the clinical course and management strategies used for anaphylaxis in infancy. Patients attending to our clinic and who had anaphylaxis under 2 years old were evaluated. Sixty-three patients were enrolled for the study. The mean ± standard deviation age was 10.6 ± 6.1 months (median, 11 months). Anaphylaxis occurred at home in 48 infants (76.2%). Food was the most common causative agent (n = 52 [82.5%]), with cow's milk (n = 21 [40.4%]) and egg white (n = 13 [25%]) being the most frequent. Medication was the other causative agent (n = 9 [14.3%]), with antibiotics being the most frequent (n = 6 [66.7%]). The clinical manifestations were cutaneous (95.2%) and respiratory symptoms (79.4%). The median time lapse between contact and onset of symptoms was 10 minutes (5-15 minutes) (median, interquartile range [IQR] 25-75%). The total duration of symptoms was 2 hours (0.5-3 hours) (median, IQR 25-75%). Six patients had mild (9.5%), 40 moderate (63.5%), and 17 severe (27%) symptoms. A biphasic course was noticed in two infants (3.2%), with a symptom-free interval between a minimum of 30 minutes and a maximum of 4 hours. Forty-three (68.3%) received H1 antihistamines, 31 received corticosteroids (49.2%), and 23 received adrenaline (36.5%). Only one patient needed intensive care. This study provided detailed clinical information in the diagnosis of anaphylaxis in infants. Diagnosing and managing anaphylaxis are difficult in infancy. Arrangements for definition of symptoms should be made in the new anaphylaxis guidelines.

  1. Epidemiology, Mechanisms, and Diagnosis of Drug-Induced Anaphylaxis

    PubMed Central

    Montañez, Maria Isabel; Mayorga, Cristobalina; Bogas, Gador; Barrionuevo, Esther; Fernandez-Santamaria, Ruben; Martin-Serrano, Angela; Laguna, Jose Julio; Torres, Maria José; Fernandez, Tahia Diana; Doña, Inmaculada

    2017-01-01

    Anaphylaxis is an acute, life-threatening, multisystem syndrome resulting from the sudden release of mediators by mast cells and basophils. Although anaphylaxis is often under-communicated and thus underestimated, its incidence appears to have risen over recent decades. Drugs are among the most common triggers in adults, being analgesics and antibiotics the most common causal agents. Anaphylaxis can be caused by immunologic or non-immunologic mechanisms. Immunologic anaphylaxis can be mediated by IgE-dependent or -independent pathways. The former involves activation of Th2 cells and the cross-linking of two or more specific IgE (sIgE) antibodies on the surface of mast cells or basophils. The IgE-independent mechanism can be mediated by IgG, involving the release of platelet-activating factor, and/or complement activation. Non-immunological anaphylaxis can occur through the direct stimulation of mast cell degranulation by some drugs, inducing histamine release and leading to anaphylactic symptoms. Work-up of a suspected drug-induced anaphylaxis should include clinical history; however, this can be unreliable, and skin tests should also be used if available and validated. Drug provocation testing is not recommended due to the risk of inducing a harmful reaction. In vitro testing can help to confirm anaphylaxis by analyzing the release of mediators such as tryptase or histamine by mast cells. When immunologic mechanisms are suspected, serum-sIgE quantification or the use of the basophil activation test can help confirm the culprit drug. In this review, we will discuss multiple aspects of drug-induced anaphylaxis, including epidemiology, mechanisms, and diagnosis. PMID:28611774

  2. Case of anaphylaxis caused by ingestion of royal jelly.

    PubMed

    Katayama, Mirei; Aoki, Mikako; Kawana, Seiji

    2008-04-01

    Anaphylaxis is a severe form of allergic disease. Royal jelly is widely consumed in Japan, but a few cases of anaphylaxis caused by royal jelly have been reported. We encountered a 26-year-old Japanese woman who developed anaphylaxis after drinking a beverage of crude royal jelly including honey. She had a history of bronchial asthma, allergic rhinitis, allergic conjunctivitis, atopic dermatitis and food allergy (abalone). Prick tests were performed with the beverage of crude royal jelly including honey and with two other beverages including honey. Only the crude royal jelly beverage showed a positive reaction. An oral challenge test with the crude royal jelly beverage was not performed, but a similar test with a beverage including honey caused no symptoms. A positive response to the beverage of crude royal jelly was not observed in normal volunteers. A positive diagnosis of anaphylaxis due to royal jelly was made based on the positive prick test, systemic clinical symptoms and the negative prick tests in healthy volunteers. Moreover, the patient had no symptoms when taking lemon and orange, which were present as essences in the crude royal jelly beverage, and also had no response to honey after anaphylaxis. Increased consumption of royal jelly in health food supplements may increase the incidence of royal jelly-related allergic reactions. Therefore, royal jelly should be considered as a causative allergen in food-induced anaphylaxis.

  3. Diagnosis and management of anaphylaxis in precision medicine.

    PubMed

    Castells, Mariana

    2017-08-01

    Anaphylaxis is the most severe and frightening of the allergic reactions, placing patients at high risk and demanding prompt recognition and immediate management by health care providers. Yet because its symptoms imitate those of other diseases, such as asthma and urticaria, current data suggest that its diagnosis is often missed, with underuse of tryptase measurement; its treatment is delayed, with little use of epinephrine; and its underlying cause or causes are poorly investigated. Deaths from anaphylaxis are difficult to investigate because of miscoding. Surprisingly, patients treated with new and powerful chemotherapy agents and humanized mAbs present with nonclassical symptoms of anaphylaxis, and patients may present with unrecognized clonal mast cell disorders with KIT mutations may present as Hymenoptera-induced or idiopathic anaphylaxis. The goal of this review is to recognize the presentations of anaphylaxis with the description of its current phenotypes, to provide new insight and understanding of its mechanisms and causes through its endotypes, and to address its biomarkers for broad clinical use. Ultimately, the aim is to empower allergists and heath care providers with new tools that can help alleviate patients' symptoms, preventing and protecting them against anaphylaxis. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  4. Adrenaline for the treatment of anaphylaxis: cochrane systematic review.

    PubMed

    Sheikh, A; Shehata, Y A; Brown, S G A; Simons, F E R

    2009-02-01

    Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death. Adrenaline is recommended as the initial treatment of choice for anaphylaxis. To assess the benefits and harms of adrenaline in the treatment of anaphylaxis. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 1), MEDLINE (1966 to March 2007), EMBASE (1966 to March 2007), CINAHL (1982 to March 2007), BIOSIS (to March 2007), ISI Web of Knowledge (to March 2007) and LILACS (to March 2007). We also searched websites listing ongoing trials: http://www.clinicaltrials.gov/, http://www.controlledtrials.com and http://www.actr.org.au/ and contacted pharmaceutical companies and international experts in anaphylaxis in an attempt to locate unpublished material. Randomized and quasi-randomized controlled trials comparing adrenaline with no intervention, placebo or other adrenergic agonists were eligible for inclusion. Two authors independently assessed articles for inclusion. We found no studies that satisfied the inclusion criteria. On the basis of this review, we are unable to make any new recommendations on the use of adrenaline for the treatment of anaphylaxis. In the absence of appropriate trials, we recommend, albeit on the basis of less than optimal evidence, that adrenaline administration by intramuscular injection should still be regarded as first-line treatment for the management of anaphylaxis.

  5. CLINICAL FACTORS FOR DEVELOPING SHOCK IN RADIOCONTRAST MEDIA INDUCED ANAPHYLAXIS.

    PubMed

    Kim, Sang Min; Ko, Byuk Sung; Kim, Ji Yeon; Ha, Sang Ook; Ahn, Shin; Sohn, Chang Hwan; Seo, Dong Woo; Kim, Tae-Bum; Kim, Won Young

    2016-03-01

    The aim of this study was to investigate the time interval between radiocontrast media (RCM) administration and the development of anaphylactic shock, and risk factors associated with RCM-induced anaphylactic shock. We reviewed the medical records of 154 patients with RCM-induced anaphylaxis presenting to the emergency department of a tertiary care hospital between January 2005 and December 2014. Clinical features of RCM-induced anaphylaxis were analyzed, and patients were categorized into shock and non-shock groups to identify associated factors in affected patients. Of the 154 cases of RCM-induced anaphylaxis, 101 (65.9%) patients experienced shock. The median time between RCM exposure and the onset of shock was 11 min (interquartile range, 7.0-18.8). In patients with RCM-induced anaphylaxis accompanying shock, the median time from RCM to the first symptom onset was 6 min (interquartile range, 5.0-10.0). In the multivariate analysis, age, neurological manifestations, and allergy history except RCM were associated with the development of shock. RCM-induced anaphylaxis was commonly accompanied with shock, and the time interval between RCM exposure and the onset of shock was short. Physicians should pay attention to the development of potential cardiovascular collapse in anaphylaxis patients of old age and with neurologic manifestations.

  6. Use of online clinical videos for clinical skills training for medical students: benefits and challenges

    PubMed Central

    2014-01-01

    Background Multimedia learning has been shown effective in clinical skills training. Yet, use of technology presents both opportunities and challenges to learners. The present study investigated student use and perceptions of online clinical videos for learning clinical skills and in preparing for OSCE (Objective Structured Clinical Examination). This study aims to inform us how to make more effective us of these resources. Methods A mixed-methods study was conducted for this study. A 30-items questionnaire was administered to investigate student use and perceptions of OSCE videos. Year 3 and 4 students from 34 Korean medical schools who had access to OSCE videos participated in the online survey. Additionally, a semi-structured interview of a group of Year 3 medical students was conducted for an in-depth understanding of student experience with OSCE videos. Results 411 students from 31 medical schools returned the questionnaires; a majority of them found OSCE videos effective for their learning of clinical skills and in preparing for OSCE. The number of OSCE videos that the students viewed was moderately associated with their self-efficacy and preparedness for OSCE (p < 0.05). One-thirds of those surveyed accessed the video clips using mobile devices; they agreed more with the statement that it was convenient to access the video clips than their peers who accessed the videos using computers (p < 0.05). Still, students reported lack of integration into the curriculum and lack of interaction as barriers to more effective use of OSCE videos. Conclusions The present study confirms the overall positive impact of OSCE videos on student learning of clinical skills. Having faculty integrate these learning resources into their teaching, integrating interactive tools into this e-learning environment to foster interactions, and using mobile devices for convenient access are recommended to help students make more effective use of these resources. PMID:24650290

  7. Use of online clinical videos for clinical skills training for medical students: benefits and challenges.

    PubMed

    Jang, Hye Won; Kim, Kyong-Jee

    2014-03-21

    Multimedia learning has been shown effective in clinical skills training. Yet, use of technology presents both opportunities and challenges to learners. The present study investigated student use and perceptions of online clinical videos for learning clinical skills and in preparing for OSCE (Objective Structured Clinical Examination). This study aims to inform us how to make more effective us of these resources. A mixed-methods study was conducted for this study. A 30-items questionnaire was administered to investigate student use and perceptions of OSCE videos. Year 3 and 4 students from 34 Korean medical schools who had access to OSCE videos participated in the online survey. Additionally, a semi-structured interview of a group of Year 3 medical students was conducted for an in-depth understanding of student experience with OSCE videos. 411 students from 31 medical schools returned the questionnaires; a majority of them found OSCE videos effective for their learning of clinical skills and in preparing for OSCE. The number of OSCE videos that the students viewed was moderately associated with their self-efficacy and preparedness for OSCE (p < 0.05). One-thirds of those surveyed accessed the video clips using mobile devices; they agreed more with the statement that it was convenient to access the video clips than their peers who accessed the videos using computers (p < 0.05). Still, students reported lack of integration into the curriculum and lack of interaction as barriers to more effective use of OSCE videos. The present study confirms the overall positive impact of OSCE videos on student learning of clinical skills. Having faculty integrate these learning resources into their teaching, integrating interactive tools into this e-learning environment to foster interactions, and using mobile devices for convenient access are recommended to help students make more effective use of these resources.

  8. Online training on the safe use of fluoroscopy can result in a significant decrease in patient dose.

    PubMed

    Frederick-Dyer, Katherine C; Faulkner, Austin R; Chang, Ted T; Heidel, R Eric; Pasciak, Alexander S

    2013-10-01

    Concerns over medical radiation exposure have received national press in recent years, and training in the appropriate use of radiation has become an essential component of every radiology residency program. Appropriate training is particularly important in fluoroscopy because it is commonly used by inexperienced radiology residents and has the potential to impart relatively high patient radiation doses. In an effort to minimize the radiation doses received by patients, our institution has recently initiated an online training program in the safe use of fluoroscopy. This course is required and must be completed by new radiology residents before their first fluoroscopy rotation. The goal of this study was to determine if the use of an online course in the safe use of fluoroscopy could result in decreased patient dose without affecting diagnostic quality. Four years of retrospective procedural data for residents performing gastrointestinal and genitourinary fluoroscopic procedures without specialized training were reviewed. Incoming residents took an American Medical Association-accredited online training program in the safe use of fluoroscopy the week before their first fluoroscopy rotation. Patient dose and diagnostic quality data, inferred from the frequency of attending physician intervention necessary to complete the procedure, were collected for all exams performed by the new group of residents after completion of the training course. This was then compared to data from prior classes and stratified by procedure type. Statistically significant reductions in both average fluoroscopy time (FT) or dose-area-product (DAP) were found for many of the fluoroscopic procedures performed by residents who participated in the online fluoroscopy training program. Specifically, statistically significant reductions in FT for barium enema, cystogram, defecogram, and esophagram procedures (P < .001) were found. Esophagram and upper gastrointestinal studies were completed with a

  9. Impact of online toxicology training on health professionals: the Global Educational Toxicology Uniting Project (GETUP).

    PubMed

    Wong, Anselm; Vohra, Rais; Dawson, Andrew H; Stolbach, Andrew

    2017-11-01

    The Global Educational Toxicology Uniting Project (GETUP), supported by the American College of Medical Toxicology, links countries with and without toxicology services via distance education with the aim to improve education. Due to the lack of toxicology services in some countries there is a knowledge gap in the management of poisonings. We describe our experience with the worldwide delivery of an online introductory toxicology curriculum to emergency doctors and other health professionals treating poisoned patients. We delivered a 15-module introductory Internet-based toxicology curriculum to emergency doctors and health professionals, conducted from August to December 2016. This Internet-based curriculum was adapted from one used to teach emergency residents toxicology in the United States. Modules covered themes such as pharmaceutical (n = 8), toxidromes (n = 2) and agrochemicals (n = 5) poisoning. Participants completed pre-test and post-test multiple choice questions (MCQs) before and after completing the online module, respectively, throughout the course. We collected information on participant demographics, education and training, and perception of relevance of the curriculum. Participants gave feedback on the course and how it affected their practice. One hundred and thirty-six health professionals from 33 countries participated in the course: 98 emergency doctors/medical officers, 25 physicians, eight pharmacists/poisons information specialists, two toxicologists, two medical students and one nurse. Median age of participants was 34 years. Median number of years postgraduate was seven. Ninety (65%) had access to either a poisons information centre over the phone or toxicologist and 48 (35%) did not. All participants expected the course to help improve their knowledge. Overall median pre-module MCQ scores were 56% (95%CI: 38, 75%) compared to post-module MCQ scores median 89% (95% CI: 67, 100%) (p < .0001). Our participants demonstrated an

  10. IgG subclasses determine pathways of anaphylaxis in mice.

    PubMed

    Beutier, Héloïse; Gillis, Caitlin M; Iannascoli, Bruno; Godon, Ophélie; England, Patrick; Sibilano, Riccardo; Reber, Laurent L; Galli, Stephen J; Cragg, Mark S; Van Rooijen, Nico; Mancardi, David A; Bruhns, Pierre; Jönsson, Friederike

    2017-01-01

    Animal models have demonstrated that allergen-specific IgG confers sensitivity to systemic anaphylaxis that relies on IgG Fc receptors (FcγRs). Mouse IgG2a and IgG2b bind activating FcγRI, FcγRIII, and FcγRIV and inhibitory FcγRIIB; mouse IgG1 binds only FcγRIII and FcγRIIB. Although these interactions are of strikingly different affinities, these 3 IgG subclasses have been shown to enable induction of systemic anaphylaxis. We sought to determine which pathways control the induction of IgG1-, IgG2a-, and IgG2b-dependent passive systemic anaphylaxis. Mice were sensitized with IgG1, IgG2a, or IgG2b anti-trinitrophenyl mAbs and challenged with trinitrophenyl-BSA intravenously to induce systemic anaphylaxis that was monitored by using rectal temperature. Anaphylaxis was evaluated in mice deficient for FcγRs injected with mediator antagonists or in which basophils, monocytes/macrophages, or neutrophils had been depleted. FcγR expression was evaluated on these cells before and after anaphylaxis. Activating FcγRIII is the receptor primarily responsible for all 3 models of anaphylaxis, and subsequent downregulation of this receptor was observed. These models differentially relied on histamine release and the contribution of mast cells, basophils, macrophages, and neutrophils. Strikingly, basophil contribution and histamine predominance in mice with IgG1- and IgG2b-induced anaphylaxis correlated with the ability of inhibitory FcγRIIB to negatively regulate these models of anaphylaxis. We propose that the differential expression of inhibitory FcγRIIB on myeloid cells and its differential binding of IgG subclasses controls the contributions of mast cells, basophils, neutrophils, and macrophages to IgG subclass-dependent anaphylaxis. Collectively, our results unravel novel complexities in the involvement and regulation of cell populations in IgG-dependent reactions in vivo. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier

  11. Pediatric anaphylaxis: triggers, clinical features, and treatment in a tertiary-care hospital.

    PubMed

    Manuyakorn, Wiparat; Benjaponpitak, Suwat; Kamchaisatian, Wasu; Vilaiyuk, Soamarat; Sasisakulporn, Cherapat; Jotikasthira, Wanlapa

    2015-12-01

    Anaphylaxis is a life-threatening condition. There are limited data about its etiology and clinical characteristics in Asian children with anaphylaxis. To investigate triggers, presenting symptoms, treatment and clinical course of anaphylaxis in Thai children. Medical record of children who were diagnosed with anaphylaxis between 2004 and 2013 at Ramathibodi Hospital, Bangkok, Thailand were reviewed. One hundred-seventy two episodes of anaphylaxis occurred in 160 children (91 boys, 69 girls) aged 3 months to 18 years. Anaphylaxis increased from 2.7 cases/1000 pediatric admission to 4.51 cases/1000 pediatric admission between 2004-2008 and 2009-2013. The main causes were food (34.92%), drug (33.1%), blood components (23.8%), insect sting (9%), and unidentified causes (2.8%). Allergy to the triggers was known prior to anaphylaxis in 42 episodes (24.6%). Treatment consisted of epinephrine intramuscularly (93.8%), corticosteroids (92.5%), H₁antihistamines (96%), H₂antihistamines (50%), and β₂agonists nebulization (35.1%). Biphasic anaphylaxis occurred in 8.7% of the documented episodes and severe anaphylaxis in 34.3% of the documented episodes. Biphasic anaphylaxis and severe anaphylaxis were associated with fewer administrations of intramuscular epinephrine (OR 0.08 [95% CI 0.014-0.43]; p =0.01 and OR 9.36 [95% CI 2.5-34.7]; p <0.001 respectively). There were no fatality cases. There were associations between triggers of anaphylaxis and atopic histories, patients with severe anaphylaxis and cardiovascular involvement (p <0.01). The incidence of anaphylaxis in Thai children is increasing. Anaphylaxis in children commonly occurred without the histories of prior reaction to the causative agent. Less frequent treatment with intramuscular epinephrine was associated with biphasic and severe anaphylaxis. A better knowledge of patterns and causes of anaphylaxis might contribute to a better management.

  12. OMARC: An online multimedia application for training health care providers in the assessment of respiratory conditions.

    PubMed

    Meruvia-Pastor, Oscar; Patra, Pranjal; Andres, Karen; Twomey, Creina; Peña-Castillo, Lourdes

    2016-05-01

    OMARC, a multimedia application designed to support the training of health care providers for the identification of common lung sounds heard in a patient's thorax as part of a health assessment, is described and its positive contribution to user learning is assessed. The main goal of OMARC is to effectively help health-care students become familiar with lung sounds as part of the assessment of respiratory conditions. In addition, the application must be easy to use and accessible to students and practitioners over the internet. OMARC was developed using an online platform to facilitate access to users in remote locations. OMARC's unique contribution as an educational software tool is that it presents a narrative about normal and abnormal lung sounds using interactive multimedia and sample case studies designed by professional health-care providers and educators. Its interface consists of two distinct components: a sounds glossary and a rich multimedia interface which presents clinical case studies and provides access to lung sounds placed on a model of a human torso. OMARC's contents can be extended through the addition of sounds and case studies designed by health-care educators and professionals. To validate OMARC and determine its efficacy in improving learning and capture user perceptions about it, we performed a pilot study with ten nursing students. Participants' performance was measured through an evaluation of their ability to identify several normal and adventitious/abnormal sounds prior and after exposure to OMARC. Results indicate that participants are able to better identify different lung sounds, going from an average of 63% (S.D. 18.3%) in the pre-test evaluation to an average of 90% (S.D. of 11.5%) after practising with OMARC. Furthermore, participants indicated in a user satisfaction questionnaire that they found the application helpful, easy to use and that they would recommend it to other persons in their field. OMARC is an online multimedia

  13. Factors Contributing to the Development of Distance Education through Preliminary Online Training and Identifying Various Levels of Technical Competencies by Online Instructors within the University of North Carolina System

    ERIC Educational Resources Information Center

    Tillman, Makia R.

    2009-01-01

    Distance Education (DE) is one of the well-known methods of instruction and learning at many colleges and universities throughout the United States as well as other countries. Instructors teaching online courses need some form of training prior to teaching online classes. Most higher education institutions use some form of Learning Management…

  14. Anaphylaxis and ethnicity: higher incidence in British South Asians.

    PubMed

    Buka, R J; Crossman, R J; Melchior, C L; Huissoon, A P; Hackett, S; Dorrian, S; Cooke, M W; Krishna, M T

    2015-12-01

    The incidence of anaphylaxis in South Asians (Indian, Pakistani and Bangladeshi ethnicity) is unknown. Birmingham is a British city with a disproportionately large population of South Asians (22.5%) compared with the rest of the UK (4.9%). The main aims of this study were to determine the incidence and severity of anaphylaxis in this population and to investigate the differences between the South Asian and White populations. A retrospective electronic search of emergency department attendances at three hospitals in Birmingham during 2012 was carried out. Wide search terms were used, medical notes were scrutinized, and the World Allergy Organization diagnostic criteria for anaphylaxis were applied. Patients' age, sex, ethnicity and home postal code were collected, reactions were graded by severity, and other relevant details including specialist assessment were extracted. Multivariate analysis was undertaken using 2011 UK census data. Age-, sex- and ethnicity-standardized incidence rate of anaphylaxis was 34.5 per 100 000 person-years. Multivariate logistic regression which controlled for the confounders of age, sex and level of socioeconomic deprivation showed that incidence was higher in the South Asian population (OR 1.48, P = 0.005). Incidence rate in the South Asian population was 58.3 cases per 100 000 person-years compared to 31.5 in the White population. South Asian children were more likely to present with severe anaphylaxis (OR 5.31, P = 0.002). Incidence of anaphylaxis is significantly higher in British South Asians compared to the white population. British South Asian children are at a greater risk of severe anaphylaxis than White children. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Anaphylaxis in the community: learning from the survivors.

    PubMed

    Simons, F Estelle R; Clark, Sunday; Camargo, Carlos A

    2009-08-01

    Most studies of anaphylaxis in the community focus on persons at risk who might, or might not, have experienced anaphylaxis. We sought to focus on survivors of anaphylaxis in the community and their experiences in using, or not using, an epinephrine autoinjector for first-aid treatment. An e-mail survey was conducted. Responses were anonymous and could not be traced to any person or location. Anaphylaxis was defined as the most severe sudden-onset allergic reaction ever experienced by the participants or a person for whom they were responsible (eg, a child). There were 17 core multiple-choice questions for all participants, with 16 additional questions for users who injected epinephrine either into themselves or someone else, and 1 additional question for nonusers. Of the 1885 participants, 500 (27%) were epinephrine users, and 1385 (73%) were nonusers. The groups were similar with regard to multisystem organ involvement (82% vs 78%, P = .07) and many other aspects of anaphylaxis; however, epinephrine users were more likely (all P < .05) to report respiratory or shock symptoms; to report peanut, fish, or insect sting triggers; to be asthmatic; and to have taken or been given asthma medication on the day of the episode. Epinephrine users reported problems in deciding whether to give the injection, repeat the dose, and/or go to an emergency department. Nonusers reported not injecting epinephrine for various reasons, including use of an H(1)-antihistamine (38%), no prescription for epinephrine (28%), and/or a mild anaphylaxis episode (13%). In a unique population composed of 1885 survivors of anaphylaxis in the community, users of epinephrine autoinjectors for first-aid treatment were outnumbered by nonusers. The insights reported by epinephrine users and the reasons why nonusers did not inject epinephrine are documented.

  16. Clinical Immunology Review Series: An approach too the patient with anaphylaxi

    PubMed Central

    El-Shanawany, T; Williams, P E; Jolles, S

    2008-01-01

    ARTICLES PUBLISHED IN THIS CLINICAL IMMUNOLOGY REVIEW SERIESallergy in childhood, allergy diagnosis by use of the clinical immunology laboratory, anaphylaxis, angioedema, management of pulmonary disease in primary antibody deficiency, recurrent infections in childhood, recurrent infections in adulthood, recurrent oro-genital ulceration, recurrent superficial abscesses, urticaria, vasculitis/CTD Anaphylaxis is a severe, life-threatening, generalized or systemic hypersensitivity reaction. While there is agreement as to this definition of anaphylaxis, the clinical presentation is often variable and it is not uncommon for there to be debate after the event as to whether anaphylaxis had actually occurred. The management of anaphylaxis falls into two distinct phases: (1) emergency treatment and resuscitation of a patient with acute anaphylaxis and (2) the search for a cause for the event and the formulation of a plan to prevent and treat possible further episodes of anaphylaxis. Both aspects are important in preventing death from anaphylaxis and are covered in this review. PMID:18577027

  17. Transfer and maintenance effects of online working-memory training in normal ageing and mild cognitive impairment.

    PubMed

    Vermeij, Anouk; Claassen, Jurgen A H R; Dautzenberg, Paul L J; Kessels, Roy P C

    2016-10-01

    Working memory (WM) is one of the cognitive functions that is susceptible to ageing-related decline. Interventions that are able to improve WM functioning at older age are thus highly relevant. In this pilot study, we explored the transfer effects of core WM training on the WM domain and other cognitive domains in 23 healthy older adults and 18 patients with amnestic mild cognitive impairment (MCI). Performance on neuropsychological tests was assessed before and after completion of the online five-week adaptive WM training, and after a three-month follow-up period. After training, both groups improved on the Digit Span and Spatial Span, gains that were maintained at follow-up. At an individual level, a limited number of participants showed reliable training gain. Healthy older adults, and to a lesser extent MCI patients, additionally improved on figural fluency at group level, but not at individual level. Results furthermore showed that global brain atrophy and hippocampal atrophy, as assessed by MRI, may negatively affect training outcome. Our study examined core WM training, showing gains on trained and untrained tasks within the WM domain, but no broad generalisation to other cognitive domains. More research is needed to evaluate the clinical relevance of these findings and to identify participant characteristics that are predictive of training gain.

  18. Online equivalence-based instruction about statistical inference using written explanation instead of match-to-sample training.

    PubMed

    Critchfield, Thomas S

    2014-01-01

    Equivalence-based instruction of college students was adapted for use in a commercial online course-delivery system, with written explanation replacing match-to-sample training. Outcomes rivaled those of previous studies in which students were taught in low-distraction settings through match-to-sample procedures that were controlled by custom computer programs, demonstrating that such supports are not essential to the effectiveness of equivalence-based instruction. © Society for the Experimental Analysis of Behavior.

  19. Support for Astronaut's View of Mexican/ Central American Fires and on-Line Earth Observations Training Manual

    NASA Technical Reports Server (NTRS)

    Kaminski, Charles F., Jr.

    1999-01-01

    A small project to compile remote sensing and in-site data to review the processes leading to the May 1998 Mexican/Central American fires was undertaken. A web page based on this project was assembled. The second project initiated involved an interactive and on-line program that will replace the paper version of the Earth Observations Preflight Training Manual. Technical support was provided to Prof. Marvin Glasser as needed.

  20. Intraoperative anaphylaxis: verba volant, scripta manent!

    PubMed

    Bilò, M B; Cinti, B; Chiarello, M; Bonifazi, F; Moneret-Vautrin, D A

    2005-11-01

    We describe a case of intraoperative gelatine-induced anaphylaxis whose diagnosis was delayed as the use of gelatine during surgical procedures was omitted for two times in patient's medical records. The subject is a 66-year old woman, with a negative medical history of atopy, food and drug allergy, with arterial hypertension on a course of beta-blockers and with bladder carcinoma requiring surgery. The patient had tolerated both general and local anaesthesia on several previous occasions. On the first occasion she experienced arterial fibrillation secondary to a severe episode of hypotension following local anaesthesia, while on a course of beta-blockers. On the second occasion she developed a very severe episode of hypotension followed by the outbreak of a generalised rash during general anaesthesia. The tryptase sera level was 109 mg/L one hour after the reaction had subsided, while the basal values were normal. On the third occasion the patient redeveloped severe hypotension and a generalised rash during general anaesthesia. The allergological work-up was negative, except for intradermal test with gelatine. A study of the intra-cellular cytokines in blood lymphocytes showed a production of IL4 from CD4+ lymphocytes after stimulation by gelatine. The patient underwent a successive surgical procedure without any adverse event.

  1. Component Resolved Diagnosis in Hymenoptera Anaphylaxis.

    PubMed

    Tomsitz, D; Brockow, K

    2017-06-01

    Hymenoptera anaphylaxis is one of the leading causes of severe allergic reactions and can be fatal. Venom-specific immunotherapy (VIT) can prevent a life-threatening reaction; however, confirmation of an allergy to a Hymenoptera venom is a prerequisite before starting such a treatment. Component resolved diagnostics (CRD) have helped to better identify the responsible allergen. Many new insect venom allergens have been identified within the last few years. Commercially available recombinant allergens offer new diagnostic tools for detecting sensitivity to insect venoms. Additional added sensitivity to nearly 95% was introduced by spiking yellow jacket venom (YJV) extract with Ves v 5. The further value of CRD for sensitivity in YJV and honey bee venom (HBV) allergy is more controversially discussed. Recombinant allergens devoid of cross-reactive carbohydrate determinants often help to identify the culprit venom in patients with double sensitivity to YJV and HBV. CRD identified a group of patients with predominant Api m 10 sensitization, which may be less well protected by VIT, as some treatment extracts are lacking this allergen. The diagnostic gap of previously undetected Hymenoptera allergy has been decreased via production of recombinant allergens. Knowledge of analogies in interspecies proteins and cross-reactive carbohydrate determinants is necessary to distinguish relevant from irrelevant sensitizations.

  2. Buckwheat anaphylaxis: an unusual allergen in Taiwan.

    PubMed

    Wang, Tsung-Chi; Shyur, Shyh-Dar; Wen, Da-Chin; Kao, Yu-Hsuan; Huang, Li-Hsin

    2006-01-01

    IgE-mediated hypersensitivity to buckwheat is common in Korea, Japan, and some other Asian countries. However, buckwheat is not a common allergen in Taiwan. We report a woman with asthma who had anaphylactic shock, generalized urticaria, and an acute exacerbation of asthma five minutes after ingesting buckwheat. The patient underwent skin prick and Pharmacia CAP testing (Uppsala, Sweden) for specific IgE to buckwheat, white sesame and soybean as well as other common allergens in Taiwan including Dermatophagoides pteronyssinus (Dp), D. farinae (Df), cat and dog dander, cockroach, egg white, cow milk and codfish. The patient had a strongly positive skin prick test response to buckwheat and positive reactions to Dp and latex. Specific IgE results were class 6 for buckwheat, class 4 for Dp and Df, and class 2 for dog dander, wheat, sesame and soybean. Results of an open food challenge with white sesame and soybean were negative. Although buckwheat is a rare allergen in Taiwan, it can cause extremely serious reactions and should be considered in patients presenting with anaphylaxis after exposure to buckwheat.

  3. Angiopoietin1 Inhibits Mast Cell Activation and Protects against Anaphylaxis

    PubMed Central

    Li, Meng-Tao; Liu, Yi-Nan; He, Qi-Hua; Xiao, Jun-Jun; Bai, Yun

    2014-01-01

    Since morbidity and mortality rates of anaphylaxis diseases have been increasing year by year, how to prevent and manage these diseases effectively has become an important issue. Mast cells play a central regulatory role in allergic diseases. Angiopoietin1 (Ang-1) exhibits anti-inflammatory properties by inhibiting vascular permeability, leukocyte migration and cytokine production. However, Ang-1's function in mast cell activation and anaphylaxis diseases is unknown. The results of our study suggest that Ang-1 decreased lipopolysaccharide (LPS)-induced pro-inflammatory cytokines production of mast cells by suppressing IκB phosphorylation and NF-κB nuclear translocation. Ang-1 also strongly inhibited compound 48/80 induced and FcεRI-mediated mast cells degranulation by decreasing intracellular calcium levels in vitro. In vivo lentivirus-mediated delivery of Ang-1 in mice exhibited alleviated leakage in IgE-dependent passive cutaneous anaphylaxis (PCA). Furthermore, exogenous Ang-1 intervention treatment prevented mice from compound 48/80-induced mesentery mast cell degranulation, attenuated increases in pro-inflammatory cytokines, relieved lung injury, and improved survival in anaphylaxis shock. The results of our study reveal, for the first time, the important role of Ang-1 in the activation of mast cells, and identify a therapeutic effect of Ang-1 on anaphylaxis diseases. PMID:24586553

  4. Anaphylaxis: an update on its understanding and management.

    PubMed

    Incorvaia, Cristoforo; Mauro, Marina; Pravettoni, Valerio; Incorvaia, Stefano; Riario-Sforza, Gian G

    2010-06-01

    Anaphylaxis is the most concerning manifestation of hypersensitivity. Recent thorough investigations on the pathophysiology of anaphylaxis achieved important advances in its understanding, regarding in particular the emerging role of mediators such as platelet activating factor (PAF) and sphyngosine 1 phosphate (S1P) and the improved knowledge on the actors of the signaling cascade, from the contact between the specific allergen and the IgE fixed on the Fc-epsilon-RI receptor to the opening of calcium channels. These advances may provide new diagnostic and therapeutical tools. In particular, a role for PAF and S1P as laboratory markers of anaphylaxis is likely to be developed, and innovative preventive strategies able to induce a negative signaling are currently under evaluation. Also, using well known preventive treatments, such as allergen specific immunotherapy may offer new perspectives for the management of patients at risk of potentially fatal reaction to foods. In fact, controlled studies demonstrated that sublingual immunotherapy is able to significantly increase the tolerance to the causative foods, fulfilling the need and protecting the allergic subject from anaphylaxis caused by accidental ingestion of small food amounts. The article also presented some promising patents on anaphylaxis.

  5. Glucocorticoids for the treatment of anaphylaxis: Cochrane systematic review.

    PubMed

    Choo, K J L; Simons, E; Sheikh, Aziz

    2010-10-01

    Anaphylaxis is a serious hypersensitivity reaction that is rapid in onset and may result in death. A number of guidelines recommend glucocorticoids for the treatment of people experiencing anaphylaxis. We sought to assess the benefits and harms of glucocorticoid treatment during episodes of anaphylaxis. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2009, Issue 3), MEDLINE (Ovid) (1966 to September 2009), EMBASE (Ovid) (1988 to September 2009), CINAHL (EBSCOhost) (to September 2009) and The Science Citation Index Expanded (SCI-EXPANDED) (1945 to September 2009). We also searched the UK National Research Register and websites listing ongoing trials and contacted international experts in anaphylaxis in an attempt to locate unpublished material. We sought to include randomized and quasi-randomized controlled trials comparing glucocorticoids with any control (either placebo, adrenaline (epinephrine), an antihistamine, or any combination of these). Two authors independently assessed articles for inclusion. None of the 2496 reports identified satisfied the inclusion criteria. We conclude that there is no evidence from high-quality studies for the use of steroids in the emergency management of anaphylaxis. Therefore, we can neither support nor refute the use of these drugs for this purpose.

  6. The Effects of an Online Mind-Body Training Program on Stress, Coping Strategies, Emotional Intelligence, Resilience and Psychological State

    PubMed Central

    Jung, Ye-Ha; Ha, Tae Min; Oh, Chang Young; Lee, UI Soon; Jang, Joon Hwan; Kim, Jungwon; Park, Jae-Oh; Kang, Do-Hyung

    2016-01-01

    The goal of this study was to evaluate the effects of an online mind-body training (MBT) program on participants’ stress, anger, coping strategies, emotional intelligence, resilience, and positive and negative affect. Forty-two healthy women participated in an online MBT program for approximately 8–10 minutes a day for 8 weeks; a control group of 45 healthy women did not participate in the program. Self-report psychological questionnaires were administered before the beginning of the program and at 4 and 8 weeks following its onset. Data from the MBT group and the control group were compared using repeated measures ANOVA and Student’s t-tests. Significant time x group interaction effects were found with respect to stress, coping strategies, anger, emotional intelligence, negative affect and resilience. These results demonstrate beneficial effects of the online MBT program and significant improvements in the psychological capabilities of participants compared with the control group. The effects of online MBT program were similar with those of the previous offline MBT in psychological aspects, suggesting further studies for neuroscientific evidence related stress and emotion of online MBT effects. PMID:27479499

  7. The Effects of an Online Mind-Body Training Program on Stress, Coping Strategies, Emotional Intelligence, Resilience and Psychological State.

    PubMed

    Jung, Ye-Ha; Ha, Tae Min; Oh, Chang Young; Lee, Ui Soon; Jang, Joon Hwan; Kim, Jungwon; Park, Jae-Oh; Kang, Do-Hyung

    2016-01-01

    The goal of this study was to evaluate the effects of an online mind-body training (MBT) program on participants' stress, anger, coping strategies, emotional intelligence, resilience, and positive and negative affect. Forty-two healthy women participated in an online MBT program for approximately 8-10 minutes a day for 8 weeks; a control group of 45 healthy women did not participate in the program. Self-report psychological questionnaires were administered before the beginning of the program and at 4 and 8 weeks following its onset. Data from the MBT group and the control group were compared using repeated measures ANOVA and Student's t-tests. Significant time x group interaction effects were found with respect to stress, coping strategies, anger, emotional intelligence, negative affect and resilience. These results demonstrate beneficial effects of the online MBT program and significant improvements in the psychological capabilities of participants compared with the control group. The effects of online MBT program were similar with those of the previous offline MBT in psychological aspects, suggesting further studies for neuroscientific evidence related stress and emotion of online MBT effects.

  8. Demonstration of an aberrant mast-cell population with clonal markers in a subset of patients with “idiopathic” anaphylaxis

    PubMed Central

    Scott, Linda M.; Kocabas, Can N.; Kushnir-Sukhov, Nataliya; Brittain, Erica; Noel, Pierre; Metcalfe, Dean D.

    2007-01-01

    Idiopathic anaphylaxis remains a perplexing disorder in which existing prophylactic therapy is inadequate. In this prospective study, we sought to determine whether patients with idiopathic anaphylaxis might have evidence for a clonal disorder of mast cells related to mastocytosis and for which novel targeted therapies might be considered. We report 12 patients with “idiopathic” anaphylaxis who did not exhibit either urticaria pigmentosa or the characteristic bone marrow biopsy finding of multifocal mast-cell aggregates observed in systemic mastocytosis. Of these 12 patients, 5 had evidence of 1 or more minor criteria for mastocytosis. C-KIT mutational analysis was positive for the 816D>V activating mutation in 3 of 3 patients in CD25+ bone marrow cells where the analysis was performed. These results demonstrate the presence of an aberrant mast-cell population carrying clonal markers in a subset of patients diagnosed with “idiopathic” anaphylaxis, who may respond to inhibitors targeting mutated C-KIT. This intramural clinical trial was conducted in 2003 and 2004 and was registered at http://clinicalcenter.nih.gov with a study number 03-I-0010. Since the study is now closed, it is no longer available online. PMID:17638853

  9. An Investigation of a Computer Training Company's Migration to a New Distance Learning Platform and the Implementation of an Online Professional Development Program

    ERIC Educational Resources Information Center

    Rudd, Denis; Bernadowski, Carianne

    2015-01-01

    The purpose of the study was to determine if the Training Partner Program was successful in preparing trainers to use a new distance learning platform. Results indicate the program was a success in improving self-efficacy, engagement, and collaboration among trainers. Additionally, characteristics of online trainers are identified. Online learning…

  10. An Investigation of a Computer Training Company's Migration to a New Distance Learning Platform and the Implementation of an Online Professional Development Program

    ERIC Educational Resources Information Center

    Rudd, Denis; Bernadowski, Carianne

    2015-01-01

    The purpose of the study was to determine if the Training Partner Program was successful in preparing trainers to use a new distance learning platform. Results indicate the program was a success in improving self-efficacy, engagement, and collaboration among trainers. Additionally, characteristics of online trainers are identified. Online learning…

  11. Comparing Online and In-Person Delivery Formats of the OSHA 10-Hour General Industry Health and Safety Training for Young Workers.

    PubMed

    Shendell, Derek G; Milich, Lindsey J; Apostolico, Alexsandra A; Patti, Alexa A; Kelly, Siobhan

    2017-05-01

    Seven school districts or comprehensive high schools were enrolled in online OSHA 10-hour General Industry or Construction health and safety training via CareerSafe to determine the feasibility of online training for students, given limited resources for in-person trainings. A two-campus school district was analyzed comparing OSHA 10 for General Industry across in-person, supervisor-level teachers as authorized trainers, and online course formats. The online training courses were completed by 86 of 91 students, while another 53 of 57 students completed in-person training. Both groups completed identical OSHA-approved quizzes for "Introduction to OSHA," the initial 2-h module consistently provided in OSHA 10 courses across topics and formats. Results indicated teacher supervision was critical, and girls had higher online course completion rates, overall quiz scores, and never failed. Though both cohorts passed, in-person had significantly higher scores than online; both struggled with two questions. Online OSHA 10 for General Industry can be an efficient learning tool for students when limited resources prevent widespread availability of in-person courses.

  12. Efficacy of a hybrid online training for panic symptoms and agoraphobia: study protocol for a randomized controlled trial.

    PubMed

    Ebenfeld, Lara; Kleine Stegemann, Stefan; Lehr, Dirk; Ebert, David Daniel; Jazaieri, Hooria; van Ballegooijen, Wouter; Funk, Burkhardt; Riper, Heleen; Berking, Matthias

    2014-11-04

    Recently, internet-based interventions have been proposed as effective treatments for people with panic disorder (PD). However, little is known about the clinical effects of integrating mobile technology into these interventions. Because users carry their smartphones with them throughout the day, we hypothesize that this technology can be used to significantly support individuals with monitoring and overcoming their PD symptoms. The aim of the present study is to evaluate the efficacy and cost-effectiveness of a newly developed hybrid intervention that combines internet/PC with smartphone delivery to treat the symptoms of PD. The intervention is based on cognitive behavioral therapy and consists of six modules over a total of six weeks. A two-arm randomized controlled trial (RCT) will be conducted to evaluate the effects of a hybrid online training module for PD. Based on a power calculation (d =0.60; 1-β of 80%; α =0.05), 90 participants with mild to moderate panic symptoms with or without agoraphobia (as assessed by the Panic and Agoraphobia Scale) will be recruited from the general population and randomly assigned to either the intervention group or a six-month waitlist control group. The primary outcome measure will be the severity of panic symptoms. Secondary outcomes will include depression, quality of life, and an observer-based rating of panic severity. Furthermore, data regarding acceptance and the usability of the smartphone app will be assessed. Assessments will take place at baseline as well as eight weeks, three months, and six months after randomization. Moreover, a cost-effectiveness analysis will be performed from a societal perspective. Data will be analyzed on an intention-to-treat basis and per protocol. To our knowledge, this RCT is one of the first to examine the efficacy of a hybrid online training for adult PD. This study seeks to contribute to the emerging field of hybrid online training. If the intervention is efficacious, then research

  13. Early skin and challenge testing after rocuronium anaphylaxis.

    PubMed

    Schulberg, E M; Webb, A R; Kolawole, H

    2016-05-01

    We present a case of early skin and challenge testing in a patient following severe anaphylaxis to rocuronium. The patient presented for semi-elective laparoscopic cholecystectomy and developed anaphylaxis with severe cardiovascular collapse after induction of anaesthesia. Surgery was cancelled but was considered necessary before the recommended four to six weeks for formal allergy testing. Limited skin and challenge testing was performed to rocuronium and cisatracurium while the patient was in the intensive care unit to identify a safe neuromuscular blocking drug for subsequent early surgery. The subsequent surgery, 48 hours after the initial reaction, was uneventful. The case highlights the difficulties when anaesthetising patients with recent anaphylaxis who have not yet had formal allergy testing and presents a potential management strategy involving early skin testing.

  14. Acute symptoms of drug hypersensitivity (urticaria, angioedema, anaphylaxis, anaphylactic shock).

    PubMed

    Limsuwan, Ticha; Demoly, Pascal

    2010-07-01

    Drug hypersensitivity reactions (HSRs) are the adverse effects of drugs which, when taken at doses generally tolerated by normal subjects, clinically resemble allergy. Immediate-reaction of drug HSRs are those that occur less than 1 hour after the last drug intake, usually in the form of urticaria, angioedema, rhinitis, conjunctivitis, bronchospasm, and anaphylaxis or anaphylactic shock. Acute urticarial and angioedema reactions are common clinical problems frequently encountered by internists and general practitioners. They are not specific to drug allergic reaction, and can be caused by various pathogenic mechanisms. Despite the benign course of urticaria and angioedema, a mucocutaneous swelling of the upper respiratory tract could be life-threatening by itself or a feature of anaphylaxis. This article reviews acute symptoms of drug HSR-related urticaria, angioedema, anaphylaxis, and anaphylactic shock, and how clinicians should approach these problems. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  15. Sugammadex in the management of rocuronium-induced anaphylaxis.

    PubMed

    McDonnell, N J; Pavy, T J G; Green, L K; Platt, P R

    2011-02-01

    Anaphylaxis during anaesthesia is a rare event that in ∼60-70% of cases is secondary to neuromuscular blocking agents. It has been suggested previously that the recent introduction of sugammadex may provide a novel therapeutic approach to the management of rocuronium-induced anaphylaxis. We describe the case of a 33-yr-old female who suffered a severe anaphylactic reaction to rocuronium, presenting with cardiovascular collapse on induction of anaesthesia. After 19 min of traditional management, she was given a bolus of sugammadex 500 mg. This was associated with an improvement in the adverse haemodynamic state. The underlying reasons for this are unclear, but sugammadex may potentially be a useful adjunct in the management of rocuronium-induced anaphylaxis.

  16. Characterization of anaphylaxis after ecallantide treatment of hereditary angioedema attacks.

    PubMed

    Craig, Timothy J; Li, H Henry; Riedl, Marc; Bernstein, Jonathan A; Lumry, William R; MacGinnitie, Andrew J; Stolz, Leslie E; Biedenkapp, Joseph; Chyung, Yung

    2015-01-01

    Ecallantide is a human plasma kallikrein inhibitor indicated for treatment of acute attacks of hereditary angioedema for patients 12 years of age and older. Ecallantide is produced in Pichia pastoris yeast cells by recombinant DNA technology. Use of ecallantide has been associated with a risk of hypersensitivity reactions, including anaphylaxis. The objective of this detailed retrospective data review was to characterize anaphylaxis cases within the ecallantide clinical trials database. Potential cases of hypersensitivity reactions in the ecallantide clinical development program were identified by examining reported adverse events. The National Institute of Allergy and Infectious Disease criteria were used to identify those events that were consistent with anaphylaxis; these cases were then reviewed in detail. Results from investigational antibody testing also were examined. Among patients who received subcutaneous ecallantide (n = 230 patients; 1045 doses of 30 mg ecallantide), 8 patients (3.5%) had reactions that met the National Institute of Allergy and Infectious Disease criteria for anaphylaxis; none occurred on first exposure to the drug. All 8 reactions had symptom onset within 1 hour of exposure and cutaneous manifestations commonly observed in type I hypersensitivity reactions. All the reactions responded to standard management of type I hypersensitivity reactions and resolved without fatal outcomes. IgE antibody testing to ecallantide or P pastoris was not consistently positive in patients who experienced apparent type I hypersensitivity reactions. Anaphylaxis episodes after subcutaneous ecallantide exposure have clinical features suggestive of type I hypersensitivity reactions. However, anti-ecallantide or anti-P pastoris IgE antibody status was not found to be reliably associated with anaphylaxis. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  17. A Case of Immunoglobulin E Mediated Anaphylaxis to Levodropropizine

    PubMed Central

    Park, Kyung Hee; Yun, Il Seon; Choi, Soo-Young; Lee, Jae-Hyun; Hong, Chein-Soo

    2013-01-01

    We experienced a case of immunoglobulin E (IgE) mediated anaphylaxis to levodropropizine. The patient was an 18-year old Korean woman. After taking the common cold medication including acetaminophen, domperidone, and levodropropizine, skin rash, angioedema and anaphylaxis were developed immediately. As she was tolerable to acetaminophen alone, we thought the culprit agent was maybe a levodropropizine tablet. To confirm the culprit, she underwent skin prick test and oral drug provocation test with the suspected one. Finally we detected levodropropizine specific IgE and confirmed the specificity by inhibition enzyme-linked immunosorbent assay (ELISA). PMID:23225830

  18. The Hidden Culprit: A Case of Repeated Anaphylaxis to Cremophor.

    PubMed

    Kim, Young Nam; Kim, Jun Young; Kim, Ji Won; Kim, Jin Hae; Kim, Hye In; Yune, Sehyo; Choi, Dong Chull; Lee, Byung Jae

    2016-03-01

    Drug-induced anaphylaxis is a big pitfall in patients receiving antineoplastic chemotherapy. We report a case of lung cancer patient who experienced two near-fatal anaphylactic reactions that resulted from paclitaxel and multivitamin, seperately. Recurrent severe reactions to different agents led to further investigation to which material the patient was hypersensitive. The skin prick test revealed sensitization to cremophor, which is a commonly used emulsifying agent. This case emphasizes the importance of correctly identifying the culprit drug of anaphylaxis to avoid potentially fatal reaction.

  19. Previous iodinated contrast anaphylaxis in blunt abdominal trauma: management options.

    PubMed

    Zaman, Shahriar Raj

    2012-06-01

    A 34-year-old man presented with significant intra-abdominal and orthopaedic injuries following a high-speed motorbike crash. The man had a history of an anaphylactic reaction to iodine. As a result, the gold standard CT of the abdomen with contrast was unable to be performed to ascertain the exact nature of the intra-abdominal injuries. After stabilisation, an MRI of the abdomen was performed which localised the injuries. The previous contrast anaphylaxis delayed full assessment of the patient and subsequent management. This case discusses the current literature and the management guidelines in a patient with previous anaphylaxis to contrast.

  20. Pediatric anaphylaxis and hyper IgE syndrome

    PubMed Central

    Dosanjh, Amrita

    2017-01-01

    Patients with autosomal-dominant (AD) hyper immunoglobulin E (IgE) syndrome (HIES) or Job syndrome develop frequent dermatologic and pulmonary infections. As patients have an extreme elevation of IgE levels, this database analysis study sought to study the association between AD HIES, Job syndrome, and anaphylaxis. HIES is a heterogeneous group of immune disorders characterized by extremely elevated levels of serum IgE. Although the molecular defects and clinical phenotypes found in association with Job syndrome are well characterized, the association with severe allergic reactions and anaphylaxis is a subject of ongoing investigation. PMID:28280372