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Objectives: To evaluate and analyze the efficacy of implementation of hemorrhage-control training into the formal medical school curriculum. We predict this training will increase the comfort and confidence levels of students with controlling major hemorrhage and they will find this a valuable skill set for medical and other healthcare professional students. Methods: After IRB and institutional approval was obtained, hemorrhage-control education was incorporated into the surgery clerkship curriculum for 96 third-year medical students at the University of Arkansas for Medical Sciences using the national Stop The Bleed program. Using a prospective study design, participants completed pre- and post-training surveys to gauge prior experiences and comfort levels with controlling hemorrhage and confidence levels with the techniques taught. Course participation was mandatory; survey completion was optional. The investigators were blinded as to the individual student’s survey responses. A knowledge quiz was completed following the training. Results: Implementation of STB training resulted in a significant increase in comfort and confidence among students with all hemorrhage-control techniques. There was also a significant difference in students’ perceptions of the importance of this training for physicians and other allied health professionals. Conclusion: Hemorrhage-control training can be effectively incorporated into the formal medical school curriculum via a single 2-hour Stop The Bleed course, increasing students’ comfort level and confidence with controlling major traumatic bleeding. Students value this training and feel it is a beneficial addition to their education. We believe this should be a standard part of undergraduate medical education.

The College Advisory Program offered by Total Vision Soccer Club aims at providing young players with the opportunity to learn how to navigate the collegiate recruiting process, market themselves to college coaches, and increase their exposure to potential colleges and universities. A team of external evaluators (authors of this chapter) conducted a formative evaluation to determine what the program needs to do to reach its goal. By following a systemic evaluation process, the evaluation team investigated five dimensions of the program and collected data by reviewing various program materials and conducting surveys and interviews with players and their parents, upstream stakeholders, and downstream impactees. By triangulating the multiple sources of data, the team drew a conclusion that most program dimensions were rated as mediocre although the program had several strengths. The team provided evidence-based recommendations for improving the quality of the program.

Case: A traumatic nondisplaced periprosthetic trochanteric fracture around a well-fixed and functioning Birmingham Hip Resurfacing prosthesis was managed with a reconstruction intramedullary nail. The surgical procedure provided excellent pain relief, and the patient was able to mobilize with crutches the day after surgery. Follow-up at 1 year confirmed excellent clinical and radiographic results. Conclusion: In a patient with a previously well-functioning hip resurfacing prosthesis, internal fixation rather than revision hip arthroplasty can offer good clinical and radiographic outcomes. The use of a reconstruction intramedullary nail may be a good option for fixing a periprosthetic trochanteric fracture around a Birmingham Hip Resurfacing implant.

To determine the general utility of clinical (Asthma Control Test) and physiologic (forced expiratory volume in the first second of exhalation [FEV(1)] and fractionated exhaled nitric oxide level [FeNO]) parameters for characterizing asthma patients.Two cross-sectional independent studies simultaneously enrolled 100 patients in the US and 109 patients in Spainor = 18 years of age with a physician-diagnosis of asthma and confirmed by aor = 12% improvement in FEV(1) after bronchodilators or the presence of airway hyperresponsiveness, a central feature of asthma, as measured by methacholine challenge (PC(20)10 mg/mL). There was no restriction on asthma severity or treatment. Patients were excluded if they had a diagnosis of chronic obstructive pulmonary disease and/or were current cigarette smokers. Statistical analyses were performed to compare ACT, FeNO, and spirometry within and between sites.Population characteristics revealed significant differences in distributions of age, percent-predicted FEV(1) (%FEV(1)), FeNO, inhaled corticosteroid usage, and atopy between the two populations. The Spain site enrolled younger patients with milder asthma, based on higher %FEV(1) values and less frequent treatment with inhaled corticosteroids. At each site, mean FeNO levels decreased as asthma control categories increased, and means were lower in the US. There was a negative correlation between ACT and FeNO that was statistically significant for Spain patients not treated with inhaled corticosteroids.The results of this study support the use of FeNO as an adjunctive tool for assessing asthma primarily in mild inhaled corticosteroid (ICS)-naïve asthma patients. The lack of correlation of ACT with FeNO in this and other studies across the entire population appears to reflect the heterogeneity of asthma patients who have an admixture of asthma severity and treatment regimens making it very difficult to appreciate the nuances of sensitive tests like FeNO.

Traditionally, illustrations have been subsidiary to text in the higher learning. Visual information is being set free from its dependence on text and the consequences for education will be immense, if we can learn to exploit its possibilities.