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You searched for +publisher:"University of Otago" +contributor:("Walker, Rob"). Showing records 1 – 3 of 3 total matches.

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University of Otago

1. Roy, Melyssa Claire. Validity of a Virtual Reality-Based Clinical Case for Assessment of Clinical Competence .

Degree: 2013, University of Otago

Reliable and valid assessment of the clinical competence of medical students and doctors is essential for the safety of patients. Current modes of assessment are limited in their ability to evaluate some key aspects of competence, such as clinical reasoning ability and timely decision-making. The aims of this study were to assess the validity of a virtual reality-based clinical case as a method of assessment of clinical competence. In addition, this study intended to specifically examine the capacity of the virtual reality case format to assess clinical reasoning ability. The Otago Virtual Hospital is a virtual reality-based computer programme in which the performance of doctors and students can be assessed while managing a simulated clinical case in real time. As a pilot study, 12 participants, (consisting of three cohorts comprised of third-year medical students, fifth-year medical students and qualified doctors) from Otago Medical School participated in a simulated clinical case. Their performance was measured by scoring their achievement of set outcomes representing optimal management; these were developed from expert opinion. Qualitative thematic analysis of case transcripts was undertaken to compare clinical reasoning skills. Scores of performance from the virtual reality case showed qualified doctors achieved the highest scores, significantly higher than the third-year student group. Qualified doctors were also significantly better able to make correct full diagnoses and achieve safe clinical management compared with the student cohorts. These results showed some significant differences between groups at different stages of medical training, hence supporting the construct validity of the virtual-reality based clinical case. Thematic analysis to identify clinical reasoning themes indicated that compared to the student cohorts, the qualified doctor group was better able to transform information into key clinical concepts, generate more accurate diagnoses, and generate correct diagnoses more efficiently. With increasing clinical experience there was a superior ability to communicate clinical information succinctly and precisely, and to construct effective patient management plans. The virtual reality based clinical case provided an authentic clinical task. Within the programme, overall performance and clinical reasoning abilities could be assessed by analysis of a summary admission note at the conclusion of the case. These results suggest that simulated virtual cases may provide a valid and rapid means of assessing clinical competence, and can provide more comprehensive information about clinical reasoning ability than traditional means of assessment. Advisors/Committee Members: Walker, Rob (advisor).

Subjects/Keywords: clinical competence; competence assessment; virtual reality

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APA (6th Edition):

Roy, M. C. (2013). Validity of a Virtual Reality-Based Clinical Case for Assessment of Clinical Competence . (Masters Thesis). University of Otago. Retrieved from http://hdl.handle.net/10523/4493

Chicago Manual of Style (16th Edition):

Roy, Melyssa Claire. “Validity of a Virtual Reality-Based Clinical Case for Assessment of Clinical Competence .” 2013. Masters Thesis, University of Otago. Accessed July 16, 2019. http://hdl.handle.net/10523/4493.

MLA Handbook (7th Edition):

Roy, Melyssa Claire. “Validity of a Virtual Reality-Based Clinical Case for Assessment of Clinical Competence .” 2013. Web. 16 Jul 2019.

Vancouver:

Roy MC. Validity of a Virtual Reality-Based Clinical Case for Assessment of Clinical Competence . [Internet] [Masters thesis]. University of Otago; 2013. [cited 2019 Jul 16]. Available from: http://hdl.handle.net/10523/4493.

Council of Science Editors:

Roy MC. Validity of a Virtual Reality-Based Clinical Case for Assessment of Clinical Competence . [Masters Thesis]. University of Otago; 2013. Available from: http://hdl.handle.net/10523/4493


University of Otago

2. Leader, Catherine. Cardiorenal syndrome in a transgenic hypertensive rat model .

Degree: University of Otago

Hypertension is a leading cause of cardiovascular disease and myocardial infarction (MI), and these are strongly associated with renal injury. However, the impact of MI additional to the effect of hypertension on renal injury is not clearly described. Further, while mineralocorticoid blockade with spironolactone (SP) has been shown to reduce cardiac fibrosis and improve cardiac re-modelling post MI; its effects on the kidney are unknown. We aimed to explore the effects of SP on renal fibrosis in hypertensive rats post MI. Methods: Adult male transgenic Cyp1a1Ren2 rats were divided initially into two groups, normotensive (N) and hypertensive (H), and each further divided into five experimental groups: control animals, animals fed SP daily (50 mg.day-1) (+SP), animals that underwent sham operation (as a surgical control) (sham), animals with surgically induced MI (permanent left anterior coronary ligation) (+MI) and animals with surgically induced MI with additional daily administration of SP (+MI+SP). Hypertension (>160 mmHg systolic) was induced by addition of 0.167 % (w/w) indole-3-carbinol to the rat chow. Systolic blood pressure (SBP), urine collection and echocardiograms were recorded every four weeks. Cardiac and renal tissues were harvested for analysis either one month or three months. Results: SBP was lower in the H+MI group (p=0.05) compared with the other H groups (155 ± 24 and 173 ± 11mmHg respectively). SBP was not significantly reduced by SP in either of the treated groups. Ejection fraction (EF) was significantly (p<0.001) reduced by MI induction, but not improved by SP treatment in both N and H groups. Glomerulosclerosis indices (GSI) were significantly raised in all hypertensive groups against normotensive values of 0.2 ± 0.1. SP significantly (p=0.002) decreased GSI in the H+SP group (0.9±0.04) from H controls (1.2 ± 0.07) and in the H+MI+SP (1 ± 0.1; p=0.04) from the H+MI group (1.3±0.1). The degree of renal cortical interstitial fibrosis in all hypertensive groups was not however modified by SP following one month, but did show a significantly slowed progression in induced hypertensive animals following three months. Conclusion: Malignant hypertension produced extensive renal glomerulosclerosis and interstitial fibrosis over one month, which was increased further by three months. SP improved GSI scores, and reduced the extent of cardiac and renal fibrosis in hypertensive Cyp1a1Ren2 rats. No effect of SP administration was seen on SBP or cardiac EF. Further work will aim to better define the relationship between cardiac injury and renal damage. Advisors/Committee Members: Walker, Rob (advisor).

Subjects/Keywords: Cardiorenal; hypertension; kidney; Cyp1a1Ren2; renal

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APA (6th Edition):

Leader, C. (n.d.). Cardiorenal syndrome in a transgenic hypertensive rat model . (Doctoral Dissertation). University of Otago. Retrieved from http://hdl.handle.net/10523/8119

Note: this citation may be lacking information needed for this citation format:
No year of publication.

Chicago Manual of Style (16th Edition):

Leader, Catherine. “Cardiorenal syndrome in a transgenic hypertensive rat model .” Doctoral Dissertation, University of Otago. Accessed July 16, 2019. http://hdl.handle.net/10523/8119.

Note: this citation may be lacking information needed for this citation format:
No year of publication.

MLA Handbook (7th Edition):

Leader, Catherine. “Cardiorenal syndrome in a transgenic hypertensive rat model .” Web. 16 Jul 2019.

Note: this citation may be lacking information needed for this citation format:
No year of publication.

Vancouver:

Leader C. Cardiorenal syndrome in a transgenic hypertensive rat model . [Internet] [Doctoral dissertation]. University of Otago; [cited 2019 Jul 16]. Available from: http://hdl.handle.net/10523/8119.

Note: this citation may be lacking information needed for this citation format:
No year of publication.

Council of Science Editors:

Leader C. Cardiorenal syndrome in a transgenic hypertensive rat model . [Doctoral Dissertation]. University of Otago; Available from: http://hdl.handle.net/10523/8119

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No year of publication.


University of Otago

3. Mitchell, Logan Vaughan. SOPARIX Study – PHOX2A (ARIX) and PHOX2B Gene Analysis of a Cohort with Radiologically-Proven Congenital Superior Oblique Palsies .

Degree: University of Otago

Introduction: Congenital superior oblique palsy (CSOP) remains enigmatic in terms of diagnosis, classification, and pathophysiology. Tendon abnormalities are commonly recognized intra-operatively, whilst recent orbital imaging advances find superior oblique (SO) muscle hypoplasia to be a key diagnostic feature. The relationship between these two features is unclear, but congenital superior oblique palsy may be a congenital cranial dysinnervation disorder (CCDD) – perhaps a milder variant of congenital fibrosis of the extra-ocular muscles type 2 (CFEOM2). Mutations in homeobox gene PHOX2A (ARIX) are found to cause CFEOM2. Polymorphisms in homologs PHOX2A and PHOX2B are reported among clinically diagnosed CSOP cases in Japan, including three familial cases. Aim: To describe polymorphisms in the PHOX2A and PHOX2B genes among a cohort of predominantly Caucasian Australians with radiologically-proven CSOP. Methods: Lionel Kowal routinely images the orbits of patients with cyclovertical strabismus in his private practice. Patients with radiologically-proven congenital superior oblique palsy were seen for repeat assessment by the investigator, and DNA samples were collected via saliva specimen. Coding sequences of PHOX2A and PHOX2B were amplified by polymerase chain reaction (PCR), then underwent Sanger sequencing. Sequences were compared to published genome and single nucleotide polymorphism (SNP) databases. Results: Thirty-five patients (average age 35.7 years) were included. Mean ipsilateral:contralateral SO diameter ratio on coronal CT or MRI images was 0.41 (range 0.1-0.67). Gene sequencing of PHOX2A and PHOX2B samples from these patients revealed a single heterozygous SNP of gene PHOX2A, C328T, representing a minor allele frequency (MAF) of 0.029 – a statistically insignificant difference to this SNP’s published MAF of 0.014. Conclusion: In this Australian cohort of radiologically-proven CSOP, sequencing of PHOX2A and PHOX2B revealed a single, recognized, SNP in line with published frequencies. This contrasted to previous literature studying different patient populations. Advisors/Committee Members: Walker, Rob (advisor).

Subjects/Keywords: ophthalmology; strabismus; superior oblique palsy; genetics

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APA (6th Edition):

Mitchell, L. V. (n.d.). SOPARIX Study – PHOX2A (ARIX) and PHOX2B Gene Analysis of a Cohort with Radiologically-Proven Congenital Superior Oblique Palsies . (Masters Thesis). University of Otago. Retrieved from http://hdl.handle.net/10523/7838

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Chicago Manual of Style (16th Edition):

Mitchell, Logan Vaughan. “SOPARIX Study – PHOX2A (ARIX) and PHOX2B Gene Analysis of a Cohort with Radiologically-Proven Congenital Superior Oblique Palsies .” Masters Thesis, University of Otago. Accessed July 16, 2019. http://hdl.handle.net/10523/7838.

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No year of publication.

MLA Handbook (7th Edition):

Mitchell, Logan Vaughan. “SOPARIX Study – PHOX2A (ARIX) and PHOX2B Gene Analysis of a Cohort with Radiologically-Proven Congenital Superior Oblique Palsies .” Web. 16 Jul 2019.

Note: this citation may be lacking information needed for this citation format:
No year of publication.

Vancouver:

Mitchell LV. SOPARIX Study – PHOX2A (ARIX) and PHOX2B Gene Analysis of a Cohort with Radiologically-Proven Congenital Superior Oblique Palsies . [Internet] [Masters thesis]. University of Otago; [cited 2019 Jul 16]. Available from: http://hdl.handle.net/10523/7838.

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No year of publication.

Council of Science Editors:

Mitchell LV. SOPARIX Study – PHOX2A (ARIX) and PHOX2B Gene Analysis of a Cohort with Radiologically-Proven Congenital Superior Oblique Palsies . [Masters Thesis]. University of Otago; Available from: http://hdl.handle.net/10523/7838

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No year of publication.

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