The Grand Rounds encompasses natural features, including lakes, creeks, woodlands, riverbanks, and wetlands, as well as constructed features, like canals, lagoons, greenways and parks, playgrounds, parkways, trails, golf courses, athletic fields, picnic grounds, gardens, and bridges.
Public Health Grand Rounds (PHGR) will continue to promote Preventive Medicine Grand Rounds (PMGR) while our monthly PHGR sessions are on hold. We welcome your questions. Please email us at grandrounds@cdc.gov.
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Method: For this systematic review, the authors searched Ovid MEDLINE, Embase, and Scopus from inception through February 20, 2020. Experimental studies were included if they (1) compared bedside rounds to any other form of rounds in a hospital-based setting, and (2) reported a quantitative comparison of a learning outcome (e.g., learner reaction, knowledge, skills, behavior, health care delivery) among physicians-in-training (medical students, residents, fellows). Extraction elements were summarized using descriptive statistics and a narrative synthesis of design, implementation, and outcomes.
Results: Twenty studies met inclusion criteria, including 7 randomized trials. All studies involved resident physicians, and 11 also involved medical students. The design and implementation of bedside rounds varied widely, with most studies (n = 13) involving cointerventions (e.g., staff education, real-time order entry).Of the 15 studies that reported learner satisfaction, 7 favored bedside rounds, 4 favored the control, and 4 were equivocal. Of the 4 studies reporting an outcome of learners' knowledge and skills, 2 favored bedside rounds and 2 were equivocal. Of the 8 studies that reported on learner behavior (e.g., bedside communication with patients), 5 favored bedside rounds, 1 favored the control, and 2 were equivocal. Finally, of the 14 studies that reported a health care delivery outcome (e.g., teamwork, rounding time), 8 favored bedside rounds and 6 were equivocal. Due to the high risk of bias and unexplained heterogeneity across studies, the overall strength of evidence was low.
Conclusions: In hospital-based settings, learners' satisfaction with bedside rounds is mixed. However, bedside rounds appear to have a positive effect on learner behavior and health care delivery. Given their potential value, additional research is needed to identify barriers to and facilitators of educationally successful bedside rounds.
Education has very few opportunities for the kind of lifelong professional learning that those in the medical community can access. At Project Zero we have been engaged since 1995 in an effort to create a powerful learning community based on the medical model of "rounds", where doctors young and old come together to share knowledge and practice clinical diagnostic skills. Designed and facilitated by Steve Seidel, the result is ROUNDS, a monthly discussion group giving educators an opportunity to gather and discuss emerging issues in educational practice, to present their personal puzzles about teaching and learning, and to practice looking at student work together. This group is made up of teachers, administrators, and researchers with varying levels of experience who have either collaborated on Project Zero research studies or have been students at the Harvard Graduate School of Education. Everyone is considered to have special perspectives and expertise to offer the group, and those who attend engage in serious and spirited dialogue about educational matters. We intend to continue ROUNDS in the foreseeable future, hoping that it will continue to foster a rich dialogue month by month and also serve as a viable model of a voluntary, long-term professional learning practice for educators.
• Why are there 31 first-round picks this year?
• Who are the lowest drafted HOFs ever?
• When did the draft change to seven rounds?
• Who is the oldest person drafted?
• Who are the best Mr. Irrelevants ever?
As you become responsible for some patient care or move closer to that responsibility, participation in discussions regarding the ethical dilemmas arising from patient care is important. At ethics grand rounds, you will see how faculty and guests approach the resolution of difficult ethical issues in patient care, and you will be able to enter a discussion of the case. The objective is that this experience will assist in your practice and help you acquire an ease in addressing ethical and public policy issues.
Does the top of your cake stick when you turn it out of the pan? Not when you use parchment! Handy round parchment paper is pre-cut for your convenience and fits perfectly in your 8" or 9" round layer cake pan. Simply line the bottom of your cake pans with parchment paper rounds, spray the sides of the pan, add the batter and then bake. Cakes will release easily when turning out, with no bits sticking to the bottom of the pan. One less thing to worry about when baking!
The answer: Silver rounds are privately minted coin-shaped silver pieces, produced by private mints. They are not referred to as coins because they are not government minted nor are they legal tender.
Silver rounds and silver coins are fabricated exactly the same way, so it is reasonable to think that their premiums might be similar. The labor involved in fabrication of coins and rounds drives much of the premiums charged for bullion products. So part of the premium difference in rounds versus coins can be explained by costs and efficiency in the private sector relative to government. Private mints and refiners compete for business, government mints do not.
Savvy investors currently stand to save as much as $1.00 - $3.00 per ounce by choosing silver rounds vs bullion coins including US Mint Silver Eagles, Canadian Maple Leaf, and a few others. Buying rounds means getting more silver for your money, while still getting beautiful, highly liquid, investment grade silver.
As a result of poorly run government mints, supply issues frequently emerge with newly minted coins, making their premiums volatile. This makes silver rounds even more attractive during periods of high silver demand. As an example, the dysfunctional U.S. Mint, in particular, has suspended or rationed sales when buying silver Eagles on a number of occasions. This inevitably pushes coin premiums higher and often creates delays in shipping.
Meanwhile, during periods of silver demand, supply of rounds remained plentiful, keeping a lid on premiums. Of course, this too could change. With ever-increasing demand for physical silver, even the more efficient and profit-oriented private mints could have a hard time keeping up with demand. Much of the demand for coins is diverted to rounds whenever government mints sell out or impose rationing. But, regardless of what happens, you can expect rounds to remain lower cost and more readily available than coins.
As the silver spot price constantly fluctuates, and those price movements are typically small on a day to day basis, it is quite possible to see a 5% move in 24 hours and 25% in a year. Of course, any change in the silver price has a direct impact on the value of pure silver bars or silver rounds. That said, even though the spot price is major factor contributing to the silver coins value of the bullion, there are many other factors contributing to the final purchase price of silver bullion such as minting, taxes, dealer margins, or shipping.
Probably the two most popular silver rounds traded today are the Walking Liberty and Buffalo Silver Rounds -- they are both attractive and a good-value option for low cost silver. They are so popular that you can find them produced by all existing private mints and provided by all online dealers. Because of the great range of their producers, they vary to some extent..
There are good options in rounds for people looking for silver to barter with. Money Metals Exchange offers silver rounds as small as 1/10th ounce. Compared with Pre-1965 US silver coins -- perhaps the most popular product for use barter situation -- the rounds have the advantages of beauty, newer condition, and simplicity to valuing. Some old silver coins can be tarnished or worn and calculating the silver value requires a bit more math.
Boston VA Neurology Lecture Series Mondays @Noon Eastern showcases a variety of specialized lectures led by VA neurology and non-neurology faculty as well as non-VA guest speakers, covering important topics relating to the field of Neurology. The goal of this educational series is to improve our clinical practices by sharing neurological knowledge and expertise across services, promoting teamwork, and maximize patient outcomes utilizing evidence base approach. Within this innovated series, our department is also proud to host invited speakers and grand-rounds lectures that address major topics in neurology and latest clinical research for continued medical education and professional development.
These recorded programs are from the OMH video library of Statewide Grand Rounds programs. These interactive videoconferences were previously broadcast live via satellite to OMH facilities. The programs on this site are selected videos of these statewide grand rounds and each is 1.5 hours in length.
CME certificates will not be issued on an activity-by-activity basis. However, a transcript of CME credits earned through GW grand rounds may be requested from the Office of Continuing Education in the Health Professions by calling 202-994-4285. be457b7860
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