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INTRODUCTION: Non-alcoholic fatty liver disease (NAFLD) is a growing public health issue. Non-invasive methods to assess the fibrosis stage are limited, and biopsy remains the gold standard. The objective of our study was to assess whether the portal venous pulsatility index (VPI) can be used as a predictor of high-risk NAFLD at a tertiary referral centre for liver transplantation. METHODS: We retrospectively reviewed patients with biopsy-proved NAFLD who had undergone a liver ultrasound scan within 1 year of biopsy at our centre from 2011 to 2019. RESULTS: We did not find a significant correlation between the VPI and the NAFLD risk category or correlation between the VPI and degree of steatosis (P > 0.05 for both). CONCLUSION: Since VPI can be easily obtained on routine liver ultrasound and since other studies do report a positive association with significant fibrosis, more studies are needed before it can be recommended or not in risk-stratifying NAFLD patients into high- vs. low-risk NAFLD.
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Journal writing is one of many strategies that can help promote learning in a process-oriented curriculum. This article explores the experience of implementing journal writing as an expectation of second-year baccalaureate nursing students in a clinical practicum. Faculty had a vital role in facilitating this experience. The journals provided a medium within which students explored in depth significant events that occurred in their practicum. Their analysis of these events included application of theoretical frameworks and concepts that supported and strengthened the arguments made in the journals. Students responded very favorably to their experiences in journal writing. In the evaluation of this experience, students reported increased abilities in critical thinking and self-directed learning. These two important concepts complement each other in the students' learning processes.