Interprofessional communication with hospitalist and consultant physicians in general internal medicine : a qualitative study

This study helps to improve our understanding of the collaborative environment in GIM, comparing the communication styles and strategies of hospitalist and consultant physicians, as well as the experiences of providers working with them. The implications of this research are globally important for understanding how to create opportunities for physicians and their colleagues to meaningfully and consistently participate in interprofessional communication which has been shown to improve patient, provider, and organizational outcomes

Comparative analysis of bones, mites, soil chemistry, nematodes and soil micro-Eukaryotes from a suspected homicide to estimate the post-mortem interval

Criminal investigations of suspected murder cases require estimating the post-mortem interval (PMI, or time after death) which is challenging for longer periods. Here we present the case of human remains found in a Swiss forest. We have used a multidisciplinary approach involving the analysis of bones, soil chemical characteristics, mites and nematodes (by microscopy) and micro-Eukaryotes (by Illumina high throughput sequencing). We analysed soil samples collected beneath the remains of the head, upper and lower body and “control” samples taken a few meters away. The PMI estimated on hair 14C-data via bomb peak radiocarbon dating gave a time range of 1 to 2 years before the finding of the remains on site. Cluster analyses for chemical constituents, nematodes, mites and micro- Eukaryotes revealed two clusters 1) head and upper body and 2) lower body and controls. From mite evidence, we conclude that the body was likely to have been brought to the site after death. However, chemical analyses, nematode community analyses and the analyses of micro-Eukaryotes indicate that decomposition took place at least partly on site. This study illustrates the usefulness of combining several lines of evidence for the study of homicide cases to better calibrate PMI inference tools

Will the Public's Health Fall Victim to the Home Foreclosure Epidemic?

Gary Bennett and colleagues discuss the ways in which the dramatic rise in home foreclosures, particularly in the US, may have health consequences

Soil pH and chemical concentrations in soils below decomposing cadavers.

<p>TN and TOC are total extractable nitrogen and organic carbon, respectively. Each number is the mean ± standard deviation of n = 4 cadavers. Statistically, stages that were significantly different from the others are indicated by different letter designation (p < 0.05, ranked ANOVA, Tukey-Kramer).</p><p>Soil pH and chemical concentrations in soils below decomposing cadavers.</p

Functional and Structural Succession of Soil Microbial Communities below Decomposing Human Cadavers

<div><p>The ecological succession of microbes during cadaver decomposition has garnered interest in both basic and applied research contexts (e.g. community assembly and dynamics; forensic indicator of time since death). Yet current understanding of microbial ecology during decomposition is almost entirely based on plant litter. We know very little about microbes recycling carcass-derived organic matter despite the unique decomposition processes. Our objective was to quantify the taxonomic and functional succession of microbial populations in soils below decomposing cadavers, testing the hypotheses that a) periods of increased activity during decomposition are associated with particular taxa; and b) human-associated taxa are introduced to soils, but do not persist outside their host. We collected soils from beneath four cadavers throughout decomposition, and analyzed soil chemistry, microbial activity and bacterial community structure. As expected, decomposition resulted in pulses of soil C and nutrients (particularly ammonia) and stimulated microbial activity. There was no change in total bacterial abundances, however we observed distinct changes in both function and community composition. During active decay (7 - 12 days postmortem), respiration and biomass production rates were high: the community was dominated by Proteobacteria (increased from 15.0 to 26.1% relative abundance) and Firmicutes (increased from 1.0 to 29.0%), with reduced Acidobacteria abundances (decreased from 30.4 to 9.8%). Once decay rates slowed (10 - 23 d postmortem), respiration was elevated, but biomass production rates dropped dramatically; this community with low growth efficiency was dominated by Firmicutes (increased to 50.9%) and other anaerobic taxa. Human-associated bacteria, including the obligately anaerobic <i>Bacteroides</i>, were detected at high concentrations in soil throughout decomposition, up to 198 d postmortem. Our results revealed the pattern of functional and compositional succession in soil microbial communities during decomposition of human-derived organic matter, provided insight into decomposition processes, and identified putative predictor populations for time since death estimation.</p></div

Richness and diversity of soil microbial communities below decomposing cadavers.

<p>A. Chao1 richness estimate, and B. Inverse of the Simpson diversity index, both calculated on libraries of equal size (121,340 sequences). Gut samples were also included for comparison. Mean and standard deviation of n = 4 cadavers are presented for each stage; means with the same letter are not significantly different (p < 0.05, mixed model ANOVA, Tukey-Kramer post-hoc). The light grey bar is the mean and standard deviation of the control (no cadaver) soil libraries throughout the duration of the study (n = 8).</p

Microbial respiration rates in soils below decomposing cadavers.

<p>Means and standard deviations of n = 4 cadavers are presented for each stage; means with the same letter are not significantly different (p < 0.05, mixed model ranked ANOVA, Tukey-Kramer post-hoc). The light grey bar is the mean and standard deviation for control (no cadaver) soils throughout the duration of the study (n = 45).</p