Physician Communication Skills: Results of a Survey of General/Family Practitioners in Newfoundland

Purpose: To describe the attitudes related to communication skills, confidence in using commnication skills, and use of communication skills during the physician-patient encounter among a population-based sample of family physicians. Procedures: A mailed survey, distributed to all family physicians and general practitioners currently practicing in Newfoundland. The questionnaire was designed to collect data in five general areas participant demographics, physician confidence in using specific communication strategies, perceived adequacy of time spent by physicians with their patients, physician use of specific communication strategies with the adult patients they saw in the prior week, and physician use of specific communication strategies during the closing minutes of the encounters they had with adult patients in the prior week. Main Findings: A total of 160 completed surveys was received from practicing family physicians/general practitioners in Newfoundland, yielding an adjusted response rate of 43.1%. Most of the respondents (83.8%) indicated their communication skills are as important as technical skills in terms of achieving positive patient outcomes. Between one-third and one-half of the respondents, depending on the educational level queried, rated their communications skills training as being inadequate. Fewer than 20% of the respondents rated the communications skills training they received as being excellent. Physicians indicated a need to improve their use of 8 of 13 specific communication strategies during patient encounters, and reported using few communication strategies during the closing minutes of the encounter. Interactions that occurred during a typical encounter tended to focus on biomedical versus psychosocial issues. Conclusions: Family physicians/general practitioners recognize a need to improve their commnications skills. Well-designed communications skills training programs should be implemented at multi-levels of physician training in order to improve patient satisfaction with their encounters with family/general practitioners, and to increase the likelihood of positive patient outcomes

Assembly of a Tripeptide and Anti-Inflammatory Drugs into Supramolecular Hydrogels for Sustained Release

5siSupramolecular hydrogels offer interesting opportunities for co-assembly with drugs towards sustained release over time, which could be achieved given that the drug participates in the hydrogel nanostructure, and it is not simply physically entrapped within the gel matrix. dLeu-Phe-Phe is an attractive building block of biomaterials in light of the peptide’s inherent biocompatibility and biodegradability. This study evaluates the assembly of the tripeptide in the presence of either of the anti-inflammatory drugs ketoprofen or naproxen at levels analogous to commercial gel formulations. Fourier-transformed infrared (FT-IR), circular dichroism, Thioflavin T fluorescence, transmission electron microscopy (TEM), and oscillatory rheometry are used. Drug release over time is monitored by means of reverse-phase high performance liquid chromatography, and shows different kinetics for the two drugs.openopenKurbasic, Marina; Romano, Chiara Damiana; Garcia Fernandez, Ana Maria; Kralj, Slavko; Marchesan, SilviaKurbasic, Marina; Romano, CHIARA DAMIANA; GARCIA FERNANDEZ, ANA MARIA; Kralj, Slavko; Marchesan, Silvi

Simultaneous mapping of membrane voltage and calcium in zebrafish heart in vivo reveals chamber-specific developmental transitions in ionic currents

The cardiac action potential (AP) and the consequent cytosolic Ca2+ transient are key indicators of cardiac function. Natural developmental processes, as well as many drugs and pathologies change the waveform, propagation, or variability (between cells or over time) of these parameters. Here we apply a genetically encoded dual-function calcium and voltage reporter (CaViar) to study the development of the zebrafish heart in vivo between 1.5 and 4 days post fertilization (dpf). We developed a high-sensitivity spinning disk confocal microscope and associated software for simultaneous three-dimensional optical mapping of voltage and calcium. We produced a transgenic zebrafish line expressing CaViar under control of the heart-specific cmlc2 promoter, and applied ion channel blockers at a series of developmental stages to map the maturation of the action potential in vivo. Early in development, the AP initiated via a calcium current through L-type calcium channels. Between 90 and 102 h post fertilization (hpf), the ventricular AP switched to a sodium-driven upswing, while the atrial AP remained calcium driven. In the adult zebrafish heart, a sodium current drives the AP in both the atrium and ventricle. Simultaneous voltage and calcium imaging with genetically encoded reporters provides a new approach for monitoring cardiac development, and the effects of drugs on cardiac function

Effective triplet interactions in nematic colloids

Three-body effective interactions emerging between parallel cylindrical rods immersed in a nematic liquid crystals are calculated within the Landau-de Gennes free energy description. Collinear, equilateral and midplane configurations of the three colloidal particles are considered. In the last two cases the effective triplet interaction is of the same magnitude and range as the pair one

Annihilation of edge dislocations in smectic A liquid crystals

This paper presents a theoretical study of the annihilation of edge dislocations in the same smectic plane in a bulk smectic-A phase. We use a time-dependent Landau-Ginzburg approach where the smectic ordering is described by the complex order parameter psi( r--> ,t) =eta e(iphi) . This quantity allows both the degree of layering and the position of the layers to be monitored. We are able to follow both precollision and postcollision regimes, and distinguish different early and late behaviors within these regimes. The early precollision regime is driven by changes in the phi ( r--> ) configuration. The relative velocity of the defects is approximately inversely proportional to the interdefect separation distance. In the late precollision regime the symmetry changes within the cores of defects also become influential. Following the defect collision, in the early postcollision stage, bulk layer order is approached exponentially in time. At very late times, however, there seems to be a long-time power-law tail in the order parameter fluctuation relaxation

The right to higher education for refugee students:analysis of higher education policies in the Republic of Croatia

Abstract. International migrations are not a new phenomenon; however, the movement of people across borders in recent years is becoming more diverse with an increasing impact on educational systems worldwide. The right to education is a fundamental human right for everyone, including refugees, asylum seekers, and displaced persons. Nevertheless, refugees experience limited access to education at all levels, and especially on the higher education level which is often overlooked as it is not mandatory. This qualitative study relies on reflexive thematic analysis of official higher education policies in a post-socialist and most recent European Union member, the Republic of Croatia, and aims to provide an overview of the social dimension of Croatian higher education with the focus on refugees and refugee-like students in higher education. The research looks at how two higher education policy documents, Strategy for Education, Science and Technology (2014) and National Plan for Enhancing the Social Dimension of Higher Education in the Republic of Croatia 2019–2021 (2018) address the right to education for refugees according to the 4A Framework by Katarina Tomaševski. The 4A Framework implies that inclusive education systems ought to be: available, accessible, acceptable, and adaptable. The framework was adjusted for the higher education context and expanded with an additional marker of affordability. The findings show that the Croatian higher education system does not have a standard policy around the inclusion of refugee students. Although there is consistency between the two analysed documents and there have been attempts and adjustments to make higher education more inclusive, policy gaps are detected in the adaptation of curriculum, the language of instruction as well as in recognition of prior learning, and quality of overall higher education reaching the conclusion that there is more that has to be done and given attention to

The mechanism of caesium intercalation of graphene

Properties of many layered materials, including copper- and iron-based superconductors, topological insulators, graphite and epitaxial graphene can be manipulated by inclusion of different atomic and molecular species between the layers via a process known as intercalation. For example, intercalation in graphite can lead to superconductivity and is crucial in the working cycle of modern batteries and supercapacitors. Intercalation involves complex diffusion processes along and across the layers, but the microscopic mechanisms and dynamics of these processes are not well understood. Here we report on a novel mechanism for intercalation and entrapment of alkali-atoms under epitaxial graphene. We find that the intercalation is adjusted by the van der Waals interaction, with the dynamics governed by defects anchored to graphene wrinkles. Our findings are relevant for the future design and application of graphene-based nano-structures. Similar mechanisms can also play a role for intercalation of layered materials.Comment: 8 pages, 7 figures in published form, supplementary information availabl

Comparative algological and bacteriological examinations on biofilms developed on different substrata in a shallow soda lake

According to the European Water Framework Directives, benthic diatoms of lakes are a tool for ecological status assessment. In this study, we followed an integrative sample analysis approach, in order to find an appropriate substratum for the water qualification-oriented biomonitoring of a shallow soda lake, Lake Velencei. Six types of substrata (five artificial and one natural), i.e., andesite, granite, polycarbonate, old reed stems, Plexiglass discs and green reed, were sampled in May and in November. We analysed total alga and diatom composition, chlorophyll a content of the periphyton, surface tension and roughness of the substrata and carbon source utilisation of microbial communities. Water quality index was calculated based on diatom composition. Moreover, using a novel statistical tool, a self-organising map, we related algal composition to substratum types. Biofilms on plastic substrates deviated to a great extent from the stone and reed substrata, with regard to the parameters measured, whereas the biofilms developing on reed and stone substrata were quite similar. We conclude that for water quality monitoring purposes, sampling from green reed during springtime is not recommended, since this is the colonization time of periphyton on the newly growing reed, but it may be appropriate from the second half of the vegetation period. Stone and artificially placed old reed substrata may be appropriate for biomonitoring of shallow soda lakes in both spring and autumn since they showed in both seasons similar results regarding all measured features

Screening Fluorescent Voltage Indicators with Spontaneously Spiking HEK Cells

Development of improved fluorescent voltage indicators is a key challenge in neuroscience, but progress has been hampered by the low throughput of patch-clamp characterization. We introduce a line of non-fluorescent HEK cells that stably express NaV 1.3 and KIR 2.1 and generate spontaneous electrical action potentials. These cells enable rapid, electrode-free screening of speed and sensitivity of voltage sensitive dyes or fluorescent proteins on a standard fluorescence microscope. We screened a small library of mutants of archaerhodopsin 3 (Arch) in spiking HEK cells and identified two mutants with greater voltage-sensitivity than found in previously published Arch voltage indicators

Learning Interpretable Rules for Multi-label Classification

Multi-label classification (MLC) is a supervised learning problem in which, contrary to standard multiclass classification, an instance can be associated with several class labels simultaneously. In this chapter, we advocate a rule-based approach to multi-label classification. Rule learning algorithms are often employed when one is not only interested in accurate predictions, but also requires an interpretable theory that can be understood, analyzed, and qualitatively evaluated by domain experts. Ideally, by revealing patterns and regularities contained in the data, a rule-based theory yields new insights in the application domain. Recently, several authors have started to investigate how rule-based models can be used for modeling multi-label data. Discussing this task in detail, we highlight some of the problems that make rule learning considerably more challenging for MLC than for conventional classification. While mainly focusing on our own previous work, we also provide a short overview of related work in this area.Comment: Preprint version. To appear in: Explainable and Interpretable Models in Computer Vision and Machine Learning. The Springer Series on Challenges in Machine Learning. Springer (2018). See http://www.ke.tu-darmstadt.de/bibtex/publications/show/3077 for further informatio