Medical student attachments in private practice – The experience and views of the family practitioners

Background: Medical student attachments with family/general practitioners (GPs) in non-academic or private practice are a valued resource in the undergraduate teaching of Family Medicine. This study describes the experience and views of GPs in private practice with final-year medical student attachments from the University of Transkei. Methods: A postal questionnaire was distributed to all GPs who had one or more student attachment. Results: Out of 37 GPs, 25 replied, giving a response rate of 68%. Positive experiences of the attachments were enjoyment of teaching (n=24) and improvement in knowledge (n=20). Staff and patients' reaction to the students was felt to be positive overall. Negative aspects reported were finishing later at work (n=11) and patients leaving the practice (n=2). All GPs were willing to have students again and could take, on average, three students per annum. Twenty-one (84%) stated that a one-week's attachment was satisfactory. Eighteen (72%) were interested in teacher training. The majority (64%, n=14) did not require payment for teaching and 15 (60%) stated that they should be appointed as lecturers. Patients' consent to be seen by students was obtained by most GPs (n=13) when accompanied by the student. Out of 16 GPs who had students with Xhosa as their second language, eight assessed their language proficiency as poor. Conclusions: The GPs in private practice that have medical student attachments enjoy teaching and their overall experience is positive. They feel their teaching commitment should be recognised by an academic appointment. Issues of patients' consent to examination and student language proficiency need further exploration. SA Fam Pract 2004;46(9): 27-3

Comparison of modelling techniques for milk-production forecasting

peer-reviewedThe objective of this study was to assess the suitability of 3 different modeling techniques for the prediction of total daily herd milk yield from a herd of 140 lactating pasture-based dairy cows over varying forecast horizons. A nonlinear auto-regressive model with exogenous input, a static artificial neural network, and a multiple linear regression model were developed using 3 yr of historical milk-production data. The models predicted the total daily herd milk yield over a full season using a 305-d forecast horizon and 50-, 30-, and 10-d moving piecewise horizons to test the accuracy of the models over long- and short-term periods. All 3 models predicted the daily production levels for a full lactation of 305 d with a percentage root mean square error (RMSE) of ≤12.03%. However, the nonlinear auto-regressive model with exogenous input was capable of increasing its prediction accuracy as the horizon was shortened from 305 to 50, 30, and 10 d [RMSE (%) = 8.59, 8.1, 6.77, 5.84], whereas the static artificial neural network [RMSE (%) = 12.03, 12.15, 11.74, 10.7] and the multiple linear regression model [RMSE (%) = 10.62, 10.68, 10.62, 10.54] were not able to reduce their forecast error over the same horizons to the same extent. For this particular application the nonlinear auto-regressive model with exogenous input can be presented as a more accurate alternative to conventional regression modeling techniques, especially for short-term milk-yield predictions

A comparison of cervical smear adequacy using either the cytobrush or the Ayre spatula: a practice audit

Background: To obtain an adequate cervical (Papanicolaou) smear, the transformation zone, including the squamo-columnar junction, should be sampled as carcinoma develops preferentially in this transformation zone. The Ayre spatula has been widely used but is not very effective. Other sampling devices have been developed to improve efficiency, including the cytobrush. The purpose of this study was to compare the adequacy of cervical smears taken with the Ayre spatula as opposed to the cytobrush. Methods: This was a retrospective analytical study. One sampler, an experienced general practitioner, took the smears in the period 1990 to 2004. Initially, the Ayre spatula was used to consecutively sample the cervix and thereafter, a cytobrush alone was used. Two groups were thus formed for comparison. The presence of endocervical cells was accepted as an indicator of an adequate smear. A Cusco speculum was used to visualize the cervix. The sample was smeared onto a slide and fixated with an alcohol aerosol spray. Results: A total of 4561 smears were taken and 247 had no endocervical cells. A further 34 smears were classified as unsatisfactory due to the presence of degeneration (19), insufficient squamous cells (7), inflammatory exudate (4), excess blood (3) and/or a thick slide (1).The cytobrush group was similar demographically to the Ayre spatula group: 1981 (99%) and 2490 (98%) respectively were non pregnant; 67 (3%) and 110 (4%) were nulliparous, 1008 (50%) and 1370 (54%) were para 1 – 5, and 931 (46%) and 1075 (42%) were para 6 or more; 0 (0%) and 2 (0.1%) were aged between 10 – 19 years, 1496 (75%) and 2012 (78%) between 20 – 49, and 510 (25%) and 541 (21%) were aged 50 years or more. Of 2006 smears taken with a cytobrush, 1955 (97.5%) contained endocervical cells compared with 2325 (91%) of 2555 smears taken with an Ayre spatula. The difference was significant with an Odds Ratio of 4.56 (95% Confidence Interval 3.42-6.42). Conclusion: The cytobrush is significantly more efficacious than the Ayre spatula in obtaining adequate cervical smears. Use of the cytobrush will ensure less repeat smears with a consequent reduction in workload for samplers and laboratories. Although very few smears lacked sufficient squamous cells (an indicator of adequate ectocervical sampling), current best practice is that the cytobrush be used together with a wooden spatula to ensure adequate sampling of both the endocervical and ectocervical components of the transformation zone. For full text, click here: South African Family Practice2006;48(9): 15-15

Doctors’ practice and attitudes towards red blood cell transfusion at Mthatha Regional Hospital, Eastern Cape, South Africa: A mixed methods study

Background: Unnecessary blood transfusion exposes recipients to potential harms. Aim: The aim of this study was to describe blood transfusion practice and explore doctors’ attitudes towards transfusion. Setting: A hospital providing level 1 and 2 services. Methods: A mixed-methods study design was used. In the cross-sectional descriptive component, a sample was taken from patients transfused over a 2-month period. Blood use was categorised as for medical anaemia or haemorrhage, and appropriate or not. The qualitative component comprised a purposeful sample for focus group and individual semi-structured interviews. Results: Of 239 patients sampled, 62% were transfused for medical anaemia and 38% for haemorrhage. In the medical anaemia group, compliance with age-appropriate transfusion thresholds was 69%. In medical anaemia and haemorrhage, 114 (77%) and 85 (93.4%) of recipients had orders for ≥ 2 red blood cell (RBC) units, respectively. In adults ≥ 18 years old with medical anaemia, 47.1% of orders would have resulted in a haemoglobin (Hb) < 8 g/dL. Six doctors participated in focus group and eleven in individual interviews. There was a lack of awareness of institutional transfusion guidelines, disagreement on appropriate RBC transfusion thresholds and comments that more than one RBC unit should always be transfused. Factors informing decisions to transfuse included advice from senior colleagues, relieving symptoms of anaemia and high product costs. Conclusion: Most orders were for two or more units. In medical anaemia, doctors’ compliance with RBC transfusion thresholds was reasonable; however, almost half of the orders would have resulted in overtransfusion. The attitudes of doctors sampled suggest that their transfusion practice is influenced more by institutional values than formal guidelines

Coopetition of software firms in Open source software ecosystems

Software firms participate in an ecosystem as a part of their innovation strategy to extend value creation beyond the firms boundary. Participation in an open and independent environment also implies the competition among firms with similar business models and targeted markets. Hence, firms need to consider potential opportunities and challenges upfront. This study explores how software firms interact with others in OSS ecosystems from a coopetition perspective. We performed a quantitative and qualitative analysis of three OSS projects. Finding shows that software firms emphasize the co-creation of common value and partly react to the potential competitiveness on OSS ecosystems. Six themes about coopetition were identified, including spanning gatekeepers, securing communication, open-core sourcing and filtering shared code. Our work contributes to software engineering research with a rich description of coopetition in OSS ecosystems. Moreover, we also come up with several implications for software firms in pursing a harmony participation in OSS ecosystems.Comment: This is the author's version of the work. Copyright owner's version can be accessed at https://link.springer.com/chapter/10.1007/978-3-319-69191-6_10, Coopetition of software firms in Open source software ecosystems, 8th ICSOB 2017, Essen, Germany (2017

Gambling advertising during live televised male sporting events in Ireland: a descriptive study

Objectives: There are no data relating to gambling advertisements shown during live sporting events in Ireland. The aim of the present study was to analyze gambling advertisements shown during live sporting events broadcast in Ireland and to assess these advertisements for responsible gambling (RG) practices. Methods: Sixty-five live televised sporting events comprising Association Football (soccer), Rugby Union, and Gaelic Athletic Association (GAA) matches broadcast in Ireland were analyzed. Pre-match (up to 30 minutes before kick-off), half-time, and post-match (up to 30 minutes after the match has ended) advertisement breaks were analyzed for gambling advertisements, including in-game fixed (static advertising) and dynamic (electronic advertisements changing at regular intervals) pitch-side advertising. Gambling advertisements were studied for evidence of RG practices. Results: A total of 3602 television advertisements, 618 dynamic advertisements, and 394 static advertisements were analyzed. Gambling advertisements were shown in 75.4% (n = 49) games and were the seventh most commonly televised advertisement shown overall. Gambling advertising was more common in football (fourth most common advertisement) compared to rugby (12th most common) and GAA (13th most common). Static and dynamic gambling advertising were common during football matches (second and first most common advertisements, respectively). The majority of advertisements contained RG messaging, an age limit, and an RG organization. No advertisements showing responsible gambling tools were observed. Conclusions: Gambling advertisements are commonly shown during live televised sporting broadcasts in Ireland, especially during live football matches and typically before the adult television watershed. Gambling legislation is required to minimize harm to vulnerable groups including children

Self-Doping of Gold Chains on Silicon: A New Structural Model for Si(111)5x2-Au

A new structural model for the Si(111)5x2-Au reconstruction is proposed and analyzed using first-principles calculations. The basic model consists of a "double honeycomb chain" decorated by Si adatoms. The 5x1 periodicity of the honeycomb chains is doubled by the presence of a half-occupied row of Si atoms that partially rebonds the chains. Additional adatoms supply electrons that dope the parent band structure and stabilize the period doubling; the optimal doping corresponds to one adatom per four 5x2 cells, in agreement with experiment. All the main features observed in scanning tunneling microscopy and photoemission are well reproduced.Comment: 4 pages, 4 figures, to appear in Phys. Rev. Lett. (preprint with high quality figures available at http://cst-www.nrl.navy.mil/~erwin/papers/ausi111