58 research outputs found

    The Motivation of Students of Color for Pursuing Leadership Positions at Faith-Based Universities

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    As faith-based universities increasingly diversify the culture of their student body, student leadership roles also diversify. While there is literature on barriers and challenges students of color experience in these roles, there is little to help understand their motivation in pursuing these roles. Using conversations, interviews, and surveys this research was conducted to start such a conversation. The researchers\u27 goal was to go beyond conventional wisdom and begin gathering data reflecting the experiences of students of color on our campuses. While compensation is definitely a motivation, this research suggested there might be a variety of reasons to pursue these roles

    Changing Autonomy in Operative Experience Through UK General Surgery Training:A National Cohort Study

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    Objectives:To determine the operative experience of UK general surgery trainees and assess the changing procedural supervision and acquisition of competency assessments through the course of training.Background Summary Data: Competency assessment is changing with concepts of trainee autonomy decisions (termed entrustment decisions) being introduced to surgical training.Methods: Data from the Intercollegiate Surgical Curriculum Programme (ISCP) and the eLogbook databases for all UK General Surgery trainees registered from 1st August 2007 who had completed training were used. Total and index procedures (IP) were counted and variation by year of training assessed. Recorded supervision codes and competency assessment outcomes for IPs were assessed by year of training.Results: We identified 311 trainees with complete data. Appendicectomy was the most frequently undertaken IP during first year of training (mean procedures (mp) = 26) and emergency laparotomy during final year of training (mp = 27). The proportion of all IPs recorded as unsupervised increased through training (

    Time Out of General Surgery Specialty training in the UK:A National Database Study

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    ObjectiveGeneral surgery specialty training in the United Kingdom takes 6 years and allows trainees to take time out of training. Studies from the United States have highlighted an increasing trend for taking time out of surgical training for research. This study aimed to evaluate trends in time out of training and the impact on the duration of UK general surgical specialty training.Design, setting, and participantsA cohort study using routinely collected surgical training data from the Intercollegiate Surgical Curriculum Program database for General surgery trainees registered from August 1, 2007. Trainees were classified as Completed Training or In-Training. Out of training periods were identified and time in training calculated (both unadjusted and adjusted for out of training periods) with a predicted time in training for those In-Training.ResultsOf the trainees still In-Training (n = 994), a greater proportion had taken time out of training compared with those who had completed training (n = 360; 54.5% vs 45.9%, p < 0.01). A greater proportion of the In-Training group had undertaken a formal research period compared with the Completed Training group (35.1% vs 6.1%, p < 0.01). Total unadjusted training time in the Completed Training group was a median 6.0 (interquartile range 6.0-7.0) years compared with a predicted unadjusted training time in the In-Training group, with an out of training period recorded, of a median 8.0 (interquartile range 7.0-9.0) years.ConclusionsTrainees are increasingly taking time out of surgical training, particularly for research, with a subsequent increase in total time of training. This should be considered when redesigning surgical training programs and planning the future surgical workforce

    Roles and mechanisms of action of the L-cysteine cystathionine-gamma-lyase hydrogen sulphide pathway in the heart

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    Hydrogen sulphide (H2S) is a naturally occurring gas and originally the primary focus of research was to investigate its toxicity. In 1989 a physiological role of H2S was proposed after endogenous levels were detected in the rat brain and normal human post-mortem tissue. This discovery has led to an explosion of interest in H2S as a biological mediator. Identification of H2S synthesising enzymes in the cardiovascular system has led to a number of studies examining specific regulatory actions of H2S. The hypothesis underlying the studies in this thesis was that H2S synthesising enzymes exist in the myocardium and the resulting H2S provides cardioprotection against ischaemia-reperfusion injury. This was investigated using a broad range of experimental techniques including Langendorff isolated perfused rat heart models, biochemical H2S stimulation and detection assays, PCR, and Western blotting. The principal findings can be summarised as follows: 1. Rat myocardium has the potential to express both CSE and CBS H2S synthesising enzymes, due to the confirmed detection of mRNA. 2. Furthermore it was possible to exogenously stimulate the CSE enzyme, with its substrate L-cysteine, to produce H2S gas which limited infarct size during regional ischaemia-reperfusion. 3. Endogenous H2S levels were up-regulated during ischaemia-reperfusion, consistent with an endogenous protective role within the myocardium. 4. Simple and complex H2S/thiol containing compounds produced cardioprotection during regional ischaemia-reperfusion, with a mechanism that involves PI3k and Akt activation, implicating recruitment of downstream kinases within the RISK pathway. The studies presented have provided a significant advancement in understanding the involvement of H 2S in cardioprotection during ischaemia-reperfusion. It has also raised questions such as the exact mechanism of action of H2S donor/thiol containing compounds and highlighted the need for more robust H2S donors. The scope for H2S as an endogenous mediator also stems beyond that of cardioprotection, as the range of body systems and cell types are continually expanding

    Lessons from Laparoscopic Liver Surgery: A Nine-Year Case Series

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    Objective. This series describes a developing experience in laparoscopic liver surgery presenting results from 40 procedures including right hemihepatectomy, left lateral lobectomy, and microwave ablation therapy. Methods. Forty patients undergoing laparoscopic liver surgery between September 1997 and November 2006 were included. The data set includes: operative procedure and duration, intraoperative blood loss, conversion to open operation rates, length of hospital stay, complications, mortality, histology of lesions/resection margins, and disease recurrence. Results. Mean age of patient: 59 years, 17/40 male, 23/40 female, 23/40 of lesions were benign, and 17/40 malignant. Operations included: laparoscopic anatomical resections n = 15, nonanatomical resections n = 11, microwave ablations n = 8 and deroofing of cysts n = 7. Median anaesthetic time: 120 minutes (range 40–240), mean blood loss 78 mL and 1/40 conversions to open. Median resection margins were 10 mm (range 1–14) and median length of stay 3 days (range 1–10). Operative and 30-day mortality were zero with no local disease recurrence. Conclusion. Laparoscopic liver surgery appears safe and effective and is associated with reduced hospital stay. Larger studies are required to confirm it is oncologically sound

    Time out of general surgery specialty training in the UK: a national database study

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    Objective:General surgery specialty training in the UK takes 6 years and allows trainees to take time out of training. Studies from the USA have highlighted an increasing trend for taking time out of surgical training for research. This study aimed to evaluate trends in time out of training and the impact on the duration of UK general surgical specialty training. Design, setting and participants: A cohort study using routinely collected surgical training data from the Intercollegiate Surgical Curriculum Programme (ISCP) database for General Surgery trainees registered from 1st August 2007. Trainees were classified as Completed Training or In-Training. Out of training periods were identified and time in training calculated (both unadjusted and adjusted for out of training periods) with a predicted time in training for those In-Training. Results: Of the trainees still In-Training (n=994), a greater proportion had taken time out of training compared with those who had completed training (n=360) (54.5% vs 45.9%, p<0.01). A greater proportion of the In-Training group had undertaken a formal research period compared to the Completed Training group (35.1% vs 6.1%, p<0.01). Total unadjusted training time in the Completed Training group was a median 6.0 (IQR 6.0- 7.0) years compared with a predicted unadjusted training time in the In-Training group, with an out of training period recorded, of a median 8.0 (IQR 7.0- 9.0) years. Conclusions: Trainees are increasingly taking time out of surgical training, particularly for research, with a subsequent increase in total time of training. This should be considered when redesigning surgical training programmes and planning the future surgical workforce

    Time out of general surgery specialty training in the UK: a national database study

    Get PDF
    Objective:General surgery specialty training in the UK takes 6 years and allows trainees to take time out of training. Studies from the USA have highlighted an increasing trend for taking time out of surgical training for research. This study aimed to evaluate trends in time out of training and the impact on the duration of UK general surgical specialty training. Design, setting and participants: A cohort study using routinely collected surgical training data from the Intercollegiate Surgical Curriculum Programme (ISCP) database for General Surgery trainees registered from 1st August 2007. Trainees were classified as Completed Training or In-Training. Out of training periods were identified and time in training calculated (both unadjusted and adjusted for out of training periods) with a predicted time in training for those In-Training. Results: Of the trainees still In-Training (n=994), a greater proportion had taken time out of training compared with those who had completed training (n=360) (54.5% vs 45.9%, p<0.01). A greater proportion of the In-Training group had undertaken a formal research period compared to the Completed Training group (35.1% vs 6.1%, p<0.01). Total unadjusted training time in the Completed Training group was a median 6.0 (IQR 6.0- 7.0) years compared with a predicted unadjusted training time in the In-Training group, with an out of training period recorded, of a median 8.0 (IQR 7.0- 9.0) years. Conclusions: Trainees are increasingly taking time out of surgical training, particularly for research, with a subsequent increase in total time of training. This should be considered when redesigning surgical training programmes and planning the future surgical workforce

    Contributions of scale: What we stand to gain from Indigenous and local inclusion in climate-health monitoring and surveillance systems

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    Understanding how climate change will affect global health is a defining challenge this century. This is predicated, however, on our ability to combine climate and health data to investigate the ways in which variations in climate, weather, and health outcomes interact. There is growing evidence to support the value of place- and community-based monitoring and surveillance efforts, which can contribute to improving both the quality and equity of data collection needed to investigate and understand the impacts of climate change on health. The inclusion of multiple and diverse knowledge systems in climate-health surveillance presents many benefits, as well as challenges. We conducted a systematic review, synthesis, and confidence assessment of the published literature on integrated monitoring and surveillance systems for climate change and public health. We examined the inclusion of diverse knowledge systems in climate-health literature, focusing on: 1) analytical framing of integrated monitoring and surveillance system processes 2) key contributions of Indigenous knowledge and local knowledge systems to integrated monitoring and surveillance systems processes; and 3) patterns of inclusion within these processes. In total, 24 studies met the inclusion criteria and were included for data extraction, appraisal, and analysis. Our findings indicate that the inclusion of diverse knowledge systems contributes to integrated climate-health monitoring and surveillance systems across multiple processes of detection, attribution, and action. These contributions include: the definition of meaningful problems; the collection of more responsive data; the reduction of selection and source biases; the processing and interpretation of more comprehensive datasets; the reduction of scale dependent biases; the development of multi-scale policy; long-term future planning; immediate decision making and prioritization of key issues; as well as creating effective knowledge-information-action pathways. The value of our findings and this review is to demonstrate how neither scientific, Indigenous, nor local knowledge systems alone will be able to contribute the breadth and depth of information necessary to detect, attribute, and inform action along these pathways of climate-health impact. Rather, it is the divergence or discordance between the methodologies and evidences of different knowledge systems that can contribute uniquely to this understanding. We critically discuss the possibility of what we, mainly local communities and experts, stand to lose if these processes of inclusion are not equitable. We explore how to shift the existing patterns of inclusion into balance by ensuring the equity of contributions and justice of inclusion in these integrated monitoring and surveillance system processes
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