Multicultural Aspects Affecting Patient-Doctor Interactions and the Conduct of Clinical Research Examples Drawn from the Literature and First-Hand Knowledge

Interest in international multicenter clinical trials is increasing for a variety of reasons. Working with different cultures in clinical research creates its own unique set of problems. This paper focuses on these issues from multicenter and multicultural perspectives.The influence of culture on patient-doctor communication is considered. Expectations and the use of outcomes measurements with different cultures are also explored. Details on the issue of pain and how it is expressed and measured in different cultures is also presented.Having considered the patient-doctor dynamic, the paper concludes with an examination of the unique difficulties that international multicenter studies present. Multicultural differences manifest themselves in different forms in international clinical research. Although its impact is often ignored or minimized, this manuscript demonstrates that the impact of culture on a study's success is a very real issue.In addition to secondary sources, examples from our own clinical investigations are outlined throughout this paper. A successful model to locate researchers in previously untapped countries is also outlined

Patient-reported outcomes feedback report for knee arthroplasty patients should present selective information in a simple design - findings of a qualitative study

BACKGROUND: Technical innovation to assess patient-reported outcomes (PROs) facilitates their implementation in clinical practice. In particular, mobile applications (apps) allow PROs to be assessed outside of the clinical setting. A patient\u27s health status can be remotely monitored and evaluated after discharge, and their recovery process tracked. This is of particular interest for patients after knee arthroplasty, as the recovery phase after surgery usually takes place in an outpatient setting and requires a high level of patient engagement. Providing results of PRO assessments to patients in the form of a feedback report could increase patient engagement and may improve communication between health care professionals and patients. The aim of the study is to develop a PRO feedback report for mobile devices that is comprehensible and provides valuable information for patients after knee arthroplasty. RESULTS: In an iterative development process, our expert group developed two preliminary feedback reports (a text-based version and a graphical display) based on previous research results and practical experience. In a second step, we discussed these reports with orthopedic patients (n = 8) in terms of comprehensibility and value using semi-structured interviews and cognitive debriefing methods. Participants assessed the reports as informative, but had some difficulties in fully comprehending all of the information provided. Based on the feedback from patients, we modified both versions and reduced complexity to increase comprehensibility. CONCLUSIONS: A PRO feedback report for patients for mobile app use has to take account of the heterogeneous user group, particularly demographics such as age and experience with mobile devices. Information should be presented in a simple way to be comprehensible and of value to patients. Technological advancements allow a simple default report to be set, something which enables patients interested in additional information to make customizations

Y-aminobutyric acid type B (GABAB) receptor expression is needed for inhibition of N-type (Cav2.2) calcium channels by analgesic a-conotoxins

Background: A class of analgesic a-conotoxins potently inhibits N-type calcium channels. Results: The activity of a-conotoxins Vc1.1 and RgIA was reduced following knockdown of GABAB receptor expression in sensory neurons and can be reconstituted in HEK293 cells expressing human GABAB receptor and Cav2.2. Conclusion: GABAB receptors are needed for inhibition of Cav2.2 by Vc1.1 and RgIA. Significance: These analgesic a-conotoxins activate human GABAB receptors

Awareness, Attitudes, and Perceptions of Croatian-Based Orthopedic and Trauma Surgeons toward Scientific Manuscripts, Publishing Internationally and Medical Writing. Results of an Online Questionnaire

The objective of this survey was to identify the importance placed by Croatian-based surgeons on writing scientific manuscripts and publishing them internationally, as well as their awareness of and attitudes toward medical writing. A link to an online survey was sent to 327 Croatian-based orthopedic and trauma surgeons. The electronic questionnaire consisted of rating scales, multiple choice questions and free text reply boxes. A total of 61 surgeons based in Croatia replied to the survey, yielding a response rate of 19% (61/327). The survey results indicate that surgeons in Croatia are active in both research and the writing of manuscripts. There is also a high level of interest among them to publish internationally in English to further their careers. While 68% (38/56) of respondents initially claimed to know about medical writing, further questioning on the subject revealed a reduced level of familiarity with the concept. Only 19% (11/58) of respondents had ever engaged the services of a medical writer and they were generally satisfied with the work done across the three areas of language, editing and scientific knowledge. Medical writers are advised to increase awareness of their services among Croatian-based orthopedic and trauma surgeons who may well have a need for their expertise

Mangled Extremity – Case Report, Literature Review and Borderline Cases Guidelines Proposal

Treatment of a mangled lower extremity represents a major challenge. The decision whether to amputate or attempt reconstruction is currently based upon surgical evaluation. The aim of this paper is to propose a new approach to surgical evaluation based on scoring systems, local clinical status of the patient as well as comorbidities, mechanism of trauma and hospital resources. Available literature regarding this topic was evaluated and a case of patient with mangled extremity is presented. Based on current literature guidelines and evidence-based medicine, management for borderline cases is proposed to aid clinical decision making in these situations. We describe a 44-year old male patient who presented with mangled lower left leg. Despite a borderline Mangled Extremity Severity Score (MESS), due to the overall health status of the patient and local clinical status with preserved plantar sensitivity and satisfactory capillary perfusion, reconstruction was attempted. After 6 months of treatment, all wounds healed completely with no pain, and satisfactory motor and sensory function was achieved. In conclusion, the treatment of mangled extremity treatment should be based on evidence based literature along with a clinical evaluation of every individual patient. Scores are helpful, but should not be taken as the sole indication for amputation

EIRFLAT-1: A FlatSat platform for the development and testing of the 2U CubeSat EIRSAT-1

The Educational Irish Research Satellite (EIRSAT-1) is a 2U CubeSat being designed, built and tested at University College Dublin. A FlatSat platform known as EIRFLAT-1 has been constructed to enable the testing and development of the CubeSat. EIRFLAT-1 facilitates the electrical connections between CubeSat components while leaving key interfaces accessible for test equipment and allowing for the hot swapping of components. Commercial Off The Shelf and in-house developed hardware has been tested using EIRFLAT-1 at component, subsystem and full system level. In addition, the FlatSat has been used for flight software development. This paper describes the design of EIRFLAT-1 including electrical and mechanical components and additional ground support equipment developed to assist in the testing and development activities. EIRFLAT-1 has proven to be an invaluable tool for testing and has led to the discovery of issues and unexpected behaviour with flight hardware which would have contributed to schedule delays if undiscovered until after the satellite was assembled. Moreover, EIRFLAT-1 facilitated early and incremental testing of both software and operations procedures. The schematics for the electrical design of EIRFLAT-1, which is compatible with all CubeSat Kit PC/104 components, has been made publicly available for use by other educational CubeSat team

Crowdfunding Education : Objectives, Content, Pedagogy, and Assessment

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The effect of curricular and extracurricular activities on university students? entrepreneurial intention and competences

This study examines how the alliance-building process affects the intention to enter into international alliances in the case of small and medium-sized enterprises (SMEs). From a psychological perspective (Perceived Behavioural Control), the authors analyse the alliance-building process as an inhibitor of the international collaboration intention, considering to what extent the experience affects the intention of the partners involved. The study explores these hypotheses based on a sample of 220 Spanish SMEs. The results provide empirical evidence showing that the intention to develop international alliances is negatively affected by the search and the selection process as well as by the negotiation of the agreement, which reduces the intention to establish an international agreement. In addition, the intention is moderated by the experience of the SME manager. Moreover, there is a negative relationship between the extent of the SME manager's international experience and the intention to develop an international alliance