A controlled release technique using microporous membranes

A novel controlled release device based on aqueous-organic partitioning is described. The device comprises a reservoir, bounded by a microporous or porous membrane in the form of a hollow fiber or flat film. The reservoir liquid phase and the pore liquid phase are immiscible. The agent partitions between the phases at the aqueous-organic interface of the reservoir and the pore mouth, and then diffuses through the membrane pore liquid into a surrounding aqueous solution. The partition coefficient significantly influences the rate of release of the agent by reducing the driving force for diffusion across the fluid-filled membrane pore. The performance of the system is evaluated using model agents benzoic acid, caffeine, nicotine and phenylalanine-glycine. Two aqueous-organic configurations were investigated: an agent in an organic reservoir solution with water-filled pores, and an agent in an aqueous reservoir with organic filled pores. Specifically, the model systems included benzoic acid in three reservoir solvents (octanol, decanol, and mineral oil) partitioning into waterfilled pores, an aqueous reservoir of nicotine partitioning into either mineral oil- or octanol-filled pores, and caffeine or phenylalanine-glycine partitioning into octanol-filled pores. The peptide phenylalanine-glycine was used to investigate pH-based controlled release from this type of device. Studies using benzoic acid demonstrate the effectiveness of a thin, nonporous coating on the release rate. When a fast-dissolving dispersion of the agent is present in the reservoir, the period of zero order release is extended; when the dispersion dissolves slowly, the release rate is decreased and the period of zero order release is extended. Simultaneous release of two agents (benzoic acid and nicotine, nicotine and caffeine) from a single reservoir and from two separate reservoirs was achieved. Models are presented for many of these systems. Solutions have been developed to describe the observed release, and dimensional analysis was used to identify important parameters which govern the release rate of the agent from the device. Finally, a new technique is presented for achieving controlled release of liposomes from a membrane-type diffusion based controlled release system

A method to quantify residents\u27 jargon use during counseling of standardized patients about cancer screening

Background Jargon is a barrier to effective patient-physician communication, especially when health literacy is low or the topic is complicated. Jargon is addressed by medical schools and residency programs, but reducing jargon usage by the many physicians already in practice may require the population-scale methods used in Quality Improvement. Objective To assess the amount of jargon used and explained during discussions about prostate or breast cancer screening. Effective communication is recommended before screening for prostate or breast cancer because of the large number of false-positive results and the possible complications from evaluation or treatment. Participants Primary care internal medicine residents. Measurements Transcripts of 86 conversations between residents and standardized patients were abstracted using an explicit-criteria data dictionary. Time lag from jargon words to explanations was measured using “statements,” each of which contains one subject and one predicate. Results Duplicate abstraction revealed reliability κ = 0.92. The average number of unique jargon words per transcript was 19.6 (SD = 6.1); the total jargon count was 53.6 (SD = 27.2). There was an average of 4.5 jargon-explanations per transcript (SD = 2.3). The ratio of explained to total jargon was 0.15. When jargon was explained, the average time lag from the first usage to the explanation was 8.4 statements (SD = 13.4). Conclusions The large number of jargon words and low number of explanations suggest that many patients may not understand counseling about cancer screening tests. Educational programs and faculty development courses should continue to discourage jargon usage. The methods presented here may be useful for feedback and quality improvement efforts

Pediatric residents\u27 use of jargon during counseling about newborn genetic screening results

OBJECTIVE. The goal was to investigate pediatric residents’ usage of jargon during discussions about positive newborn screening test results. METHODS. An explicit-criteria abstraction procedure was used to identify jargon usage and explanations in transcripts of encounters between residents and standardized parents of a fictitious infant found to carry cystic fibrosis or sickle cell hemoglobinopathy. Residents were recruited from a series of educational workshops on how to inform parents about positive newborn screening test results. The time lag from jargon words to explanations was measured by using “statements,” each of which contained 1 subject and 1 predicate. RESULTS. Duplicate abstraction revealed reliability K of 0.92. The average number of unique jargon words per transcript was 20; the total jargon count was 72.3 words. There was an average of 7.5 jargon explanations per transcript, but the explained/ total jargon ratio was only 0.17. When jargon was explained, the average time lag from the first usage to the explanation was 8.2 statements. CONCLUSION. The large number of jargon words and the small number of explanations suggest that physicians’ counseling about newborn screening may be too complex for some parents

Child Health Providers\u27 Precautionary Discussion of Emotions During Communication about Results of Newborn Genetic Screening

Objective To demonstrate a quantitative abstraction method for Communication Quality Assurance projects to assess physicians\u27 communication about hidden emotions after newborn genetic screening. Design Communication quality indicator analysis. Setting Standardized parent encounters performed in practicing physicians\u27 clinics or during educational workshops for residents. Participants Fifty-nine pediatrics residents, 53 pediatricians, and 31 family physicians. Intervention Participants were asked to counsel standardized parents about a screening result; counseling was recorded, transcribed, and parsed into statements (each with 1 subject and 1 predicate). Pairs of abstractors independently compared statements with a data dictionary containing explicit-criteria definitions. Outcome Measures Four groups of precautionary empathy behaviors (assessment of emotion, anticipation/validation of emotion, instruction about emotion, and caution about future emotion), with definitions developed for both definite and partial instances. Results Only 38 of 143 transcripts (26.6%) met definite criteria for at least 1 of the precautionary empathy behaviors. When partial criteria were counted, this number increased to 80 of 143 transcripts (55.9%). The most common type of precautionary empathy was the instruction about emotion behavior (eg, don\u27t be worried ), which may sometimes be leading or premature. Conclusions Precautionary empathy behaviors were rare in this analysis. Further study is needed, but this study should raise concerns about the quality of communication services after newborn screening

An investigation into the food related traditions associated with the Christmas period in rural Ireland

The interdisciplinary nature of food studies lends itself to the study of food through many avenues, most notably in this research, through folklore and the oral history transcripts of the Schools’ Collection made by the Irish Folklore Commission in 1937–1938. Folklore can give us an insight into sometimes overlooked features of society and how people’s lives can be studied and highlighted through their relationship with food. The Christmas period was an extremely important time in Irish tradition, and food was a main aspect of that celebration. This paper, therefore, at first delves into the literature surrounding Christmas, folklore, and food; diet and social class; gender, and food in rural Ireland, before comparing it with the oral history transcripts of the National Folklore Collection’s online archive, to unearth a better understanding of the relation[1]ship and the role of food in the Christmas festival in Ireland’s recent pas

LGBTQ+ Safe Zone Ally Workshop

Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals have historically faced harassment, exclusionary behavior, and discrimination in many aspects of their lives, including in educational settings. This workshop will equip participants with the knowledge and tools to (1) recognize the negative impact of bias and heterosexual/cisgender privilege on the experiences of LGBTQ+ individuals; (2) recognize challenges faced by LGBTQ+ individuals in STEM fields; (3) identify strategies for creating an inclusive and affirming environment; and (4) formulate a plan to become an ally for LGBTQ+ individuals. The workshop is open to students, faculty, and the professional community in STEM fields and assumes a basic understanding of LGBTQ+ concepts and terminology. By becoming Safe Zone allies, STEM professionals can help create a more diverse and talented engineering workforce and promote diversity and inclusion within the field

Esthesioneuroblastoma: Management of the N0 neck

Esthesioneuroblastoma is a rare sinonasal malignancy that arises from the olfactory epithelium. The overall incidence of lymph node metastases is 25%. However, neck disease can present in a delayed fashion. As such, management of the clinically negative neck is controversial, with some advocating for elective neck treatment and others recommending observation with salvage treatment if necessary. At this time, no prospective head-to-head comparisons of elective versus salvage treatment have been performed