Life Skill Needs of Occupational Therapy Assistant Students: Perceptions of Instructors, Preceptors, Graduates and Current Students

Life skills are the basic skills required to function in everyday life. Occupational therapy assistant (OTA) students may struggle with life skills, and as a result experience challenges in academics and practicum. The purpose of this phase of a multiphase study was to identify the life skill needs of OTA students from multiple perspectives. This study used a pragmatic qualitative design. Students in the second year of a 2-year therapy assistant diploma program, graduates, instructors, and preceptors participated in interviews or focus groups to discuss OTA students’ life skill needs. Interviews and focus groups were recorded and transcribed. Applied thematic analysis was used to analyze the interview and focus group data and draw conclusions. Common themes were identified: contributors to student success; impact of students’ life skills on clinical encounters; and life skills training needs. These themes were identified across all participant groups. Findings suggest that OTA students with lower confidence or abilities in life skills may also have lower confidence and success in clinical encounters. Life skills training tailored to OTA students may help students develop foundational skills to enhance their confidence and competence in relevant life skill areas

Time trends in survival and readmission following coronary artery bypass grafting in Scotland, 1981-96: retrospective observational study

Improvements in coronary revascularisation techniques and an increase in the use of percutaneous interventions1 have led to a rise in the number of coronary artery bypass grafting operations in older patients with more severe cardiac disease and worse comorbidity and who have previously undergone revascularisation procedures. 2 3 Advances in surgical and anaesthetic techniques have prevented a worsening risk profile from being translated into an increase in perioperative deaths. 2 3 The aim of our study was to examine time trends in major outcomes up to two years after coronary artery bypass grafting

Short-term and long-term outcomes in 133 429 emergency patients admitted with angina or myocardial infarction in Scotland, 1990-2000: population-based cohort study

Objective: To analyse short- and long-term outcomes and prognostic factors in a large population-based cohort of unselected patients with a first emergency admission for suspected acute coronary syndrome between 1990 and 2000 in Scotland. Methods: All first emergency admissions for acute myocardial infarction (AMI) and all first emergency admissions for angina (the proxy for unstable angina) between 1990 and 2000 in Scotland (population 5.1 million) were identified. Survival to five years was examined by Cox multivariate modelling to examine the independent prognostic effects of diagnosis, age, sex, year of admission, socioeconomic deprivation and co-morbidity. Results: In Scotland between 1990 and 2000, 133 429 individual patients had a first emergency admission for suspected acute coronary syndrome: 96 026 with AMI and 37 403 with angina. After exclusion of deaths within 30 days, crude five-year case fatality was similarly poor for patients with angina and those with AMI (23.9% v 21.6% in men and 23.5% v 26.0% in women). The longer-term risk of a subsequent fatal or non-fatal event in the five years after first hospital admission was high: 54% in men after AMI (53% in women) and 56% after angina (49% in women). Event rates increased threefold with increasing age and 20–60% with different co-morbidities, but were 11–34% lower in women. Conclusions: Longer-term case fatality was similarly high in patients with angina and in survivors of AMI, about 5% a year. Furthermore, half the patients experienced a fatal or non-fatal event within five years. These data may strengthen the case for aggressive secondary prevention in all patients presenting with acute coronary syndrome

Bray, una cueva sepulcral de la Edad del Bronce en el Peñón de Gibraltar

Las excavaciones en la Cueva de Bray en Gibraltar han documentado una serie de enterramientos de la Edad de Bronce, esto supone una nueva aportación al conocimiento de la ocupación prehistórica del Peñón de Gibraltar y se convierte en una referencia regional para el estudio de los rituales funerarios de este período

Fibre-based fluorescence-lifetime imaging microscopy:a real-time biopsy guidance tool for suspected lung cancer

Lung cancer is the most common cause of cancer-related deaths worldwide. Early detection improves outcomes, however, existing sampling techniques are associated with suboptimal diagnostic yield and procedure-related complications. Autofluorescence-based fluorescence-lifetime imaging microscopy (FLIM), a technique which measures endogenous fluorophore decay rates, may aid identification of optimal biopsy sites in suspected lung cancer. Our fibre-based fluorescence-lifetime imaging system, utilising 488 nm excitation, which is deliverable via existing diagnostic platforms, enables real-time visualisation and lifetime analysis of distal alveolar lung structure. We evaluated the diagnostic accuracy of the fibre-based fluorescence-lifetime imaging system to detect changes in fluorescence lifetime in freshly resected ex vivo lung cancer and adjacent healthy tissue as a first step towards future translation. The study compares paired non-small cell lung cancer (NSCLC) and non-cancerous tissues with gold standard diagnostic pathology to assess the performance of the technique. Paired NSCLC and non-cancerous lung tissues were obtained from thoracic resection patients (N=21). A clinically compatible 488 nm fluorescence-lifetime endomicroscopy platform was used to acquire simultaneous fluorescence intensity and lifetime images. Fluorescence lifetimes were calculated using a computationally-lightweight, rapid lifetime determination method. Fluorescence lifetime was significantly reduced in ex vivo lung cancer, compared with non-cancerous lung tissue [mean ± standard deviation (SD), 1.79±0.40 vs. 2.15±0.26 ns, P&lt;0.0001], and fluorescence intensity images demonstrated distortion of alveolar elastin autofluorescence structure. Fibre-based fluorescence-lifetime imaging demonstrated good performance characteristics for distinguishing lung cancer, from adjacent non-cancerous tissue, with 81.0% sensitivity and 71.4% specificity. Our novel fibre-based fluorescence-lifetime imaging system, which enables label-free imaging and quantitative lifetime analysis, discriminates ex vivo lung cancer from adjacent healthy tissue. This minimally invasive technique has potential to be translated as a real-time biopsy guidance tool, capable of optimising diagnostic accuracy in lung cancer. </p

Susceptibility to scrapie and disease phenotype in sheep: cross-PRNP genotype experimental transmissions with natural sources

<p>Abstract</p> <p>It has long been established that the sheep <it>Prnp</it> genotype influences the susceptibility to scrapie, and some studies suggest that it can also determine several aspects of the disease phenotype. Other studies, however, indicate that the source of infection may also play a role in such phenotype. To address this question an experiment was set up in which either of two different natural scrapie sources, AAS from AA₁₃₆ Suffolk and VVC from VV₁₃₆ Cheviot sheep, were inoculated into AA₁₃₆, VA₁₃₆ and VV₁₃₆ sheep recipients (<it>n</it> = 52). The immunohistochemical (IHC) profile of disease-associated PrP (PrP^d) accumulation in the brain of recipient sheep was highly consistent upon codon 136 homologous and semi-homologous transmission, but could be either similar to or different from those of the inoculum donors. In contrast, the IHC profiles were highly variable upon heterologous transmission (VVC to AA₁₃₆ and AAS to VV₁₃₆). Furthermore, sheep of the same <it>Prnp</it> genotype could exhibit different survival times and PrP^d profiles depending on the source of infection, and a correlation was observed between IHC and Western blot profiles. It was found that additional polymorphisms at codons 112 or 141 of AA₁₃₆ recipients resulted in a delayed appearance of clinical disease or even in protection from infection. The results of this study strongly suggest that the scrapie phenotype in sheep results from a complex interaction between source, donor and recipient factors, and that the <it>Prnp</it> genotype of the recipient sheep does not explain the variability observed upon codon 136 heterologous transmissions, arguing for other genetic factors to be involved.</p

Where myth and archaeology meet: Discovering the Gorgon Medusa's Lair.

Here we report the discovery of ceramic fragments that form part of a Gorgoneion, a ceramic image representation of the Gorgon Medusa. The fragments were found in a deep part of Gorham's Cave, well known to ancient mariners as a natural shrine, between the 8th and 2nd century BCE. We discuss the context of this discovery, both within the inner topography of the cave itself, and also the broader geographical context. The discovery is situated at the extreme western end of the Mediterranean Sea, where it meets the Atlantic Ocean. The location was known to ancient mariners as the northern Pillar of Herakles, which marked the end of the known world. We relate the discovery, and its geographical and chronological context, to Greek legends that situated the lair of the Gorgon sisters at a location which coincides with the physical attributes and geographical position of Gorham's Cave. We thus provide, uniquely, a geographical and archaeological context to the myth of Perseus and the slaying of the Gorgon Medusa

Enhanced rock-slope failure following ice-sheet deglaciation : timing and causes

This research was supported by NERC Cosmogenic Isotope Analysis Facility [Grant Number: 9046.0308]The temporal pattern of rock-slope failures (RSFs) following Late Pleistocene deglaciation on tectonically stable terrains is controversial: previous studies variously suggest (1) a rapid response due to removal of supporting ice (‘debuttressing’), (2) a progressive decline in RSF frequency, and (3) a millennial-scale delay before peak RSF activity. We test these competing models through beryllium-10 (10Be) exposure dating of five closely-spaced quartzite RSFs on the Isle of Jura, Scotland, to establish the relationship between timing of failure and those of deglaciation, episodes of rapid warming and periods of rapid glacio-isostatic uplift. All five dated RSFs occurred at least 720–2240 years after deglaciation, with the probability of failure peaking ~2 ka after deglaciation, consistent with millennial-scale delay model (3). This excludes debuttressing as an immediate cause of failure, though it is likely that time-dependent stress release due to deglacial unloading resulted in progressive development of failure planes within the rock. Thaw of permafrost ice in joints is unlikely to have been a prime trigger of failure as some RSFs occurred several centuries after the onset of interstadial warming. Conversely, the timespan of the RSFs coincides with the period of maximum glacio-isostatic crustal uplift, suggesting that failure was triggered by uplift-driven seismic events acting on fractured rock masses. Implications of this and related research are: (1) that retreat of the last Pleistocene ice sheets across tectonically-stable mountainous terrains was succeeded by a period of enhanced rock-slope failure due to deglacial unloading and probably uplift-driven seismicity; (2) that the great majority of RSFs in the British Isles outside the limits of Loch Lomond Stadial (= Younger Dryas) glaciation are of Lateglacial (pre-Holocene) age; and (3) numerous RSFs must also have occurred inside Loch Lomond Stadial (LLS) glacial limits, but that runout debris was removed by LLS glaciers.PostprintPeer reviewe