Systematic development of a communication skills training course for physicians performing work disability assessments: from evidence to practice

<p>Abstract</p> <p>Background</p> <p>Physicians require specific communication skills, because the face-to-face contact with their patients is an important source of information. Although physicians who perform work disability assessments attend some communication-related training courses during their professional education, no specialised and evidence-based communication skills training course is available for them. Therefore, the objectives of this study were: 1) to systematically develop a training course aimed at improving the communication skills of physicians during work disability assessment interviews with disability claimants, and 2) to plan an evaluation of the training course.</p> <p>Methods</p> <p>A physician-tailored communication skills training course was developed, according to the six steps of the Intervention Mapping protocol. Data were collected from questionnaire studies among physicians and claimants, a focus group study among physicians, a systematic review of the literature, and meetings with various experts. Determinants and performance objectives were formulated. A concept version of the training course was discussed with several experts before the final training course programme was established. The evaluation plan was developed by consulting experts, social insurance physicians, researchers, and policy-makers, and discussing with them the options for evaluation.</p> <p>Results</p> <p>A two-day post-graduate communication skills training course was developed, aimed at improving professional communication during work disability assessment interviews. Special focus was on active teaching strategies, such as practising the skills in role-play. An adoption and implementation plan was formulated, in which the infrastructure of the educational department of the institute that employs the physicians was utilised. Improvement in the skills and knowledge of the physicians who will participate in the training course will be evaluated in a randomised controlled trial.</p> <p>Conclusions</p> <p>The feasibility and practical relevance of the communication skills training course that was developed seem promising. Such a course may be relevant for physicians in many countries who perform work disability assessments. The development of the first training course of this type represents an important advancement in this field.</p

Mapping environmental injustices: pitfalls and potential of geographic information systems in assessing environmental health and equity.

Geographic Information Systems (GIS) have been used increasingly to map instances of environmental injustice, the disproportionate exposure of certain populations to environmental hazards. Some of the technical and analytic difficulties of mapping environmental injustice are outlined in this article, along with suggestions for using GIS to better assess and predict environmental health and equity. I examine 13 GIS-based environmental equity studies conducted within the past decade and use a study of noxious land use locations in the Bronx, New York, to illustrate and evaluate the differences in two common methods of determining exposure extent and the characteristics of proximate populations. Unresolved issues in mapping environmental equity and health include lack of comprehensive hazards databases; the inadequacy of current exposure indices; the need to develop realistic methodologies for determining the geographic extent of exposure and the characteristics of the affected populations; and the paucity and insufficiency of health assessment data. GIS have great potential to help us understand the spatial relationship between pollution and health. Refinements in exposure indices; the use of dispersion modeling and advanced proximity analysis; the application of neighborhood-scale analysis; and the consideration of other factors such as zoning and planning policies will enable more conclusive findings. The environmental equity studies reviewed in this article found a disproportionate environmental burden based on race and/or income. It is critical now to demonstrate correspondence between environmental burdens and adverse health impacts--to show the disproportionate effects of pollution rather than just the disproportionate distribution of pollution sources

Biofilm development in time on a silicone voice prosthesis:A case study

Voice prostheses from silicone elastomers become rapidly colonised by a mixed biofilm of bacteria and yeasts. In this study, microorganisms were isolated from biofilms on explanted prostheses after having been in place for various time intervals ranging from 1 to 67 d. The isolates were examined for their identity, adhesion to hexadecane and electrophoretic mobility. Bacteria from early (shorter than 8 d) and late (longer than 8 d) explants could not be classified according to their taxonomy, hydrophobicity or electrophoretic mobility. However, the yeasts clearly revealed a dominance of only hydrophilic Candida albicans isolates from early explants and only hydrophobic C. tropicalis isolates from late explants. These findings may be of significance for the development of strategies to control mixed biofilms on biomaterials.</p

On semiclassical approximation for correlators of closed string vertex operators in AdS/CFT

We consider the 2-point function of string vertex operators representing string state with large spin in AdS_5. We compute this correlator in the semiclassical approximation and show that it has the expected (on the basis of state-operator correspondence) form of the strong-coupling limit of the 2-point function of single trace minimal twist operators in gauge theory. The semiclassical solution representing the stationary point of the path integral with two vertex operator insertions is found to be related to the large spin limit of the folded spinning string solution by a euclidean continuation, transformation to Poincare coordinates and conformal map from cylinder to complex plane. The role of the source terms coming from the vertex operator insertions is to specify the parameters of the solution in terms of quantum numbers (dimension and spin) of the corresponding string state. Understanding further how similar semiclassical methods may work for 3-point functions may shed light on strong-coupling limit of the corresponding correlators in gauge theory as was recently suggested by Janik et al in arXiv:1002.4613.Comment: 19 pages, 1 figure; minor corrections, references added, footnote below eq. (4.5) adde

Holographic three-point functions of semiclassical states

We calculate the holographic three-point functions in N = 4 super-Yang-Mills theory in the case when two of the operators are semiclassical and one is dual to a supergravity mode. We further discuss the transition to the regime when all three operators are semiclassical.Comment: 17 pages, 3 figures; v2: refs. added, discussion in sec. 2.1 expanded; v3: misprint in (2.28) corrected, published versio

Large N=4 Holography

The class of 2d minimal model CFTs with higher spin AdS3 duals is extended to theories with large N=4 superconformal symmetry. We construct a higher spin theory based on the global D(2,1|alpha) superalgebra, and propose a large N family of cosets as a dual CFT description. We also indicate how a non-abelian version of this Vasiliev higher spin theory might give an alternative description of IIB string theory on an AdS3 x S3 x S3 x S1 background.Comment: 41 pages, LaTe

Proteomics of Human Dendritic Cell Subsets Reveals Subset-Specific Surface Markers and Differential Inflammasome Function.

Dendritic cells (DCs) play a key role in orchestrating adaptive immune responses. In human blood, three distinct subsets exist: plasmacytoid DCs (pDCs) and BDCA3+ and CD1c+ myeloid DCs. In addition, a DC-like CD16+ monocyte has been reported. Although RNA-expression profiles have been previously compared, protein expression data may provide a different picture. Here, we exploited label-free quantitative mass spectrometry to compare and identify differences in primary human DC subset proteins. Moreover, we integrated these proteomic data with existing mRNA data to derive robust cell-specific expression signatures with more than 400 differentially expressed proteins between subsets, forming a solid basis for investigation of subset-specific functions. We illustrated this by extracting subset identification markers and by demonstrating that pDCs lack caspase-1 and only express low levels of other inflammasome-related proteins. In accordance, pDCs were incapable of interleukin (IL)-1β secretion in response to ATP

Universality and exactness of Schrodinger geometries in string and M-theory

We propose an organizing principle for classifying and constructing Schrodinger-invariant solutions within string theory and M-theory, based on the idea that such solutions represent nonlinear completions of linearized vector and graviton Kaluza-Klein excitations of AdS compactifications. A crucial simplification, derived from the symmetry of AdS, is that the nonlinearities appear only quadratically. Accordingly, every AdS vacuum admits infinite families of Schrodinger deformations parameterized by the dynamical exponent z. We exhibit the ease of finding these solutions by presenting three new constructions: two from M5 branes, both wrapped and extended, and one from the D1-D5 (and S-dual F1-NS5) system. From the boundary perspective, perturbing a CFT by a null vector operator can lead to nonzero beta-functions for spin-2 operators; however, symmetry restricts them to be at most quadratic in couplings. This point of view also allows us to easily prove nonrenormalization theorems: for any Sch(z) solution of two-derivative supergravity constructed in the above manner, z is uncorrected to all orders in higher derivative corrections if the deforming KK mode lies in a short multiplet of an AdS supergroup. Furthermore, we find infinite classes of 1/4 BPS solutions with 4-,5- and 7-dimensional Schrodinger symmetry that are exact.Comment: 31 pages, plus appendices; v2, minor corrections, added refs, slight change in interpretation in section 2.3, new Schrodinger and Lifshitz solutions included; v3, clarifications in sections 2 and 3 regarding existence of solutions and multi-trace operator

A Fly in the Ointment: Evaluation of Traditional Use of Plants to Repel and Kill Blowfly Larvae in Fermented Fish

Introduction: In rural areas in Laos, fly larvae infestations are common in fermenting fish. Blowflies (Chrysomyamegacephala, Diptera: Calliphoridae) are attracted to oviposit (and/or larviposit) onto fermenting fish which results ininfestations with fly larvae. Knowledge of traditional use of plants to repel larvae during the production of fermented fish iscommon and widespread in Lao PDR. Research Questions: How effective are the most salient species in repelling, and killing fly larvae in fermenting fish? Material and Methods: The three plant species most frequently reported to repel fly larvae during an ethnobotanical surveythroughout Lao PDR were tested for repellence and larvicidal activity of fly larvae infesting fermented fish. The lethality andrepellence of Tadehagi triquetrum (L.) H. Ohashi (Fabaceae), Uraria crinita (L.) Desv. ex DC. (Fabaceae) and Bambusa multiplex(Lour.) Raeusch. ex Schult. &amp; Schult. f. (Poaceae) were tested in an experimental design using fermenting fish in Vientiane,Lao PDR. Results: The repellent effect of fresh material of T. triquetrum and U. crinita, and the larvicidal effect of fresh B. multiplex, issignificantly more effective than that of dried material of the same species, and the total effect (repellence and larvicidaleffect combined) for each of the three species was significantly more effective for fresh than for dry material. Fresh materialof T. triquetrum, U. crinita, or B. multiplex added on top of the fermenting fish repelled 50%, 54%, 37%, and killed 22%, 28%,and 40% of fly larvae. The total effect was not significantly different per species at 72%, 82%, and 77%, respectively. Discussion and Conclusions: The three most salient species are effective in repelling and killing fly larvae in the productionof fermented fish, and may be essential to augment food safety during traditional fermentation in open jars