Your students have excellent knowledge and skills but they don’t think about them...:a reflective learning project

This paper describes two phases of a project set up to encourage students to be more reflective about their studies and their career goals. it takes as its starting point a discussion with employers about the Jack of reflection that they observed in otherwise highly skilled management graduates. The project.examin!ld.a number of processes, including mentoring, logbooks and learning style questionnaires to gauge which was the most effective in inspiring students to be reflective. Having identified the best methods the project entered a second phase which involved rolling out the findings to large numbers of students. The challenges of doing this are analysed in the paper

Physician Assistant Distribution in Texas-Mexico Border Counties: Public Health Implications

Purpose. Texas Medical Board physician assistant (PA) data were assessed to assist workforce education and planning strategies for PA programs in regions with high percentages of Hispanic populations. Methods. Data were assessed for gender, ethnicity, program attended and current employment addresses within the 14 Texas-Mexico border counties. Results. Of the 329 border county PAs, 227 self-reported as Hispanic (69%), and 53% were female. Remarkably, 72% of all Hispanic PAs attended two of the six public Texas PA Programs. Conclusions. The Sullivan Commission report of 2004 concluded that the primary cause of poor public health care for minorities resulted from unequal representation of minorities in the health care professions. Two public Texas PA programs have made substantial contributions to public health care access in poverty-stricken border areas by educating and placing Hispanic PAs within medically underserved communities

Eye See Eye Learn The Benefit of Comprehensive Eye Examinations for Preschoolers

Objective: Undetected vision problems in children can lead to permanent vision loss, a condition known as amblyopia. Early detection and treatment of the causes of amblyopia may prevent this vision loss. The objective of this paper is to look for evidence that comprehensive eye examinations upon entry to junior Kindergarten are an effective way to identify and treat vision problems early. methods: Relevant peer-reviewed publications on amblyopia and the importance of comprehensive eye examinations were reviewed. Specific areas investigated include: the prevalence and causes of amblyopia; impact of vision problems on child development and education; impact of amblyopia and/or strabismus on quality of life; and the cost effectiveness of treating amblyopia. The validity of vision screening compared to a comprehensive eye examination was also reviewed. Synthesis:The review suggests that without a complete eye examination many eye or vision problems remain undetected at school entry. Left uncorrected these problems negatively impact child development, education and quality of life. Reduced vision due to amblyopia also restricts future employment opportunities and increases the risk of bilateral visual impairment in adulthood. Examination procedures with high sensitivity and specificity are required to accurately detect these problems. Studies show that amblyopia treatment initiated at an early age is one of the most cost-effective of all health interventions. Conclusion: There is good evidence in the literature that a full eye examination is critical to detect all cases of amblyopia. This and other visual problems can be detected and managed at an early age, which leads to better visual quality of life and economical outcomes. The Eye See Eye Learn program offers the “gold standard” of eye care

Microbial diversity in individuals and their household contacts following typical antibiotic courses.

BackgroundAntibiotics are a mainstay of treatment for bacterial infections worldwide, yet the effects of typical antibiotic prescriptions on human indigenous microbiota have not been thoroughly evaluated. We examined the effects of the two most commonly prescribed antibiotics (amoxicillin and azithromycin) in the USA to discern whether short-term antibiotic courses may have prolonged effects on human microbiota.ResultsWe sampled the feces, saliva, and skin specimens from a cohort of unrelated, cohabitating individuals over 6 months. An individual in each household was given an antibiotic, and the other a placebo to discern antibiotic impacts on microbiota, as well as determine whether antibiotic use might reshape the microbiota of each household. We observed household-specific patterns of microbiota on each body surface, which persevered despite antibiotic perturbations. While the gut microbiota within an individual became more dissimilar over time, there was no evidence that the use of antibiotics accelerated this process when compared to household members. There was a significant change in microbiota diversity in the gut and mouth in response to antibiotics, but analogous patterns were not observed on the skin. Those who received 7 days of amoxicillin generally had greater reductions in diversity compared to those who received 3 days, in contrast to those who received azithromycin.ConclusionsAs few as 3 days of treatment with the most commonly prescribed antibiotics can result in sustained reductions in microbiota diversity, which could have implications for the maintenance of human health and resilience to disease

Host-Mediated Post-Translational Prenylation of Novel Dot/Icm-Translocated Effectors of Legionella Pneumophila

The Dot/Icm type IV translocated Ankyrin B (AnkB) effector of Legionella pneumophila is modified by the host prenylation machinery that anchors it into the outer leaflet of the Legionella-containing vacuole (LCV), which is essential for biological function of the effector in vitro and in vivo. Prenylation involves the covalent linkage of an isoprenoid lipid moiety to a C-terminal CaaX motif in eukaryotic proteins enabling their anchoring into membranes. We show here that the LCV harboring an ankB null mutant is decorated with prenylated proteins in a Dot/Icm-dependent manner, indicating that other LCV membrane-anchored proteins are prenylated. In silico analyses of four sequenced L. pneumophila genomes revealed the presence of eleven other genes that encode proteins with a C-terminal eukaryotic CaaX prenylation motif. Of these eleven designated Prenylated effectors of Legionella (Pel), seven are also found in L. pneumophila AA100. We show that six L. pneumophila AA100 Pel proteins exhibit distinct cellular localization when ectopically expressed in mammalian cells and this is dependent on action of the host prenylation machinery and the conserved cysteine residue of the CaaX motif. Although inhibition of the host prenylation machinery completely blocks intra-vacuolar proliferation of L. pneumophila, it only had a modest effect on intracellular trafficking of the LCV. Five of the Pel proteins are injected into human macrophages by the Dot/Icm type IV translocation system of L. pneumophila. Taken together, the Pel proteins are novel Dot/Icm-translocated effectors of L. pneumophila that are post-translationally modified by the host prenylation machinery, which enables their anchoring into cellular membranes, and the prenylated effectors contribute to evasion of lysosomal fusion by the LCV

Meeting local information needs with ASCS and PSS SACE data

Blog summarising the key findings from the case study of further analysis, conducted with three local authorities during the fact-finding phase of the MAX project, which identified three local practices that maximised the local relevance and value of survey data: adding questions to the surveys, conducting further analysis and drawing on supplementary sources of data

Further analysis of ASCS and PSS SACE data: Case studies of local authority (LA) practice

The Maximising the value of survey data in adult social care (MAX) project aims to develop toolkits, with local authority (LA) staff where possible, to encourage and support LAs to make more use of data drawn from the ASCS and PSS SACE1 to inform local policy and practice. The initial fact-finding phase (MAX Phase 1) activities aimed to:learn more about how LAs currently use ASCS and PSS SACE data, including identifying local practices and barriers; identify potential uses of the data to inform local decision-making; and inform the development of a toolkit to support LAs to make better local use of the data. Along with two analysis and interpretation consultation panel workshops conducted early in the second phase of the project, 139 staff from 95 LAs have so far taken part in MAX. In summary, the findings from these activities demonstrate that LAs generally seem to value the ASCS and PSS SACE and, to some extent, are using the views of service users and carers to inform local service planning and delivery. However, there were several challenges. One of these, identified by just over half of the LAs, concerned analysing the survey data and interpreting the findings to address local questions. A number of barriers seem to underlie this challenge, including difficulties with: identifying local information needs; managing and analysing ASCS and PSS SACE data; and being allocated sufficient time to conduct further analysis. While some LAs find analysing ASCS and PSS SACE data challenging, others are carrying out local statistical analysis, over and above those required for national (ASCOF) reporting. The case studies reported here describe how three local authorities have used and analysed the ASCS and PSS SACE data to support local decision-making. In turn, the case studies will be used to inform the development of ‘how to’ guides and tools to help LAs analyse and interpret survey data, as well as report and interpret analysis finding

Janus as a Client: Ethical Obligations When Your Client Plays Two Roles in One Fiduciary Estate

Is it possible for an attorney to have a conflict of interest when the attorney represents a trustee who is also a beneficiary of the trust? Is that situation similar to having two clients? What if the trustee is not only a beneficiary, but also a claimant against the trust? Since the trustee has three roles to play, is that situation similar to an attorney having three clients? The issue presented by these potential conflicts was one of the most vexing for the drafters of the Fifth Edition of the ACTEC Commentaries. The range of possible approaches goes from a requirement that a separate lawyer is needed for each role to a view that a client with multiple roles can rely on one lawyer. This article examines the various court and ethics opinions, considers the arguments for the different approaches, and recommends best practices for attorneys when their clients have such conflicts

Dynamics Impact Tolerance of Shuttle RCC Leading Edge Panels Using LS-DYNA

This paper describes a research program conducted to enable accurate prediction of the impact tolerance of the shuttle Orbiter leading-edge wing panels using physics-based codes such as LS-DYNA, a nonlinear, explicit transient dynamic finite element code. The shuttle leading-edge panels are constructed of Reinforced-Carbon-Carbon (RCC) composite material, which is used because of its thermal properties to protect the shuttle during reentry into the Earth's atmosphere. Accurate predictions of impact damage from insulating foam and other debris strikes that occur during launch required materials characterization of expected debris, including strain-rate effects. First, analytical models of individual foam and RCC materials were validated. Next, analytical models of foam cylinders impacting 6- in. x 6-in. RCC flat plates were developed and validated. LS-DYNA pre-test models of the RCC flat plate specimens established the impact velocity of the test for three damage levels: no-detectable damage, non-destructive evaluation (NDE) detectable damage, or visible damage such as a through crack or hole. Finally, the threshold of impact damage for RCC on representative Orbiter wing panels was predicted for both a small through crack and for NDE-detectable damage