153 research outputs found

    Perceptions of recent medical graduates and their workplace supervisors towards a medical school clinical audit program

    Get PDF
    Objectives: This study explores how medical graduates and their workplace supervisors perceive the value of a structured clinical audit program (CAP) undertaken during medical school. Methods: Medical students at the University of Notre Dame Fremantle complete a structured clinical audit program in their final year of medical school. Semi-structured inter-views were conducted with 12 Notre Dame graduates (who had all completed the CAP), and seven workplace supervisors (quality and safety staff and clinical supervisors). Purposeful sampling was used to recruit participants and data were analysed using thematic analysis. Results: Both graduates and workplace supervisors perceived the CAP to be valuable. A major theme was that the CAP made a contribution to individual graduate’s medical practice, including improved knowledge in some areas of patient care as well as awareness of healthcare systems issues and preparedness to undertake scientifically rigorous quality improvement activities. Graduates perceived that as a result of the CAP, they were confident in undertaking a clinical audit after graduation. Workplace supervisors perceived the value of the CAP beyond an educational experience and felt that the audits undertaken by students improved quality and safety of patient care. Conclusions: It is vital that health professionals, including medical graduates, be able to carry out quality and safety activities in the workplace. This study provides evidence that completing a structured clinical audit during medical school prepares graduates to undertake quality and safety activities upon workplace entry. Other health professional faculties may be interested in incorporating a similar program in their curricula

    [5,10,15,20-Tetra­kis(4-tol­yl)porphyrin]zinc(II) dichloro­methane solvate

    Get PDF
    In the title complex, [Zn(C48H36N4)]·CH2Cl2, the ZnII atom lies on an inversion center and the dichloro­methane solvent mol­ecule is disordered around an inversion center. The tolyl substituents are twisted compared to the central aromatic ring system of the porphyrin, similar to what is seen in previously published structures of this molecule [Dastidar & Goldberg (1996 ▶). Acta Cryst. C52, 1976–1980]. The dihedral angles between the mean planes of the tolyl rings and the central ring are 66.98 (6) and 60.40 (6)°

    Direct inhibition of the cold-activated TRPM8 ion channel by Gαq

    Get PDF
    Activation of the TRPM8 ion channel in sensory nerve endings produces a sensation of pleasant coolness. Here we show that inflammatory mediators such as bradykinin and histamine inhibit TRPM8 in intact sensory nerves, but do not do so through conventional signalling pathways. The G-protein subunit Gα(q) instead binds to TRPM8 and when activated by a Gq-coupled receptor directly inhibits ion channel activity. Deletion of Gα(q) largely abolished inhibition of TRPM8, and inhibition was rescued by a Gα(q) chimaera whose ability to activate downstream signalling pathways was completely ablated. Activated Gα(q) protein, but not Gβγ, potently inhibits TRPM8 in excised patches. We conclude that Gα(q) pre-forms a complex with TRPM8 and inhibits activation of TRPM8, following activation of G-protein-coupled receptors, by a direct action. This signalling mechanism may underlie the abnormal cold sensation caused by inflammation

    Traumatic Brain Injury in the Elderly: Is it as Bad as we Think?

    Get PDF
    Traumatic brain injury in elderly patients is a neglected global disease burden. The main cause is fall, followed by motor vehicle accidents. This review article summarizes different aspects of geriatric traumatic brain injury, including epidemiology, pathology, and effects of comorbidities and pre-injury medications such as antiplatelets and anticoagulants. Functional outcome with or without surgical intervention, cognitive outcome, and psychiatric complications are discussed. Animal models are also reviewed in attempt to explain the relationship of aging and outcome, together with advances in stem cell research. Though elderly people in general did fare worse after traumatic brain injury, certain “younger elderly” people, aged 65–75 years, could have a comparable outcome to younger adults after minor to moderate head injury

    Characteristics of gay, bisexual and other men who have sex with men with multiple diagnoses of infectious syphilis in British Columbia, Canada, 2005-2014

    Get PDF
    Background: Infectious syphilis has increased substantially over the past decade. Targeting limited public health resources toward subpopulations with multiple reinfections may have a large impact in reducing onward transmission within a community. Methods: A chart review was conducted for individuals with 4 or more infectious syphilis diagnoses between 2005 and 2014 (the top 1% of all syphilis diagnoses in British Columbia, Canada). We characterized the sociodemographics, partner notification outcomes and social network. Results: Between 2005 and 2014, there were 30 individuals with 4 or more syphilis diagnoses, accounting for 139 diagnoses. All were men who have sex with men and 29 (96%) were human immunodeficiency virus–positive. Of the 139 diagnoses, 65% occurred in the early latent stage of infection, 22% in the secondary stage, and 14% in the primary stage. The median number of sexual partners per diagnosis was 5 (range, 1–50). Among the 838 partners reported, 79% were notifiable, 53% were notified, and 23% were reported to be tested or treated. Sexual network mapping showed that almost half of the members of this group could be linked to one another either directly or indirectly via partners over 10 years. Social network mapping demonstrated high connectivity, with 4 venues associated with almost two thirds of the study population. Conclusions: The connectivity and recurrent diagnoses in this study population suggest potential benefits of targeted interventions to individuals with multiple diagnoses and their partners. Our study highlights the need for enhanced care, increased syphilis testing frequency, and exploring alternative preventative methods among individuals with syphilis rediagnoses to reduce syphilis incidence

    Iron conservation by reduction of metalloenzyme inventories in the marine diazotroph Crocosphaera watsonii

    Get PDF
    The marine nitrogen fixing microorganisms (diazotrophs) are a major source of nitrogen to open ocean ecosystems and are predicted to be limited by iron in most marine environments. Here we use global and targeted proteomic analyses on a key unicellular marine diazotroph Crocosphaera watsonii to reveal large scale diel changes in its proteome, including substantial variations in concentrations of iron metalloproteins involved in nitrogen fixation and photosynthesis, as well as nocturnal flavodoxin production. The daily synthesis and degradation of enzymes in coordination with their utilization results in a lowered cellular metalloenzyme inventory that requires ~40% less iron than if these enzymes were maintained throughout the diel cycle. This strategy is energetically expensive, but appears to serve as an important adaptation for confronting the iron scarcity of the open oceans. A global numerical model of ocean circulation, biogeochemistry and ecosystems suggests that Crocosphaera’s ability to reduce its iron-metalloenzyme inventory provides two advantages: It allows Crocosphaera to inhabit regions lower in iron and allows the same iron supply to support higher Crocosphaera biomass and nitrogen fixation than if they did not have this reduced iron requirement.National Science Foundation (U.S.). Chemical and Biological Oceanography Program (OCE-0452883)National Science Foundation (U.S.). Chemical and Biological Oceanography Program (OCE-0752291)National Science Foundation (U.S.). Chemical and Biological Oceanography Program (OCE-0723667)National Science Foundation (U.S.). Chemical and Biological Oceanography Program (OCE-0928414)National Science Foundation (U.S.). Polar Program (ANT-0732665)United States. Environmental Protection Agency (Star Fellowship)Woods Hole Oceanographic Institution. Ocean Life InstituteCenter for Microbial Oceanography: Research and EducationCenter for Environmental Bioinorganic Chemistr
    corecore