An evaluation of palliative care education in the specialist training programme in family medicine

Aim: The study aimed to evaluate the teaching in palliative care (PC) provided during the Specialist Training Programme in Family Medicine (STPFM) in Malta. Methodology: A questionnaire was used, based on two other validated questionnaires used in a similar population. Fifteen topics commonly encountered in PC were analysed. Results: Twenty-two (74.4%) trainees returned the questionnaire. All trainees received exposure to palliative care patients, but only 5 (22.7%) felt involved in their care and only 6 (27.3%) ever used a syringe driver. Most PC teaching in the STPFM was formal in nature. Trainees felt that palliative care subjects were covered well in the STPFM, but non-medical areas received lower scores. Trainees’ confidence closely mirrored the scores for subject coverage. The Half-Day Release Programmes were the most useful palliative care teaching resource. A correct answer for the question on pain management was obtained by 63.3% of trainees and 23.7% got a correct answer for the question on the use of a syringe driver. Concerns on managing dying patients in the community were raised by 40.9% of trainees. Trainees judged overall positively their STPFM. Conclusion: GP trainees need to be trained in PC in a manner that adequately addresses their future caseload. Changes need to be made in the PC teaching within the STPFM to address areas such as ethical issues in end-of-life; using a syringe driver; selfcare and managing patients in the community.peer-reviewe

Attitudes of family doctors, attached to the Department of Family Medicine, towards consulting and treating young people

Background: There is a perceived concern that there is no law which governs the right of young people (YP), defined as ages 15-18, to be treated by doctors and to have their privacy protected from their parents or legal guardians. On the other hand doctors seem not to be covered by a specific law which allows them to see and treat this age group, although the Medical Council has expressed itself once in this regard. Method: This study aimed to assess the perception of doctors to seeing young adults alone since they are considered vulnerable because of their age and may not express concerns and practices if in front of parents or guardians. In this regard a questionnaire was delivered to family doctors attached with the department of family medicine at the University of Malta. Results: the response rate was 72.5%. Most respondents were males. Most (89.6%) agreed that YP have a right toe speak to the family doctor alone. Doctors are happy to discuss various topics with YP alone, but in certain issues, find difficulty in providing treatment to YP alone. There seems to be a significant difference in attitude towards the sex of the doctor with respect to the sex of the patient. Conclusion: The study was meant to be a pilot study including those doctors attached to the Department of Family Medicine at the Medical School, with a future study planned on a larger number. The significance and importance of the results however merited previous publication of this study as a sentinel. Doctors are largely concerned about the law and are sometimes reluctant to see young adults alone even if they feel that they should be able to do so. The importance of having a clarification of the law by an amendment is discussed.peer-reviewe

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Managing Access to Biobanks:How Can We Reconcile Privacy and Public Interests in Genetic Research?

This article is concerned with the ultimate objectives of genetic biobanks set up to promote the public interest—being the sharing of samples and data for medical research—and the consequences for personal privacy of realising them. Our aim is to chart the values, interests and principles in play, to consider the challenges of realizing biobanking objectives on a global scale, and to propose viable ways forward that ensure, as far as possible, that access provisions remain fit for purpose throughout the entire life of a biobank, while adequately protecting the privacy interests at stake. It is argued that key features in any robust access model must include mechanisms to (a) maintain participant trust in management of the resource and to measure and respond to participants’ expectations, (b) facilitate and promote the sharing of benefits, and (c) respond timeously and effectively to new challenges

Induction of Triploidy in Indian Edible Oyster Crassostrea madrasensis (Preston) Using 6-Dimethylaminopurine

Triploidy was induced in the Indian edible oyster Crassostrea madrasensis, by treating the newly fertilized eggs with 6-Dimethylaminopurine.The effect of different concentrations and durations of treatment on triploidy induction and survival of embryos were examined. The optimum condition was found to be 100 μM concentration of 6-DMAP for 8 minutes when 50% of the freshly fertilized eggs have extruded the first polar bodies. This yielded 67±1.7 % of triploid on the first day and 62±1.5% on the D-stage larvae as determined by examination of the metaphase chromosomes. Survivability among the different treatment groups at D stage were not significantly different. This is the first demonstration of induction of triploidy in Crassostrea madrasensis using 6-DMAP and since edible oyster farming is becoming increasingly popular in India, application of this technique in the production of culture stock assumes importance

Induction and evaluation of triploidy in edible oyster, Crassostrea madrasensis (Preston) - an approach to enhance bivalve aquaculture

Induced triploidy can be used for enhancing production of commercially valuable bivalve species. Triploid individuals, having an extra set of chromosomes (3n) typically exhibit reduced gametogenic activity leading to better growth since the energy used for reproduction is reallocated for somatic growth. In India, research on genetic manipulation of the edible oyster, Crassostrea madrasensis by triploidy inducement and assessment of triploid performance as a strategy to increase production has been underway since 1998. This article outlines the potential of using triploidy in bivalve culture for better returns

Growth of triploid oyster, Crassostrea madrasensis (Preston)

The performance of I and II meiotic triploids and control oysters (Crassostrea madrasensis) reared at Tuticorin Bay was compared to determine if the improvements in the growth of edible oysters were additive to faster growth in triploids. After a grow-out period of 12 months, both mean whole weights and shell heights were in order Imeiotic triploid4IImeiotic triploid control. Mean whole weights and shell height of diferent oyster lines were all signi¢cantly different (Po0.05). On an average, larger morphological traits indicated that growth improvements from triploids were additive, and throughout the study triploid oystersmaintained faster growth rate than their diploid siblings. Condition index and adductormuscle diameter of both triploids were higher than those of control

Psychometric properties of the FertiQoL questionnaire in Italian infertile women in different stages of treatment

Background: Reliable Fertility-specific QoL measures can be obtained through the FertiQoL, a questionnaire with six-subscales that consider different core aspects of the person’s wellbeing and way of behaving during treatment. Objective: Examine the psychometric properties of all six-subscales of the Italian FertiQoL in a sample of infertile women and explore the effects of the ART treatment phases. Method: 323 women, in three different treatment stages (Diagnostic, Stimulation, Transfer), completed the FertiQoL. Raw data were subject to Confirmatory Factor Analysis (CFA), and a structural equation modelling (SEM) was used to validate the hypothesised model. Results: CFA shows a good fit of the data to the FertiQoL hierarchical model (chi-square/df = 1.989, CFI = 0.88, RMSEA = 0.055). After the deletion of 2 items, all FertiQoL scales have good internal consistency. SEM showed that the ART treatment phase was positively associated with fertility-related QoL scores both in the Relational (β = 0.14, p < 0.05) and in the Tolerability (β = 0.17, p < 0.05) subscales. Conclusion: All scales of the Italian FertiQoL version maintain good psychometric characteristics; Tolerability and Relational subscales are sensitive to the treatment stage and thus providing relevant information for the medical staff

Effect of temperature on polar body formation in the edible oyster, Crassostrea madrasensis

Freshly fertilized eggs of edible oyster Crassostrea madrasensis were maintained at temperatures of 23,29 and 31°C and the biological developments were viewed under a light microscope to monitor the kinetics of polar body extrusion at these temperatures. Time of release of fifty percent of polar bodies at 23"C, 28°C and 31°C were 18,16 and 15 minutes post fertilization respectively, indicating the temperature dependence of this event