Chiral Crystal Growth under Grinding

To study the establishment of homochirality observed in the crystal growth experiment of chiral molecules from a solution under grinding, we extend the lattice gas model of crystal growth as follows. A lattice site can be occupied by a chiral molecule in R or S form, or can be empty. Molecules form homoclusters by nearest neighbor bonds. They change their chirality if they are isolated monomers in the solution. Grinding is incorporated by cutting and shafling the system randomly. It is shown that Ostwald ripening without grinding is extremely slow to select chirality, if possible. Grinding alone also cannot achieve chirality selection. For the accomplishment of homochirality, we need an enhanced chirality change on crystalline surface. With this "autocatalytic effect" and the recycling of monomers due to rinding, an exponential increase of crystal enantiomeric excess to homochiral state is realized.Comment: 10 pages, 5 figure

Essential Skills for Family Medicine Residents Practicing Integrated Behavioral Health: A Delphi Study

BACKGROUND AND OBJECTIVES: There are several trends compelling physicians to acquire team-based skills for interprofessional care. One underdeveloped area of team-based skills for physicians is integrated behavioral health (IBH) in primary care. We used a Delphi method to explore what skills were needed for residents to practice integrated behavioral health. METHODS: We conducted a literature review of IBH competencies and found 41 competencies across seven domains unique to physicians. Using a modified Delphi technique, we recruited family medicine educators to rate each competency as essential, compatible, or irrelevant. We also shared findings from the Delphi study with a focus group for additional feedback. RESULTS: Twenty-one participants (12 physicians, nine behavioral health providers) completed all three rounds of the Delphi survey resulting in a list of 21 competencies. The focus group gave additional feedback. CONCLUSIONS: Participants chose skills that required physicians to share responsibilities across the entire care team, were not redundant with standard primary care, and necessitated strong communication ability. Many items were revised to reflect team-based care and a prescribed physician role as a team facilitator. Next steps include determining how these competencies fit with a variety of medical providers and creating effective training programs that develop competency in IBH