Improving the Information Provided to Patients Prior to Undergoing Varicose Vein Procedures

Research has shown that the provision of appropriate patient information has the potential to positively impact patient autonomy, understanding and satisfaction. This quality improvement plan focused on improving the provision of information to patients prior to varicose vein procedures. At the project site, the patient information leaflet for varicose vein procedures was suggested by the vascular team to be out of date in terms of treatment options. The Lean Six Sigma approach to quality improvement was used to investigate the problem. Deficits were identified compared to best practice guidelines with respect to currency, readability, clarity and use as a decision-making aid. Furthermore, complications discussed in the consent form did not match those on the patient information leaflet. There was also no provision of a suitable leaflet for patients with a limited English proficiency. Following a root cause analysis, improvements were proposed including the development of a process for evaluation and creation of a patient leaflet that conforms to best practice guidelines, incorporating both vascular team and patient opinion. A team member responsible for this quality improvement process was subsequently identified. The complications in the consent form and those on the patient information leaflet would be closely aligned. Also, provision would be made for patients with limited English proficiency by way of written translated notes on the patient leaflet or recorded notes on the patient's smartphone by the interpreter at consultation. Implementation and maintenance of this project plan would facilitate closer alignment with the HSE objectives of high-quality patient centered care.</p

Data repository - Effects of Historical Coinfection on Host Shift Abilities of Exploitative and Competitive Viruses

Data repository and analysis scripts for pre-print version of paper "Effects of Historical Coinfection on Host Shift Abilities of Exploitative and Competitive Viruses."<br

Host Shift Dynamics of Competitive and Exploitative Viruses

RNA viruses are able to evolve rapidly and often emerge as pathogens on novel host types. However, predicting which viruses will emerge as new pathogens has been elusive. From prior work with the lytic bacteriophage ɸ6 Cystovirus, phage evolved a at low ratio of viral particles : bacterial cells (MOI) may be under selection for greater reproductive capacity on their host cell, while phage evolved at high MOI are under selection for intracellular competition. Here, we explore how evolution at high or low MOI affects the subsequent ability of a virus to infect novel host bacteria. We analyzed the maximal and extinction densities of bacteria infected with clones of ɸ6 from lineages evolved at either high or low MOI. Viral clones from lineages evolved at low MOI were, in general, better able to infect and kill novel hosts than clones from lineages evolved at high MOI. Examination of the bacterial growth dynamics revealed genotype-specific differences in the clones' infective abilities on each host: Clones that performed well on the laboratory host also tended to perform well on the novel hosts. However, the relationship between the maximal and extinction densities of the bacteria varied by host. These patterns suggest that while traits that improve viral reproduction on the native host can also enhance infectivity of novel hosts, the exact effects are modulated by the host environment.<p><br></p

Gold and BINOL-Phosphoric Acid Catalyzed Enantioselective Hydroamination/<i>N</i>‑Sulfonyliminium Cyclization Cascade

A highly enantioselective hydroamination/<i>N</i>-sulfonyliminium cyclization cascade is reported using a combination of gold(I) and chiral phosphoric acid catalysts. An initial 5-<i>exo</i>-dig hydroamination and a subsequent phosphoric acid catalyzed cyclization process provide access to complex sulfonamide scaffolds in excellent yield and high enantiocontrol. The method can be extended to lactam derivatives, with excellent yields and enantiomeric excesses of up to 93% ee

Comparison of NPS culture and serotyping results by processing method.

<p>1,107 nasopharyngeal swabs evaluated by both methods.</p

Duration of first pneumococcal carriage episode, stratified by NPS culture/serotyping method.

<p>100 infants were included in each group.</p

Infant carriage pneumococcal serotype distribution, by latex sweep serotyping.

<p>Results of culture of 8,736 swabs from 364 infants. The bars indicate the number of isolates of each serotype and the dashed lines indicate the cumulative frequency (cumulative frequency of 67% is indicated by the vertical arrows). Dark grey bars highlight PCV13 serotypes.</p

Individual pneumococcal serotype acquisition rates, by NPS culture/serotyping method.

<p>100 infants were included in each group; each serotype considered independently.</p>a<p>Acquisition rate per day.</p>b<p>Non-typeable pneumococcal colonisation excluded.</p

Relationship between colonisation density and agreement between WHO culture and latex sweep result.

<p>Relationship between colonisation density and agreement between WHO culture and latex sweep result.</p

Study flow diagram.

<p>* Described in detail in reference <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0067933#pone.0067933-Turner3" target="_blank">[8]</a>.</p