Some observations on asymmetrical separation in thermal diffusion columns

Data have been obtained in steady-state batch operated thermogravitational separation columns using different binary mixtures to test the theory recently published by Morgado et al. The experimental results confirm that separations by thermal diffusion are asymmetrical except when the initial concentration is 0.5 and that the asymmetry is larger as the initial concentration deviates from 0.5 and as the separation potential increases

Ocular toxoplasmosis: phenotype differences between toxoplasma IgM positive and IgM negative patients in a large cohort

Purpose: To investigate the differences in demographics and clinical characteristics of patients diagnosed with ocular toxoplasmosis according to their IgM status. Methods: Retrospective case note analysis was carried out on patients who tested positive for serum Toxoplasma gondii-specific IgM antibodies (IgM+) as well as a comparator group who tested negative for serum IgM (IgM-), but positive for serum IgG. Patient demographics and clinical features were compared between the two groups to evaluate for any significant differences. Results: One hundred and six patients were included in the study between March 2011 and June 2018, consisting of 37 in the IgM +group and 69 in the IgM- group. Patients in the IgM +group were significantly older (51.1 vs 34.1 years, p<0.0001), more likely to present with central macular lesions (32% vs 12%, p=0.012), and more likely to develop rhegmatogenous retinal detachment (11% vs 1%, p=0.049). In contrast, patients in the IgM- group were more likely present with pain (20% vs 3%, 0.017) and exhibit more severe inflammation of the anterior chamber and vitreous (p<0.05). Overall, retinal lesions were more likely to be superotemporal (55%) and superonasal (31%). Furthermore, age was associated with larger (p=0.003) and more peripheral lesions (p=0.007). Conclusions: This study demonstrated significant differences in clinical characteristics of ocular toxoplasmosis according to serum IgM status. IgM+ patients were older, less likely to report pain, had lower levels of intraocular inflammation, but were more likely to have macular involvement. We also found age to be correlated with larger and more peripheral lesions

Understanding Visual Impairment and Its Impact on Patients: A Simulation-Based Training in Undergraduate Medical Education

Introduction: Simulation activities are valuable teaching aids for understanding about living with visual impairment (VI). Our medical students used low-vision simulation spectacles (Sim-specs) to enable learning about VI. Methods: Students made tea and filled dosette boxes using Sim-specs simulating central visual loss (age-related macular degeneration) and navigated using Sim-specs simulating peripheral visual loss (glaucoma). Facilitators recorded errors made for each task. Students completed questionnaires to grade the tasks’ difficulty on a 4-point Likert-type scale. The students also participated in focus groups to discuss how their approach to working with patients may change following this training. Results: In total, 252 out of 254 students participated. Central visual loss provided the greatest challenge when undertaking fine motor skilled activity (dosette box). Highest average number of errors made was for dosette box task (0.70 error), followed by navigation (0.59), then making tea task (0.34). Students scored the most difficult task on average as the dosette box task (3.23 Likert-type points), followed by navigation (2.97), then making tea task (2.63). Our students have shown learning in recognising the challenges of VI and have adapted their approach to patients. Conclusions: Simulation activities are valuable additions to the undergraduate curriculum. Such activities can potentially enable greater empathy for our visually impaired patients

Schizophrenia and Bipolar Disorder in Urban Areas

Background Earlier studies have shown that schizophrenic patients are more likely to be living in densely populated inner city areas, whereas bipolar patients are more widely distributed. These studies, however, were generally carried out in the pre-community psychiatry era. Aim of this study To examine the geographical distribution of cases of schizophrenia and bipolar disorder in an urban area of West Yorkshire to see if the drive towards care in the community has led to wider dispersion of cases. Method Admissions of schizophrenic and bipolar patients to in-patient facilities of Leeds Mental Health Teaching NHS Trust over a 3-year period were mapped to the electoral wards in which they were living at the time of admission. Results 949 cases of schizophrenia and 930 cases of bipolar disorder were hospitalized over this period. At the time of admission significantly more schizophrenic and bipolar patients were residing in inner city areas of Leeds. Conclusion Closure of large mental hospitals and the trend towards management of psychiatric patients in the community does not appear to have had an appreciable effect on the concentration of schizophrenic patients in densely populated inner city areas. Surprisingly, the bipolar population is also following the same trend. Competing Interests Nil Details of contributors This study was carried out by a group of 4th year medical students, as the Selected Study Component of their Psychiatry, Primary care and Public Health module. Dr T Mahmood, as supervisor, planned the study and critically revised the draft

Design my Doctor: a student-led intervention.

Many opportunities for patient and public involvement already exist in medical education. Current approaches may not fully harness the educational potential of the patient voice, so it appears that new approaches are worth exploring. This article, co-written by students and faculty members, describes an educational initiative in which medical students had opportunistic conversations with randomly selected members of the public to explore their priorities regarding health care. METHODS: The 'Design my Doctor' project enabled medical students to hear participants' spontaneous responses to the question 'What should our medical school teach your future doctors?' Students experienced the unfiltered patient voice. The 183 responses were recorded in writing, and on video, and were analysed using the nominal group technique. The themes focused on the health care priorities of members of the public. RESULTS: Themes from the public data included 'interpersonal qualities', 'empowering patients', 'medical knowledge' and the 'health system'. Student reflective pieces showed how powerful hearing first-hand unfiltered feedback can be. Engagement in collecting and interpreting data enhanced the significance of the content and the process for the learners. Students realised that 'medical knowledge', although important, was not the overriding priority for patients. Students identified specific areas for future application and considered how it could be incorporated systematically into their programme. DISCUSSION: As medical educators, we can use interventions like 'Design my Doctor' to facilitate and support students to proactively seek and reflect on patient feedback

Role of ethnicity and socioeconomic status (SES) in the presentation of retinoblastoma: findings from the UK

Background: The relationship between the ethnic background or socioeconomic status (SES) and late retinoblastoma (Rb) presentation in the UK is unclear. We aimed to investigate if such correlations exist in a cohort of non-familial Rb cases. / Methods: A cross-sectional study based at the two centres providing Rb care in the UK. Included were non-familial Rb cases that presented from January 2006 to December 2011. Epidemiological and clinical data were retrieved from medical charts, as well as patients’ postcodes used to obtain the Index of Multiple Deprivation (IMD) score. A postal questionnaire was sent to participants’ parents to collect further, person-level, information on languages spoken and household socioeconomic position. Statistical correlations to advanced Rb at presentation as well as to treatment by enucleation and need for adjuvant chemotherapy were investigated. / Results: The cohort included 189 cases, 98 (51.8%) of which were males. The median age at diagnosis was 16 months (IQR 8–34 months). Of the study patients, 153 (81%) presented with advanced Rb; 78 (41%) with group D and 75 (40%) with group E Rb. A total of 134 (72%) patients were treated with enucleation. South Asian ethnicity and being in the most deprived IMD quintile were associated with a higher likelihood of presentation with advanced disease, but these estimates did not reach statistical significance. Older age at presentation was associated with enucleation and bilateral disease with adjuvant chemotherapy. / Conclusions: In this national UK study of patients with non-familial Rb, there was no evidence of an association of ethnicity or SES and the risk of presenting with advanced disease. These findings may reflect equality in access of healthcare in the UK