Can the arts enhance postgraduate GP training?

The value of arts based medical education is becoming increasingly well established in undergraduate curricula. However, little is known about its value, and acceptability, to qualified doctors undertaking postgraduate training. In this work we examined GP trainees’ views on whether arts based education was useful for their professional development and, if so, what they perceived its value to be. All first and second year GP trainees on the Dorset Vocational Training Scheme attended a one day course which showcased how the arts (film, poetry, painting, photography, theatre) could enhance their professional development as doctors. GP trainees rated the day as interesting, enjoyable and thought proving. The majority felt that the arts could contribute to making them more competent and humane doctors’. Following this, we ran a mandatory six months arts based course for six GP trainees, and evaluated their feedback through qualitative analysis of a focus group discussion. Overall, GP trainees found the course enjoyable and valuable to their learning. It not only gave them a deeper appreciation of the patient’s perspective, but also encouraged them to think about their own health and wellbein

The effect of dentifrice abrasion on denture topography and the subsequent retention of microorganisms on abraded surfaces

Statement of problem. Denture surfaces provide hard nonshedding niches for the adhesion and subsequent accumulation of oral microorganisms into denture plaque, which can harbor various potential pathogens linked with oral mucosal lesions and inhalation pneumonia. The initial adhesion is the prerequisite for subsequent biofilm growth, and surface roughness niches facilitate this process by trapping cells. Retained microorganisms are then able to proliferate when the denture is returned to the oral cavity.Purpose. The purpose of this study was to measure the amount and strength of the attachment of microorganisms to a roughened denture acrylic resin surface. An increase in surface roughness increases the retention of microorganisms and a greater amount of cell-surface contact interface may increase the strength of adhesion and, therefore, retention. Cleaning denture surfaces with brushes and dentifrices can influence the denture surface topography and, therefore, may affect retention.Material and methods. Denture acrylic resin specimens were abraded to provide different surface roughness. The amount of attachment of Streptococcus oralis or Candida albicans to these surfaces was assessed by measuring the area of a microscopic field covered by stained cells after 1 hour of incubation. The strength of attachment was assessed with atomic force microscopy, whereby an increasing force was applied to the attached cells until they detached from the surface.Results. Both bacteria and yeast cells were retained in increasing amounts on surfaces of increasing roughness. Cells were most strongly attached on surfaces whose linear features (scratches) were of comparable size with the cells (the streptococci on the low-abraded surfaces, and the yeast on high-abraded surfaces).Conclusion. Analysis of findings reveal that even small abrasions may enhance retention on denture surfaces and reduce surface cleanability. The strength of attachment instead of the amount is more important in terms of surface hygiene. © 2014 Editorial Council for the Journal of Prosthetic Dentistry

An observational study of temperature and thermal images of surgical wounds for detecting delayed wound healing within four days after surgery

Aim: This study aimed to elucidate the infrared thermal patterns and temperature readings of the surfaces of surgical wounds for detecting delayed wound healing within four days after surgery. Background: The nursing assessment of surgical wounds within the first four days after surgery is commonly based on visual and physical examination. Surgical wounds with delayed healing may be not detected if they do not exhibit signs such as redness or exudate within four days after surgery. Design: This study was conducted using prospective observational design with reference to the STROBE Statement to examine the temperatures of surgical wounds in their natural settings. Methods: Based on convenience sampling, 60 participants admitted to the colorectal surgical ward for enterostoma closure from January to November 2013 were recruited. Results: Although both infected and non-infected surgical wounds exhibited a significant increase in wound temperature from Days 1 to 4, the infected wounds revealed a statistically significantly lower temperature than the non-infected ones. Within the infrared thermal images, the infected wounds presented with partial warming of the skin surrounding and along the incision, suggesting that delayed healing could be identified. Conclusion: This study demonstrates that delayed wound healing can be detected within the first four days after surgery for early intervention of prevention and treatment before discharge

Strategies for Surveillance of Pediatric Hemolytic Uremic Syndrome: Foodborne Diseases Active Surveillance Network (FoodNet), 2000–2007

Background. Postdiarrheal hemolytic uremic syndrome (HUS) is the most common cause of acute kidney failure among US children. The Foodborne Diseases Active Surveillance Network (FoodNet) conducts population-based surveillance of pediatric HUS to measure the incidence of disease and to validate surveillance trends in associated Shiga toxin–producing Escherichia coli (STEC) O157 infection

Non-O157 Shiga Toxin–producing Escherichia coli Associated with Venison

News reports of “E. coli outbreaks” usually refer to Shiga toxin–producing E. coli O157. But there are other types of Shiga toxin–producing E. coli, often called STEC,about which less is known. For these other types of STEC, what is the source? What are the risk factors? An outbreak among 29 high school students in Minnesota provided some answers. The source of this outbreak was a white-tailed deer that had been butchered and eaten at the school. The risk factors for infection were handling raw or eating undercooked venison. To prevent this type of STECinfection, people should handle and cook venison with the same caution recommended for other meats

Variability of RNA quality extracted from biofilms of foodborne pathogens using different kits impacts mRNA quantification by qPCR

The biofilm formation by foodborne pathogens is known to increase the problem related with surface disinfection procedure in the food processing environment and consequent transmission of these pathogens into the population. Messenger RNA has been increasingly used to understand the action and the consequences of disinfectants in the virulence on such biofilms. RNA quality is an important requirement for any RNA-based analysis since the quality can impair the mRNA quantification. Therefore, we evaluated five different RNA extraction kits using biofilms of the foodborne pathogens Listeria monocytogenes, Escherichia coli, and Salmonella enterica. The five kits yielded RNA with different quantities and qualities. While for E. coli the variability of RNA quality did not affect the quantification of mRNA, the same was not true for L. monocytogenes or S. enterica. Therefore, our results indicate that not all kits are suitable for RNA extraction from bacterial biofilms, and thus, the selection of RNA extraction kit is crucial to obtain accurate and meaningful mRNA quantification.AF and JCB acknowledge the financial support of individual grants SFRH/BD/62359/2009 and SFRH/BD/66250/2009, respectively. The authors acknowledge the gift of bacterial strains to Joana Azeredo and Maria Olivia Pereira.

Conceptualising the technical relationship of animal disease surveillance to intervention and mitigation as a basis for economic analysis

<p>Abstract</p> <p>Background</p> <p>Surveillance and intervention are resource-using activities of strategies to mitigate the unwanted effects of disease. Resources are scarce, and allocating them to disease mitigation instead of other uses necessarily involves the loss of alternative sources of benefit to people. For society to obtain the maximum benefits from using resources, the gains from disease mitigation must be compared to the resource costs, guiding decisions made with the objective of achieving the optimal net outcome.</p> <p>Discussion</p> <p>Economics provides criteria to guide decisions aimed at optimising the net benefits from the use of scarce resources. Assessing the benefits of disease mitigation is no exception. However, the technical complexity of mitigation means that economic evaluation is not straightforward because of the technical relationship of surveillance to intervention. We argue that analysis of the magnitudes and distribution of benefits and costs for any given strategy, and hence the outcome in net terms, requires that mitigation is considered in three conceptually distinct stages. In Stage I, 'sustainment', the mitigation objective is to sustain a free or acceptable status by preventing an increase of a pathogen or eliminating it when it occurs. The role of surveillance is to document that the pathogen remains below a defined threshold, giving early warning of an increase in incidence or other significant changes in risk, and enabling early response. If a pathogen is not contained, the situation needs to be assessed as Stage II, 'investigation'. Here, surveillance obtains critical epidemiological information to decide on the appropriate intervention strategy to reduce or eradicate a disease in Stage III, 'implementation'. Stage III surveillance informs the choice, timing, and scale of interventions and documents the progress of interventions directed at prevalence reduction in the population.</p> <p>Summary</p> <p>This article originates from a research project to develop a conceptual framework and practical tool for the economic evaluation of surveillance. Exploring the technical relationship between mitigation as a source of economic value and surveillance and intervention as sources of economic cost is crucial. A framework linking the key technical relationships is proposed. Three conceptually distinct stages of mitigation are identified. Avian influenza, salmonella, and foot and mouth disease are presented to illustrate the framework.</p