9 research outputs found
Altruism in medical education: assessing attitudes of hospital in-patients towards face-to-face contact with medical students during the COVID-19 pandemic
Abstract
Background
Limited research indicated patients were largely amenable to seeing medical students pre-pandemic. However, the COVID-19 pandemic has highlighted the potential risk of nosocomial transmission and harm to patients from students. Patient opinions regarding these risks remain unexplored, which impacts elicitation of informed consent. We aim to identify these, and explore whether reflection on the risks and benefits of direct student interaction influenced patientsâ attitudes. For guidance, we further explored measures to reduce perceived infection risk.
Method
We designed an original questionnaire for a cross-sectional study, completed by 200 inpatients from 25 wards between 18/02 and 16/03/2022 at Derriford Hospital, Plymouth. Patients in intensive care, with active COVID-19 infection or unable to comprehend the study information were excluded. The responses of a guardian were recorded for inpatients under 16. 17 questions were included - the initial question, reporting willingness to talk with and be examined by students, was repeated following nine questions exploring risks and benefits of student interaction. A further four questions addressed reducing the perceived infection risk. Data is summarised using frequencies and percentages, and with Wilcoxon signed-rank and rank-sum tests of association.
Results
85.4% (169/198) of participants gave an initial positive response to seeing medical students, and despite a third of participants changing their response 87.9% (174/197) remained willing after the survey resulting in no significant change. Furthermore, 87.2% (41/47) of those who perceived themselves at severe risk of harm from COVID-19 remained happy to see students. Participants reported reassurance knowing students were: fully vaccinated (76.0%); wearing masks (71.5%); lateral flow test negative within the last week (68.0%) and wearing gloves and gown (63.5%).
Conclusion
This study demonstrated the willingness of patients to engage in medical education despite recognised risks. Patient reflection on the risks and benefits of student interaction did not significantly reduce numbers willing to see students. Even those perceiving a risk of serious harm remained happy to have direct student contact â a demonstration of altruism in medical education. This suggests informed consent should include discussion of infection control measures, risks and benefits to patients and students, and offer alternatives to direct inpatient contact.
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Cerium(IV) Imido Complexes: Structural, Computational, and Reactivity Studies
A series of alkali
metal capped ceriumÂ(IV) imido complexes, [MÂ(solv)<sub><i>x</i></sub>]Â[Ceî»NÂ(3,5-(CF<sub>3</sub>)<sub>2</sub>C<sub>6</sub>H<sub>3</sub>)Â(TriNOx)] (M = Li, K, Rb, Cs; solv = TMEDA,
THF, Et<sub>2</sub>O, or DME), was isolated and fully characterized.
An X-ray structural investigation of the cerium imido complexes demonstrated
the impact of the alkali metal counterions on the geometry of the
[Ceî»NÂ(3,5-(CF<sub>3</sub>)<sub>2</sub>C<sub>6</sub>H<sub>3</sub>)Â(TriNOx)]<sup>â</sup> moiety. Substantial shortening of the
Ceî»N bond was observed with increasing size of the alkali metal
cation. The first complex featuring an unsupported, terminal multiple
bond between a CeÂ(IV) ion and a ligand fragment was also isolated
by encapsulation of a Cs<sup>+</sup> counterion with 2.2.2-cryptand.
This complex shows the shortest recorded Ceî»N bond length of
2.077(3) Ă
. Computational investigation of the cerium imido complexes
using DFT methods showed a relatively larger contribution of the cerium
5d orbital than the 4f orbital to the Ceî»N bonds. The [KÂ(DME)<sub>2</sub>]Â[Ceî»NÂ(3,5-(CF<sub>3</sub>)<sub>2</sub>C<sub>6</sub>H<sub>3</sub>)Â(TriNOx)] complex cleaves the SiîžO bond in (Me<sub>3</sub>Si)<sub>2</sub>O, yielding the [(Me<sub>3</sub>SiO)ÂCe<sup>IV</sup>(TriNOx)] adduct. The reaction of the rubidium capped imido
complex with benzophenone resulted in the formation of a rare CeÂ(IV)âoxo
complex, that was stabilized by a supramolecular, tetrameric oligomerization
of the Ceî»O units with rubidium cations
An Alkali Metal-Capped Cerium(IV) Imido Complex
Structurally authenticated, terminal
lanthanideâligand multiple
bonds are rare and expected to be highly reactive. Even capped with
an alkali metal cation, poor orbital energy matching and overlap of
metal and ligand valence orbitals should result in strong charge polarization
within such bonds. We expand on a new strategy for isolating terminal
lanthanideâligand multiple bonds using ceriumÂ(IV) complexes.
In the current case, our tailored trisÂ(hydroxylÂaminato) ligand
framework, TriNOx<sup>3â</sup>, provides steric protection
against ligand scrambling and metal complex oligomerization and electronic
protection against reduction. This strategy culminates in isolation
of the first formal Ceî»N bonded moiety in the complex [KÂ(DME)<sub>2</sub>]Â[Ceî»NÂ(3,5-(CF<sub>3</sub>)<sub>2</sub>C<sub>6</sub>H<sub>3</sub>)Â(TriNOx)], whose Ceî»N bond is the shortest known
at 2.119(3) Ă