Combined novice, near-peer, e-mentoring palliative medicine program: A mixed method study in Singapore

INTRODUCTION:An acute shortage of senior mentors saw the Palliative Medicine Initiative (PMI) combine its novice mentoring program with electronic and peer mentoring to overcome insufficient mentoring support of medical students and junior doctors by senior clinicians. A three-phased evaluation was carried out to evaluate mentees' experiences within the new CNEP mentoring program. METHODS:Phase 1 saw use of a Delphi process to create a content-valid questionnaire from data drawn from 9 systematic reviews of key aspects of novice mentoring. In Phase 2 Cognitive Interviews were used to evaluate the tool. The tool was then piloted amongst mentees in the CNEP program. Phase 3 compared mentee's experiences in the CNEP program with those from the PMI's novice mentoring program. RESULTS:Thematic analysis of open-ended responses revealed three themes-the CNEP mentoring process, its benefits and challenges that expound on the descriptive statistical analysis of specific close-ended and Likert scale responses of the survey. The results show mentee experiences in the PMI's novice mentoring program and the CNEP program to be similar and that the addition of near peer and e-mentoring processes enhance communications and support of mentees. CONCLUSION:CNEP mentoring is an evolved form of novice mentoring built on a consistent mentoring approach supported by an effective host organization. The host organization marshals assessment, support and oversight of the program and allows flexibility within the approach to meet the particular needs of mentees, mentors and senior mentors. Whilst near-peer mentors and e-mentoring can make up for the lack of senior mentor availability, their effectiveness hinges upon a common mentoring approach. To better support the CNEP program deeper understanding of the mentoring dynamics, policing and mentor and mentee training processes are required. The CNEP mentoring tool too needs to be validated

The Pivotal Role of Host Organizations in Enhancing Mentoring in Internal Medicine: A Scoping Review.

In undergraduate and postgraduate medical education, mentoring offers personalized training and plays a key role in continuing medical education and the professional development of healthcare professionals. However, poor structuring of the mentoring process has been attributed to failings of the host organization and, as such, we have conducted a scoping review on the role of the host organization in mentoring programs. Guided by Levac et al's methodological framework and a combination of thematic and content analysis, this scoping review identifies their "defining" and secondary roles. Whilst the "defining" role of the host is to set standards, nurture, and oversee the mentoring processes and relationships, the secondary roles comprise of supporting patient care and specific responsibilities toward the mentee, mentor, program, and organization itself. Critically, striking a balance between structure and flexibility within the program is important to ensure consistency in the mentoring approach whilst accounting for the changing needs and goals of the mentees and mentors

Enhancing Mentoring in Palliative Care: An Evidence Based Mentoring Framework

Background: Growing concerns over ethical issues in mentoring in medicine and surgery have hindered efforts to reinitiate mentoring for Palliative Care (PC) physicians following the easing of COVID-19 restrictions. Ranging from the misappropriation of mentee’s work to bullying, ethical issues in mentoring are attributed to poor understanding and structuring of mentoring programs, underlining the need for a consistent approach to mentoring practices. Methods: Given diverse practices across different settings and the employ of various methodologies, a novel approach to narrative reviews (NR)s is proposed to summarize, interpret, and critique prevailing data on novice mentoring. To overcome prevailing concerns surrounding the reproducibility and transparency of narrative reviews, the Systematic Evidenced Based Approach (SEBA) adopts a structured approach to searching and summarizing the included articles and employed concurrent content and thematic analysis that was overseen by a team of experts. Results: A total of 18 915 abstracts were reviewed, 62 full text articles evaluated and 41 articles included. Ten themes/categories were ascertained identified including Nature; Stakeholders; Relationship; Approach; Environment; Benefits; Barriers; Assessments; Theories and Definitions. Conclusion: By compiling and scrutinizing prevailing practice it is possible to appreciate the notion of the mentoring ecosystem which sees each mentee, mentor, and host organization brings with them their own microenvironment that contains their respective goals, abilities, and contextual considerations. Built around competency based mentoring stages, it is possible to advance a flexible yet consistent novice mentoring framework. </jats:sec

Postgraduate ethics training programs: a systematic scoping review

BACKGROUND: Molding competent clinicians capable of applying ethics principles in their practice is a challenging task, compounded by wide variations in the teaching and assessment of ethics in the postgraduate setting. Despite these differences, ethics training programs should recognise that the transition from medical students to healthcare professionals entails a longitudinal process where ethics knowledge, skills and identity continue to build and deepen over time with clinical exposure. A systematic scoping review is proposed to analyse current postgraduate medical ethics training and assessment programs in peer-reviewed literature to guide the development of a local physician training curriculum. METHODS: With a constructivist perspective and relativist lens, this systematic scoping review on postgraduate medical ethics training and assessment will adopt the Systematic Evidence Based Approach (SEBA) to create a transparent and reproducible review. RESULTS: The first search involving the teaching of ethics yielded 7669 abstracts with 573 full text articles evaluated and 66 articles included. The second search involving the assessment of ethics identified 9919 abstracts with 333 full text articles reviewed and 29 articles included. The themes identified from the two searches were the goals and objectives, content, pedagogy, enabling and limiting factors of teaching ethics and assessment modalities used. Despite inherent disparities in ethics training programs, they provide a platform for learners to apply knowledge, translating it to skill and eventually becoming part of the identity of the learner. Illustrating the longitudinal nature of ethics training, the spiral curriculum seamlessly integrates and fortifies prevailing ethical knowledge acquired in medical school with the layering of new specialty, clinical and research specific content in professional practice. Various assessment methods are employed with special mention of portfolios as a longitudinal assessment modality that showcase the impact of ethics training on the development of professional identity formation (PIF). CONCLUSIONS: Our systematic scoping review has elicited key learning points in the teaching and assessment of ethics in the postgraduate setting. However, more research needs to be done on establishing Entrustable Professional Activities (EPA)s in ethics, with further exploration of the use of portfolios and key factors influencing its design, implementation and assessment of PIF and micro-credentialling in ethics practice. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12909-021-02644-5

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Moris Mai : to be born

Moris Mai, meaning “to be born” in Tetum, the indigenous language of Timor-Leste, is a 20-minute documentary on the pressing child and maternity issue in the young nation, its root causes, practical implications and the hopes of the locals towards an improved healthcare system. The documentary is produced by a group of final year students, specializing in Broadcast and Cinema Studies, from the Wee Kim Wee School of Communication and Information, Nanyang Technological University. Production of the documentary took place from July 2011 to March 2012, spanning across different districts in Timor-Leste, from the capital, Dili to Oecussi, a coastal enclave separated from Timor-Leste by West Timor. This serves to provide a more accurate portrayal of the maternal healthcare situation across the country, both in its capital and remote regions. Commonly known as East Timor, Timor-Leste achieved its independence in 2002, making it the youngest nation in Southeast Asia. Centuries of civil war hindered its social and economical development, with one of the imperative concerns being the high Child and Maternal Mortality Rates. Persistent traditional beliefs and practices, lack of adequate medical facilities and skilled birth attendants, poor basic infrastructure and low educational level are contributing factors towards the stark mortality rates. The documentary highlights the main causes of the high death rates from childbirth through the voices of our interviewees, which include a Timorese man who had to deal with the painful decision of sending his wife to the hospital, despite resistance from his family, as the traditional birth attendants were unable to handle the emergency situation. Thereafter, his wife and the baby died on the operation table. Views from the authorities such as Non Governmental Organizations, foreign doctors in the country, and even the President of Timor-Leste are similarly included for their expert opinions and to provide a different perspective on this solemn topic. While the state of healthcare system in Timor-Leste requires much attention by the international community, Moris Mai – To Be Born is the first documentary to be made on the maternal healthcare issues in the nation. Through the documentary, we hope to break new grounds and bring about emphasis and awareness on its current child and maternal situation. Overall, the production team overcame tremendous obstacles in terms of language barriers, lack of basic infrastructure such as availability of electricity, clean water and transportation, and most importantly, the sensitivity of this topic itself, with regards to women and children‟s death. As such, this report serves to detail the objectives and treatment of our documentary, pre-production, production and post-production process, the challenges we have faced and our team‟s learning journey.Bachelor of Communication Studie

Exploring organ donation in Singapore - The role of Motivation, Ability, Role Perceptions and Situational Factors in affecting the Intention to donate.

This study investigates the motivation behind an individual’s decision in the Human Organ Transplant Act (HOTA) in Singapore. The group had adopted the use of the MARS model, which is originally used as a theory in the study of organisational behaviour, and had modified it to suit the study of organ donation in Singapore. We aim to determine the roles of ability, role perceptions and situational factors in increasing the motivation of an individual to donate his/her organs, and establish the relationship between motivation and intention, which indicates the ultimate decision that an individual makes with regards to HOTA. The group came up with 4 main hypotheses and 7 sub-hypotheses. We conducted a computer-administered survey which garnered 322 responses from participants from various universities. It was found that both ability and role perceptions had a positive impact towards an individual’s motivation to donate his/her organs, with role perceptions having the greatest impact. The study gives an indication to the National Health Board and the relevant organisations that they could improve publicity about the HOTA, and these advertisements can be targeted at an individual’s identity. The results can also be used to help review the existing means used to educate the public about the importance of HOTA and further improve the channels used for this cause.BUSINES

Arboridinine, a Pentacyclic Indole Alkaloid with a New Cage Carbon–Nitrogen Skeleton Derived from a Pericine Precursor

A new monoterpene indole alkaloid characterized by an unprecedented pentacyclic cage skeleton, arboridinine (<b>1</b>), was isolated from a Malaysian <i>Kopsia</i> species. The structure and absolute configuration of the alkaloid were determined based on NMR, MS, and X-ray diffraction analysis. A possible biogenetic pathway from a pericine precursor is presented

Criofolinine and Vernavosine, New Pentacyclic Indole Alkaloids Incorporating Pyrroloazepine and Pyridopyrimidine Moieties Derived from a Common Yohimbine Precursor

Two new indole alkaloids characterized by previously unencountered natural product skeletons, viz., criofolinine (<b>1</b>), incorporating a pyrroloazepine motif within a pentacyclic ring system, and vernavosine (<b>2</b>, isolated as its ethyl ether derivative <b>3</b>, which on hydrolysis regenerated the putative precursor alkaloid <b>2</b>), incorporating a pyridopyrimidine moiety embedded within a pentacyclic carbon framework, were isolated from a Malayan <i>Tabernaemontana</i> species. The structures and absolute configuration of these alkaloids were determined on the basis of NMR and MS analysis and confirmed by X-ray diffraction analysis

Discovery and characterization of genes conferring natural resistance to the antituberculosis antibiotic capreomycin

Abstract Metagenomic-based studies have predicted an extraordinary number of potential antibiotic-resistance genes (ARGs). These ARGs are hidden in various environmental bacteria and may become a latent crisis for antibiotic therapy via horizontal gene transfer. In this study, we focus on a resistance gene cph, which encodes a phosphotransferase (Cph) that confers resistance to the antituberculosis drug capreomycin (CMN). Sequence Similarity Network (SSN) analysis classified 353 Cph homologues into five major clusters, where the proteins in cluster I were found in a broad range of actinobacteria. We examine the function and antibiotics targeted by three putative resistance proteins in cluster I via biochemical and protein structural analysis. Our findings reveal that these three proteins in cluster I confer resistance to CMN, highlighting an important aspect of CMN resistance within this gene family. This study contributes towards understanding the sequence-structure-function relationships of the phosphorylation resistance genes that confer resistance to CMN