"Sorry does not pay my bills". The Handling of Complaints in Everyday Interaction/Cross-Cultural Business Interaction

This article is concerned with the teaching of pragmatic functions when training stu-dents for a future career in intercultural business communication. Having outlined six important constellations likely to result in success or failure, we focus on strategies for the successful handling of customer complaints seen in comparison with responses to complaints in everyday interactions. It is suggested that transfer of behaviour con-sidered suitable in everyday face-to-face interaction to business interaction may lead to unsuccessful processing of customer complaints

Rest

Thesis (M.A.)--Boston Universit

The utility of scoring systems in critically ill cirrhotic patients admitted to a general intensive care unit

Purpose: This study aimed to establish which prognostic scoring tool provides the greatest discriminative ability when assessing critically ill cirrhotic patients in a general intensive care unit (ICU) setting.<p></p> Methods: This was a 12-month, single-centered prospective cohort study performed in a general, nontransplant ICU. Forty clinical and demographic variables were collected on admission to calculate 8 prospective scoring tools. Patients were followed up to obtain ICU and inhospital mortality. Receiver operating characteristic curve analysis was used to determine the discriminative ability of the scores. Univariate and multivariate analyses were used to identify any independent predictors of mortality in these patients. The incorporation of any significant variables into the scoring tools was assessed.<p></p> Results: Fifty-nine cirrhotic patients were admitted over the study period, with an ICU mortality of 31%. All scores other than the renal-specific Acute Kidney Injury Network score had similar discriminative abilities, producing area under the curves of between 0.70 and 0.76. None reached the clinically applicable level of 0.8. The Sequential Organ Failure Assessment score was the best performing score. Lactate and ascites were individual predictors of ICU mortality with statistically significant odds ratios of 1.69 and 5.91, respectively. When lactate was incorporated into the Child-Pugh score, its prognostic accuracy increased to a clinically applicable level (area under the curve, 0.86).<p></p> Conclusions: This investigation suggests that established prognostic scoring systems should be used with caution when applied to the general, nontransplant ICU as compared to specialist centers. Our data suggest that serum arterial lactate may improve the prognostic ability of these scores

Anatomic Knowledge and Perceptions of the Adequacy of Anatomic Education Among Applicants to Orthopaedic Residency.

BackgroundThe time dedicated to the study of human anatomy within medical school curriculums has been substantially reduced. The effect of this on the knowledge of incoming orthopaedic trainees is unknown. The current study aimed to evaluate both the subjective perceptions and objective anatomic knowledge of fourth-year medical students applying for orthopaedic residency.MethodsA multicenter prospective study was performed that assessed 224 students during the course of their interview day for an orthopaedic residency. Participants provided demographic data and a subjective assessment of the quality of their anatomic education, and completed either an upper or lower extremity anatomic examination. Mean total scores and subscores for various anatomic regions and concepts were calculated.ResultsStudents on average rated the adequacy of their anatomic education as 6.5 on a 10-point scale. Similarly, they rated the level of importance their medical school placed on anatomic education as 6.2 on a 10-point scale. Almost 90% rated the time dedicated to anatomy as good or fair. Of six possible methods for learning anatomy, dissection was rated the highest.On objective examinations, the mean score for correct answers was 44.2%. This improved to 56.4% when correct and acceptable answers were considered. Regardless of anatomic regions or concepts evaluated, percent correct scores did not reach 50%. There were no significant correlations between performance on the anatomic examinations and either prior academic performance measures or the student's subjective assessment of their anatomic education.ConclusionsCurrent students applying into orthopaedic residency do not appear to be adequately prepared with the prerequisite anatomic knowledge. These deficits must be explicitly addressed during residency training to produce competent, safe orthopaedic surgeons

Electron Transfer Precedes ATP Hydrolysis during Nitrogenase Catalysis

The biological reduction of N2 to NH3 catalyzed by Mo-dependent nitrogenase requires at least eight rounds of a complex cycle of events associated with ATP-driven electron transfer (ET) from the Fe protein to the catalytic MoFe protein, with each ET coupled to the hydrolysis of two ATP molecules. Although steps within this cycle have been studied for decades, the nature of the coupling between ATP hydrolysis and ET, in particular the order of ET and ATP hydrolysis, has been elusive. Here, we have measured first-order rate constants for each key step in the reaction sequence, including direct measurement of the ATP hydrolysis rate constant: kATP = 70 s−1, 25 °C. Comparison of the rate constants establishes that the reaction sequence involves four sequential steps: (i) conformationally gated ET (kET = 140 s−1, 25 °C), (ii) ATP hydrolysis (kATP = 70 s−1, 25 °C), (iii) Phosphate release (kPi = 16 s−1, 25 °C), and (iv) Fe protein dissociation from the MoFe protein (kdiss = 6 s−1, 25 °C). These findings allow completion of the thermodynamic cycle undergone by the Fe protein, showing that the energy of ATP binding and protein–protein association drive ET, with subsequent ATP hydrolysis and Pi release causing dissociation of the complex between the Feox(ADP)2 protein and the reduced MoFe protein

Hedgehog Signalling in Androgen Independent Prostate Cancer

Objectives: Androgen-deprivation therapy effectively shrinks hormone-naïve prostate cancer, both in the prostate and at sites of distant metastasis. However prolonged androgen deprivation generally results in relapse and androgen-independent tumour growth, which is inevitably fatal. The molecular events that enable prostate cancer cells to proliferate in reduced androgen conditions are poorly understood. Here we investigate the role of Hedgehog signalling in androgen-independent prostate cancer (AIPC). Methods: Activity of the Hedgehog signalling pathway was analysed in cultured prostate cancer cells, and circulating prostate tumour cells were isolated from blood samples of patients with AIPC. Results: AIPC cells were derived through prolonged culture in reduced androgen conditions, modelling hormone therapy in patients, and expressed increased levels of Hedgehog signalling proteins. Exposure of cultured AIPC cells to cyclopamine, which inhibits Hedgehog signalling, resulted in inhibition of cancer cell growth. The expression of the Hedgehog receptor PTCH and the highly prostate cancer-specific gene DD3PCA3 was significantly higher in circulating prostate cancer cells isolated from patients with AIPC compared with samples prepared from normal individuals. There was an association between PTCH and DD3PCA3 expression and the length of androgen-ablation therapy. Conclusions: Our data are consistent with reports implicating overactivity of Hedgehog signalling in prostate cancer and suggest that Hedgehog signalling contributes to the androgen-independent growth of prostate cancer cells. As systemic anti-Hedgehog medicines are developed, the Hedgehog pathway will become a potential new therapeutic target in advanced prostate cancer.Peer reviewedFinal Accepted Versio

The Sydney west knowledge portal: Evaluating the growth of a knowledge portal to support translational research

BACKGROUND: The Sydney West Translational Cancer Research Centre is an organization funded to build capacity for translational research in cancer. Translational research is essential for ensuring the integration of best available evidence into practice and for improving patient outcomes. However, there is a low level of awareness regarding what it is and how to conduct it optimally. One solution to addressing this gap is the design and deployment of web-based knowledge portals to disseminate new knowledge and engage with and connect dispersed networks of researchers. A knowledge portal is an web-based platform for increasing knowledge dissemination and management in a specialized area. OBJECTIVE: To measure the design and growth of an web-based knowledge portal for increasing individual awareness of translational research and to build organizational capacity for the delivery of translational research projects in cancer. METHODS: An adaptive methodology was used to capture the design and growth of an web-based knowledge portal in cancer. This involved stakeholder consultations to inform initial design of the portal. Once the portal was live, site analytics were reviewed to evaluate member usage of the portal and to measure growth in membership. RESULTS: Knowledge portal membership grew consistently for the first 18 months after deployment, before leveling out. Analysis of site metrics revealed members were most likely to visit portal pages with community-generated content, particularly pages with a focus on translational research. This was closely followed by pages that disseminated educational material about translational research. CONCLUSIONS: Preliminary data from this study suggest that knowledge portals may be beneficial tools for translating new evidence and fostering an environment of communication and collaboration

Utah State University - University Libraries Metadata Application Profile for CONTENTdm Digital Collections, version 2.0

The Utah State University Libraries Digital Collections Application Profile outlines the metadata fields, mappings, definitions, and resources used to assign metadata for digital collections in the USU CONTENTdm repository. Utah State University is a collection partner of the Mountain West Digital Library (MWDL). Therefore, this profile pulls substantially from the MWDL application profile 3.0, which is available at this URL: https://github.com/mountainwestdl/mwdl-map/wiki/MWDL-Metadata-Application-Profil

Anatomically Correct: Implementing and Evaluating an Educational Digital Game for Applied Sciences Students

Digital games are a common form of entertainment in modern society and are increasingly prevalent in health education. However, little research has been conducted into their use for delivering anatomy and histology education for health students. This is surprising considering the difficulty many health students have learning anatomy and histology. The study used a mixed methodology, consisting of a controlled trial and qualitative evaluation of learner attitudes towards the digital game. The trial stratified learners into two groups: a digital game group and a multiple-choice quiz group, for one semester. At the end of semester final examination results from the two groups were compared to see if the digital game was a comparable means of revising anatomy and histology subject matter. Additionally, an online survey and semi-structured interviews were used to explore student attitudes towards the digital game. Findings demonstrated that a digital game could be as effective as alternative methods to support revision of anatomy subject matter. Further, results post-intervention survey (n=10) and semi-structured interviews (n=6) showed that students were interested in the use of digital games to support revision and enjoyed their experiences using the digital game during their studies