Duoethnography as a dialogic and collaborative form of curriculum inquiry for resident professionalism and self-care education

Medical residency is an important time in the development of physician professionalism, as residents’ identities and medical responsibilities shift from student-learners to practitioner-leaders. During this transition time, many residents struggle with stress due to the unique pressures of their post-graduate training. This, in turn, can potentially hinder successful professional identity development. In response, the Royal College of Physicians and Surgeons of Canada (RCPSC) has incorporated physician health into its CanMEDS professional competency framework.Although this framework identifies enabling self-care professional competencies (e.g., capacity for self-regulation and resilience for sustainable practice), it does not specify the types of educational strategies best suited to teach and assess these competencies. To support the prevention and rehabilitation of resident health issues, residency training programs are faced with the complex challenge of developing socially accountable curricula that successfully foster self-care competencies. Duoethnography, a dialogic and collaborative form of curriculum inquiry, is presented as a pedagogical model for resident professionalism and self-care education. Merits of duoethnography centers on its: 1) capability to foster self-reflexive and transformative learning; 2) versatility to accommodate learner diversity; and 3) adaptability for use in different social, situational, and ethical contexts

Evaluating the Efficacy of the “Support for Life” Program for People with Dementia and Their Families and Carers’ to Enable Them to Live Well: A Protocol for a Cluster Stepped Wedge Randomized Controlled Trial

Introduction Assistance provided to support people living with dementia and carers is highly valued by them. However, current support systems in Australia are disjointed, inaccessible to all, poorly coordinated, and focus on dysfunction rather than ability. Support workers for people with dementia are in short supply, and there is little consistency in their roles. To address this large service gap and unmet need, we have developed an evidence-based optimized model of holistic support for people with dementia and their carers and families. This article describes the “Support for Life” model intervention. Methods A stepped wedge cluster randomized controlled trial will be conducted over 3 years across three Australian states. One hundred participants with dementia and/or their carers/family members will be randomly selected from community health center client lists in each state to receive either the dementia “Support for Life” intervention (Group A) or routine care (Group B). Group A participants will have access to the intervention from year 1. Group B participants will continue to receive usual care and will not be denied information on dementia or dementia services in year 1. In year 2, Group B participants will have access to the intervention. A highly trained expert dementia support worker will provide the “Support for Life” intervention, which is a flexible, individually tailored, holistic support that is relationship-centered, focused on enablement as opposed to dysfunction, and facilitate participants’ continued engagement in their community and the workforce. Additionally, dementia education, information resources, advocacy, and practical support to navigate and access dementia services and health care will be provided. The mode of support will include face to face, telephone, and internet interaction on an “as needed basis” for 12 months. The primary hypothesis is that the intervention will improve the quality of life of people with dementia and the health and well-being of carers/family through facilitating the continuation and enhancement of regular daily activities. Secondary hypotheses will examine other health and service usage outcomes. The outputs will also include a health economic analysis to investigate the costs (and savings) of any associated reduction in unnecessary health services use and delay in accessing permanent residential aged care

Rings graded equivalent to the Weyl algebra

We consider the first Weyl algebra, A, in the Euler gradation, and completely classify graded rings B that are graded equivalent to A: that is, the categories gr-A and gr-B are equivalent. This includes some surprising examples: in particular, we show that A is graded equivalent to an idealizer in a localization of A. We obtain this classification as an application of a general Morita-type characterization of equivalences of graded module categories.Comment: 38 pages; minor changes to final published versio

Differential effects of nutritional folic acid deficiency and moderate hyperhomocysteinemia on aortic plaque formation and genome-wide DNA methylation in vascular tissue from ApoE-/- mice

Low folate intake is associated with vascular disease. Causality has been attributed to hyperhomocysteinemia. However, human intervention trials have failed to show the benefit of homocysteine-lowering therapies. Alternatively, low folate may promote vascular disease by deregulating DNA methylation. We investigated whether folate could alter DNA methylation and atherosclerosis in ApoE null mice. Mice were fed one of six diets (n = 20 per group) for 16 weeks. Basal diets were either control (C; 4% lard) or high fat (HF; 21% lard and cholesterol, 0.15%) with different B-vitamin compositions: (1) folic acid and B-vitamin replete, (2) folic acid deficient (−F), (3) folic acid, B6 and B12 deficient (−F−B). −F diets decreased plasma (up to 85%; P < 0.05), whole blood (up to 70%; P < 0.05), and liver folate (up to 65%; P < 0.05) and hepatic SAM/SAH (up to 80%; P < 0.05). −F−B diets reduced plasma (up to 76%; P < 0.05), whole blood (up to 72%; P < 0.05), and liver B12 (up to 39%; P < 0.05) and hepatic SAM/SAH (up to 90%; P < 0.05). −F increased homocysteine 2-fold, while −F−B increased homocysteine 3.6- and 6.8-fold in the C and HF groups (P < 0.05). Plaque formation was increased 2-fold (P < 0.0001) in mice fed a HF diet. Feeding a HF–F diet increased lesion formation by 17% (P < 0.05). There was no change in 5-methyldeoxycytidine in liver or vascular tissue (aorta, periadventitial tissue and heart). These data suggest that atherogenesis is not associated with genome-wide epigenetic changes in this animal model

Nutritional B vitamin deficiency alters the expression of key proteins associated with vascular smooth muscle cell proliferation and migration in the aorta of atherosclerotic apolipoprotein E null mice.

Low B vitamin status is linked with human vascular disease. We employed a proteomic and biochemical approach to determine whether nutritional folate deficiency and/or hyperhomocysteinemia altered metabolic processes linked with atherosclerosis in ApoE null mice. Animals were fed either a control fat (C; 4 % w/w lard) or a high-fat [HF; 21 % w/w lard and cholesterol (0/15 % w/w)] diet with different B vitamin compositions for 16 weeks. Aorta tissue was prepared and global protein expression, B vitamin, homocysteine and lipoprotein status measured. Changes in the expression of aorta proteins were detected in response to multiple B vitamin deficiency combined with a high-fat diet (P < 0.05) and were strongly linked with lipoprotein concentrations measured directly in the aorta adventitia (P < 0.001). Pathway analysis revealed treatment effects in the aorta-related primarily to cytoskeletal organisation, smooth muscle cell adhesion and invasiveness (e.g., fibrinogen, moesin, transgelin, vimentin). Combined B vitamin deficiency induced striking quantitative changes in the expression of aorta proteins in atherosclerotic ApoE null mice. Deregulated expression of these proteins is associated with human atherosclerosis. Cellular pathways altered by B vitamin status included cytoskeletal organisation, cell differentiation and migration, oxidative stress and chronic inflammation. These findings provide new insight into the molecular mechanisms through which B vitamin deficiency may accelerate atherosclerosis

CE10011

Use the URI link below to search the Marine Institute Data Discovery Catalogue for datasets relevant to this report.Acoustic surveys on blue whiting (Micromesistius poutassou) spawning aggregations in the north east Atlantic have been carried out by the Institute of Marine Research (IMR) Norway since the early 1970s. In the early 1980s a coordinated acoustic survey approach was adopted, with both Russia and Norway participating to estimate the size of this migratory stock within the main spawning grounds to the west of Ireland and Britain. Since 2004, an International coordinated survey program has expanded to include vessels from the EU (Ireland and the Netherlands) and the Faroes. Due to the highly migratory nature of the stock a large geographical area has to be surveyed. Spawning takes place from January through to April along the shelf break from the southern Porcupine Bank area northwards to the Faroe Shetland Ridge including offshore areas as the Rosemary, Hatton and Rockall Banks. Peak spawning occurs between mid-March and mid April and acoustic surveys are timed to occur during this phase. To facilitate a more coordinated spatio-temporal approach to the survey participating countries meet annually to discuss survey methods and define target areas at the ICES led Working Group on Northeast Atlantic Pelagic Ecosystem Surveys (WGNAPES). Data from the annual spawning stock abundance survey (March/April, western waters), juvenile surveys (May, Norwegian Sea and January-March, Barents Sea trawl survey) and commercial landings data are presented annually at the ICES Working Group of Widely Distributed Stocks (WGWDS). Ultimately, combined data inputs into the management and catch advice for this international cross boundary stock. The 2010 survey was part of an International collaborative survey using the vessels RV Celtic Explorer (Ireland), RV Fridtjof Nansen (Russia), RV Tridens (Netherlands) and the RV Magnus Heinason (Faroes) and the RV G.O. Sars (Norway). The total combined area coverage extended from the Faroe Islands in the north (60.30°N) to south of Ireland (52°N), with east -west extension from 6°-18° W. International survey participants meet shortly after the survey to present data and produce a combined relative abundance and biomass index the blue whiting spawning stock in western waters. The combined survey report is presented annually at the WGNAPES meeting held in August and made available to the WGWDS assessment group