Implementation of a resident-led patient safety curriculum.

The Royal College of Physicians and Surgeons of Canada has made Quality Improvement and Patient Safety (QIPS) a priority in residency education, however, implementation is limited by the heterogeneity of previously published curricula. We created a longitudinal resident-led patient safety (PS) curriculum using relatable, real-life PS incidents (PSIs) and an analysis framework.Implementation was feasible, well received by residents and demonstrated significant improvement in residents' PS knowledge,skills, and attitudes.

Preparing for CBME: How often are faculty observing residents?

Background: The Royal College of Physicians and Surgeons of Canada officially launched 'Competence by Design' in July 2017, moving from time-based to outcomes-based training. Transitioning to competency-based medical education (CBME) necessitates change in resident assessment. A greater frequency of resident observation will likely be required to adequately assess whether entrustable professional activities have been achieved.

R2C2 in Action: Testing an Evidence-Based Model to Facilitate Feedback and Coaching in Residency.

Background: Feedback is increasingly seen as a collaborative conversation between supervisors and learners, where learners are actively and reflectively engaged with feedback and use it to improve. Based on this, and through earlier research, we developed an evidence- and theory-informed, 4-phase model for facilitating feedback and practice improvement-the R2C2 model (relationship, reaction, content, coaching).

Objective: Our goal was to explore the utility and acceptability of the R2C2 model in residency education, specifically for engaging residents in their feedback and in using it to improve, as well as the factors influencing its use.

Adolescent interviewing skills: effect of feedback.

Background: Communicating with adolescent patients can be challenging. Our study assessed the effect of structured feedback following a standardised patient (SP) encounter on postgraduate year-1 (PGY1) residents' adolescent-specific communication skills. Communicating with adolescent patients can be challenging METHODS: A two-group, prospective, double-blind randomised control study design was employed.

Skills for Interviewing Adolescent Patients: Sustainability of Structured Feedback in Undergraduate Education on Performance in Residency.

Background: Effective adolescent (10 to 19 years) interviewing by physicians is an essential skill that many trainees can find challenging.

Objective: We assessed whether structured adolescent interviewing using standardized patients (SPs) and feedback in undergraduate medical education (UME) has a sustained effect on residents' skills.

Methods: Postgraduate year (PGY) 1 residents conducted interviews with a SP adolescent-mother pair.

Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: A Pilot Study to Evaluate the Utility of the ProCore Biopsy Needle for Lymph Node Sampling.

Objective: The ProCore ultrasound biopsy needle, used primarily to obtain intra-abdominal tissue core biopsies, has not been widely used for endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). In this pilot study we evaluated the utility of the ProCore needle for sampling mediastinal or hilar lymph nodes during EBUS-TBNA.

Design: Thirty-two patients were identified using both ProCore and conventional fine-needle aspiration (FNA) needles for sampling mediastinal or hilar lymph nodes (the study group).

The effects on ruminal pH and serum haptoglobin after feeding a grain-based supplement to grazing dairy cows as a partial mixed ration or during milking.

Ruminal pH and serum concentrations of haptoglobin (Hp) were measured in order to assess the risk of subacute ruminal acidosis (SARA) in grazing cows offered rolled wheat grain twice daily in the dairy at milking (Control group; n= 64), or as a partial mixed ration (PMR group; n= 64) on a feedpad. Cows were allocated various levels of the supplement (8, 10, 12 or 14 kg dry matter/day). Ruminal pH was measured in 16 rumen-fistulated cows (eight PMR and eight Control group cows), using indwelling pH meters, recording every 10 min for 14 days.

Youth health care utilization in Nova Scotia: what is the role of age, sex and socio-economic status?

Objective: Youth have distinct health care needs that are not always met within a framework designed for children or adults. In Canada, little attention has been given to how youth utilize health care services and limited data are available. The aim of this study was to identify whether age, sex, socio-economic status (SES) and geographic location were significant mediators of youth health care utilization in Nova Scotia.

The Virtual Physiological Human ToolKit.

The Virtual Physiological Human (VPH) is a major European e-Science initiative intended to support the development of patient-specific computer models and their application in personalized and predictive healthcare. The VPH Network of Excellence (VPH-NoE) project is tasked with facilitating interaction between the various VPH projects and addressing issues of common concern. A key deliverable is the 'VPH ToolKit'--a collection of tools, methodologies and services to support and enable VPH research, integrating and extending existing work across Europe towards greater interoperability and sustainability.

Real science at the petascale.

We describe computational science research that uses petascale resources to achieve scientific results at unprecedented scales and resolution. The applications span a wide range of domains, from investigation of fundamental problems in turbulence through computational materials science research to biomedical applications at the forefront of HIV/AIDS research and cerebrovascular haemodynamics. This work was mainly performed on the US TeraGrid 'petascale' resource, Ranger, at Texas Advanced Computing Center, in the first half of 2008 when it was the largest computing system in the world available for open scientific research.

Mortality of bullous pemphigoid: an evaluation of 223 patients and comparison with the mortality in the general population in the United States.

Background: There are large discrepancies in reported mortality for bullous pemphigoid (BP).

Objective: We sought to determine the mortality of a large cohort of patients with BP and compare this with age-matched control subjects.

Methods: Data were collected on 223 patients with a new diagnosis of BP between 1998 and 2003 through our cutaneous immunofluorescence laboratory databases.

Patient-specific simulation as a basis for clinical decision-making.

Patient-specific medical simulation holds the promise of determining tailored medical treatment based on the characteristics of an individual patient (for example, using a genotypic assay of a sequence of DNA). Decision-support systems based on patient-specific simulation can potentially revolutionize the way that clinicians plan courses of treatment for various conditions, ranging from viral infections to arterial abnormalities. Basing medical decisions on the results of simulations that use models derived from data specific to the patient in question means that the effectiveness of a range of potential treatments can be assessed before they are actually administered, preventing the patient from experiencing unnecessary or ineffective treatments.

Functional ceramic materials database: an online resource for materials research.

We present work on the creation of a ceramic materials database which contains data gleaned from literature data sets as well as new data obtained from combinatorial experiments on the London University Search Instrument. At the time of this writing, the database contains data related to two main groups of materials, mainly in the perovskite family. Permittivity measurements of electroceramic materials are the first area of interest, while ion diffusion measurements of oxygen ion conductors are the second.

Design of electroceramic materials using artificial neural networks and multiobjective evolutionary algorithms.

We describe the computational design of electroceramic materials with optimal permittivity for application as electronic components. Given the difficulty of large-scale manufacture and characterization of these materials, including the theoretical prediction of their materials properties by conventional means, our approach is based on a recently established database containing composition and property information for a wide range of ceramic compounds. The electroceramic materials composition-function relationship is encapsulated by an artificial neural network which is used as one of the objectives in a multiobjective evolutionary algorithm.

Multi-objective and constrained design of fibre Bragg gratings using Evolutionary Algorithms.

We apply a multi-objective evolutionary algorithm to a grating problem where only very specific features of the transmission spectrum are specified during the optimisation process. The design problem analysed here relates to the passive extraction of 10 GHz clock signals from a 10 Gbps OTDM RZ encoded data stream. Four spectral features of interest such as bandwidth and passband quality are explicitly defined.

Helical growth of stage-IVb sporangiophores of Phycomyces blakesleeanus: the relationship between rotation and elongation growth rates.

An understanding of the relationship between the two components of helical growth (rotation rate and elongation rate) is fundamental to understanding the biophysical and molecular mechanism(s) of cell wall extension in algal cells, fungal cells, and plant stems and roots. Helical growth occurs throughout development of the sporangiophores of Phycomyces blakesleeanus. Previous studies within the growth zone of stage-IVb sporangiophores have reported conflicting conclusions.

Electron tomography and computer visualisation of a three-dimensional 'photonic' crystal in a butterfly wing-scale.

A combination of transmission electron tomography and computer modelling has been used to determine the three-dimensional structure of the photonic crystals found in the wing-scales of the Kaiser-I-Hind butterfly (Teinopalpus imperialis). These scales presented challenges for electron microscopy because the periodicity of the structure was comparable to the thickness of a section and because of the complex connectivity of the object. The structure obtained has been confirmed by taking slices of the three-dimensional computer model constructed from the tomography and comparing these with transmission electron microscope (TEM) images of microtomed sections of the actual scale.

Microstructured polymer optical fibre.

The first microstructured polymer optical fibre is described. Both experimental and theoretical evidence is presented to establish that the fibre is effectively single moded at optical wavelengths. Polymer-based microstructured optical fibres offer key advantages over both conventional polymer optical fibres and glass microstructured fibres.

Expression and modulation of the vitronectin receptor on human dermal microvascular endothelial cells.

Microvascular endothelial cells express a variety of cell-surface integrins in vivo and in vitro with varying affinities for matrix proteins. The vitronectin receptor (VnR), a complex of the alpha v and beta 3 integrin chains, is capable of binding to a variety of matrix proteins that are deposited in injured tissues, including vitronectin, fibrinogen, and thrombin. Staining of frozen sections of human skin with antibodies recognizing the VnR and examination by immunofluorescence microscopy demonstrates staining in a vascular pattern suggesting in vivo expression of the vitronectin receptor on endothelial cells.