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Communication and teamwork failures are a common cause of adverse events. Residency programs, with a mandate to teach systems-based practice, are particularly challenged to address these important skills.To develop a multidisciplinary teamwork training program focused on teaching teamwork behaviors and communication skills.Internal medicine residents, hospitalists, nurses, pharmacists, and all other staff on a designated inpatient medical unit at an academic medical center.We developed a 4-h teamwork training program as part of the Triad for Optimal Patient Safety (TOPS) project. Teaching strategies combined didactic presentation, facilitated discussion using a safety trigger video, and small-group scenario-based exercises to practice effective communication skills and team behaviors. Development, planning, implementation, delivery, and evaluation of TOPS Training was conducted by a multidisciplinary team.We received 203 evaluations with a mean overall rating for the training of 4.49 +/- 0.79 on a 1-5 scale. Participants rated the multidisciplinary educational setting highly at 4.59 +/- 0.68.We developed a multidisciplinary teamwork training program that was highly rated by all participating disciplines. The key was creating a shared forum to learn about and discuss interdisciplinary communication and teamwork.

BackgroundYoung people living with long term conditions are vulnerable to health service disengagement. This endangers their long term health. Studies report requests for digital forms of communication – email, text, social media – with their health care team. Digital clinical communication is troublesome for the UK NHS.AimIn this article we aim to present the research protocol for evaluating the impacts and outcomes of digital clinical communications for young people living with long term conditions and provide critical analysis of their use, monitoring and evaluation by NHS providers (LYNC study: Long term conditions, Young people, Networked Communications).MethodsThe research involves: (a) patient and public involvement activities with 16–24 year olds with and without long term health conditions; (b) six literature reviews; (c) case studies – the main empirical part of the study – and (d) synthesis and a consensus meeting. Case studies use a mixed methods design. Interviews and non-participant observation of practitioners and patients communicating in up to 20 specialist clinical settings will be combined with data, aggregated at the case level (non-identifiable patient data) on a range of clinical outcomes meaningful within the case and across cases. We will describe the use of digital clinical communication from the perspective of patients, clinical staff, support staff and managers, interviewing up to 15 young people and 15 staff per case study. Outcome data includes emergency admissions, A&E attendance and DNA (did not attend) rates. Case studies will be analysed to understand impacts of digital clinical communication on patient health outcomes, health care costs and consumption, ethics and patient safety.

Deoxyguanosine kinase (ATP: deoxyguanosine 5'-phosphotransferase) activity has been identified in neonatal mouse skin tissue. This activity which has a molecular weight of 44 000 was shown to be highly specific for deoxyguanosine as a substrate. Unique to deoxynucleoside kinases was the observation that this enzyme possessed a pH optimum of 5.2. In dilute solutions catalytic activity is lost, however the enzymatic activity can be stabilized by the addition of 20 micrometer MgATP or ATP. Kinetic analysis gave an apparent Km for deoxyguanosine of 7 micrometer. Double-reciprocal plots of activity vs. MgATP concentration produced a broken line with the break occurring at 0.5 mM MgATP. Below this concentration an apparent Km for MgATP of 23 micrometer was measured; above 0.5 mM MgATP an apparent Km of 265 micrometer was calculated. Mouse skin deoxyguanosine kinase was strongly inhibited by dGTP, dGDP and UDp. dGTP was a competitive inhibitor of deoxyguanisine with an apparent Ki of 1.9 micrometer. UPD (K1,app = 3 micrometer), dGDP = 0.7 micrometer) (Ki,app = 0.07 micrometer] were competitive inhibitors of MgATP and dGTP ki,app = 0.07 micrometer) were competitive inhibitors of MGATP when the concentration of MgATRP was greater than 0.5 mM.

With the ever-increasing necessity of economy of processing and uniformity of product, automation becomes more and more vital to the citrus industry. Our present purpose is to define the subject, briefly describe its functions, and discuss, as time will allow, its pertinent applications. Paper published with permission.