A pilot study investigating the use of Action Planning Statements in tutoring clinical skills to second year medical students

Increasing numbers of Australian medical students are requiring education in clinical skills. This pilot study aimed to investigate the effect of one method of reflective learning, Action Planning Statements (APS), on teacher rating and student learning in Clinical Skills tutorials. 15 second year medical students were administered a Student Experience of Learning and Teaching (SELT) assessment which is a standardised questionnaire. Student feedback on their perceptions of the author’s teaching and the use of APS was sought through the use of SELTs both before and after students had completed APS. One parameter of the teacher rating, ‘effectiveness’ significantly increased and there was more than 72% broad agreement that the APS had improved students’ reflection and feedback. APS may be an important tool for improving teacher effectiveness and feedback and student reflection in Clinical Skills tutorials for medical students. Further research is needed to clarify the use of APS

Role of chloride in hot salt stress-corrosion cracking of titanium-aluminum alloys

Role of chloride in hot salt stress corrosion cracking of titanium-aluminum alloy

Corrective treatment and anatomic considerations for laparoscopic cholecystectomy injuries

BACKGROUND: Complete reports of biliary and vascular injuries after laparoscopic cholecystectomy are rare. STUDY DESIGN: Fifteen patients with complex laparoscopic cholecystectomy injuries underwent corrective operations. The injuries consisted of 14 bile duct injuries and one large laceration of a cirrhotic liver. Five of the bile duct injuries were accompanied by inadvertent occlusion of the right hepatic artery, and one was further complicated by portal vein occlusion. One hepatic artery occlusion and one portal vein occlusion were successfully reconstructed. Two patients with arterial occlusion required right hepatic lobectomy. Corrective biliary operations consisted of common hepaticojejunostomy (seven cases), right and left hepaticojejunostomies (one case), right anterior and left hepaticojejunostomies (two cases), right hepaticojejunostomy (one case), right posterior hepaticojejunostomy (one case), and left hepaticojejunostomy after right lobectomy (two cases). RESULTS: Except for a patient with a severe laceration of a cirrhotic liver who died as a result of hepatic failure, the remaining 14 patients are alive and well with normal hepatic function tests at six and 37 months after corrective operations. CONCLUSIONS: A knowledge of anatomy is critical to the prevention of injuries to the hepatobiliary tree and related structures during laparoscopic cholecystectomy

The clinical significance of the arterial ketone body ratio as an early indicator of graft viabilityin human liver transplantation

Arterial ketone body ratio (AKBR) was measured sequentially in 84 liver transplantations (OLTx). These transplantation procedures were classified into 3 groups with respect to graft survival and patient condition at the end of the first month (Group A, the grafts survived longer than 1 month with satisfactory patient condition; Group B, the grafts survived longer than 1 month but the patients were ICU-bound; Group C, the grafts were lost and the patients died or underwent re-OLTx). In Group A, the AKBR was elevated to above 1.0 by the second postoperative day. In Group B, the AKBR was elevated to above 0.7 but stayed below 1.0 during this period. In Group C, the AKBR remained below 0.7 longer than 2 days after operation. Although conventional liver function tests showed significant increases in Groups B and C as compared with Group A, they were less specific in predicting ultimate graft survival. © 1991 by Williams & Wilkins

The Y-Band at 1.035 um: Photometric Calibration and the Dwarf Stellar/Sub-Stellar Color Sequence

We define and characterize a photometric bandpass (called "Y") that is centered at 1.035 um, in between the traditionally classified ``optical'' and ``infrared'' spectral regimes. We present Y magnitudes and Y-H and Y-K colors for a sample consisting mostly of photometric and spectral standards, spanning the spectral type range sdO to T5V. Deep molecular absorption features in the near-infrared spectra of extremely cool objects are such that the Y-H and Y-K colors grow rapidly with advancing spectral type especially from late M through mid L, substantially more rapidly than J-H or H-K which span a smaller total dynamic range. Consistent with other near-infrared colors, however, Y-H and Y-K colors turn blueward in the L6-L8 temperature range with later T-type objects having colors similar to those of warmer M and L stars. Use of the Y-band filter is nonetheless promising for easy identification of low-mass stars and brown dwarfs, especially at young ages. The slope of the interstellar reddening vector within this filter is A_Y = 0.38 x A_V. Reddening moves stars nearly along the YHK dwarf color sequence making it more difficult to distinguish unambiguously very low mass candidate brown dwarf objects from higher mass stars seen, e.g. through the galactic plane or towards star-forming regions. Other diagrams involving the Y-band may be somewhat more discriminating.Comment: accepted at PAS

Logistics and technique for combined hepatic-intestinal retrieval

During a 13-month period, en bloc liver-small bowel cadaveric grafts were procured for seven children and one adult. All liver grafts functioned immediately, and all but one of the recipient patients recovered. Return of absorptive small bowel function was slow, but the integrity of the bacterial intestinal barrier was not disrupted. The described technique allows the procurement of other abdominothoracic organs, with the exception of the whole pancreas