Memorial Institute Research Articles

What can we learn from pandemic educational methods?: military general practice trainees’ attitudes to feedback from recorded consultations

ABSTRACT Background Recorded consultations are a useful tool for developing consultation skills for general practice speciality trainees (GPSTs). Historical barriers to utility include a lack of recording equipment and trainee discomfort. Widespread use of online communication platforms during the pandemic led to the introduction of the Recorded Consultation Assessment (RCA), prompting an exploration of its impact on GPSTs’ attitudes and acceptability of using recorded consultations for feedback. Aim This sequential explanatory mixed methods study explored attitudes of military GPSTs towards using recorded consultations for feedback to develop consultation skills, and identify factors influencing GPST attitudes. Methods Participants of this study completed a questionnaire, followed by a representative sample focus group. Descriptive statistics were used to analyse quantitative data, reflexive thematic analysis was employed for qualitative data. Triangulation was conducted using a meta-matrix. Results Results indicated agreement among respondents on the usefulness of recorded consultations for developing consultation skills, particularly communication skills. Perceived trainer attitudes significantly influence the GPST utility of this tool. The RCA positively impacted attitudes, providing familiarity, free access to easy-to-use online recording platforms, simplified consenting procedures, secure data storage, and improved feedback quality from trainers. Conclusion Pre-pandemic studies cited equipment access and consent procedures as barriers to utilising recording as a method of feedback. The pandemic and RCA introduced online resources and imperative to utilise this method, resulting in largely positive GPST learning experiences. As we move away from the RCA it is important to retain institutional memory of the benefits gained from feedback using recorded methods.

Outcomes of Pediatric Renal Tumors over 5 Years in Regional Cancer Center, Kidwai Memorial Institute of Oncology, Bengaluru, South India

Wilms' tumor (WT) is the most common malignant renal tumor in the pediatric population and it is managed with a multimodal treatment. Improvements in chemotherapy and risk stratification have led to dramatic improvement in the prognosis of renal tumors, which was once a lethal malignancy. Seventy-three patients with histopathologically proven diagnosis of renal tumor who received treatment from January 2011 to December 2015 were included for analysis. Eight children underwent upfront nephrectomy. The patients were analyzed for event-free survival and overall survival. The outcomes were correlated with age, sex, stage at presentation, and histology. A favorable histology was found in 74% patients, while an unfavorable histology was observed in 26% of the cases. The 5-year event-free survival was 82.7% and overall survival was 87.6%. The stage at presentation had a prognostic value (p < 0.001). Tumor histology was the single most important factor in predicting the survival.

Health impact assessment in two planning projects in England: reflections on normative effectiveness

BackgroundThis article reports on research commissioned by (what was at the time) Public Health England (PHE). The objective is to reflect on the normative effectiveness of Health Impact Assessment (HIA) applied to two planning projects; (a) the new town at Cranbrook, Devon (HIA prepared in 2007), and (b) the regeneration of the Marsh farm area in Luton (HIA prepared in 2009). In this context, the focus is on the contribution of HIA to actions that are intended to lead to good or improved health and wellbeing.MethodsNormative HIA effectiveness criteria derived from a literature review were used to guide the analysis. The two included HIA cases were previously identified as good practice examples with regards to procedure and report quality. Semi-structured interviews with public health, planning and other actors originally involved in the HIAs were conducted in 2021. This was followed up by web-searches for evidence on actual developments in 2023.ResultsInterviews indicated that normative effectiveness initially appeared to be high, but that the longer-term effects of the financial crash of 2008 reduced this. Delays in initially anticipated timelines and HIA actors moving elsewhere or retiring meant that HIAs were not followed-up and connections between developments and the HIAs were no longer made. However, web-based searches conducted in 2023 found that key HIA suggestions were eventually implemented, albeit with delay. There is also evidence for improved IMD (index of multiple deprivation) rankings in the Marsh farm regeneration case.ConclusionA mismatch is observed with regards to HIA exercises appearing to be largely ‘forgotten’ after over a decade of their publication, but recommendations still being implemented, possibly as a result of ‘institutional memory’. Making monitoring and follow-up of HIA binding rather than advisory would allow for direct linkages to be made.

Ethicizing Agency in Body Documentification

ABSTRACTWhile considerations of documents and data are longstanding in the tenants and practices of library and information science (LIS), the recent turn toward bodies and embodiment in the social sciences invites a critical interrogation of our assumptions about the interplay of documents, data, and bodies embedded within sociotechnical systems of power and bodily agency. In response, we begin to theorize the intersection of datafication and documentation as documentification, encapsulating how acts of datafication revoking agency results in a one‐directional superficial documentary status, producing assumptions about bodies by power systems which aim to simplify, nullify, and suppress. We initially examine documentification as it relates to practices of surveillance, BMI, and memory institutions. In doing so, we interrogate the ethical dilemmas emerging from assumptions about agency ascribed to documentified bodies. Finally, we challenge the library and information professions to imagine a world designed with putting people first that centers, rather than reduces, their agency.

Modeling Memory Institutions: The Ainu Case Study

ABSTRACTThis study aimed to construct a model of memory institutions (libraries, archives, and museums) as a lens for analyzing contemporary collective memory practices related to the Ainu people. First, we developed a pilot model to organize the current phenomena and practices of collective memories and suggest a respective circulation mechanism consisting of three core elements: media, collective representations, and collective memory. Additionally, employing this pilot model, we conducted close readings of 449 pieces of literature and illustrated the characteristics of collective memory practices and phenomena in a case study of the Ainu. Our findings indicate that 1) the traditional collective memory of the Ainu has gradually shifted toward recognizing them as a unique ethnic group, and 2) by translating their oral literature into diverse media, the Ainu have reshaped their cultural identity.

Blue Sunglasses and New Habits: Female Correspondence Networks and the Irish Religious Diaspora

Abstract During the nineteenth century female Irish religious orders established missions across the Irish diaspora which were designed with flexibility and adaptation in mind. The Sisters of Mercy's personal letter networks allowed these women, who were often very young, to continue their religious and technical “apprenticeship” while abroad. These letters enabled women in the diaspora to maintain a sense of consistency and belonging across the oceans: with their sisters in Ireland and elsewhere in the world on an ethnic and institutional level. Engaging with these letters as both intimate conversations and professional reflections presents opportunities for investigating how long-distance institutional memory was developed and a continuing connection to Ireland and Irishness maintained. This article moves the focus of ethnic culture brokers from the priest and bishop to the formal and informal networks of women religious who worked within a system designed for men. In doing so, it demonstrates that these letters provided an important extra layer to public global Irish networks, a layer which acted as both a whisper network and an opportunity for reflection on efficient methods for varied work in large, fluctuating, and cross-class ethnic communities.

Effects of Pressure, Hypoxia, and Hyperoxia on Neutrophil Granulocytes

Background: The application of normo- and hyperbaric O2 is a common therapy option in various disease patterns. Thereby, the applied O2 affects the whole body, including the blood and its components. This study investigates influences of pressure and oxygen fraction on human blood plasma, nutrient media, and the functions of neutrophil granulocytes (PMNs). Methods: Neutrophil migration, reactive oxygen species (ROS) production, and NETosis were examined by live cell imaging. The treatment of various matrices (Roswell Park Memorial Institute 1640 medium, Dulbecco’s Modified Eagle’s Medium, H2O, human plasma, and isolated PMNs) with hyperbaric oxygen (HBO) was performed. In addition, the expression of different neutrophil surface epitopes (CD11b, CD62L, CD66b) and the oxidative burst were investigated by flow cytometry (FACS). The application of cold atmospheric plasma (CAP) to normoxic and normobaric culture media served as a positive control. Soluble reaction products such as H2O2, reactive nitrogen species (RNS: NO2− and NO3−), and ROS-dependent dihydrorhodamine oxidation were quantified by fluoro- and colorimetric assay kits. Results: Under normobaric normoxia, PMNs migrate slower and shorter in comparison with normobaric hyper- or hypoxic conditions and hyperbaric hyperoxia. The pressure component has less effect on the migration behavior of PMNs than the O2 concentration. Individual PMN cells produce prolonged ROS at normoxic conditions. PMNs showed increased expression of CD11b in normobaric normoxia, lower expression of CD62L in normobaric normoxia, and lower expression of CD66b after HBO and CAP treatment. Treatment with CAP increased the amount of ROS and RNS in common culture media. Conclusions: Hyperbaric and normobaric O2 influences neutrophil functionality and surface epitopes in a measurable way, which may have an impact on disorders with neutrophil involvement. In the context of hyperbaric experiments, especially high amounts of H2O2 in RPMI after hyperbaric oxygen should be taken into account. Therefore, our data support a critical indication for the use of normobaric and hyperbaric oxygen and conscientious and careful handling of oxygen in everyday clinical practice.

A Punahou moʻolelo: the creation of institutional memory and myth

ABSTRACT This paper investigates how Punahou School, a K-12 Hawaiʻi private school with tremendous local influence, has represented its history and particularly its ties to the U.S. colonization of Hawaiʻi. This account of how various actors tell, grapple with, or memorialize violent histories has implications locally for the Hawaiian sovereignty movement and broadly for questions surrounding memory and representation. I argue that Punahou has employed a two-pronged approach to representing its historical founding and articulating a school identity: first, Punahou has strategically sanitized the history of its founding to present a narrative that glorifies the missionary project and implies, or at least fails to question, the notion that the Christianization and colonization of Hawaiʻi were beneficial. Second, Punahou has incorporated – or, alternatively, appropriated – Hawaiian cultural symbolism, moʻolelo, and heritage to indigenize itself, thus deemphasizing the role the school itself has played in the erasure of those very same hallmarks of indigeneity. The impact of Punahou’s representational strategies is to erase the brutality of the missionary project and settler colonialism; normalize colonial ideas, behaviors, and histories; and grant implicit pardon to Punahou as an institution from reckoning with its violent history.

What Is Culture Made of? An Exploratory Study of Ethical Cultures and Provider Perspectives on the Care of Periviable Neonates

Objective Studies examining intercenter variation in neonatal intensive care unit practices at the limits of fetal viability have hypothesized that institutional “culture” can be one of many factors that impact patient care. This study aimed to describe institutional culture at a single, large academic center with regard to the antenatal consultation, resuscitation, and postnatal management of periviable neonates. Study Design Members of six clinical groups—attending and fellow maternal–fetal medicine physicians, attending and fellow neonatal–perinatal medicine physicians, neonatal nurses, advanced practiced neonatal nurses, pediatric hospitalist physicians, and neonatal respiratory therapists—were invited to complete qualitative, semi-structured interviews. All audio recordings were transcribed. Dedoose software was used to complete team-based coding and thematic analysis. Results Twenty-two interviews were completed. Thematic analysis revealed three central themes described by participants as contributory to institutional culture: Perception, referring to factors based on individual attitudes and insights, Statements of Information, referring to factors anchored in more objective concepts such as outcomes data and institutional policy, and Dynamic Factors, referring to the relatively fluid factors of institutional culture that interact with both Perception and Statements of Information. Participants were more likely to mention factors in the Perception category (n = 430) compared with factors in the Information category (n = 225), and although the latter were described as critical components of antenatal counseling and perinatal management, the philosophy of our unit appeared to be more heavily rooted in institutional memory and individual belief systems. Conclusion Our data demonstrate a personal undertone to institutional culture at the limits of viability, with an emphasis on individual attitudes and subjective interpretations of fact rather than empirical data. As the landscape of neonatology continues to change, understanding those factors that contribute to culture remains a necessary step toward deconstructing institutional belief systems and optimizing clinical care. Key Points

User-centred collection metadata: from images as information to facilitating socio-affective connections

PurposeAs museums and other memory institutions continue to invest considerably in mass-digitising collections and participating in large search portals, it is essential to understand existing and potential users, their motivations and search needs to inform collections’ documentation. In this article, we discuss insights from a collaborative project with National Museums Scotland, set up to enhance the findability of collection images and inform documentation practices by understanding the collections users and their search terms.Design/methodology/approachThe research involved interviews with National Museums Scotland staff, users and non-users of the Museums’ Search our Collections portal encompassing a concept mapping and card sort activity; online surveys and content analysis of user search queries.FindingsThe project revealed that participants are interested in searching the online collections by terms often not represented in collections metadata, including terms related to identity (their own but also others’) and social context (e.g. through seasonal and social events); emotional and sensory interests (e.g. visual characteristics) and narrative themes (e.g. on under-represented histories).Originality/valueBased on the findings, we further theorise the semantic gap in online museum collection metadata. To bridge this gap and cater to how users search, we argue for a paradigm shift in documentation practices: suggesting practitioners should not only view collection images as information but also tap into their rich potential for enabling social and affective connections.

Identification of antigenic proteins from the venom of Malaysian snakes using immunoprecipitation assay and tandem mass spectrometry (LC-MS/MS)

Snake envenomation poses a significant risk to Malaysians and country visitors. Malaysia witnesses an estimated 650 snake bites per 100,000 population annually. The primary treatment for snake envenomation involves administering antivenom derived from horses, despite its drawbacks, such as anaphylactic reactions and serum sickness. Identifying the venom proteome is crucial for understanding and predicting the clinical implications of envenomation and developing effective treatments targeting specific venom proteins. In this study, we employ an immunoprecipitation assay followed by LC-MS/MS to identify antigenic proteins in five common venomous snakes in Malaysia compassing of two families which are pit vipers, (Calloselasma rhodostoma and Cryptelytrops purpureomaculatus) and cobras (Ophiophagus hannah, Naja kaouthia, and Naja sumatrana). The immunoprecipitation assay utilises a 2 % agarose gel, allowing antigenic proteins to diffuse and bind with antibodies in the antivenom. The antivenom utilised in this research was procured from the Queen Saovabha Memorial Institute (QSMI), Thailand, including king cobra antivenom (KCAV), cobra antivenom (CAV), Malayan pit viper antivenom (MPAV), Russell's viper antivenom (RPAV), hematopolyvalent antivenom (HPAV), neuropolyvalent antivenom (NPAV), banded krait antivenom (BKAV), and Malayan krait antivenom (MKAV). The protein identified through these interactions which are exclusive to the cobras are three-finger toxins (3FTXs) while snake C-type lectins (Snaclecs) are unique to the pit vipers. Common protein that are present in both families are L-amino acid oxidase (LAAO), Phospholipase A2 (PLA2), and snake venom metalloproteinase (SVMP). Identifying these proteins is vital for formulating a broad-spectrum antivenom applicable across multiple species.

Antioxidant and Antiplasmodial Potentials of Methanol Bark Extract of <i>Entada africana </i>Via <i>in Vitro</i> Approaches

<i>Plasmodium </i>parasites, which cause malaria, continue to pose a serious threat to global health, necessitating the continuous search for novel antimalarial agents. Oxidative stress has also been linked to the pathophysiology of malaria. <i>Entada africana</i> is a plant known for its ethnomedicinal uses in treating various ailments associated with inflammation including malaria. This study aimed at evaluating the antiplasmodial and antioxidant potentials of methanol bark extract from <i>Entada africana </i>(MBEEA). <i>In vitro </i>approaches were adopted for the study.<i> Plasmodium falciparum-</i>infected erythrocyte samples were cultured in Roswell Park Memorial Institute (RPMI) 1640 media under anaerobic conditions for 72 hours. Eighteen test tubes were labeled and grouped into three replicates per group. Group I (untreated), Group II, and III were treated with chloroquine (CQ) and artemether (AR) at a concentration of 5 mg/dL. Group IV, V, and VI were treated with the extract at respective concentrations of 5 mg/dL, 10 mg/dL, and 20 mg/dL for 72 hours. The parasitemia count and the percentage parasitemia inhibition were determined by microscopic examination of Giemsa-stained smears. The antioxidant potential of the extract was assessed using <i>in vitro</i> assays, including superoxide radical scavenging activity (SRSA), hydroxyl radical scavenging activity (HRSA), 1,1-diphenyl-2-picrylhydrazyl (DPPH), and ferric reducing antioxidant power (FRAP). Microscopic examination of the treated samples revealed varying degrees of parasitemia inhibition. Group II and III treated with CQ and AR demonstrated a considerable reduction in parasitemia count with percentage inhibition of 100% and 83% respectively. The <i>E. africana</i> extract showed a concentration-dependent effect on parasitemia count. At 5 mg/dL, the extract exhibited 50% parasitemia inhibition, which increased to 100% at 10 mg/dL, and 20 mg/dL respectively. The MBEEA demonstrated significant <i>in vitro </i>antioxidant activities by scavenging DPPH, SRSA, and hydroxyl radical compared to the standard antioxidant (ascorbic acid). MBEEA thus exhibit potent antioxidant and antiplasmodial properties. This plant is therefore offers to be a promising medicinal plant in the treatment of malaria, hence it is recommended as potent antiplasmodial plant usable for treating malaria.

Seventh Annual Research Meeting of the Noguchi Memorial Institute for Medical Research, University of Ghana

Seventh Annual Research Meeting of the Noguchi Memorial Institute for Medical Research, University of Ghana

Seventh Annual Research Meeting of the Noguchi Memorial Institute for Medical Research: Neglected Tropical Diseases

Seventh Annual Research Meeting of the Noguchi Memorial Institute for Medical Research: Neglected Tropical Diseases

Seventh Annual Research Meeting of the Noguchi Memorial Institute for Medical Research: Non-Communicable Diseases

Seventh Annual Research Meeting of the Noguchi Memorial Institute for Medical Research: Non-Communicable Diseases

Seventh Annual Research Meeting of the Noguchi Memorial Institute for Medical Research: Viral Infections

Seventh Annual Research Meeting of the Noguchi Memorial Institute for Medical Research: Viral Infections

Seventh Annual Research Meeting of the Noguchi Memorial Institute for Medical Research: Malaria Control and Elimination

Seventh Annual Research Meeting of the Noguchi Memorial Institute for Medical Research: Malaria Control and Elimination

Seventh Annual Research Meeting of the Noguchi Memorial Institute for Medical Research: Health Systems Research

Seventh Annual Research Meeting of the Noguchi Memorial Institute for Medical Research: Health Systems Research

Seventh Annual Research Meeting of the Noguchi Memorial Institute for Medical Research: Bacterial Infections and Antimicrobial Resistance

Seventh Annual Research Meeting of the Noguchi Memorial Institute for Medical Research: Bacterial Infections and Antimicrobial Resistance

Artificial intelligence (AI) and process safety: Some cautionary observations

AbstractArtificial intelligence (AI) has become a vogue topic in the press, and descriptions of its potential impact range from apocalyptic to salvational. Interest in the topic will no doubt stimulate the search for applications to support both the technical and management systems aspects of process safety management. Within our industries, maintaining institutional memory and technical capability is made increasingly challenging by more frequent job movement among younger staff and the loss to the retirement of more senior staff. One would hope that AI could help fill the gaps caused by these factors. However, the author's sampling of current AI capabilities suggests that AI is not yet ready to do so. This paper provides some examples of errors and insufficiencies identified when seeking AI assistance in addressing process safety issues. It also suggests some existing challenges to better “training” of AI to support the needs of the process safety community. It concludes that caution should be applied, especially by less experienced personnel, when seeking AI assistance in addressing process safety–related technical matters.