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Guidelines for conversations typically shared a common structure, and strategies aligned with a stage. Core transferrable communication skills (i.e., micro-skills) were identified across various types of conversation, and the major differences between frameworks were related to the way that power was distributed in the conversation and the evolution of conversations along the along the path of redistributing power. As part of the synthesis, an overarching framework "prepare-EMPOWER enact" was developed to capture these shared principles across discourses. CONCLUSIONS Adopting frameworks for work-based communication that promote dialogue and empower individuals to contribute may represent an important step towards learner-centred education and person-centred care for patients.BACKGROUND Domestic violence (DV) has become a global burden. The high occurrence of intimate partner violence (IPV) across the globe has implications for the socioeconomic wellbeing and health of children and women. METHODS Data for the study was from the 2014 Ghana Demographic and Health Survey (GDHS). The association between approval of wife-beating and background characteristics of women was examined by the use of a Binary Logistic Regression model. RESULTS A higher proportion of respondents were from urban areas (53.7 and 52.2% women and men respectively). The ages of women ranged from 15 to 49 (mean = 30, SD = 9.7) whilst the age range of men was 15-59 (mean = 32, SD = 12.5). Twenty-four percent of the men and 23% of the women were within the richest wealth category. The results showed that few women (6.3%) and men (11.8%) had attained higher education. Both women (AOR = 1.3; CI = 1.01-1.24) and men (AOR = 2.2; CI = 1.72-2.76) aged 15-24 had higher odds of approving wife-beating than those aged 35-49 (rmedia has also proven to be a protective factor against domestic violence approval and, as such, much progress can be made if utilised by human rights activists, especially through radio, magazine and television broadcasting.BACKGROUND Dental caries is one of the most prevalent chronic oral diseases worldwide. Dental caries is mainly associated with Streptococcus mutans and the Lactobacillus species. A specific relationship was found between nicotine and S. mutans growth as the presence of nicotine increased S. mutans biofilm formation. Nicotine is able to increase the number of S. mutans and extracellular polysaccharide (EPS) synthesis. Among the widely used herbs and spices is cinnamon which demonstrated a strong antibacterial activity against a wide variety of bacteria including S. mutans and showed the ability to inhibit S. Epinephrinebitartrate mutans biofilm formation. Cinnamon essential oil, obtained from the leaves of C. zeylanicum, has been demonstrated to be effective against S. mutans and Lactobacillus acidophilus, which are partially responsible for dental plaque formation and caries development. The aim of this study was to identify the effects of nicotine exposure on the inhibitory effects of cinnamon water extract on S. mutans biofilm formation. MATERIALS AND METHODS A 24-h culture of S. mutans UA159 in microtiter plates was treated with varying nicotine concentrations (0-32 mg/ml) in Tryptic Soy broth supplemented with 1% sucrose (TSBS) with or without a standardized concentration (2.5 mg/ml) of cinnamon water extract. A spectrophotometer was used to determine total growth absorbance and planktonic growth. The microtiter plate wells were washed, fixed and stained with crystal violet dye and the absorbance measured to determine biofilm formation. RESULTS The presence of 2.5 mg/ml cinnamon water extract inhibits nicotine-induced S. mutans biofilm formation from 34 to 98% at different concentrations of nicotine (0-32 mg/ml). CONCLUSION The results demonstrated nicotine-induced S. mutans biofilm formation is decreased from 34 to 98% in the presence of 2.5 mg/ml cinnamon water extract. This provides further evidence about the biofilm inhibitory properties of cinnamon water extract and reconfirms the harmful effects of nicotine.BACKGROUND Modern data driven medical research promises to provide new insights into the development and course of disease and to enable novel methods of clinical decision support. To realize this, machine learning models can be trained to make predictions from clinical, paraclinical and biomolecular data. In this process, privacy protection and regulatory requirements need careful consideration, as the resulting models may leak sensitive personal information. To counter this threat, a wide range of methods for integrating machine learning with formal methods of privacy protection have been proposed. However, there is a significant lack of practical tools to create and evaluate such privacy-preserving models. In this software article, we report on our ongoing efforts to bridge this gap. RESULTS We have extended the well-known ARX anonymization tool for biomedical data with machine learning techniques to support the creation of privacy-preserving prediction models. Our methods are particularly well suited for chniques. CONCLUSIONS With the tool presented in this article, accurate prediction models can be created that preserve the privacy of individuals represented in the training set in a variety of threat scenarios. Our implementation is available as open source software.BACKGROUND In the Netherlands, the obstetric and neonatal healthcare system consists of multiple healthcare organizations. Due to this system, transfers between healthcare professionals are inevitable. Transfers can interrupt the continuity of care, which is an important aspect of care quality. The aim of this study is to examine how healthcare professionals transfer their clients and to understand factors that facilitate or impede continuity of care. METHODS We conducted 15 semi-structured interviews with community midwives (4), obstetricians/clinical midwives (4), maternity care assistants (4), and youth healthcare nurses (3) between June and September 2016. After discussing the meaning of transfers of care, we introduced a vignette on the care process of a pregnant woman and asked about the methods the professional would use to transfer a client and about factors that facilitate or impede continuity of care. RESULTS Obstetric and neonatal healthcare professionals mentioned 19 factors that facilitate or impede continuity of care. The facilitating factors were, e.g., usage of protocols and standard formats, transfers in person, being accessible, and multidisciplinary meetings. Impeding factors included, e.g., acute situations, experienced hierarchy, insufficient knowledge of protocols, and privacy concerns. CONCLUSION Professionals mentioned a broad variety of factors facilitating and impeding continuity of care.BACKGROUND Telemedicine is one of the healthcare sectors that has developed the most in recent years. Currently, telemedicine is mostly used for patients who have difficulty attending medical consultations because of where they live (teleconsultation) or for specialist referrals when no specialist of a given discipline is locally available (telexpertise). However, the use of specific equipment (with dedicated cameras, screens, and computers) and the need for institutional infrastructure made the deployment and use of these systems expensive and rigid. Although many telemedicine systems have been tested, most have not generally gone beyond local projects. Our hypothesis is that the use of smartphones will allow health care providers to overcome some of the limitations that we have exposed, thus allowing the generalization of telemedicine. MAIN BODY This paper addresses the problem of telemedicine applications, the market of which is growing fast. Their development may completely transform the organization of healthcare systems, change the way patients are managed and revolutionize prevention. This new organization should facilitate the lives of both patients and doctors. In this paper, we examine why telemedicine has failed for years to take its rightful place in many European healthcare systems although there was a real need. By developing the example of France, this article analyses the reasons most commonly put forth the administrative and legal difficulties, and the lack of funding. We argue that the real reason telemedicine struggled to find its place was because the technology was not close enough to the patient. CONCLUSION Finally, we explain how the development of smartphones and their current ubiquitousness should allow the generalization of telemedicine in France and on a global scale.BACKGROUND To assess the prevalence of urban-rural disparity in lower extremities amputation (LEA) among patients with diabetes and to explore whether patient-related or physician-related factors might have contributed to such disparity. METHODS This was a population-based study including patients with diabetes aged ≥55 years from 2009 to 2013. Among them, 9236 received LEA. Data were retrieved from Taiwan's National Health Insurance (NHI) claims. A multiple Poisson regression model was also employed to assess the urban-rural difference in LEA prevalence by simultaneously taking into account socio-demographic variables and density of practicing physicians. RESULTS Between 2009 and 2013, the annual prevalence of LEA declined from 30.4 to 20.5 per 10,000 patients. Compared to patients from urban areas, those who lived in sub-urban and rural areas suffered from a significantly elevated prevalence of LEA, with a prevalence rate ratio (PRR) of 1.47 (95% CI, 1.39-1.55) and 1.68 (95% CI, 1.56-1.82), respectively. The density of physicians who presumably provided diabetes care can barely explain the urban-rural disparity in LEA prevalence. CONCLUSIONS Although the universal health insurance has largely removed financial barriers to health care, the urban-rural disparity in LEA prevalence still exists in Taiwan after nearly two decades of the NHI program.BACKGROUND The Objective Structured Clinical Examination (OSCE) has been used in pediatrics since the 1980s. Its main drawback is that large numbers of children are needed to make up for the fatigue factor inherent in prolonged testing periods. Also, examinations mainly include children between 7 and 16 years old. We describe the summative examination used in our institution to evaluate medical students' clinical competencies in pediatrics with realistic available resources and for a wider age-range. We also evaluated different factors known to influence medical students' performances. METHODS This retrospective, descriptive, observational study evaluated the 740 distinct pediatric examination results of fourth-year medical students over 5 years. Their summative examination combined two different assessment methods a structured real-patient examination (SRPE) using standardized assessment grids for the most frequent pediatric diagnoses, and a computer-based written examination (CBWE). RESULTS Our approach defined an appropriate setting for some key elements of the educational objectives of pediatrics training, such as balancing the child-parent-pediatrician triangle and the ability to interact with pediatric patients, from newborns to 16-year-old adolescents, in a child-friendly fashion in realistic scenarios. SRPE scores showed no associations with students' degrees of exposure to specific lecture topics, vignettes, or bedside teaching. The impacts of clinical setting, topic, and individual examiners on SRPE scores was quite limited. Setting explained 1.6%, topic explained 4.5%, and examiner explained 4.7% of the overall variability in SRPE scores. CONCLUSIONS By combining two different assessment methods, we were able to provide a best-practice approach for assessing clinical skills in Pediatrics over a wide range of real patients.
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