Junior doctors' preparedness to prescribe, monitor, and treat patients with the antibiotic vancomycin in an Australian teaching hospital / 보건의료교육평가

PURPOSE: We aimed to assess the preparedness of junior doctors to use vancomycin, and to determine whether attending an educational session and being provided pocket guidelines were associated with self-reported confidence and objective knowledge. METHODS: This was a 2-component cross-sectional study. A 60-minute educational session was implemented and pocket guidelines were provided. Preparedness was evaluated by a self-reported confidence survey in the early and late stages of each training year, and by continuing medical education (CME) knowledge scores. RESULTS: Self-confidence was higher among those later in the training year (n=75) than in those earlier (n=120) in the year for all questions. In the late group, vancomycin education was associated with higher self-confidence regarding the frequency of therapeutic drug monitoring (P=0.02) and dose amendment (P=0.05); however, the confidence for initial monitoring was lower (P<0.05). Those with pocket guidelines were more confident treating patients with vancomycin (P<0.001), choosing initial (P=0.01) and maintenance doses (P<0.001), and knowing the monitoring frequency (P=0.03). The 85 respondents who completed the knowledge assessment scored a mean±standard deviation of 8.55±1.55 on 10 questions, and the interventions had no significant effect. CONCLUSION: Attending an educational session and possessing pocket guidelines were associated with preparedness, as measured by higher self-reported confidence using vancomycin. High knowledge scores were attained following CME; however attending an educational session or possessing pocket guidelines did not significantly increase the knowledge scores. Our findings support providing educational sessions and pocket guidelines to increase self-confidence in prescribing vancomycin, yet also highlight the importance of evaluating content, format, and delivery when seeking to improve preparedness to use vancomycin through education.

Maintenance of horse embryonic stem cells in different conditions

Embryonic stem cells [EScs] are originally derived from the ICM of blastocysts and are characterized by their ability to self-renew and their pluripotencies. Only a few reports have been published on ESC isolations and line establishment in animals, even fewer in horses. However, it is still important to isolate equine ESCs for animal biotechnology and therapeutic applications. In the present study, we tried to derive horse ESC lines from the ICM of blastocysts fertilized in vivo and maintain their pluripotencies in different conditions. The primary horse ESCs were able to self-renew when they were cultured in basic medium on gamma-irradiated colonies were positive for Oct-4, SSEA-1, GCTM-2, TRA-1-60 and TRA-1-81. Moreover, to optimize the culture conditions, these putative horse ESCs were cultured in basic medium supplemented with human leukemia inhibitory factor [hLIF] only, human basic fibroblastic growth factor [hbFGF] only, or hbFGF plus hLIF with or without heterologous [MEF] feeder cells. Based on our results, the heterologous feeder [MEF] cells are necessary to maintain the undifferentiated state for horse ESCs, and ESC-like cell morphology of suggested that hLIF was neither prerequisite nor negative for maintenance of horse ESCs; bFGF seemed to be negative for maintenance of horse ECSs and the combination of hLIF and bFGF was unable to improve the culture condition