Barriers to effective research supervision in clinical specialist training: Experience from a medical school in Malaysia

@#Introduction: A compulsory research component is becoming increasingly common for clinical residents. However, integrating research into a busy clinical training schedule can be challenging. This study aimed to explore barriers to research supervision in specialist training programmes from the perspectives of clinical supervisors and trainees at a Malaysian university hospital. Methods: Qualitative interviews and focus group discussions were conducted (December 2016 to July 2017) with clinical supervisors (n=11) and clinical trainees (n=26) utilising a topic guide exploring institutional guidelines, research culture and supervisor-student roles. Interviews were transcribed verbatim and analysed thematically to identify barriers to research supervision. Results: Supervisors and trainees from 11 out of 18 departments participated. Both clinical supervisors and trainees struggled to successfully integrate a compulsory research component into residency training. Among the reasons identified included a lack of supervisory access due to the nature of clinical rotations and placements, clashing training priorities (clinical vs research) that discouraged trainees and supervisors from engaging in research, poor research expertise and experience among clinical supervisors hampering high-quality supervision, and a frustrating lack of clear standards between the various parties involved in research guidance and examination. Conclusion: Both clinical supervisors and trainees struggled to successfully integrate a compulsory research component into residency training. This was not only an issue of resource limitation since questions regarding clinical priorities and unclear research standards emerged. Thus, institutional coordinators need to set clear standards and provide adequate training to make research meaningful and achievable for busy clinical supervisors and trainees.

Experimental study on effect of anhydroicaritin phytosomes in preventing and treating bone loss and enhancing bone quality in ovariectomized osteoporosis rats / 中国中药杂志

<p><b>OBJECTIVE</b>To explore the effect of anhydroicaritin phytosomes (AIP) in preventing and treating bone loss and enhancing bone quality in ovariectomized osteoporosis rats.</p><p><b>METHOD</b>Seventy-two SD female rats were randomly divided into 6 groups: the sham group, the model group, the estrogen group and AIP groups (low, middle, high). The sham group was only sham operated, and the remaining five groups were ovariectomized. One week after the ovariectomy, the rats were given 17 beta-estrogen and AIP (15, 30, 60 mg x kg(-1)) for consecutively three months, during which period their serum calcium (s-Ca), serum phosphorus(s-P), alkaline phosphate (ALP), urine calcium (u-Ca), urine phosphorus(u-P), urinary deoxypyridinoline (D-Pyr) and creatinine (Cr) were detected. Subsequently, rats were sacrificed, and their thighbone, second lumbar vertebrate and forth lumbar vertebrate were collected to detect bone mineral density (BMD), bone calcium (b-Ca) and phosphorus (b-P), biomechanical properties and bone histomorphometric parameters.</p><p><b>RESULT</b>Compared with the sham group, the model group showed a significant increase in serum ALP, u-Ca and D-Pyr /Cr, and reduction in BMD of femur, b-Ca and b-P, biomechanical properties (elastic load, maximum load, break load, stiffness), static parameters (total tissue area, trabecular area, trabecular perimeter) and dynamic parameters (% L Pm, BFR/BV and BFR/ TV), with metratrophia. Compared with the model group, ALP high and middle-dose groups and the estrogen group showed a decrease in serum ALP, u-Ca and D-Pyr/Cr, and growth in BMD of femur, b-Ca and b-P, biomechanical properties of the forth lumbar vertebrae (elastic load, maximum load, break load, stiffness), static parameters (total tissue area, trabecular area, trabecular perimeter) and dynamic parameters (% L Pm, BFR/BV and BFR/TV). The beta-estrogen group showed endometrial hyperplasia, whereas AIP groups showed no hyperplastic change.</p><p><b>CONCLUSION</b>AIP could inhibit enhanced bone turnover induced by ovariectomy, improve BMD the biomechanical properties of vertebrae, without any stimulation on uterus.</p>

Electrocardiographic characteristics and radiofrequency catheter ablation results of ventricular tachycardia or premature ventricular contractions originating in the vicinity of atrioventricular annulus / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the electrocardiographic (ECG) characteristics and results of radiofrequency catheter ablation (RFCA) of idiopathic ventricular tachycardia or premature ventricular contractions (VT/PVCs) originating in the vicinity of atrioventricular annulus.</p><p><b>METHODS</b>Nineteen patients with idiopathic VT/PVCs underwent conventional electrophysiological study and RFCA were included in this analysis. The 12 leads (ECG) characteristics were also analyzed.</p><p><b>RESULTS</b>The VT/PVCs were originated in the vicinity of mitral annulus in 10 cases, including anterolateral (n = 5), posterolateral (n = 3) and posteroseptal (n = 2). The VT/PVCs were originated in the vicinity of tricuspid annulus in the rest 9 cases, including the free wall (n = 5) and the septal portion (n = 4). The 12-lead ECG patterns of VT/PVCs originating in the vicinity of atrioventricular annulus were helpful for determine the site of RFCA. The VT/PVCs were successfully eliminated by RFCA in all cases.</p><p><b>CONCLUSION</b>The exact origin of VT/PVCs originating in the vicinity of atrioventricular annulus could be determined by 12-leads ECG analysis and can be successfully and safely cured by RFCA.</p>