Different abundance and correlational patterns exist between total and presumed pathogenic Vibrio vulnificus and V. parahaemolyticus in shellfish and waters along the North Carolina coast.

Monitoring of Vibrio vulnificus and V. parahaemolyticus abundance is pertinent due to the ability of these species to cause disease in humans through aquatic vectors. Previously, we performed a multiyear investigation tracking Vibrio spp. levels in five sites along the southeastern North Carolina coast. From February 2013 to October 2015, total V. vulnificus and V. parahaemolyticus abundance was measured in water, oysters and clams. In the current study, pathogenic subpopulations were identified in these isolates using molecular markers, revealing that 5.3% of V. vulnificus isolates possessed the virulence-correlated gene (vcgC), and 1.9% of V. parahaemolyticus isolates harbored one or both of the virulence-associated hemolysin genes (tdh and trh). Total V. parahaemolyticus abundance was not sufficient to predict the abundance of pathogenic subpopulations. Specifically, pathogenic V. parahaemolyticus isolates were more often isolated in cooler waters and were sometimes isolated when no other V. parahaemolyticus strains were detectable. Vibrio vulnificus clinical (C-) genotypes correlated with total V. vulnificus; however, salinity, water depth and total suspended solids influenced C- and E-genotypes differently. Lastly, we documented individual oysters harboring significantly higher V. vulnificus levels for which there was no ecological explanation, a phenomenon that deserves closer attention due to the potentially elevated health hazard associated with these 'hot' shellfish.

Participation in interprofessional education: an evaluation of student and staff experiences.

This study investigates the experiences of staff and students involved in an identified Common Learning unit (module) named "Preparation for Practice". The unit was studied by those undertaking pre-registration undergraduate pathways in Physiotherapy, Occupational Therapy, Diagnostic Radiography and Therapeutic Radiography at London South Bank University. The study comprised uni-professional, inter-professional and staff focus groups. The main themes that emerged from the student focus groups were "Interprofessional awareness", "Impact on patient care" and "Positive and negative aspects of unit delivery". These themes were reflected in the staff focus group which also highlighted the impact of different learning and teaching strategies in working with interprofessional groups. Students and staff were able to understand the benefits of interprofessional education but they also identified barriers that detracted from the students' learning. Overall a variety of views were expressed which reflected the diversity of the student group and the challenges that this presented in the delivery of interprofessional education.

Perioperative workflow: barriers to efficiency, risks, and satisfaction.

An in-depth, interdisciplinary case study was conducted to map and describe the information, material, and functional processes common to high-volume surgical specialty procedures at a southeastern US hospital. Researchers identified process defects and their effects using both observation and staff member interviews. Outdated information and structural barriers to communications were responsible for many procedural delays, procedural interruptions, and staff member work-arounds. Opportunities for improvement are identified, including redesigns and enhancement of information technology systems.