"I'm a Medic" - a web-based, social capital approach to health careers.

This article was migrated. The article was marked as recommended. Widening access to medicine in U.K. requires outreach that engages schools in remote areas, schools with below average attainment, and schools serving disadvantaged communities in order to develop a more representative profession and meet serious workforce shortages. The approach reported here embodies ideas about how to develop social and educational capital by facilitating live web chats between school children (13-17 years) and teams of health practitioners. "I'm a Medic" comprised three 2-week events over a 10-month period with circa 900 school students and 22 health professionals from general (family) practices participating. A high proportion (78%) of the students was actively engaged in live chats, asking questions, and voting for the most valuable health practitioner. Questions covered education and training, the nature of the practitioners' work, political and ethical aspects of healthcare, and a variety of scientific and personal aspects. Evaluation showed a positive increase in career interest and aspiration for science, healthcare and medicine. Teachers would all recommend "I'm a Medic" to colleagues and all bar one would take part again. They reported it was effective in engaging students, improving their confidence in asking questions, and their awareness of general practice and the NHS. Practitioners reported improvements in their understanding of how school students view healthcare professions, their interest in public engagement, and their confidence in communicating their work. Logistic challenges included conflict between scheduled web chats in normal school time and practitioners' clinical commitments. Nevertheless, the project demonstrated effective engagement across geographic and social/educational barriers, and can provide a valuable mode of outreach, particularly about careers in healthcare.

Surveying the RHIO landscape. A description of current RHIO models, with a focus on patient identification.

Across the country, new RHIOs are being formed every day. The 21 RHIOs studied by the work group illustrate the variety of purposes, funding, and record linking methods RHIOs may adopt. As this trend continues to evolve and improve, RHIOs may prove to be a valuable stepping stone on the road to a national system in which a patient's medical data will be available anywhere, anytime. Accurate patient identification and linking are the foundation of health technology that is implemented in a RHIO or any similar network that shares patient information. Without accurate patient identification, patient safety and quality of care are compromised. When high percentages of duplication or overlaying of records occurs in electronic health record databases, physician trust in the system is lost. As HIM professionals, we must be involved in addressing the security and confidentiality of RHIO databases and in defining the record linking method appropriate to the RHIO. As professionals skilled in patient identification methods and possessing significant organizational skills and personnel management experience, HIM professionals should become involved in this process at the earliest opportunity in the RHIO formation. HIM professionals can participate in long-term planning, business plan development, and organizational structure definition. Future articles will address how HIM professionals can become involved, what particular attributes and skills they can bring to the table, and job descriptions appropriate to HIM professionals in the healthcare information sharing industry. The work group urges all HIM professionals to become involved personally in this exciting new field.

Expression of inducible nitric oxide synthase in cultured smooth muscle cells from rat mesenteric lymphatic vessels.

OBJECTIVE: The objective was to devise a method for establishing cultures of rat mesenteric lymphatic vessel smooth muscle cells (LSMC) and to investigate if inducible nitric oxide synthase (iNOS) expression could be activated in LSMC treated with bacterial lipopolysaccharide (LPS). METHODS: LSMC were successfully grown from explanted rat lymphatic microvessels and maintained by subculture. Treatment of LSMC for 24 h with LPS (1-100 microg/mL) activated iNOS protein induction, associated with (1) assay of increased nitrite concentrations in the medium representing cellular nitric oxide synthesis, and (2) demonstration of iNOS in cell extracts by Western blotting. RESULTS: The protein synthesis inhibitor cycloheximide (10 microM) blocked both LPS-induced nitrite formation and iNOS protein expression in LSMC. 1400 W (1 microM), a selective iNOS inhibitor, prevented LPS-induced nitrite formation but not iNOS expression. As well as induction of iNOS by LPS, "constitutive" iNOS was present in some cultures, producing nitrite in amounts that were also subsequently reduced after cell treatment with 1400 W. CONCLUSION: Rat mesenteric LSMC produce nitrite and express iNOS in response to bacterial LPS. Cultured LSMC may provide a useful model for studying mechanisms of iNOS induction in relation to possible influences of iNOS upon lymphatic vessel function.