Oesophageal acellular matrix can be successfully obtained by decellularization of pig oesophagus using a gentle DET via the oesophageal lumen. This decellularization method preserves the ultrastructure of the native tissue and could represent the basis for a tissue-engineered oesophagus.
Reflective practice is a paper requirement of your career progression in health care. However, if done properly, it can greatly improve your skills as a health care provider. This article provides some structure to reflective practice to allow a health care provider to engage more with reflective practice and get more out of the experience.
Audits and quality improvement projects are vital aspects of clinical governance and continual service improvement in medicine. In this article we describe the process of clinical audit and quality improvement project. Guidance is also provided on how to design an effective audit and bypass barriers encountered during the process.
What is a clinical audit?An audit assesses if a certain aspect of health care is attaining a recognized standard. This lets care providers and patients know where their service is doing well, and where there could be improvements. The aim is to achieve quality improvement and improve outcomes for patients.Audits are a quality improvement measure and one of the 7 pillars of clinical governance. It allows organizations to continually work toward improving quality of care by showing them where they are falling short, allows them to implement improvements, and reaudit or close the audit cycle to see if beneficial change has taken place.Clinical audits are a cycle with several steps:(1) Identifying a problem, for example, patients waiting too long in accident and emergency (A&E). (2) Defining standards/criteria, for example, guidelines recommend that 95% of patients should wait < 4 hours. (3) Collect data, for example, record over a week how long patients wait (determining that 92% wait for < 4 h). (4) Analysis, for example, 92% versus 95% target, areas for improvement. (5) Implementing change, for example, action plan to help reach target. (6) Reaudit, for example, do step 1-5 again.
Tendon injuries are a common and rising occurrence, associated with significant impairment to quality of life and financial burden to the healthcare system. Clinically, they represent an unresolved problem, due to poor natural tendon healing and the inability of current treatment strategies to restore the tendon to its native state. Tissue engineering offers a promising alternative, with the incorporation of scaffolds, cells and growth factors to support the complete regeneration of the tendon. The materials used in tendon engineering to date have provided significant advances in structural integrity and biological compatibility and in many cases the results obtained are superior to those observed in natural healing. However, grafts fail to reproduce the qualities of the pre-injured tendon and each has weaknesses subject to its constituent parts. Furthermore, many materials and cell types are being investigated concurrently, with seemingly little association or comparison between research results. In this review the properties of the most-investigated and effective components have been appraised in light of the surrounding literature, with research from early in-vitro experiments to clinical trials being discussed. Extensive comparisons have been made between scaffolds, cell types and growth factors used, listing strengths and weaknesses to provide a stable platform for future research. Promising future endeavours are also described in the field of nanocomposite material science, stem cell sources and growth factors, which may bypass weaknesses found in individual elements. The future of tendon engineering looks bright, with growing understanding in material technology, cell and growth factor application and encouraging recent advances bringing us ever closer to regenerating the native tendon.
Academic posters are an excellent way to showcase your work at conferences and meetings. They can be used in poster presentations and serve as a summary of your project. In this how to article, we demonstrate how trainees can make and deliver a successful academic poster.
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