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The Handbook: an end to 'I wish I had known that before I started'.

ABSTRACT: The importance of an effective handover between clinicians is vital, particularly for junior doctors when commencing a new clinical rotation. When junior doctors commence a new rotation there is often a significant amount of new information and tasks that they must learn, whilst also maintaining a high level of care for patients. However, very little information is formally passed from the outgoing junior doctor to the incoming junior doctor when changing rotations, resulting in a gap in knowledge and information having to be relearned by each junior doctor for each ward. Through a junior doctor led service improvement initiative we created an intranet-based, updateable, easily accessible, and secure resource to assist junior doctors during this transition period. Our project was not only beneficial to junior doctors when starting on a new rotation but also helped them understand their role within the ward environment and become more efficient in their clinical work. The project is an example of a sustainable service improvement project implemented with no cost that due to its format and low maintenance, could be easily adapted on a wider scale in other hospitals or Trusts.

SUBMITTER: Davies M

PROVIDER: S-EPMC4645908 | biostudies-other | 2015

REPOSITORIES: biostudies-other

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The Handbook: an end to 'I wish I had known that before I started'.

Davies Mike M Panchal Sonia S Misra Nikhil N

BMJ quality improvement reports 20150306 1

The importance of an effective handover between clinicians is vital, particularly for junior doctors when commencing a new clinical rotation. When junior doctors commence a new rotation there is often a significant amount of new information and tasks that they must learn, whilst also maintaining a high level of care for patients. However, very little information is formally passed from the outgoing junior doctor to the incoming junior doctor when changing rotations, resulting in a gap in knowled ...[more]

PMID: 26734361

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Project description:BACKGROUND: The black tiger shrimp (Penaeus monodon) is one of the most important aquaculture species in the world, representing the crustacean lineage which possesses the greatest species diversity among marine invertebrates. Yet, we barely know anything about their genomic structure. To understand the organization and evolution of the P. monodon genome, a fosmid library consisting of 288,000 colonies and was constructed, equivalent to 5.3-fold coverage of the 2.17 Gb genome. Approximately 11.1 Mb of fosmid end sequences (FESs) from 20,926 non-redundant reads representing 0.45% of the P. monodon genome were obtained for repetitive and protein-coding sequence analyses. RESULTS: We found that microsatellite sequences were highly abundant in the P. monodon genome, comprising 8.3% of the total length. The density and the average length of microsatellites were evidently higher in comparison to those of other taxa. AT-rich microsatellite motifs, especially poly (AT) and poly (AAT), were the most abundant. High abundance of microsatellite sequences were also found in the transcribed regions. Furthermore, via self-BlastN analysis we identified 103 novel repetitive element families which were categorized into four groups, i.e., 33 WSSV-like repeats, 14 retrotransposons, 5 gene-like repeats, and 51 unannotated repeats. Overall, various types of repeats comprise 51.18% of the P. monodon genome in length. Approximately 7.4% of the FESs contained protein-coding sequences, and the Inhibitor of Apoptosis Protein (IAP) gene and the Innexin 3 gene homologues appear to be present in high abundance in the P. monodon genome. CONCLUSIONS: The redundancy of various repeat types in the P. monodon genome illustrates its highly repetitive nature. In particular, long and dense microsatellite sequences as well as abundant WSSV-like sequences highlight the uniqueness of genome organization of penaeid shrimp from those of other taxa. These results provide substantial improvement to our current knowledge not only for shrimp but also for marine crustaceans of large genome size.

Project description:Tremella fuciformis is a popular edible fungus with fruiting bodies that can be produced in large quantities at low costs, while it is easy to transform and cultivate as yeast. This makes it an attractive potential bioreactor. Enhanced heterologous gene expression through codon optimization would be useful, but until now codon usage preferences in T. fuciformis remain unknown. The only available genome of a species in the genus Tremella was that of Tremella mesenterica. To precisely determine the preferred codon usage of T. fuciformis we sequenced the genome of strain Tr26 resulting in a 24.5 Mb draft genome with 10,040 predicted genes. 3288 of the derived predicted proteins matched the UniProtKB/Swiss-Prot databases with 40% or more similarity. Corresponding gene models of this subset were subsequently optimized trough repetitive comparison of alternative start codons and selection of best length matching gene models. For experimental confirmation of gene models, 96 random clones from an existing T. fuciformis cDNA library were sequenced, generating 80 complete CDSs. Calculated optimal codons (RSCU and RFCU values) for the 3288 predicted and the 80 cloned CDSs were highly similar, indicating sufficient accuracy of predicted gene models for codon usage analysis. T. fuciformis showed a strong preference for C and then G (C+G; 66.4 %) at the third base pair position of used codons, while average GC content of predicted genes was slightly higher (58.5 %) than he total genome sequence average (55.9%). Most frequently used codons (optimal codons) all ended in C or G except for one (Ter; AGU), and an increased frequency of C ending codons was observed in genes with higher expression levels. Surprisingly, the preferred codon usage in T. fuciformis strongly differed from T. mesenterica (same genus) and C. neoformans (same family). Instead, optimal codon usage was similar to more distant related species such as Ustilago maydis and Neurospora crassa. Despite much higher overall sequence homology between T. fuciformis and T. mesenterica only 7 out of 21 optimal codons were equal, whereas T. fuciformis shared up to 20 out 21 optimal codons with other species. Clearly, codon usage in Tremella can differ largely and should be estimated for individual species. The precise identification of optimal and high expression related codons is therefore an important step in the development of T. fuciformis as a bioreactor system.

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The Handbook: an end to 'I wish I had known that before I started'.

Publications

The Handbook: an end to 'I wish I had known that before I started'.

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