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Respiratory examination – OSCE Guide
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Explaining immunisations can be a bit daunting! This is a quick template of a general counselling station (in most OSCE situations you wouldn’t be expected to get this all out in one!) It’s more just trying to be comprehensive in order to cover several different stations along the same theme that may arise. Examples include explaining what immunisations are and why we do them, explaining the need and benefits of some immunisations,explaining the process of getting an immunization and the good old “MMR” scandal. Check out the explaining immunisations OSCE mark scheme here.

Explaining immunisations
Explanation
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Vaccine day
MMR questions
Closing the consultation
Interactive mark scheme
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Introduce yourself – explain your role

Introduce yourself –

Confirm parent and child’s details – name / DOB

Confirm parent and child’s details –

“Hello, Mrs/Mr xxxxx? I’m one of the student doctors working with the practice today. I’ve been asked to come and speak with you, is that okay? Can I just confirm baby’s name and date of birth, and who you are please?”

Establish why present, check understanding and ask what they want to find out

“Why have you come to clinic today?”

“What would you like to know about the vaccination programme? What do you already know?”

“Is there anything particular that concerns you regarding the vaccination programme?”

Explanation

Vaccinations help protect children from serious disease and also provide protection for society as a whole (herd immunity).

Vaccinations help protect children from serious disease and also provide protection for society as a whole

“The vaccination programme is very safe, and almost all babies will have them. The reason for vaccination is both to protect your child from harm, and the community as a whole.”

“Giving a child a vaccination against a disease dramatically lowers the risk of them catching the illness which could be extremely harmful to them both in the short and long-term. By stopping the disease developing in your child, we also stop your child being able to spread the disease, so it can be considered a public health benefit too. The aim is to immunize enough people that we can stop the disease completely – this happened with smallpox in some countries”

“Oh word?? So you can continue to play us but we can’t play y’all?” Trace Lysette, a transgender actress, wrote on Twitter after the casting announcement. “Hollywood is so f***ed… I wouldn’t be as upset if I was getting in the same rooms as Jennifer Lawrence and Scarlett for cis roles, but we know that’s not the case. A mess.”

“Actors who are trans never even get to audition FOR ANYTHING OTHER THAN ROLES OF TRANS CHARACTERS,” transgender actress Jamie Clayton tweeted. “THATS THE REAL ISSUE. WE CANT EVEN GET IN THE ROOM. Cast actors WHO ARE TRANS as NON TRANS CHARACTERS. I DARE YOU.”

Actors who are trans never even get to audition FOR ANYTHING OTHER THAN ROLES OF TRANS CHARACTERS. THATS THE REAL ISSUE. WE CANT EVEN GET IN THE ROOM. Cast actors WHO ARE TRANS as NON TRANS CHARACTERS. I DARE YOU

— Jamie Clayton (@MsJamieClayton)

Once the news of Johansson’s decision spread, many people took to Twitter to celebrate.

LRT: I'm glad ScarJo came to her senses with regards to portraying a trans person. If this project goes forward, I hope it does so with more appropriate casting.

still never gonna forgive her for ghost in the shell though

— Paul Krueger 2: Paulectric Kruegaloo (@NotLikeFreddy)

OMG HER MIND, I'M SO PROUD OF YOU SCARLETT INGRID JOHANSSON

— αzυ ㅤ (@scarlettf4ncy)

"It's just Twitter! It's just the internet!"

You all are going to *STOP* underestimating the access and voice that social media has given to marginalized folx to challenge these kinds of things from jump street.

— Clarkisha Kent: Bushmaster's Revenge (@IWriteAllDay_)

Good! Now cast a trans man. We deserve the chance to tell our own stories.

— Blue Lion Badger (@mysicksadlife)

IS THIS WHAT LIVING FEELS LIKE

— Julia Kaye (@upandoutcomic)

How about, we just start casting trans (honestly any LGBTQA+ in general) and poc folks in everything naturally?

Like having them appear in all sorts of content?

And not just as tokens? Or -just- to talk about being trans/gay/poc/etc?

That'd be -really- cool.

— Kdin Jenzen @ RTX Austin (@KdinJenzen)

—With files from Chris Jancelewicz

©2018Global News, a division of Corus Entertainment Inc.

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Data are presented as standardized activity index of merozoite ADRB calculated as

ADRB index = (rlu maximum sample/rlu maximum HIS) ×1000

where rlu maximum HIS is an average of the first and last wells on the plate. Only experiments in which the rlu maximum HIS was≥100 (≥6×background), were included in the analyses. An additional internal control with the same positive serum was included in each run.

Chemiluminescence assay using antigen coated on plates

Baculovirus PfMSP1p19 was coated on white Nunc opaque Maxisorp plates (Dynatech) at 1µg/mL overnight at 4°C. Plates were then washed three times with PBS-Tween-0.05% and blocked for 1h with PBS-BSA2% before a second wash. Native (undecomplemented) sera diluted 1:5 in PBS were then added and incubated for 1h at 37°C. PMN and isoluminol were then added as for classical ADRB (see above) [ 19 , 22 ], before reading in the MicroLumat Plus 96 luminometer (Berthold).

Statistical analysis of ADRB assay data

ELISA and/or ADRB data were analysed for statistical significance using the Wilcoxon signed rank test and the Spearman rank correlation test for non-normally distributed data, and values<0.05 were considered significant. Multiple regression analysis including age of individuals, Ab response to PfMSP1p19 and ADRB was done using R software.

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The prevalence and levels of IgG specific for PfMSP1p19 were first determined in a set of 233 endemic sera, including 119 from Dielmo (holo-endemic) and 114 from Ndiop (meso-endemic). Antibody responses expressed as ELISA OD ratios are summarized in Table. Prevalence of IgG to PfMSP1p19 was high, with 74 and 86% of responders in the Dielmo and Ndiop cohorts, respectively. Both seropositivity and IgG levels to PfMSP1p19 were higher in Dielmo than Ndiop ( P =0.023 and P =0.009 by Fisher’s exact test and Mann Withney rank sum test, respectively).

ADRB and antibodies to PfMSP1p19 correlated with age. A quite significant correlation between the magnitude of ADRB index and IgG responses to PfMSP1p19 was found (Rho=0.71 and 0.68, P <10 −3 for Dielmo and Ndiop, respectively). Stratification of antibody responses to PfMSP1p19 of individuals (Fig.) into non-responders (NR), positive responders (PR, individuals with OD-ratio>2) and high responders (HR; individuals with OD-ratio>7) outlined a significant association of ADRB with increasing response to PfMSP1p19 ( P <10 −3 ). The significant contribution of PfMSP1p19 antibody responses to ADRB was confirmed highly significant P <10 −4 in an age-adjusted linear regression model.

Fig.1
ADRB responses stratified by anti PfMSP1p19 antibody levels in the two villages. ADRB measured in 119 and 114 sera from Dielmo and Ndiop, respectively are plotted as function of their anti-PfMSP1p19 antibodies responses stratified into three levels: non-responders ...

To demonstrate a role for PfMSP1p19-specific IgG in the ADRB, assays were carried out using either P. falciparum D10 (D10-PfM3′) or transgenic D10 PcMEGF merozoites, in which PfMSP1p19 has been replaced by the non-cross reactive P. chabaudi homologue, PcMSP1p19 [ Pierre Hardy Woman Embellished Suede Sandals Chocolate Size 40 Pierre Hardy Cheap Popular UX0gg6acy
], such that differences in observed chemiluminescence signals can be attributed to antibodies specific for PfMSP1p19 [ 21 ]. As shown in Fig., comparative ADRBs were performed using 21 individual sera with high anti-PfMSP1p19 ELISA OD-ratios. Chemiluminescence elicited by the transgenic PcMEGF merozoites was significantly reduced compared to D10-PfM3′ for all individual sera ( P <10 −3 ), varying from 7 to 54% inhibition, with a mean of 33.1%. Importantly a similar reduction of chemiluminescence was observed using the HIS pool of 30 immune antisera, none of which was selected for presence of PfMSP1p19-binding antibodies (and thus unrelated to the 21 individually sera analysed above). These results indicate that antibodies induced by natural P. falciparum infection to this single conserved antigen represent a good proportion of antibodies mediating reactive oxygen species (ROS) release by neutrophils.

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Age Appropriate Chores
By Dr. Bill Maier
Whats in this Article
Approx.
3 min

What chores are important for your children to learn, and what are they capable of doing?

First, recognise the difference between a chore (an ongoing task that benefits the household) and a life skill (an activity that children should know how to do before living on their own, such as managing a bank account). The following list does not include life skills. It is a list of chores.

Second, remember that every child matures at a different pace. Adjust this chart to what you know about your children's skills and talents, and realise that no child should do all of the chores listed below every day.

With those two qualifiers in mind, here are some general guidelines for personal and family chores. This list is only meant as a guide and reflects the types of chores that many children in these age ranges are capable of completing:

Ages 2 and 3

Ages 4 and 5

Note: This age can be trained to use a family chore chart.

Ages 6 and 7

Note: This age can be supervised to use a family chore chart.

Ages 8 to 11

Note: This age benefits from using a family chore chart.

Ages 12 and 13

Ages 14 and 15

Ages 16 to 18

Personal chores

Assist in making their beds

Pick up playthings with your supervision

Family chores

Take their dirty laundry to the laundry basket

Fill a pet's water and food bowls (with supervision)

Help a parent clean up spills and dirt

Get dressed with minimal parental help

Make their bed with minimal parental help

Bring their things from the car to the house

Set the table with supervision

Clear the table with supervision

Help a parent prepare food

Help a parent carry in the lighter groceries

Match socks in the laundry

Answer the phone with parental assistance

Be responsible for a pet's food and water bowl

Hang up towels in the bathroom

Clean floors with a dry mop

Make their bed every day

Brush teeth

Comb hair

Choose the day's outfit and get dressed

Write thank you notes with supervision

Be responsible for a pet's food, water and exercise

Vacuum individual rooms

Wet mop individual rooms

Fold laundry with supervision

Put their laundry in their drawers and closets

Put away dishes from the dishwasher

Help prepare food with supervision

Empty indoor trash cans

Answer the phone with supervision

Take care of personal hygiene

Keep bedroom clean

Be responsible for homework

Be responsible for belongings

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