No abstract

1959that the exchangeable oxygen is an "in-plane" rather than an "axial" ligand.[98MoO(SePh)4]-and [98MoOC14(MeCN)]-enriched with 24.9 atom % "0, presumably due to their intrinsically broader line widths (Table VI) and insufficient enrichment. The observation34*35 of I7O superhyperfine coupling of about (8-16) X lo4 cm-~ in the m o~y~o e n z y m e s xanthine oxidase, xanthine dehydrogenase, and sulfite oxidase in 170H2 demonstrates the dination sphere. The magnitude of the coupling constants suggest Acknowledgment. Dr. J. R. Pilbrow and Dr. A. Edgar are thanked for their provision of computer simulation procedures and Q-band frequency measurements, respectively. A.G.W. thanks while G.R.H. acknowledges the award of a La Trobe University Postgraduate scholarshiD. K.S.M. acknowledges support from presence of an exchangeable oxygen in the molybdenum the Australian Research Grants Committee for financial support the iustralian Researih Grants Committee and a Monash University Special Research Grant. The assistance of Messrs. K. J. Berry and L. Mitchell with magnetic susceptibility measurements is gratefully acknowledged. (34) Gutteridge, S.; Malthouse, J. P. G.; Bray, R. C. J. Znorg. Biochem. (35) Cramer, S. P.; Johnson, J. L.; Rajagopalan, K. v.; Sorrell, T. M. 1979, 11, 355-360. Abstract: The rich electrochemistry of the mononuclear [MVO(XR),]-and triply bridged binuclear [MV202(XR)6z]"-anions (M = Mo, W; X = S, Se; R = Ph, p-tolyl, CH,Ph; Z = uninegative (n = 1) or neutral (n = 0) ligand) is explored in MeCN and DMF at platinum and mercury electrodes over the temperature range +25 to -60 OC. Interconversion of the mononuclear and binuclear forms occurs via reduction and oxidation processes involving the metal and ligand centers. Stepwise reduction of the binuclear MV2 to MlVqv2 and MIV2 species is observed, and the reduced forms undergo chemical reactions which lead to the appearance of 1 molecule of [MNO(XR)4]2-/molecule of [MV202(XR)6z]-reduced. In this way, the alkyl-substituted [MoO(SCH~P~)~]~-/-ions can be generated at 25 OC. Chemically reversible, one-electron reduction of [MVO(XR),]-is observed, while oxidation leads to the formation of [MV202(XR),Z] (Z = solvent) and RXXR via a process involving oxidative dissociation of ligand XR-. For [WVO(XR),]-, the following one-electron couples are observed: [WV'O(XR),] + e-= [WVO(XR),]-+ e-= [WN0(XR),I2-. In view of the direct observation of [Wv1O(XR),], an intramolecular redox step is apparently involvedin the overall oxidation process described above. Wider implications of the ligand redox processes are discussed.

This review discusses the development of trauma care and the retrieval process in Australia, particularly as it impacts on the rural population. In rural and remote settings, trauma is a major cause of death and disability with the death rate from injuries increasing with progressing remoteness. Time is a critical factor in trauma care and the length of time it takes to reach definitive care has a significant impact on patient outcome. In rural areas people have difficulties accessing medical services within a reasonable time period and the delays associated with the provision of trauma care contribute to an unacceptable level of mortality and morbidity. Since it is impractical to provide sophisticated medical services capable of managing severe trauma in rural areas, referral and retrieval form a vital part of the process of rural trauma care. The focus of this review is the management of severe trauma in rural areas. It will discuss the utilisation of clinical guidelines to improve the process of trauma care and examine if they can be used to reduce the time taken by rural health facilities to seek advice and request retrieval services. The evolution of trauma care in Australia, including the referral and retrieval processes, will be discussed and strategies aimed at improving tertiary hospital referral identified.

is the only complete medical school in northern Australia, and it has a mission to prepare graduates to meet the unique needs of the region with a particular emphasis on rural, remote, Indigenous and tropical health. Eight-week 'rural internships' have been undertaken by all sixth-year medical students at James Cook University since 2005. Each student had previously completed at least 12 weeks of structured rural placements in years 2 and 4, as well as other core teaching in rural health including the year 2 subject, 'Rural, Remote, Indigenous and Tropical Health'. Students worked in rural hospitals across northern Australia developing and practising clinical skills under the supervision of senior staff.Students undertook full-time inpatient and outpatient responsibilities under supervision, being rostered for after-hours work with appropriate support. Assessment involved a learning portfolio, including multi-source feedback from peers, supervisors and patients, and a population health project and a telephone referral exercise.Methods: This article describes the development, implementation and assessment of the first years of the program, from 2005 to 2007. Evaluation included student questionnaires, site visits and interviews, and follow-up teleconferences with preceptors. Results:The rural internship provides senior medical students with valuable experience by active participation in the healthcare team. Students reported a rich and varied clinical experience. Students accept limited supervised responsibility and further their ability and confidence to undertake the role of the intern. Importantly, they proved not to be a burden to the system. This rotation therefore appears to meet educational needs without compromising the local workforce (and indeed may add to it). Students felt welcomed by their communities and enjoyed the social and cultural aspects of their attachment, as well as the clinical aspects and the opportunity to further their understanding of rural communities, rural health care and the healthcare team. Preparation of the students, the preceptors and the communities emerged as a key element of success. Conclusion:This model extends and enhances the traditional apprenticeship model by its rural focus and distributed nature, and involvement of the entire student cohort. In addition, the contribution to patient care by senior students and junior doctors enables a © TK Sen Gupta, RB Murray, A McDonell, B Murphy, AD Underhill, 2008. A licence to publish this material has been given to ARHEN http://www.rrh.org.au 2 consultant-registrar-resident model, in which experienced rural doctors function as consultants providing advice, support and tuition rather than predominantly face-to-face patient care. This approach also provides a means to address an emerging paradox: rural preceptors and communities want to teach students, appreciating the long-term workforce implications, but are increasingly constrained by resources, particularly time. Similar innovative approaches should be explored in other settings.