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Engaging, accessible, evidence-based interventions are needed to support the professional development of research mentors within the clinical and translational sciences. This article reports on the usage and impact of the University of Minnesota Clinical and Translational Science Institute’s online mentor training module, Optimizing the Practice of Mentoring (OPM). Among the 1,124 OPM users in our contemporary evaluation sample (Feb 2019–June 2022), retrospective pre-to-post gains were observed in respondents’ self-rated mentorship skills (11 items), perceptions of the overall quality of mentoring they provide, and mentoring confidence. A high proportion (83%) of users reported making or intending to make changes in their mentoring practices as a result of the training. Example behavior changes included a greater focus on aligning expectations, more proactive attention to the relationship (overall and its distinct phases), increased usage of active communication skills, adoption of tools such as Individual Development Plans, and ongoing self-reflection. Over a 10-year period, 4,011 unique individuals registered for the module, representing over 650 different institutions (a majority being affiliated with past or current Clinical and Translational Science Hubs). OPM has the versatility to be employed as a standalone, asynchronous approach for mentor development or as one curricular component of more comprehensive, multimodal programs.
A rock cairn, with two matchbooks buried beneath, was found on the summit of the highest hill on Thomas Island, Bunger Hills, East Antarctica. The matchbooks are most likely from United States World War II-era ration packs, which were distributed to various military and civilian expeditions from the mid-1940s into the 1950s. Bunger Hills was first visited by United States Navy ‘Operation Highjump’ in February 1947, when a seaplane most likely landed on a marine inlet, rather than a lake as reported previously. Thomas Island was first visited by United States Navy ‘Operation Windmill’ in January 1948, when a survey point was established, and it is probably this location that is marked by the rock cairn. The matchbooks were replaced beneath the cairn and the rocks replaced. Just over 76 years had elapsed between burial of the matchbooks, construction of the cairn and their rediscovery.
To evaluate the impact of a diagnostic stewardship intervention on Clostridioides difficile healthcare-associated infections (HAI).
Design:
Quality improvement study.
Setting:
Two urban acute care hospitals.
Interventions:
All inpatient stool testing for C. difficile required review and approval prior to specimen processing in the laboratory. An infection preventionist reviewed all orders daily through chart review and conversations with nursing; orders meeting clinical criteria for testing were approved, orders not meeting clinical criteria were discussed with the ordering provider. The proportion of completed tests meeting clinical criteria for testing and the primary outcome of C. difficile HAI were compared before and after the intervention.
Results:
The frequency of completed C. difficile orders not meeting criteria was lower [146 (7.5%) of 1,958] in the intervention period (January 10, 2022–October 14, 2022) than in the sampled 3-month preintervention period [26 (21.0%) of 124; P < .001]. C. difficile HAI rates were 8.80 per 10,000 patient days prior to the intervention (March 1, 2021–January 9, 2022) and 7.69 per 10,000 patient days during the intervention period (incidence rate ratio, 0.87; 95% confidence interval, 0.73–1.05; P = .13).
Conclusions:
A stringent order-approval process reduced clinically nonindicated testing for C. difficile but did not significantly decrease HAIs.
Body image adjustment is a crucial issue for patients with facial cancer, but body image–specific interventions are scarce. We report results of a novel psychotherapeutic intervention to address body image concerns during acute postoperative recovery following facial reconstructive surgery. Our primary aims were to evaluate the intervention’s feasibility, acceptability, and efficacy on body image concerns, psychological distress, and quality of life (QOL).
Methods
Adults with facial cancers who endorsed body image concerns were recruited to participate in a randomized controlled trial. The intervention group participated in 4 in-person counseling sessions. The control group received an educational booklet and a brief phone call. Participants completed measures of body image, distress, and QOL at baseline and at the 4-week follow-up to assess the impact of the intervention. Intervention outcomes were assessed with 2 sample t-tests or Mann–Whitney U tests as appropriate.
Results
Twenty-nine participants completed both the baseline and follow-up assessments. The intervention demonstrated good feasibility with a high retention rate (79%), visit completion rate (81%), and high satisfaction scores (75% reported mean satisfaction score of >3). Intervention did not result in an observed statistically significant difference in reduction in body image dissatisfaction and disturbance, psychological distress, or improvement in QOL compared with the control group. However, intervention resulted in statistically significant difference in perceived social impact (−1 vs. −8.3, p = 0.033) compared to control group.
Significance of results
Our study highlights the potential clinical benefits of a novel psychotherapeutic intervention that targets body image concerns and suggests the need for further evaluation.
Testing of asymptomatic patients for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) (ie, “asymptomatic screening) to attempt to reduce the risk of nosocomial transmission has been extensive and resource intensive, and such testing is of unclear benefit when added to other layers of infection prevention mitigation controls. In addition, the logistic challenges and costs related to screening program implementation, data noting the lack of substantial aerosol generation with elective controlled intubation, extubation, and other procedures, and the adverse patient and facility consequences of asymptomatic screening call into question the utility of this infection prevention intervention. Consequently, the Society for Healthcare Epidemiology of America (SHEA) recommends against routine universal use of asymptomatic screening for SARS-CoV-2 in healthcare facilities. Specifically, preprocedure asymptomatic screening is unlikely to provide incremental benefit in preventing SARS-CoV-2 transmission in the procedural and perioperative environment when other infection prevention strategies are in place, and it should not be considered a requirement for all patients. Admission screening may be beneficial during times of increased virus transmission in some settings where other layers of controls are limited (eg, behavioral health, congregate care, or shared patient rooms), but widespread routine use of admission asymptomatic screening is not recommended over strengthening other infection prevention controls. In this commentary, we outline the challenges surrounding the use of asymptomatic screening, including logistics and costs of implementing a screening program, and adverse patient and facility consequences. We review data pertaining to the lack of substantial aerosol generation during elective controlled intubation, extubation, and other procedures, and we provide guidance for when asymptomatic screening for SARS-CoV-2 may be considered in a limited scope.
Tourette disorder (TD), hallmarks of which are motor and vocal tics, has been related to functional abnormalities in large-scale brain networks. Using a fully data driven approach in a prospective, case–control study, we tested the hypothesis that functional connectivity of these networks carries a neural signature of TD. Our aim was to investigate (i) the brain networks that distinguish adult patients with TD from controls, and (ii) the effects of antipsychotic medication on these networks.
Methods
Using a multivariate analysis based on support vector machine (SVM), we developed a predictive model of resting state functional connectivity in 48 patients and 51 controls, and identified brain networks that were most affected by disease and pharmacological treatments. We also performed standard univariate analyses to identify differences in specific connections across groups.
Results
SVM was able to identify TD with 67% accuracy (p = 0.004), based on the connectivity in widespread networks involving the striatum, fronto-parietal cortical areas and the cerebellum. Medicated and unmedicated patients were discriminated with 69% accuracy (p = 0.019), based on the connectivity among striatum, insular and cerebellar networks. Univariate approaches revealed differences in functional connectivity within the striatum in patients v. controls, and between the caudate and insular cortex in medicated v. unmedicated TD.
Conclusions
SVM was able to identify a neuronal network that distinguishes patients with TD from control, as well as medicated and unmedicated patients with TD, holding a promise to identify imaging-based biomarkers of TD for clinical use and evaluation of the effects of treatment.
Ontological parochialism persists in International Relations (IR) scholarship among gestures towards relational ontological reinvention. Meanwhile, the inter-polity relations of many Indigenous peoples pre-date contemporary IR and tend to be substantively relational. This situation invites rethinking of IR's understandings of political order and inter-polity relations. We take up this task by laying out necessary methodological innovations to engage with Aboriginal Australia and then showing how conventional and much recent heterodox IR seek to create forms of ‘escape’ from lived political relations by asserting the powerful yet problematic social science mechanism of observer's distance. This demonstrates a need to take Aboriginal Australia as a system on its own terms to speak back to IR. We next explain how Aboriginal Australian people produce political order on the Australian continent through a ‘relational-ecological’ disposition that contrasts with IR's predominant ‘survivalist’ disposition. The accompanying capacity to manage survivalism through relationalism provides an avenue for engaging with and recasting some of mainstream IR's survivalist assumptions, including by considering an Aboriginal approach to multipolarity, without attempting ‘pure escape’ through alternative ontologies. We thus argue that while it is necessary to critique and recast dominant IR, doing so requires putting dominant IR and Indigenous understandings into relational exchange.
This consensus statement by the Society for Healthcare Epidemiology of America (SHEA) and the Society for Post-Acute and Long-Term Care Medicine (AMDA), the Association for Professionals in Epidemiology and Infection Control (APIC), the HIV Medicine Association (HIVMA), the Infectious Diseases Society of America (IDSA), the Pediatric Infectious Diseases Society (PIDS), and the Society of Infectious Diseases Pharmacists (SIDP) recommends that coronavirus disease 2019 (COVID-19) vaccination should be a condition of employment for all healthcare personnel in facilities in the United States. Exemptions from this policy apply to those with medical contraindications to all COVID-19 vaccines available in the United States and other exemptions as specified by federal or state law. The consensus statement also supports COVID-19 vaccination of nonemployees functioning at a healthcare facility (eg, students, contract workers, volunteers, etc).
Healthcare personnel who perform invasive procedures and are living with HIV or hepatitis B have been required to self-notify the NC state health department since 1992. State coordinated review of HCP utilizes a panel of experts to evaluate transmission risk and recommend infection prevention measures. We describe how this practice balances HCP privacy and patient safety and health.