Objectives/Goals: Undergraduate Medical Education (UME) may apply Just-in-Time training (JITT) to provide medical students with learning experiences closely aligned with real-time clinical needs. The purpose of this scoping review is to offer an overview of the implementation of JITT training in UME. Methods/Study Population: Following the five-stage framework by Arksey and O’Malley to methodically collect and analyze studies on JITT in UME, five electronic databases were searched, and a supplemental search for grey literature was conducted. Studies exploring the integration of JITT principles into UME clinical training and their time to follow-up after training were included. Bloom’s Taxonomy was used to assess educational goals of JITT interventions. Results/Anticipated Results: The review yielded 21 studies across 4 countries. The majority were cohort studies (13) and randomized control trials (5). Assessment definitions and use of JITT varied widely. Most studies focused on short-term outcomes, defined by being measured immediately after JITT session (15) or at the end of JITT-based rotation or clerkship (3). Three studies evaluated outcomes at a period longer than 2 weeks after completion of session or clerkship. Attitudes (9), followed by skills (8) were the most common educational goals of intervention. The efficacy and utility of JITT in improving educational goal acquisition was demonstrated in 90% (17/19) of the studies with reported outcomes. Discussion/Significance of Impact: The introduction of JITT in UME has been shown to meet the immediate needs of healthcare environments; however, evidence is limited in the evaluation of longer-term outcomes. Further research to determine the impact of JITT on long-term learning retention and education goal acquisition in UME is merited.

Tape rolls are often used for multiple patients despite recommendations by manufacturers for single-patient use. We developed a survey to query Health Care Personnel about their tape use practices and beliefs and uncovered behaviors that put patients at risk for hospital-acquired infections due to tape use.

Chronic low protein intake can negatively affect human growth, cardiovascular function, metabolic profiles, immunity and exacerbate deficiencies of other nutrients including iron(1). It’s widely accepted that athletes and active individuals have an increased requirement for dietary protein, however to date little is known about the prevalence of low protein intake or protein supplementation practices within this population in Ireland.

This study aimed to examine the following in an Irish population of athletes and active adults: (i) the prevalence, frequency, and reasons for using protein supplements and protein-fortified foods; and (ii) the proportion of those at risk of consuming less than 1.0g of protein/kilogram bodyweight/day.

Participants, aged ≥18 years, residing in Ireland, and engaging in competitive sport or structured physical activities at least twice weekly, completed a self-administered, web-based questionnaire. A validated protein intake screening tool(2) was included to estimate the risk of low protein intake based on self-reported food consumption over the previous 4-weeks. Data collection occurred in April 2024 and descriptives and Chi-squared tests were performed (IBM SPSS v29).

The questionnaire yielded 885 (median age=40yrs, range=18-77yrs; 57.6% female) completed responses. More than half (54.5%) of this population were athletes competing at either local (34.3%), regional (24.3%), national (25.8%) or international (15.4%) level, while the remaining 45.5% engaged in regular exercise only. Overall, 50.2% of this population used protein supplements, with a greater prevalence among men (55.5% vs 46.3%, P<0.01) than women. There was no difference in the use of protein supplementation between athletes (55.5%) and active adults (53.7%, P = 0.595). The main reasons participants provided for using protein supplements were: 1) they found it difficult to meet daily protein requirements through diet alone (59.4%), 2) their training goals required higher intakes (47.7%), and 3) convenience (41.1%). Based on data from the protein intake screening tool, 36.5% of this population were at risk of low protein intakes from food alone, with no difference between athletes and active individuals (P = 0.909), but a higher risk among men (47.7% vs 28.2%, P<0.01) than women. Those who were at risk of low protein intakes were no more likely to use protein supplements (P =0.972) or protein-fortified foods (P = 0.956) than those not at risk. Of those at risk, 49.1% and 4.5% did not consume any protein supplements or protein-fortified foods respectively, while only 14.4% took protein supplements daily and 7.7% consumed proteinfortified foods daily.

Up to a third of this population may not consume adequate protein through their diet alone. While protein-fortified foods and supplements may be helpful, athletes and active adults should attempt to meet their daily protein requirements through a balanced whole food diet, where possible.

Food choice determinants in the general population are influenced by sociocultural, sensory, nutritional, and economic factors, among others(1). For athletes, these choices are further complicated by additional sporting and nutritional demands(2). The objective of this study is to conduct the first large-scale analysis of the determinants of food choice in athletes and active individuals, and to conduct comparison of these determinants across competition levels and sporting categories.

Participants, aged over 18, residing in Ireland, and engaged in competitive sport or structured physical activity at least twice weekly, completed an online survey via Qualtrics. The survey included the previously validated Athlete Food Choice Questionnaire (AFCQ)(3,4). The AFCQ comprises of 32 statements divided into 9 categories where athletes rate the frequency that their food choice is affected by various factors. Data were collected in February 2024, analysed using SPSS V28.0, with statistical significance set at P<0.05.

A total of 1,148 athletes (38% male, 62% female), median [IQR] age 26 years [21-40 years], reported participating in 7 hours [5-10 hours] of structured physical activity per week, spanning 32 sports. Participation levels ranged from non-competitive (32%) to those involved in international competitions (6%). Sensory appeal was highlighted as the most influential factor on food choices (P<0.01), followed by food and health awareness (P<0.01)—encompassing cooking ability, nutrition knowledge, and food planning. Performance-related factors were joint second most influential, with no significant difference with food and health awareness (P = 0.30). This included statements related to choosing food that enhances fuelling for competition, recovery and feeling energetic during training.

Ordinal logistic regressions showed variables such as age, gender, education level, and sporting variables such as competition level, sport type and average hours of exercise per week showed distinct impacts on food choice. For example, the nutritional attributes of a food impacts choice more as participants got older (Odds Ratio (OR) 1.02, 95% CI [1.01, 1.04], P = 0.01). However, the nutritional attributes had less influence if the participant was born in the USA (OR 0.37, 95% CI [0.16, 0.86], P = 0.02) or the rest of the world (OR 0.38, 95% CI [0.18, 0.81], P = 0.01) compared with those born in Ireland, and if the participant was a team sport athlete rather than an endurance athlete (OR 0.55, 95% CI [0.37, 0.81], P<0.01).

The determinants of food choice for athletes are multifaceted and more complex than those of the general population, attributed to additional exercise-related factors. Despite this complexity, sensory appeal remains the predominant influence across all sport types and competition levels. Understanding the dynamics of this food choice matrix in athletes allows for more personalised nutrition advice and identification of those at risk of poor dietary practices that may negatively impact upon their performance and health.

Freehand sketching meets a vital need in design for fluid, fast and flexible visual representations that designers build off of and learn from. Sketching more frequently during the design process correlates with positive design outcomes. Engineering designers receive minimal training on freehand sketching, and engineering students do not apply freehand sketching well during the design process. This study examines some of the underlying factors associated with using sketching more frequently. We examine how sketching skills, spatial visualization skills, sketching instruction and engineering design self-efficacy influence designers’ self-reported sketching behavior. We find that higher sketching skills are associated with using sketching in a variety of ways, and spatial visualization skills and design self-efficacy are associated with sketching more frequently. The relationships uncovered were emphasized by their longevity: spatial skills and sketching skills in students’ first semesters predicted sketching more frequently in a senior capstone design course. These long-lasting relationships suggest the need to invest in students’ spatial skills and sketching skills early in the degree program so that they can be leveraged for better design practice.

Isolation of an unusual organism, Achromobacter xylosoxidans, from 2 cardiac surgical patients on the same day prompted an investigation to search for cases and cause. An extensive review demonstrated a pseudo-outbreak related to practices to conserve laboratory saline due to short supply resulting from supply chain shortage from the coronavirus disease 2019 pandemic.

Aquatic ecosystems - lakes, ponds and streams - are hotspots of biodiversity in the cold and arid environment of Continental Antarctica. Environmental change is expected to increasingly alter Antarctic aquatic ecosystems and modify the physical characteristics and interactions within the habitats that they support. Here, we describe physical and biological features of the peripheral ‘moat’ of a closed-basin Antarctic lake. These moats mediate connectivity amongst streams, lake and soils. We highlight the cyclical moat transition from a frozen winter state to an active open-water summer system, through refreeze as winter returns. Summer melting begins at the lakebed, initially creating an ice-constrained lens of liquid water in November, which swiftly progresses upwards, creating open water in December. Conversely, freezing progresses slowly from the water surface downwards, with water at 1 m bottom depth remaining liquid until May. Moats support productive, diverse benthic communities that are taxonomically distinct from those under the adjacent permanent lake ice. We show how ion ratios suggest that summer exchange occurs amongst moats, streams, soils and sub-ice lake water, perhaps facilitated by within-moat density-driven convection. Moats occupy a small but dynamic area of lake habitat, are disproportionately affected by recent lake-level rises and may thus be particularly vulnerable to hydrological change.

Diagnostic stewardship is increasingly recognized as a powerful tool to improve patient safety. Given the close relationship between diagnostic testing and antimicrobial misuse, antimicrobial stewardship (AMS) pharmacists should be key members of the diagnostic team. Pharmacists practicing in AMS already frequently engage with clinicians to improve the diagnostic process and have many skills needed for the implementation of diagnostic stewardship initiatives. As diagnostic stewardship becomes more broadly used, all infectious disease clinicians, including pharmacists, must collaborate to optimize patient care.

This work examines the ability of commerical zeolite Y to act as a slow release agent for a number of anthelmintic drugs. Administration to rats, dosed with Nippostrongylus brasiliensis, of pyrantel and/or fenbendazole and pigs, dosed with Ascaris and Oesophagostomum, of dichlorvos (DDVP) loaded onto zeolite Y was more sucessful in killing adult worms than administration of the pure drug alone. The zeolite Y was used as supplied for initial studies and then later dealuminated for further studies. The drug loadings were monitored by thermal analysis and the loaded zeolites were used in several field trials. The results indicate that zeolite Y is a suitable vehicle for the slow release of some anthelmintics. The slow release of drug from the zeolite matrix improved its efficacy.

Enteric bacterial infections are common among people who travel internationally. During 2017–2020, the Centers for Disease Control and Prevention investigated 41 multistate outbreaks of nontyphoidal Salmonella and Shiga toxin-producing Escherichia coli linked to international travel. Resistance to one or more antimicrobial agents was detected in at least 10% of isolates in 16 of 30 (53%) nontyphoidal Salmonella outbreaks and 8 of 11 (73%) Shiga toxin-producing E. coli outbreaks evaluated by the National Antimicrobial Resistance Monitoring System. At least 10% of the isolates in 14 nontyphoidal Salmonella outbreaks conferred resistance to one or more of the clinically significant antimicrobials used in human medicine. This report describes the epidemiology and antimicrobial resistance patterns of these travel-associated multistate outbreaks. Investigating illnesses among returned travellers and collaboration with international partners could result in the implementation of public health interventions to improve hygiene practices and food safety standards and to prevent illness and spread of multidrug-resistant organisms domestically and internationally.

Diagnostic stewardship seeks to improve ordering, collection, performance, and reporting of tests. Test results play an important role in reportable HAIs. The inclusion of HAIs in public reporting and pay for performance programs has highlighted the value of diagnostic stewardship as part of infection prevention initiatives. Inappropriate testing should be discouraged, and approaches that seek to alter testing solely to impact a reportable metric should be avoided. HAI definitions should be further adapted to new testing technologies, with focus on actionable and clinically relevant test results that will improve patient care.

A large body of research demonstrates positive impacts of the Coping Power Program as a preventive intervention for youth behavioral outcomes, but potential collateral effects for caregivers is less known. The current study examined whether the youth-focused Coping Power Program can have a secondary impact on caregiver self-reported symptoms of depression and in turn result in longer-term impacts on child disruptive behavior problems including aggression, conduct problems and hyperactivity. Data from 360 youth/caregiver pairs across 8 waves of data (grades 4 through 10) were analyzed. We used two methodological approaches to (a) assess indirect effects in the presence of potential bidirectionality using timepoint-to-timepoint dynamic effects under Autoregressive Latent Trajectory modeling and (b) estimate scale scores in the presence of measurement non-invariance. Results showed that individually delivered Coping Power (ICP) produced greater direct effects on conduct problems and indirect effects on general externalizing and hyperactivity (through reductions in caregiver self-reported symptoms of depression), compared to group Coping Power (GCP). In comparison to GCP, ICP produced similar direct effects on reductions in caregiver depression. Child-focused prevention interventions can have an indirect impact on caregiver depression, which later shows improvements in longer-term reductions for child disruptive problems.

This review explores the evolution of dietary protein intake requirements and recommendations, with a focus on skeletal muscle remodelling to support healthy ageing based on presentations at the 2023 Nutrition Society summer conference. In this review, we describe the role of dietary protein for metabolic health and ageing muscle, explain the origins of protein and amino acid (AA) requirements and discuss current recommendations for dietary protein intake, which currently sits at about 0⋅8 g/kg/d. We also critique existing (e.g. nitrogen balance) and contemporary (e.g. indicator AA oxidation) methods to determine protein/AA intake requirements and suggest that existing methods may underestimate requirements, with more contemporary assessments indicating protein recommendations may need to be increased to >1⋅0 g/kg/d. One example of evolution in dietary protein guidance is the transition from protein requirements to recommendations. Hence, we discuss the refinement of protein/AA requirements for skeletal muscle maintenance with advanced age beyond simply the dose (e.g. source, type, quality, timing, pattern, nutrient co-ingestion) and explore the efficacy and sustainability of alternative protein sources beyond animal-based proteins to facilitate skeletal muscle remodelling in older age. We conclude that, whilst a growing body of research has demonstrated that animal-free protein sources can effectively stimulate and support muscle remodelling in a manner that is comparable to animal-based proteins, food systems need to sustainably provide a diversity of both plant and animal source foods, not least for their protein content but other vital nutrients. Finally, we propose some priority research directions for the field of protein nutrition and healthy ageing.