An Overview of an Undergraduate Diversity MCH Pipeline Training Program: USF's Train-A-Bull.

PURPOSE: To describe an undergraduate pipeline training program (PTP) designed to guide underrepresented minorities (URM) trainees into MCH-related health professions, ultimately contributing to a diverse maternal and child health (MCH) workforce that can improve health outcomes for all women/mothers, children, and their families, including fathers and children with special healthcare needs. DESCRIPTION: Three cohorts with 35 total undergraduate trainees were recruited to participated in the 2 years USF MCH PTP program where they were mentored, trained, guided, and supported by program faculty/staff. Students were recruited early in their education track, and the program was individually tailored based on trainees' educational discovery stages. Key program components included seminars, summer institutes, public health courses, mentorship, internship, experiential learning opportunities, and professional networking opportunities. ASSESSMENT: The majority of the undergraduate participants were diverse URMs including Hispanic/Latino (37.1%), Black/African American (31.4%), Asian (20%), and American Indian/Alaskan Native (5.7%) trainees. Out of all the cohorts, 51.4% were first-generation college students and 74.3% had economic hardships (i.e., PELL Grant, FAFSA). Resulting from the program, all cohorts increased in educational discovery stages, one-third enrolled in health-related graduate studies and half joined the MCH workforce. CONCLUSION: Recruitment in pipeline programs should be intentional and meet students where they are in their education discovery stage. The use of educational discovery stages within a pipeline program are useful in both tailoring curriculum to individuals' needs and assessment of progression in career decision-making. Mentoring from program staff remains an important component for pipeline programs.

Success of Maternal and Child Health Pipeline Training Programs: Alumni Survey Results.

INTRODUCTION: The Maternal and Child Health (MCH) Pipeline Training Program, promotes development of a diverse health workforce by training undergraduate students from underrepresented minorities. We aimed to evaluate the success of this program based on three domains: (1) demographic characteristics, (2) academic and career development, and (3) attitudes towards the field of MCH and the training programs among graduates. METHODS: Three domains of success were determined through a collaborative effort between current program directors and the funding agency project officers. The survey with questions related to the three domains was distributed via an online platform to graduates from seven sites (one former site and six current sites). Data were analyzed and presented utilizing descriptive statistics. RESULTS: The survey was distributed to 550 graduates, 162 responded (37% response rate). Demographically, 78% were female, 54% were Black/African American, 22% were Latinx and 83% did not report any disability. Eighty percent of respondents applied to graduate/professional schools, 67% received admission. Graduates often continued to work in MCH fields (70%). Majority felt confident and knowledgeable in the field (89%) and agreed the faculty were supportive at their training sites (90%). CONCLUSION: The study highlights successes in recruiting from underrepresented minorities, particularly Black/African Americans and first-time college goers in the family into the MCH Pipeline Training Programs. Programs were successful in furthering academic and career development for most trainees. Attitudes towards MCH and the training programs were overwhelmingly positive. Continued support of these programs is critical in addressing health disparities and achieving health equity.

Success of Maternal and Child Health Pipeline Training Programs: Alumni Survey Results.

INTRODUCTION: The Maternal and Child Health (MCH) Pipeline Training Program, promotes development of a diverse health workforce by training undergraduate students from underrepresented minorities. We aimed to evaluate the success of this program based on three domains: (1) demographic characteristics, (2) academic and career development, and (3) attitudes towards the field of MCH and the training programs among graduates. METHODS: Three domains of success were determined through a collaborative effort between current program directors and the funding agency project officers. The survey with questions related to the three domains was distributed via an online platform to graduates from seven sites (one former site and six current sites). Data were analyzed and presented utilizing descriptive statistics. RESULTS: The survey was distributed to 550 graduates, 162 responded (37% response rate). Demographically, 78% were female, 54% were Black/African American, 22% were Latinx and 83% did not report any disability. Eighty percent of respondents applied to graduate/professional schools, 67% received admission. Graduates often continued to work in MCH fields (70%). Majority felt confident and knowledgeable in the field (89%) and agreed the faculty were supportive at their training sites (90%). CONCLUSION: The study highlights successes in recruiting from underrepresented minorities, particularly Black/African Americans and first-time college goers in the family into the MCH Pipeline Training Programs. Programs were successful in furthering academic and career development for most trainees. Attitudes towards MCH and the training programs were overwhelmingly positive. Continued support of these programs is critical in addressing health disparities and achieving health equity.

Redesigning College Professional Development Resources to Meet the Needs of Emerging Public Health Professionals.

The University of South Florida, College of Public Health, is dedicated to providing career planning and professional development services for students in varying formats. However, changing public health training needs and an emerging need for focused attention on professional development necessitated the development of an evaluative program to better understand our students' needs in these areas. Specifically, anecdotal student feedback about feeling unprepared professionally and survey feedback from students, preceptor feedback regarding the need for students to be better trained in core professional concepts, and low rates of attendance in standard professional development events resulted in a quality improvement study to identify students' perceived career planning and professional development needs. Findings were used to redesign current services and provided the basis for developing more targeted trainings to ensure that public health graduates are better prepared to meet employer expectations and to excel in the workforce. This article provides an overview of this transformative process, including the results of the qualitative survey on student, faculty, alumni, and community preceptor perspectives, and resulting prototypes developed for the professional development pilot along with preliminary insights.

A standardized team-based approach for identifying naloxone-eligible patients in a grocery store pharmacy.

OBJECTIVES: To define a standardized team-based approach to identify naloxone-eligible patients in a community pharmacy and to evaluate the impact of the approach on the number of naloxone orders dispensed. SETTING: Two locations within one district of a chain pharmacy. PRACTICE DESCRIPTION: Kroger is a national grocery store pharmacy. PRACTICE INNOVATION: A standardized team-based approach was implemented from November 2017 to February 2018 into the dispensing workflow to identify naloxone-eligible patients. Training was provided to team members (e.g., pharmacist, student pharmacist, technician) at the intervention store. Persons age 18 years and older who met more than 1 of the following criteria were included: greater than or equal to 50 morphine milligram equivalents per day, concurrent benzodiazepine and opioid use, fentanyl patch greater than or equal to 25 µg/h, and documented or verbal history of overdose or substance use disorder. Persons were excluded if they were younger than 18 years, did not speak English, or received an opioid prescription of less than 5 days' duration and no opioid exposure during the previous 30 days. EVALUATION: If inclusion criteria were met, a clinical flag was placed in the dispensing system, alerting the pharmacist to speak with the patient at pick-up. The pharmacist educated the patient on the risks of opioid medications and the benefits of naloxone and then offered to dispense naloxone. The control store followed standard of practice. Data were evaluated using descriptive statistics. RESULTS: The intervention and control store each dispensed 3 naloxone orders from November 2016 to February 2017. During the study period, 39 persons were identified as eligible for naloxone, and 11 naloxone orders were dispensed at the intervention store (28.2%); 2 naloxone orders were dispensed at the control store. A standardized team-based approach resulted in dispensing 8 additional naloxone orders at the intervention store, representing a 367% increase compared with the prior year, when this approach was not used. CONCLUSION: A standardized team-based approach was successfully implemented in a grocery store pharmacy and resulted in increased naloxone dispensing to naloxone-eligible patients.

Serving Those That Serve.

Since 1986, health promotion has had a place within the U.S. Department of Defense. Emphasizing the leading health indicators of Healthy People, the role of health promotion has continued to support the U.S. Armed Forces in perhaps one of the most challenging decades of wartime operations. Serving a sizable population with both typical and mission-related health issues, health promotion plays a critical role in maintaining and improving health. The purpose of this article is to highlight military health promotion by offering insight into the day-to-day life of a "boots on the ground" military health educator, reviewing the challenges and opportunities of working with a unique population. A summary of a variety of military specific initiatives is provided. Additionally, the article highlights the barriers and benefits to military health promotion. Last, the article concludes with a call to action to consider the role of all health educators in serving those that serve.

Subliminal understanding of negation: unconscious control by subliminal processing of word pairs.

A series of five experiments investigated the extent of subliminal processing of negation. Participants were presented with a subliminal instruction to either pick or not pick an accompanying noun, followed by a choice of two nouns. By employing subjective measures to determine individual thresholds of subliminal priming, the results of these studies indicated that participants were able to identify the correct noun of the pair--even when the correct noun was specified by negation. Furthermore, using a grey-scale contrast method of masking, Experiment 5 confirmed that these priming effects were evidenced in the absence of partial awareness, and without the effect being attributed to the retrieval of stimulus-response links established during conscious rehearsal.

Dynamic changes in the mitochondrial electron transport chain underpinning cold acclimation of leaf respiration.

We examined the effect of short- and long-term changes in temperature on gene expression, protein abundance, and the activity of the alternative oxidase and cytochrome oxidase pathways (AOP and COP, respectively) in Arabidopsis thaliana. The AOP was more sensitive to short-term changes in temperature than the COP, with partitioning to the AOP decreasing significantly below a threshold temperature of 20 degrees C. AOP activity was increased in leaves, which had been shifted to the cold for several days, but this response was transient, with AOP activity subsiding (and COP activity increasing) following the development of leaves in the cold. The transient increase in AOP activity in 10-d cold-shifted leaves was not associated with an increase in alternative oxidase (AOX) protein or AOX1a transcript abundance. By contrast, the amount of uncoupling protein was significantly increased in cold-developed leaves. In conjunction with this, transcript levels of the uncoupling protein-encoding gene UCP1 and the external NAD(P)H dehydrogenase-encoding gene NDB2 exhibited sustained increases following growth in the cold. The data suggest a role for each of these alternative non-phosphorylating bypasses of mitochondrial electron transport at different points in time following exposure to cold, with increased AOP activity being important only in the early stages of cold treatment.

Spontaneous Remission in Paroxysmal Nocturnal Hemoglobinuria-Return to Health or Transition Into Malignancy?

Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired syndrome characterized by intravascular hemolysis, thrombosis, and bone marrow failure. The disease is caused by a mutation in the PIG-A gene that leads to the lack of glycosylphosphatidylinositol-anchored complement regulatory molecules CD55 and CD59 on affected blood cell surfaces. In previous studies, spontaneous clinical remissions have been described. The disease manifestations are very heterogeneous, and we wanted to examine if true remissions and disappearance of the clone occur. In a follow-up of a nation-wide cohort of 106 Finnish patients with a PNH clone, we found six cases, where the clone disappeared or was clearly diminished. Two of the patients subsequently developed leukemia, while the other four are healthy and in clinical remission. According to our data, spontaneous remissions are not as frequent as described earlier. Since the disappearance of the PNH cell clone may indicate either a favorable or a poor outcome-remission or malignancy-careful clinical monitoring in PNH is mandatory. Nevertheless, true remissions occur, and further studies are needed to understand the immunological background of this phenomenon and to obtain a better understanding of the natural history of the disease.

Results of a consensus meeting on the use of argatroban in patients with heparin-induced thrombocytopenia requiring antithrombotic therapy - a European Perspective.

Argatroban has been introduced as an alternative parenteral anticoagulant for HIT-patients in several European countries in 2005. In 2009 a panel of experts discussed their clinical experience with argatroban balancing risks and benefits of argatroban treatment in managing the highly procoagulant status of HIT-patients. This article summarizes the main conclusions of this round table discussion. An ongoing issue is the appropriate dosing of argatroban in special patient groups. Therefore, dosing recommendations for different HIT-patient groups (ICU patients; non-ICU patients, paediatric patients, and for patients undergoing renal replacement therapies) are summarized in this consensus statement. Because of the strong correlation between argatroban dosing requirements and scores used to characterize the severity of illness (APACHE; SAPS, SOFA) suitable dosing nomograms are given. This consensus statement contributes to clinically relevant information on the appropriate use and monitoring of argatroban based on the current literature, and provides additional information from clinical experience. As the two other approved drugs for HIT, danaparoid and lepirudin are either currently not available due to manufacturing problems (danaparoid) or will be withdrawn from the market in 2012 (lepirudin), this report should guide physicians who have limited experience with argatroban how to use this drug safely in patients with HIT.