Academic Health Centers and the Quintuple Aim of Health Care.

The Quintuple Aim of health care adds health equity to the existing Quadruple Aim of improving the individual experience of care for patients, improving the health of populations, reducing the per capita cost of care, and improving the experience of health care professionals. Health equity has previously been subsumed within the other 4 aims. Elevating health equity to the status of a distinct aim is necessary to address persistent health inequities that disproportionately affect underrepresented and minoritized groups. Academic health centers (AHCs) bear a unique responsibility to advance health equity due to the societal importance of their 4 missions: patient care, education, research, and community collaboration. Interprofessional education and practice provide natural connection points that enable AHCs to prepare both health professions students and practicing health care professionals to address all 5 aims. AHCs are well positioned to assess health outcomes related to health equity, develop a health care workforce that is representative of their communities, develop innovative research questions regarding health equity, and engage and invest in the communities they serve.

The Slow Creep Back: Threats and Opportunities for IPE Posed by COVID-19.

Interprofessional education (IPE) prepares current and future health care professionals for interprofessional collaborative practice (IPCP). IPCP results in increased quality of care demanded by patients and reimbursed in value-based care models when appropriately operationalized. The COVID-19 pandemic forced rapid and unprecedented changes in higher education and healthcare, although the impact on IPE delivery in the U.S. is unknown. Analyses of qualitative survey data collected from U.S. IPE leaders (n = 21) identified the impact and challenges of the pandemic on IPE programs. Three primary themes emerged: transition to a virtual environment, uncertainties and fears regarding finance and program sustainability, and opportunities for improvements in programming, delivery, instructional design, experiential learning, and assessment. Programs faced existential pandemic-related challenges. Concurrently, the pandemic accelerated innovation in IPE curricula, illuminated opportunities for IPE to improve the work life of healthcare providers, and raised awareness of the need to extend the Quadruple Aim to eliminate health inequities.

Toward the optimal waveform for electrical stimulation of human muscle.

Electrical stimulation of the quadriceps muscle was used to elicit 4-min isometric contractions at 10% of the maximal voluntary contraction (MVC) in four male and three female subjects. The effect of four waveforms, including Russian, interferential, sine, and square, on the mean stimulation current required to achieve the desired contraction force, subjective comfort, and physiological responses was studied. Interferential stimulation, even at full power, could not elicit a sustained contraction at 10% MVC. The contractions elicited by electrical stimulation utilizing the sine waveform required significantly less mean stimulation current to maintain the desired force of contraction with consistently lower verbal rating scale scores and greater increases in oxygen consumption than either the Russian or square waveform stimulations. Russian waveform stimulation produced a significantly greater rise in galvanic skin resistance than the sine or square waveform while the changes in respiratory quotient were similar between waveforms. The data support sine wave stimulation as working the best by producing the desired muscle tension with the least mean stimulation current and therefore, the least tissue trauma while providing the most subjective comfort.