A cross-institutional analysis of the effects of broadening trainee professional development on research productivity.

PhD-trained scientists are essential contributors to the workforce in diverse employment sectors that include academia, industry, government, and nonprofit organizations. Hence, best practices for training the future biomedical workforce are of national concern. Complementing coursework and laboratory research training, many institutions now offer professional training that enables career exploration and develops a broad set of skills critical to various career paths. The National Institutes of Health (NIH) funded academic institutions to design innovative programming to enable this professional development through a mechanism known as Broadening Experiences in Scientific Training (BEST). Programming at the NIH BEST awardee institutions included career panels, skill-building workshops, job search workshops, site visits, and internships. Because doctoral training is lengthy and requires focused attention on dissertation research, an initial concern was that students participating in additional complementary training activities might exhibit an increased time to degree or diminished research productivity. Metrics were analyzed from 10 NIH BEST awardee institutions to address this concern, using time to degree and publication records as measures of efficiency and productivity. Comparing doctoral students who participated to those who did not, results revealed that across these diverse academic institutions, there were no differences in time to degree or manuscript output. Our findings support the policy that doctoral students should participate in career and professional development opportunities that are intended to prepare them for a variety of diverse and important careers in the workforce.

Recalled early life adversity and pain: the role of mood, sleep, optimism, and control.

Early life adversity (ELA) has been associated with pain symptomatology in adulthood, but mechanisms and moderators of these associations are unclear. Using recall based and concurrently assessed self-report data, we examined associations between ELA, mood, sleep, and recent pain intensity and interference, and whether optimism and perceived control weakened these associations in a midlife community sample of diverse adults reporting some ELA. Controlling for demographic variables and BMI, higher levels of ELA were associated with more pain intensity and interference; greater sleep disturbance and negative mood accounted for these associations. When moderation was examined, only the path from sleep disturbance to pain interference was significantly attenuated for those with higher optimism and higher perceived control. These findings suggest that higher levels of ELA may link with pain in adulthood through poorer mood and sleep, and that resilience resources such as optimism and control may buffer some of these pathways.

The origin and implementation of the Broadening Experiences in Scientific Training programs: an NIH common fund initiative.

Recent national reports and commentaries on the current status and needs of the U.S. biomedical research workforce have highlighted the limited career development opportunities for predoctoral and postdoctoral trainees in academia, yet little attention is paid to preparation for career pathways outside of the traditional faculty path. Recognizing this issue, in 2013, the U.S. National Institutes of Health (NIH) Common Fund issued a request for application titled "NIH Director's Biomedical Research Workforce Innovation Award: Broadening Experiences in Scientific Training (BEST)." These 5-yr 1-time grants, awarded to 17 single or partnering institutions, were designed to develop sustainable approaches to broaden graduate and postgraduate training, aimed at creating training programs that reflect the range of career options that trainees may ultimately pursue. These institutions have formed a consortium in order to work together to develop, evaluate, share, and disseminate best practices and challenges. This is a first report on the early experiences of the consortium and the scope of participating BEST programs. In this report, we describe the state of the U.S. biomedical workforce and development of the BEST award, variations of programmatic approaches to assist with program design without BEST funding, and novel approaches to engage faculty in career development programs. To test the effectiveness of these BEST programs, external evaluators will assess their outcomes not only over the 5 yr grant period but also for an additional 10 yr beyond award completion.

Effect of anxiety on behavioural pattern separation in humans.

Behavioural pattern separation (BPS), the ability to distinguish among similar stimuli based on subtle physical differences, has been used to study the mechanism underlying stimulus generalisation. Fear overgeneralisation is often observed in individuals with posttraumatic stress disorder and other anxiety disorders. However, the relationship between anxiety and BPS remains unclear. The purpose of this study was to determine the effect of anxiety (threat of shock) on BPS, which was assessed across separate encoding and retrieval sessions. Images were encoded/retrieved during blocks of threat or safety in a 2 × 2 factorial design. During retrieval, participants indicated whether images were new, old, or altered. Better accuracy was observed for altered images encoded during periods of threat compared to safety, but only if those images were also retrieved during periods of safety. These results suggest that overgeneralisation in anxiety may be due to altered pattern separation.

Effect of attention control on sustained attention during induced anxiety.

Anxiety has wide-reaching and complex effects on cognitive performance. Although it can intrude on cognition and interfere with performance, it can also facilitate information processing and behavioural responses. In a previous study, we showed that anxiety induced by threat of shock facilitates performance on the Sustained Attention to Response Task, a vigilance test, which probes response inhibition to infrequent nogo stimuli. The present study sought to identify factors that may have contributed to such improved performance, including on- and off-task thinking (assessed with thought probes) and individual differences in attention control, as measured with the Attention Control Scale. Replicating our prior finding, we showed that shock threat significantly reduced errors of commission on the nogo trials. However, we extended this finding in demonstrating that this effect was driven by subjects with low attention control. We therefore confirm that anxiety increases inhibitory control of prepotent responses--a mechanism which is adaptive under threat--and show that this effect is greater in those who rely more upon such prepotent responding, i.e., those with low attentional control.

Increasing faculty support, respect, and ability to help doctoral students explore non-academic research career opportunities.

We examined the role of the NIH-funded Broadening Experiences in Scientific Training (BEST) program at Wayne State University in increasing faculty (1) support for doctoral students exploring non-academic research opportunities, (2) respect for non-academic research, and (3) ability to help students with non-academic research career exploration. Ninety-seven faculty participated in one or more BEST activities over a five-year period. Fifty-three of those faculty (55%) completed an online survey about their participation in the program and their support, respect, and ability to help students explore non-academic research careers. Sixteen of these faculty were also interviewed in depth about their perspectives on the role professional development can play in enhancing faculty perspectives about non-academic research career options for their students. The survey and interview data reveal some changing perceptions of BEST faculty participants in their attitudes toward and respect for non-academic research careers, as well as in their ability to help students in career exploration. These faculty perceptions correlated with their level of participation in BEST activities. Importantly, this study also showed that some faculty believe they lack the experience and connections outside of academia to adequately support doctoral students' career exploration. The results of this NIH-funded BEST program on faculty attitudes underscore the influence of federally funded programs in changing institutional attitudes towards supporting student career choices that have broad societal impact.

Emotion Regulation as a Pathway Connecting Early Life Adversity and Inflammation in Adulthood: a Conceptual Framework.

Chronic inflammation is implicated in a variety of diseases (e.g., cardiovascular disease and cancer). Much evidence suggests that early life adversity (ELA), such as maltreatment or neglect, can increase risk for inflammation in adulthood. ELA may program proinflammatory activity via its effects on brain areas involved in emotion regulation. Of multiple emotion regulation strategies, some are considered maladaptive (e.g., expressive suppression), while others are generally adaptive (e.g., cognitive reappraisal). We propose a conceptual framework for how emotion regulation tendencies may affect vulnerability or resilience to inflammation in adults who experienced adversity in childhood and/or adolescence. In support of this framework, we summarize evidence for the relationships between emotion dysregulation and higher inflammation (i.e., vulnerability), as well as between cognitive reappraisal and lower inflammation (i.e., resilience), in healthy adults with a history of ELA. Plausible neurobiological, physiological, psychosocial, and ELA-specific factors, as well as interventions, contributing to these associations are discussed. Strengths and limitations of the extant research, in addition to ideas for future directions, are presented.

Individuals with both higher recent negative affect and physical pain have higher levels of C-reactive protein.

Conceptualizing physical pain and negative affect as potentially interactive, we hypothesized that higher levels of peripheral inflammatory markers would be observed consistently only among individuals with both higher negative affect and pain symptomatology. Participants were generally healthy midlife adults from the Bronx, NY (N â€‹= â€‹212, M age â€‹= â€‹46.77; 60.8% Black, 25.5% Hispanic/Latina/o) recruited as part of a larger study. Key measures were: reported pain intensity and pain interference at baseline, recent negative affect averaged from self-reports 5x/day for 7 days, and peripheral inflammatory markers (C-reactive protein [CRP] and a composite cytokine measure based on seven cytokines). Controlling for age, BMI, gender, and education, recent negative affect significantly interacted with both pain variables to explain variance in CRP, with higher CRP levels observed only in individuals with both higher negative affect and either higher pain intensity or pain interference. These findings contribute to an emerging literature suggesting that negative affect, pain, and inflammation are related in important and complex ways.

Immune Responses in Patients with COVID-19: An Overview.

Since late 2019, the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has resulted in more than 143 million confirmed infections and more than 3 million deaths worldwide (as of publication time). In this article, we discuss current knowledge of immune responses that confer protection to more than 80% of the people who have been infected and possible mechanisms by which the virus escapes immune surveillance in people who develop severe disease and those who die from the disease. We also discuss the differences in the immune responses by which, in most children, the infection results in only mild disease, although causing severe disease in some adults. Understanding these differences in both the innate and adaptive immune responses among these people can lead to the development of biotherapeutic treatment modalities that could modulate immune responses to offer protection against SARS-CoV-2 and block the ability of the virus to cause severe disease or death in humans. [Pediatr Ann. 2021;50(5):e222-e226.].

Baseline Characteristics of the 2015-2019 First Year Student Cohorts of the NIH Building Infrastructure Leading to Diversity (BUILD) Program.

Objective: The biomedical/behavioral sciences lag in the recruitment and advancement of students from historically underrepresented backgrounds. In 2014 the NIH created the Diversity Program Consortium (DPC), a prospective, multi-site study comprising 10 Building Infrastructure Leading to Diversity (BUILD) institutional grantees, the National Research Mentoring Network (NRMN) and a Coordination and Evaluation Center (CEC). This article describes baseline characteristics of four incoming, first-year student cohorts at the primary BUILD institutions who completed the Higher Education Research Institute, The Freshmen Survey between 2015-2019. These freshmen are the primary student cohorts for longitudinal analyses comparing outcomes of BUILD program participants and non-participants. Design: Baseline description of first-year students entering college at BUILD institutions during 2015-2019. Setting: Ten colleges/universities that each received <$7.5mil/yr in NIH Research Project Grants and have high proportions of low-income students. Participants: First-year undergraduate students who participated in BUILD-sponsored activities and a sample of non-BUILD students at the same BUILD institutions. A total of 32,963 first-year students were enrolled in the project; 64% were female, 18% Hispanic/Latinx, 19% African American/Black, 2% American Indian/Alaska Native and Native Hawaiian/Pacific Islander, 17% Asian, and 29% White. Twenty-seven percent were from families with an income <$30,000/yr and 25% were their family's first generation in college. Planned Outcomes: Primary student outcomes to be evaluated over time include undergraduate biomedical degree completion, entry into/completion of a graduate biomedical degree program, and evidence of excelling in biomedical research and scholarship. Conclusions: The DPC national evaluation has identified a large, longitudinal cohort of students with many from groups historically underrepresented in the biomedical sciences that will inform institutional/national policy level initiatives to help diversify the biomedical workforce.

Research ethics in inter- and multi-disciplinary teams: Differences in disciplinary interpretations.

As research teams are increasingly comprised of members from multiple disciplines, ranging from the physical sciences, life sciences, social and behavioral sciences to the arts and humanities, it is important to revisit how research is conducted at several levels. Coupled with the national concern over rigor and reproducibility in research, it is therefore crucial to ensure that all members of such multidisciplinary teams view the need for ethics in the conduct of research in similar ways. Towards this end, Wayne State University developed a course in the Responsible Conduct of Research (RCR) which was mandatory for all its 1500 doctoral students across all disciplines in its 75 PhD programs. We found that student perceptions of the validity, applicability and usefulness of the course varied by discipline. This was in spite of iterative changes made to the course by faculty in those disciplines to make the content palatable to all. The findings show that more work needs to be done to fully incorporate the needs of social sciences and humanities disciplines in a comprehensive university course. This is especially important as these students become members of large multidisciplinary research teams in order to uphold the highest levels of rigor, reproducibility and ethics.

Knowledge and use of music therapy among pediatric practitioners in Michigan.

OBJECTIVE: Increasingly, music therapy is being used, in combination with conventional treatment modalities, as part of the health care treatment plan. The objective of our study was to determine the awareness, knowledge and use of music therapy by members of the Michigan chapter of the American Academy of Pediatrics (Michigan AAP) in their health care practice. METHODS: Members of the Michigan AAP were asked to participate in a survey designed to assess their knowledge and use of music therapy in their health care practice. RESULTS: Although the majority of respondents were aware of the use of music therapy in health care settings, very few had referred their own patients for music therapy services. CONCLUSION: Music therapy is an inexpensive and noninvasive treatment modality being used increasingly, especially to alleviate pain, stress, and anxiety among patients in a variety of conditions. Pediatric practitioners in Michigan, who responded to our survey, expressed a strong interest in learning more about music therapy and learning about ways to incorporate music therapy into their health care practice.

Traveler's diarrhea: updates for pediatricians.

Children who travel are at risk of developing the same illnesses that affect adult travelers. Treatment, etiology and actual risk of TD in children are not well defined. Prevention and self-treatment of TD should be discussed in great detail during pre-travel counseling. This includes information and instructions on various preventive measures as well as when to use medications and the potential adverse effects associated with these medications. A TD that is mild can be managed effectively by appropriate use of oral rehydration solutions. Families should be advised to carry ORS packets and start treatment in children as soon as the diarrhea begins. Self treatment with antibiotics such as azithromycin may be considered in children if diarrhea is moderate to severe. Caregivers should contact local health authorities if there is no improvement especially after self treatment with antibiotics.

Evolution of a Functional Taxonomy of Career Pathways for Biomedical Trainees.

Several reports have shown that doctoral and postdoctoral trainees in biomedical research pursue diverse careers that advance science meaningful to society. Several groups have proposed a three-tier career taxonomy to showcase these outcomes. This three-tier taxonomy will be a valuable resource for institutions committed to greater transparency in reporting outcomes, to not only be transparent in reporting their own institutional data but also to lend greater power to a central repository.

Developing Undergraduate Scientists by Scaffolding the Entry into Mentored Research.

For many college students, joining a research group is a critical step toward developing strong mentor-mentee relationships that help shape their science identities and research self-efficacy. ReBUILDetroit, a program that seeks to diversify the biomedical research workforce, uses a scaffolded process to help its scholars transition into research. The first-year curriculum includes a research methods course and a course-based undergraduate research experience that prepare ReBUILDetroit Scholars for entering a research group. Curricular and cocurricular elements prepare scholars for faculty interactions and diminish barriers that might otherwise prevent diverse students from obtaining these research experiences. The program facilitates research placements through student coaching and speed-pairing events. Quantitative and qualitative data on the scholars show strong perceived gains in science identity, enhanced research self-efficacy, and greater research preparedness.

Visualization of gender, race, citizenship and academic performance in association with career outcomes of 15-year biomedical doctoral alumni at a public research university.

It has long been thought that biomedical doctoral students pursue careers primarily as tenure-track/tenured faculty at research institutions. Recent reports showed, however, that the majority of biomedical doctoral alumni engage in a variety of careers. Wayne State University (WSU) undertook a project to understand the career trajectories of its biomedical doctoral alumni to create programs to better prepare its students for careers in multiple pathways. Data were collected on career outcomes of WSU's biomedical doctoral alumni who graduated in a 15-year period from 1999-2014. Careers were classified into three tiers by Employment Sector, Career Types and Job Functions and career paths were examined by alumni gender, race, U.S. citizenship status, and association with certain academic characteristics. Several statistically significant differences in career paths among all demographics were found. For example, women were more likely to be in teaching and providing healthcare, men in faculty and research; Black alumni pursued careers in Government at higher rates and Whites in For-Profit careers; Asians and non-U.S. citizens spent more time in training positions than others. There was no association of academic characteristics such as GRE, GPA, and Time-to-Degree completion with careers in the two largest sectors of Academia or For-profit. Since our trainees are engaged in this rich variety of careers essential to advancing biomedical science and research nationally, it is imperative for the graduate training community to embrace all careers as successful, and transform the model for biomedical doctoral training to foster student success across this broad career spectrum.

Exposure to multiple career pathways by biomedical doctoral students at a public research university.

The Broadening Experiences in Scientific Experiences (BEST) program at Wayne State University was designed to increase doctoral students' awareness of multiple employment sectors beyond academia, improve their knowledge of transferable skills required to succeed in any career path, provide opportunities to explore diverse career paths, and gain in-depth knowledge about those paths using experiential learning opportunities. We devised a three-phase program that ranged from providing students with a broad introduction to multiple career opportunities to immersive experiential learning in a specific career sector. Importantly, program content was developed and delivered by alumni and industry experts in five employment sectors-business/industry, communication, government, law/regulatory affairs, and undergraduate/PUI teaching-in partnership with WSU faculty. This article provides data on two notable outcomes: doctoral students participate equally in BEST activities regardless of gender, race, and citizenship status, and student participation in BEST activities did not correlate with lower GRE ratings, lower GPA, or increased time-to-degree. Further, a "halo" effect of the program is evidenced by participation of students from all disciplines, not just the biomedical sciences. Centralizing BEST activities within the Graduate School will allow faculty and individual programs to save resources and time.

Music therapy in pediatrics.

The soothing effects of music have been well described over the centuries and across cultures. In more recent times, studies have shown the beneficial effects of music in alleviating symptoms in a wide variety of clinical and psychologic conditions. Music therapy has been primarily used as an intervention to control emotional states, in pain management, cognitive processing, and stress management. Stress is associated with increased production of the stress hormone cortisol, which is known to suppress immune responses. Several studies in the past few decades have demonstrated a positive effect of music therapy on reducing stress or increasing immune responses, or both. Music therapy should therefore be considered as a valuable addition to standard pharmacologic therapeutic modalities in enhancing the immune response and lowering stress levels in such conditions. This article reviews the role of music as a therapeutic modality and the future for music therapy, particularly in pediatrics.

Evaluation of a child guidance model for visits for mental disorders to an inner-city pediatric emergency department.

BACKGROUND: To address a rising trend of emergency department (ED) visits for mental disorders (VMD), our ED implemented a child guidance model for their efficient evaluation and disposition. OBJECTIVES: The main objective of our study was to evaluate the impact of the child guidance model on the ED length of stay (LOS) and ED costs on children with VMD. METHODS: We conducted a retrospective chart analysis on 1031 VMD visits made to an inner-city tertiary care pediatric ED in 2002 (1.4% of the total 2002 ED visits). We collected demographic and LOS information on all VMD visits. The child guidance model was implemented June 2002, after which we divided the VMD cases into 2 groups based on the presence or absence of the model. We performed a cost analysis to assess the impact of the model on LOS and determined the opportunity costs of prolonged LOS of the VMD visits as compared with 500 non-VMD visits. RESULTS: The average LOS of VMD visits was longer than that of the 500 non-VMD visits (236.04 minutes +/- 162.82 vs. 134.69 minutes +/- 95.19; mean difference, 101.34 minutes; P = 0.001). The LOS was significantly reduced after the model was implemented (259.49 minutes +/- 171.12 vs. 216.39 +/- 152.95 minutes, P = 0.00). The lost revenue due to extended VMD LOS was calculated as opportunity costs of $201,173.30, whereas the cost savings during the study period due to reduced LOS after the model was implemented was $10,651. CONCLUSIONS: This study suggests that children with VMD visits contribute a substantial resource burden in the ED, and focused interventions such as the child guidance model in the ED can significantly decrease LOS and reduce ED costs.