Medical student program to learn from families experiencing developmental disabilities.

Patients and families experiencing developmental disabilities (DDs) may lack trust in physicians due to negative experiences in healthcare. DDs include conditions impairing physical, learning, language, or behavior areas, beginning during the developmental period and impacting daily functioning ('Developmental Disabilities'). Medical students generally do not receive standard training to effectively communicate with and diagnose patients with DDs. ARIE is a program for medical students to meet and learn from these patients and their families. Students learn about these families' experiences during home visits, guided by standardized interview questions and surveys about families' trust in physicians. Families did not appear to strongly trust physicians, with no significant changes after the program. Families shared they experienced physicians' lack of empathy and knowledge when caring for patients with DDs. Families wanted future physicians to be empathetic and informed when treating children with disabilities. Students reported increased comfort and confidence in interacting with patients with DDs as well as their families after completing the training program. Implementing a service-learning model focused on DDs at other medical schools, incorporating training with communication techniques and home visits, can increase students' confidence and experiences when engaging with patients with DDs and their families.

Retrospective Study of Healthcare Resources Developed for Patients by Interprofessional Teams.

Wayne State University (WSU) emphasizes the importance of interdisciplinary education by having students participate in an Interprofessional Team Visit (IPTV) program. A 60-minute virtual visit is conducted to assess adults aged over 50 years within the Detroit Metropolitan Area (Metro Detroit) community. This project was designed to prepare healthcare students in evaluating the mental, physical, and social health aspects of assigned patients based on specific disciplinary assessments. Upon completion of assessments, the interdisciplinary team provided the patient with resources based on the team and the patient's agreed-upon area of concern. Twenty-eight IPTV teams, consisting of a medical and occupational therapy student and a healthcare professional student from another discipline studying at WSU, were randomly created. The IPTV resource guides created by each team were reviewed and sorted into two categories based on the health or social need of the individual patient. The data identified three main areas of interest, which included medication management, diet and exercise plans, and the use of technology to stay connected to medical professionals, friends, and family. The purpose of this report is to assess the IPTV program's findings and analyze patients' concerns based on health or social needs and the resources presented to them.

Projected network performance for next generation aerosol monitoring systems.

Aerosol monitoring for radioactivity is a mature and proven technology. However, by improving key specifications of aerosol monitoring equipment, more samples per day can be collected and analyzed with the same minimum detectable concentrations as current systems. This work models hypothetical releases of 140Ba and 131I over a range of magnitudes corresponding to the inventory produced from the fission of about 100 g to 1 kiloton TNT-equivalent of 235U. The releases occur over an entire year to incorporate the natural variability in atmospheric transport. Sampling equipment located at the 79 locations for radionuclide stations identified in the Comprehensive Nuclear-Test-Ban Treaty (CTBT) for the International Monitoring System are used to determine the detections of the individual releases. Alternative collection schemes in next generation equipment that collect 2, 3, or 4 samples per day, rather than the current 1 sample per day, would result in detections in many more samples at more stations with detections for a given release level. The authors posit that next generation equipment will result in increased network resilience to outages and improved source-location capability for lower yield source releases. The application of dual-detector and coincidence measurements to these systems would significantly boost sensitivity for some isotopes and would further enhance the monitoring capability.

Best Practices in Patient Education: Medical Students' Perceptions and Implementations.

Effective patient education can help achieve better clinical outcomes, especially when a patient is managing a chronic illness. Despite patient education being an important skill in the professional formation of physicians, little is known about medical students' perceptions and implementations of such strategies. After completing a chronic illness educational module, second-year medical students were asked to rate the importance of specific patient education strategies and to assess their use of said strategies in the module's project assignment. Results indicated students utilized different patient education strategies from those they initially identified as most effective.

A Qualitative Analysis of Older Adults' Views of Healthcare Provider Attributes and Communication Skills.

Understanding factors that improve patients' healthcare experiences are essential for healthcare providers (HCPs) caring for older adults (OAs). Previous data supports that effective patient-centered care leads to a better understanding of patients' experiences, values, and preferences. The aim of this study was to evaluate OAs views of HCPs attributes and communication skills to better understand patient's views about their HCP interactions. Qualitative analysis of the data revealed five key themes that emerged: professionalism, patient rapport, patient-centered care, empathy, and communication. Addressing and optimizing performance in these areas could improve patient experiences and support enhanced training for healthcare students.

Building First-Year Medical Students' Skills in Finding, Evaluating, and Visualizing Health Information Through a "Debunking Medical Myths" Curricular Module.

To provide an online service learning opportunity for medical students during the COVID-19 pandemic, medical faculty and librarians developed and implemented a "Debunking Medical Myths" module in which students learned to search for emerging medical literature, evaluate evidence, and use that evidence to create an infographics debunking a COVID-19-related myth for a non-medical audience. The resultant infographics are visually appealing and designed to make complex health information easy to understand. The module was well-received by students, who demonstrated a nuanced understanding of the use of infographics to convey health information, and students' work was evaluated highly by community members. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-022-01541-w.

Bone health assessments by student pharmacists during interprofessional education.

INTRODUCTION: Bone-healthy lifestyle is a cornerstone of osteoporosis prevention and treatment. Student pharmacists are ideally suited to perform bone health assessments during interprofessional education (IPE) programs. In this article, we describe the outcomes of bone health assessments performed by second-year student pharmacists (P2s) as part of a novel IPE activity. METHODS: Bone health assessments provided by P2s to older adults during an interprofessional team home visit were evaluated. Three health profession students (pharmacy, medicine, physician assistant, nursing, physical therapy, occupational therapy, and/or social work) worked as collaborative teams, with each student completing discipline-specific patient assessments. Data collected included bone density scan status, Fracture Risk Assessment Tool (FRAX) score, and calcium and vitamin D intakes. P2s' recommendations for bone density testing and adjustments to dietary intakes based on patient-specific factors were also evaluated. RESULTS: All P2s (n = 98) completed a bone health assessment with their older adult. Almost all older adults (85.6%) met risk criteria for bone density scanning. In addition, 51.5% and 27.8% reported taking less than their age and sex-specific recommended dietary allowance of calcium and vitamin D, respectively. P2s recommended changes in calcium and vitamin D dietary intake, supplement use, or both for 64.3% of the older adults. CONCLUSIONS: In a novel IPE home-visit program, P2s were successfully utilized to assess bone health and provide recommendations for bone density scanning and calcium and vitamin D intakes to volunteer older adult patients.

Evaluating interprofessional socialization: Matched student self-assessments surrounding underserved clinic participation.

INTRODUCTION: To determine if an existing tool, the Interprofessional Socialization and Valuing Scale (ISVS), can be used to measure student perceptions of interprofessional (IP) socialization and teamwork in a cohort of pharmacy, medicine, physical therapy, and social work students volunteering in a student-run free clinic (SRFC). METHODS: The ISVS was distributed to these health professions students before and after participation at the SRFC. After a one-month pilot, the plan was to collect data for 12 months. A power analysis determined a minimum sample size was 15 students (power = 0.8). Student surveys were matched utilizing unique alphanumeric identifiers. Results of IP socialization were analyzed by total group and health profession. RESULTS: A mean value for each ISVS domain was compared before and after the IP SRFC experience over 11 months; the pilot was not included in the final data set. Significant improvement in interprofessional socialization was observed across all ISVS factors including Self-Perceived Ability to Work with Others (p < 0.001), Value in Working with Others (p = 0.002), and Comfort in Working with Others (p < 0.001). Pharmacy and social work disciplines met the threshold for statistical significance for at least one factor. CONCLUSIONS: Utilizing the ISVS in an IP SRFC setting can detect changes in professional development that is influenced by beliefs, behaviors, and attitudes as self-assessed in our student population. Engaging students in such a clinic demonstrates educational value and potentially leads to significant improvement in their interprofessional socialization and teamwork skills.

Planning for Older Adult Day Programs in an Arab American Community: Perceptions From Older Adults, Caregivers, and Professional Providers.

Background and Objective: This study explored Arab American stakeholders' perceptions about potential future adult day programming to inform geriatric service providers about relevant services for culturally diverse older adults. Research Design and Method: Participants (N = 28) in five focus groups were recruited through a social service provider in Metropolitan Detroit, Michigan. Results were analyzed using thematic analysis. Results: Themes included basic requirements, promoting clear and transparent understanding of adult day programs (ADPs), respecting the person, social engagement and activities, explaining complex ethnic and geographic identities, and implementing diversity. Discussion and Implications: ADP service providers can enhance services by drawing on the life experiences, resilience, and creativity of older Arab Americans. Person-focused policies and programs that draw on the strengths of the diverse local community should be developed and communicated clearly for potential participants, family members, and service providers.

Source term estimation in the presence of nuisance signals.

Many source-term estimation algorithms for atmospheric releases assume the measured concentration data are influenced only by the releases of interest. However, there are situations where identifying a short-term release from an unknown location in the presence of long-term releases from a different location is of interest. One such example is determining if part or all of a typical magnitude concentration of a radioactive isotope in a sampler came from a nuclear explosion, such as the explosion announced by DPRK in 2013, while medical isotope facilities and nuclear power plants were also operating in the region. An estimation algorithm has been developed for the case where a short-duration release is confounded by a long-term nuisance signal associated with an additional release location. The technique is demonstrated using synthetic release data for a hypothetical medical isotope production facility and a hypothetical puff release from a different location. The algorithm successfully determines the location (within 30 km) and time-varying release rate (within a factor of 2) for the medical isotope production facility and the location (within 60 km), time (within 6 h), and release magnitude (within a factor of 4) of the puff release.

Interprofessional education during an autism session.

Interprofessional education (IPE) gained a strong foothold in the beginning of the twenty-first century as an effort to improve care to patients through enhanced teamwork. The aim of this study was to compare attitudes and experiences of the learners, which included graduate students, physicians in training, and practicing healthcare professionals, before and after an interprofessional clinical practice (IPCP) six-h autism didactic and experiential training session. The training session consisted of a 1-h lecture on Autism Spectrum Disorder (ASD), a 2-h behavior review meeting consisting of four different case study discussions among the learners, a 1-h lunch, a 1-h therapy session with children diagnosed with ASD, and a 1-h discussion among the learners. The IPCP learners (n = 63) completed a pre- and post-learning questionnaire of the Readiness for Interprofessional Learning Scale (RIPLS) and 12 Statements instruments and both showed an overall significant improvement in the learners interprofessional education after completing the training session. This study was able to show that students, professional trainees, and practicing professionals from different backgrounds led by an expert in the field can exchange ideas and role perceptions in an interprofessional didactic and experiential session, and develop improved attitudes toward IPCP. Moving forward, interprofessional education research needs to focus more on professional trainees and practicing professionals working together in combined didactic and experiential environments for children diagnosed with ASD.

The Journey of an Interprofessional Diabetes Education Student-Run Free Clinic: Where Do We Go from Here?

Future health professionals must be able to function well in a dynamic team-based environment. Interprofessional education aims to enable health professional students to collaborate on teams while working toward common goals. The Diabetes Education Wellness (DEW) Clinic was established in 2011 as an interprofessional, student-run, free clinic to educate the underserved in the community about the risks and management of diabetes. Twenty-four staff and students participated in a focus group addressing perspectives and attitudes toward interprofessional education and improvements for the clinic. A grounded theory approach was used to analyze the data to identify emerging themes. Five themes emerged: 1) interprofessional collaboration allows for exposure to other professional roles specific to diabetes, 2) the interprofessional clinic provides students with a practical application in a real-life context, 3) interprofessional experiential collaboration provides exposure to other resources allowing for a more comprehensive approach to treating patients, 4) integrated team tables with complementary disciplines provide the best patient outcomes, and 5) the need for "mock clinic" format for orientation. Participants in the study indicated that interprofessional collaboration was beneficial. The clinic provided students with invaluable first-hand experiences serving individuals with type-2 diabetes, learning alongside healthcare workers, and taking the lead at problem-solving.

Examining the effects of an experiential interprofessional education activity with older adults.

The need for experienced healthcare professionals to work with older adults is great, yet educational training is limited. In this interprofessional education (IPE) study, 861 students from five professions made 293 visits in the homes or preferred community settings of 208 older adults. Surveys with quantitative and open-text feedback assessed attitudes towards older adults, IPE team functioning, and the value of home visits. Survey results showed strongly positive attitudes towards ageing and older adults. Students from all professions expressed surprise and admiration for the active lives led by these healthier older adults, lives clearly in contrast to stereotypes of ageing. They further acknowledged the value of collaborative team functioning in meeting older adult needs, learned more about the roles and responsibilities of other professions, and identified strengths of the home as a site for care. Students positively valued the experience as part of their professional training, with 82% of all students stating they would welcome additional IPE opportunities. Results suggest that an experiential IPE activity can positively shape student attitudes towards older adults, IPE, and interprofessional collaboration.

Evaluation of Intravenous Acetaminophen on Length of Stay in Abdominal Surgery Patients.

Purpose: The objective of this study is to evaluate the effect of intravenous acetaminophen on length of stay (LOS) in abdominal surgery patients. Methods: This retrospective, cohort chart review evaluated patients who underwent colon resection or pancreaticoduodenectomy between January 1, 2010 and August 31, 2013. The primary outcome is postoperative LOS. Secondary outcomes include opioid use, pain scores, and naloxone or laxative use. Patients who received intravenous acetaminophen were compared to patients who did not. Results: A total of 329 patients were included, with 269 in the non-acetaminophen group compared to 60 patients in the acetaminophen group. There was no difference in postoperative LOS (9.2 s vs 9.1 days; P = .90). Postoperative LOS was also similar when controlling for surgery type. The acetaminophen group had reduced opioid consumption in the first 24 hours postoperatively (P = .02). However, pain scores were higher in the acetaminophen group, both in the first 24 hours (P = .007) and throughout the hospital stay (P < .001). Other clinical outcomes were similar between groups. Conclusion: Intravenous acetaminophen was not associated with a decreased postoperative LOS at our institution.

The Path from Yoga Therapy in a Medical School to a School of Yoga Therapy in an Integrative Medicine Department.

We describe how yoga therapy was established within a medical school. Additionally, this paper outlines the development of a yoga therapy position as well as the implementation of a school of yoga therapy in a university-based teaching hospital.

Leptin-sensitive sensory nerves innervate white fat.

Leptin, the primary white adipose tissue (WAT) adipokine, is thought to convey lipid reserve information to the brain via the circulation. Because WAT responds to environmental/internal signals in a fat pad-specific (FPS) manner, systemic signals such as leptin would fail to communicate such distinctive information. Saturation of brain leptin transport systems also would fail to convey increased lipid levels beyond that point. WAT possesses sensory innervation exemplified by proven sensory-associated peptides in nerves within the tissue and by viral sensory nerve-specific transneuronal tract tracer, H129 strain of herpes simplex virus 1 labeling of dorsal root ganglia (DRG) pseudounipolar neurons, spinal cord and central sensory circuits. Leptin as a paracrine factor activating WAT sensory innervation could supply the brain with FPS information. Therefore, we tested for and found the presence of the long form of the leptin receptor (Ob-Rb) on DRG pseudounipolar neurons immunohistochemically labeled after injections of Fluorogold, a retrograde tract tracer, into inguinal WAT (IWAT). Intra-IWAT leptin injections (300 ng) significantly elevated IWAT nerve spike rate within 5 min and persisted for at least 30 min. Intra-IWAT leptin injections also induced significant c-Fos immunoreactivity (ir), indicating neural activation across DRG pseudounipolar sensory neurons labeled with Fluorogold IWAT injections. Intraperitoneal leptin injection did not increase c-Fos-ir in DRG or the arcuate nucleus, nor did it increase arcuate signal transducer and activator of transcription 3 phosphorylation-ir. Collectively, these results strongly suggest that endogenous leptin secreted from white adipocytes functions as a paracrine factor to activate spinal sensory nerves innervating the tissue.

Crisis intervention team (CIT) training in the jail/detention setting: a case illustration.

Research has documented the over-representation of persons with severe and persistent mental illness (SPMJ) in jails and prisons. Further increased attention has been directed to jail diversion programs and other attempts to prevent incarceration of adults with SPMI. Yet, regardless of available diversion programs, and recent trends in mental health within correctional settings, jails continue to see a disproportionate increase in inmates with SPMI. Thepurpose of this paper is to provide an overview of the research, public policy, and current best practices for the development and implementation of Crisis Intervention Team (CIT) Training as an in-house intervention in jail/detention-based settings. Our review provides support for deploying this specialized law enforcement response program to address the needs of mentally ill persons within jail settings. Strategies and issues in the utilization of the CIT model in detention contexts are discussed.