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1.
Artigo em Inglês | MEDLINE | ID: mdl-38557858

RESUMO

DISCLAIMER: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE: An investigational drug services (IDS) pharmacy plays a vital role in supporting clinical trial research by ensuring the safe and efficient management of investigational products. This article describes the implementation of an electronic project management software to improve an IDS pharmacy's study protocol work. The article describes the implementation of the software and how this approach addressed specific challenges, including project oversight, process standardization, documentation, reporting, accountability, and intrateam communication. SUMMARY: We describe an electronic project management software system used to streamline and standardize the work associated with study protocols. This software provides an organized and customizable workspace to manage tasks associated with each study protocol. The software automates task creation, tracks progress, and ensures comprehensive record keeping. Additionally, the software fosters effective communication within the team and offers real-time reporting to assess team productivity and progress. We have observed improved consistency, enhanced revenue, including approximately $18,000 in additional fee capture, and increased collaboration among pharmacy team members. CONCLUSION: Implementing an electronic project management software has proven highly beneficial in the IDS pharmacy. The software has significantly improved workflow efficiency by addressing challenges in study protocol management. While initial setup and training required time and resources, the long-term benefits in project oversight, collaboration, and revenue capture justify the investment. An electronic project management software is a valuable tool in managing the complexity of study protocol activities and supports the pharmacy's crucial role in advancing clinical research.

2.
Transl Anim Sci ; 8: txae020, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38572174

RESUMO

This study presents a design-based research approach involving five iterations (semester) of implementing design thinking for engaged learning (DTEL) in an animal science capstone course. DTEL scaffolds design thinking into 10 stages for collaborative project-based learning to foster skills like problem solving and teamwork. Across five semesters (spring 2021 to spring 2023), student reflections (n = 276) were analyzed to identify aspects that worked well or were challenging. Network analysis visualized relationships (P < 0.05; Q > 0.4) between codes representing strengths, struggles, and alignment with principles from learning theories. Utilizing the relationships between strengths and theory-based principles to address struggles, resulted in changes to the design of the capstone course each iteration (time that the course was taught). The complexity of maps increased over iterations. Initially, struggles were prominent but decreased as responsive design refinements were made. Alignment of student experiences with principles from learning theories grew substantially from the first iteration to the last (theory-related nodes representing 11.4% vs. 24.4% in each network map, respectively), with learning theories also occupying more central positions in the last map (iteration five) compared to earlier ones (iterations one through four). These changes suggest student experiences increasingly aligned with principles of cognitive constructivism, social constructivism, constructionism, situated learning, and transformative learning. Design principles derived from the five-iteration study include: (1) allocating most time to hands-on lab work vs. lecture, (2) designating a coordinator faculty, (3) scaffolding for instructors unfamiliar with DTEL, (4) emphasizing consistency in processes over grades, and (5) intentionally developing teamwork skills. The study demonstrates the value of design-based research for iteratively refining and studying learning experiences to foster critical skills for undergraduate students in animal science.

3.
Alzheimers Dement ; 2024 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-38574400

RESUMO

INTRODUCTION: Cerebral small vessel disease (SVD) and amyloid beta (Aß) pathology frequently co-exist. The impact of concurrent pathology on the pattern of hippocampal atrophy, a key substrate of memory impacted early and extensively in dementia, remains poorly understood. METHODS: In a unique cohort of mixed Alzheimer's disease and moderate-severe SVD, we examined whether total and regional neuroimaging measures of SVD, white matter hyperintensities (WMH), and Aß, as assessed by 18F-AV45 positron emission tomography, exert additive or synergistic effects on hippocampal volume and shape. RESULTS: Frontal WMH, occipital WMH, and Aß were independently associated with smaller hippocampal volume. Frontal WMH had a spatially distinct impact on hippocampal shape relative to Aß. In contrast, hippocampal shape alterations associated with occipital WMH spatially overlapped with Aß-vulnerable subregions. DISCUSSION: Hippocampal degeneration is differentially sensitive to SVD and Aß pathology. The pattern of hippocampal atrophy could serve as a disease-specific biomarker, and thus guide clinical diagnosis and individualized treatment strategies for mixed dementia.

4.
Front Neurosci ; 18: 1352409, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38595975

RESUMO

As a novel measure for irregularity and complexity of the spontaneous fluctuations of brain activities, brain entropy (BEN) has attracted much attention in resting-state functional magnetic resonance imaging (rs-fMRI) studies during the last decade. Previous studies have shown its associations with cognitive and mental functions. While most previous research assumes BEN is approximately stationary during scan sessions, the brain, even at its resting state, is a highly dynamic system. Such dynamics could be characterized by a series of reoccurring whole-brain patterns related to cognitive and mental processes. The present study aims to explore the time-varying feature of BEN and its potential links with general cognitive ability. We adopted a sliding window approach to derive the dynamical brain entropy (dBEN) of the whole-brain functional networks from the HCP (Human Connectome Project) rs-fMRI dataset that includes 812 young healthy adults. The dBEN was further clustered into 4 reoccurring BEN states by the k-means clustering method. The fraction window (FW) and mean dwell time (MDT) of one BEN state, characterized by the extremely low overall BEN, were found to be negatively correlated with general cognitive abilities (i.e., cognitive flexibility, inhibitory control, and processing speed). Another BEN state, characterized by intermediate overall BEN and low within-state BEN located in DMN, ECN, and part of SAN, its FW, and MDT were positively correlated with the above cognitive abilities. The results of our study advance our understanding of the underlying mechanism of BEN dynamics and provide a potential framework for future investigations in clinical populations.

5.
Tumori ; : 3008916241245005, 2024 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-38591573

RESUMO

This article describes the oncology programs developed in Italy for adolescents and young adults with cancer, with a specific focus on the local projects created in pediatric oncology centers. A common feature of such projects is the emphasis on creative and artistic activities and laboratories (involving music, photography, novel writing, fashion design, and so on) designed to give young patients innovative means of expression.This article highlights the amazing powers of adolescents involved in these projects: the power to produce beautiful things in a place that is not normally associated with the idea of beauty; the power to make their doctors smile and grasp the profound sense of life; the power to make hospitals become places for producing culture.

6.
J Neurogastroenterol Motil ; 30(2): 208-219, 2024 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-38576370

RESUMO

Background/Aims: The objective of this research is to examine factors related to irritable bowel syndrome (IBS) prevalence in a large population-based study. Methods: A cross-sectional study was conducted with participants in the Miyagi part of the Tohoku Medical Megabank Project Community-Based cohort study who completed the Rome II Modular Questionnaire. Multivariate odds ratios (ORs) for the presence of IBS and 95% confidence intervals (95% CIs) for the reference group were calculated for each factor. Additionally, a stratified analysis was performed by sex and age group (20-49 years, 50-64 years, and ≥ 65 years). Results: Among 16 252 participants, 3025 (18.6%) had IBS, comprising 750 men (15.5%) and 2275 women (19.9%). Multivariate ORs for the presence of IBS decreased significantly with each year of age (OR, 0.98; 95% CI, 0.98-0.99). Moreover, compared with the reference group, ORs for the presence of IBS were significantly higher in individuals whose home was partially damaged by the Great East Japan Earthquake, those with < 16 years of education, those who spent less time walking, those with high perceived stress (1.77, 1.57-2.01), those with high psychological distress (1.58, 1.36-1.82), and those with high symptoms of depression (1.76, 1.60-1.94). In stratified analyses, a significant relationship was found between psychological factors and IBS prevalence in all sex and age groups. Conclusions: This large cross-sectional population-based cohort study identified several factors associated with IBS prevalence. Psychological factors were significantly associated with IBS prevalence across all age groups and sexes.

7.
Genome Biol Evol ; 16(4)2024 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-38566597

RESUMO

Transposable elements (TE) play critical roles in shaping genome evolution. Highly repetitive TE sequences are also a major source of assembly gaps making it difficult to fully understand the impact of these elements on host genomes. The increased capacity of long-read sequencing technologies to span highly repetitive regions promises to provide new insights into patterns of TE activity across diverse taxa. Here we report the generation of highly contiguous reference genomes using PacBio long-read and Omni-C technologies for three species of Passerellidae sparrow. We compared these assemblies to three chromosome-level sparrow assemblies and nine other sparrow assemblies generated using a variety of short- and long-read technologies. All long-read based assemblies were longer (range: 1.12 to 1.41 Gb) than short-read assemblies (0.91 to 1.08 Gb) and assembly length was strongly correlated with the amount of repeat content. Repeat content for Bell's sparrow (31.2% of genome) was the highest level ever reported within the order Passeriformes, which comprises over half of avian diversity. The highest levels of repeat content (79.2% to 93.7%) were found on the W chromosome relative to other regions of the genome. Finally, we show that proliferation of different TE classes varied even among species with similar levels of repeat content. These patterns support a dynamic model of TE expansion and contraction even in a clade where TEs were once thought to be fairly depauperate and static. Our work highlights how the resolution of difficult-to-assemble regions of the genome with new sequencing technologies promises to transform our understanding of avian genome evolution.


Assuntos
Elementos de DNA Transponíveis , Pardais , Animais , Elementos de DNA Transponíveis/genética , Pardais/genética , Análise de Sequência de DNA
8.
BMC Bioinformatics ; 25(1): 150, 2024 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-38616247

RESUMO

BACKGROUND: The Eastern Africa Network for Bioinformatics Training (EANBiT) has matured through continuous evaluation, feedback, and codesign. We highlight how the program has evolved to meet challenges and achieve its goals and how experiential learning through mini projects enhances the acquisition of skills and collaboration. We continued to learn and grow through honest feedback and evaluation of the program, trainers, and modules, enabling us to provide robust training even during the Coronavirus disease 2019 (COVID-19) pandemic, when we had to redesign the program due to restricted travel and in person group meetings. RESULTS: In response to the pandemic, we developed a program to maintain "residential" training experiences and benefits remotely. We had to answer the following questions: What must change to still achieve the RT goals? What optimal platforms should be used? How would we manage connectivity and data challenges? How could we avoid online fatigue? Going virtual presented an opportunity to reflect on the essence and uniqueness of the program and its ability to meet the objective of strengthening bioinformatics skills among the cohorts of students using different delivery approaches. It allowed an increase in the number of participants. Evaluating each program component is critical for improvement, primarily when feedback feeds into the program's continuous amendment. Initially, the participants noted that there were too many modules, insufficient time, and a lack of hands-on training as a result of too much focus on theory. In the subsequent iterations, we reduced the number of modules from 27 to five, created a harmonized repository for the materials on GitHub, and introduced project-based learning through the mini projects. CONCLUSION: We demonstrate that implementing a program design through detailed monitoring and evaluation leads to success, especially when participants who are the best fit for the program are selected on an appropriate level of skills, motivation, and commitment.


Assuntos
COVID-19 , Aprendizagem , Humanos , África Oriental , COVID-19/epidemiologia , Biologia Computacional , Pandemias
9.
Psychol Res Behav Manag ; 17: 1515-1531, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38601263

RESUMO

Purpose: Recent research has focused on the impact of communication networks on the performance of construction project teams, attempting empirical exploration from various social network analysis perspectives. However, there is still a significant gap in understanding the variations in performance and the mechanisms for teams using different communication networks. Drawing from organizational learning theory and social network theory, this study, based on the Input-Mediator-Output (IMO) model, explores the effects of the interaction between centralization and tie strength in communication networks on team performance, as well as the mediating mechanisms of knowledge sharing behavior and team resilience performance in engineering project teams. Methods: Drawing on classic group communication experiment, we design an online communication and collaboration platform to simulate the execution of a construction engineering project. Finally, data was collected through the communication experiment with 720 participants, and hypotheses were tested using ANOVA and PROCESS. Results: The results indicate that under conditions of weak tie strength, centralized communication networks yield higher performance. Conversely, under conditions of strong tie strength, decentralized communication networks demonstrate superior performance. Furthermore, this study also verifies the mediating role of knowledge sharing behavior and team resilience performance when tie strength is strong. Conclusion: This study focuses on engineering project team, exploring the evolutionary development of knowledge sharing behavior and team resilience performance from the perspective of the interaction of communication network structural characteristics, as well as the paths to enhancing team performance. Our research results highlight the interactive effects of structural indicators and relational indicators of communication networks, revealing the mechanism by which the structure of communication networks impacts team performance. Additionally, from the perspectives of forming and timely adjusting team communication models, and motivating and supporting employee communication behavior, our study provides practical insights for project managers and relevant administrators.

10.
Front Psychol ; 15: 1339242, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38601821

RESUMO

Introduction: Teachers' wellbeing plays a critical role in their overall job satisfaction, motivation, and effectiveness in building supporting learning environments. In today's dynamic educational settings, where teachers often face numerous challenges and stressors, their wellbeing becomes increasingly vital. Consequently, there is an urgent need to innovate and develop targeted training interventions that can support specifically the wellbeing of educators. Methods: This study sought to provide an overview of the "Online Wellbeing Course - OWC," a serious game developed to enhance teachers' wellbeing, and to investigate the participants' feedback after being engaged in the OWC, utilizing a qualitative approach through focus group discussions. A total of 189 in-service teachers took part in the study. To qualitatively explore their experiences with the OWC, participants were involved in focus groups and asked to provide feedback about how and to what extent the course was beneficial for their wellbeing. Results: Teachers reported enhancements in areas such as emotional competence, self-care strategies, social awareness, relationship skills, decision-making, and school climate. Discussion: These outcomes suggested the potential of serious games as an innovative training approach for supporting teachers' wellbeing, offering valuable insights for researchers, policymakers, and educators.

11.
Gigascience ; 132024 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-38626723

RESUMO

BACKGROUND: Phenome-wide association studies (PheWASs) have been conducted on Asian populations, including Koreans, but many were based on chip or exome genotyping data. Such studies have limitations regarding whole genome-wide association analysis, making it crucial to have genome-to-phenome association information with the largest possible whole genome and matched phenome data to conduct further population-genome studies and develop health care services based on population genomics. RESULTS: Here, we present 4,157 whole genome sequences (Korea4K) coupled with 107 health check-up parameters as the largest genomic resource of the Korean Genome Project. It encompasses most of the variants with allele frequency >0.001 in Koreans, indicating that it sufficiently covered most of the common and rare genetic variants with commonly measured phenotypes for Koreans. Korea4K provides 45,537,252 variants, and half of them were not present in Korea1K (1,094 samples). We also identified 1,356 new genotype-phenotype associations that were not found by the Korea1K dataset. Phenomics analyses further revealed 24 significant genetic correlations, 14 pleiotropic associations, and 127 causal relationships based on Mendelian randomization among 37 traits. In addition, the Korea4K imputation reference panel, the largest Korean variants reference to date, showed a superior imputation performance to Korea1K across all allele frequency categories. CONCLUSIONS: Collectively, Korea4K provides not only the largest Korean genome data but also corresponding health check-up parameters and novel genome-phenome associations. The large-scale pathological whole genome-wide omics data will become a powerful set for genome-phenome level association studies to discover causal markers for the prediction and diagnosis of health conditions in future studies.


Assuntos
Estudo de Associação Genômica Ampla , Polimorfismo de Nucleotídeo Único , Humanos , Fenótipo , Estudos de Associação Genética , Frequência do Gene , República da Coreia , Genótipo
12.
Proc Natl Acad Sci U S A ; 121(15): e2315735121, 2024 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-38557195

RESUMO

Is there a formula for a competitive NIH grant application? The Serenity Prayer may provide one: "Grant me the serenity to accept the things I cannot change, the ability to change the things I can, and the wisdom to know the difference." But how to tell the difference? In this Perspective, we provide an inclusive roadmap-elements of NIH funding. Collectively, we have over 30 y of peer review experience as NIH Scientific Review Officers in addition to over 30 y of program experience as NIH Program Officers. This article distills our NIH experience. We use Euclid's 13-book landmark, The Elements, as our template to humbly share what we learned. We have three specific aims: inform, guide, and motivate prospective applicants. We also address ways that support diversity and inclusion among applicants and young investigators in biomedical research. The elements we describe come from a wide range of sources. Some themes will be general. Some will be specific. All will be candid. The ultimate goal is a competitive application, serenity, and hopefully both.


Assuntos
Pesquisa Biomédica , Humanos , Estados Unidos , Pesquisadores , Revisão por Pares , Motivação , National Institutes of Health (U.S.)
13.
J Relig Health ; 2024 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-38642242

RESUMO

We explored longitudinal associations between religion/spirituality (R/S) Salience and R/S Attendance, and colorectal cancer screening, among adults aged ≥ 50 years in Alberta, Canada. R/S Salience was not statistically significantly associated with colorectal cancer screening (adjusted odds ratio [aOR]: 1.06, 95% confidence interval [CI] 0.88-1.28). Conversely, R/S Attendance was statistically significantly associated with higher odds of colorectal cancer screening: the aOR was 1.28 (95% CI 1.02-1.59) for participants attending services at least once a month and 1.31 (95% CI 1.01-1.69) for participants attending between one and four times yearly, compared to participants who never attended. Researchers should explore the possibility of delivering colorectal cancer screening programs in R/S settings.

14.
J Hered ; 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38616677

RESUMO

The California Pipevine, Aristolochia californica Torr., is the only endemic California species within the cosmopolitan birthwort family Aristolochiaceae. It occurs as an understory vine in riparian and chaparral areas and in forest edges and windrows. The geographic range of this plant species almost entirely overlaps with that of its major specialized herbivore, the California Pipevine Swallowtail Butterfly Battus philenor hirsuta. While this species pair is a useful, ecologically well-understood system to study co-evolution, until recently, genomic resources for both have been lacking. Here, we report a new, chromosome-level assembly of A. californica as part of the California Conservation Genomics Project (CCGP). Following the sequencing and assembly strategy of the CCGP, we used Pacific Biosciences HiFi long reads and Hi-C chromatin proximity sequencing technology to produce a de novo assembled genome. Our genome assembly, the first for any species in the genus, contains 531 scaffolds spanning 661 megabase (Mb) pairs, with a contig N50 of 6.53 Mb, a scaffold N50 of 42.2 Mb, and BUSCO complete score of 98%. In combination with the recently published B. philenor hirsuta reference genome assembly, the A. californica reference genome assembly will be a powerful tool for studying co-evolution in a rapidly changing California landscape.

15.
Plants (Basel) ; 13(6)2024 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-38592949

RESUMO

This study aims to analyze the effects that snow cover may have on the survival of one-year-old seedlings from 15 different taxa in the Mediterranean high mountains (Sierra Nevada National Park, SE Spain) in order to have clearer criteria for the planning and management of restoration efforts in these environments. Additionally, the influence of variables that have been scarcely explored up to now is also revised. We use the survival rates of the seedlings observed from the ecological restoration trial as reference values. The survival data analyzed are based on six variables to evaluate their effects. The results confirm that the permanence of snow is a favorable factor for seedlings, independent of the plant community. Contrastingly, a specific type of foundation (stones and rocks) stands out for being clearly unfavorable, regardless of other variables. For both altitude and solar radiation, a worsening of the survival ratio has been observed as they increase. The species' geographic ranges are all shown to be unfavorable for taxa of a boreo-alpine distribution. Finally, the plant community does not have a significant influence on the survival of seedlings. These results provide novel indications to improve the results of the first stages of restoration work in the Mediterranean high mountains. They are also valuable for the management and cataloging of threatened flora, as well as having direct applications in recovery plans and protection lists.

16.
Water Sci Technol ; 89(6): 1595-1612, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38557721

RESUMO

The construction and operational costs of drainage projects are high. Traditional construction management models impose significant financial pressure on the government and reduce stakeholder motivation. Within the market-oriented development context, reforming the construction management model is crucial for breaking the current predicament. This research establishes a framework for the market-oriented construction management model for drainage projects and constructs a behavioral strategy evolutionary game model involving government, drainage management companies, and pollution discharge subjects. Through theoretical analyses and simulations, this research presents recommendations for the implementation of the market-oriented model. The research findings indicate that: (1) the market-oriented model is feasible both theoretically and practically. Pollution rights trading aids pollution discharge subjects in adapting to the market-oriented model. (2) Ensuring sewage charges remain within the interval [P1, P1 + L2 - L1] is crucial for trilateral cooperation. (3) Simulation analysis shows that intensifying policy support, reducing the cost of technological equipment upgrades, enhancing comprehensive income, lowering the pricing of sewage charges, and raising initial selection probability all promote a tendency towards ESS.


Assuntos
Indústria da Construção , Esgotos , Humanos , Estudos de Viabilidade , Simulação por Computador , China , Governo
17.
J Nutr ; 2024 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-38614240

RESUMO

BACKGROUND: Few diet quality indices have been developed and validated for use among children and adolescents. Additionally, many available indices require completion of burdensome dietary assessments. OBJECTIVE: We aimed to calculate and evaluate the performance of a modified version of the food-based Prime Diet Quality Score (PDQS) derived from different diet assessment methods conducted at four time points in a single study population from childhood through adolescence. METHODS: Among 1,460 child participants in the Project Viva cohort, we calculated the PDQS in early and mid-childhood and early and mid-adolescence using dietary data obtained from Food Frequency Questionnaire (early childhood, parent report), PrimeScreen (mid-childhood, parent report and early adolescence, self report) and 24-hour recall (mid-adolescence, self report). We evaluated construct and relative validity and internal reliability of the score in each life stage. RESULTS: The PDQS showed a range of scores at all life stages and higher scores were associated with intake of many health-promoting macro- and micronutrients (e.g. protein, fiber and vitamins) in early childhood and mid-adolescence. The PDQS performed similarly to the Youth Healthy Eating Index/Healthy Eating Index (Spearman r=0.63-0.85) in various assessments. Higher PDQS was associated with expected characteristics including more frequent breakfast eating, family dinners, and vigorous physical activity; with less frequent TV viewing and fast-food intake; and with more sleep and higher maternal diet scores during pregnancy. Cross-sectional associations of the PDQS with various anthropometric measurements and biomarkers were inconsistent but generally in the expected directions (e.g. higher PDQS associated with lower triglycerides and insulin and higher HDL cholesterol). Internal reliability was consistent with what has been found for other diet quality indices. CONCLUSIONS: The PDQS can be calculated from data collected using different and brief dietary assessment methods and appears to be a valid and useful measure of overall diet quality in children and adolescents. CLINICAL TRIAL REGISTRY INFORMATION: Project Viva is registered at clinicaltrials.gov as NCT02820402.

18.
JMIR Med Educ ; 10: e48135, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38557477

RESUMO

BACKGROUND: Substance use and overdose deaths make up a substantial portion of injury-related deaths in the United States, with the state of Ohio leading the nation in rates of diagnosed substance use disorder (SUD). Ohio's growing epidemic has indicated a need to improve SUD care in a primary care setting through the engagement of multidisciplinary providers and the use of a comprehensive approach to care. OBJECTIVE: The purpose of this study was to assess the ability of the Weitzman Extension for Community Healthcare Outcomes (ECHO): Comprehensive Substance Use Disorder Care program to both address and meet 7 series learning objectives and address substances by analyzing (1) the frequency of exposure to the learning objective topics and substance types during case discussions and (2) participants' change in knowledge, self-efficacy, attitudes, and skills related to the treatment of SUDs pre- to postseries. The 7 series learning objective themes included harm reduction, team-based care, behavioral techniques, medication-assisted treatment, trauma-informed care, co-occurring conditions, and social determinants of health. METHODS: We used a mixed methods approach using a conceptual content analysis based on series learning objectives and substances and a 2-tailed paired-samples t test of participants' self-reported learner outcomes. The content analysis gauged the frequency and dose of learning objective themes and illicit and nonillicit substances mentioned in participant case presentations and discussions, and the paired-samples t test compared participants' knowledge, self-efficacy, attitudes, and skills associated with learning objectives and medication management of substances from pre- to postseries. RESULTS: The results of the content analysis indicated that 3 learning objective themes-team-based care, harm reduction, and social determinants of health-resulted in the highest frequencies and dose, appearing in 100% (n=22) of case presentations and discussions. Alcohol had the highest frequency and dose among the illicit and nonillicit substances, appearing in 81% (n=18) of case presentations and discussions. The results of the paired-samples t test indicated statistically significant increases in knowledge domain statements related to polysubstance use (P=.02), understanding the approach other disciplines use in SUD care (P=.02), and medication management strategies for nicotine (P=.03) and opioid use disorder (P=.003). Statistically significant increases were observed for 2 self-efficacy domain statements regarding medication management for nicotine (P=.002) and alcohol use disorder (P=.02). Further, 1 statistically significant increase in the skill domain was observed regarding using the stages of change theory in interventions (P=.03). CONCLUSIONS: These findings indicate that the ECHO program's content aligned with its stated learning objectives; met its learning objectives for the 3 themes where significant improvements were measured; and met its intent to address multiple substances in case presentations and discussions. These results demonstrate that Project ECHO is a potential tool to educate multidisciplinary providers in a comprehensive approach to SUD care.


Assuntos
Nicotina , Transtornos Relacionados ao Uso de Substâncias , Humanos , Estados Unidos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Autorrelato , Serviços de Saúde Comunitária , Atenção Primária à Saúde
20.
J Interprof Care ; : 1-9, 2024 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-38655848

RESUMO

The globally disruptive impact of the COVID-19 pandemic on both healthcare systems and health profession education has created an opportunity for a reassessment of methods for delivering interprofessional practice education (IPE). A good candidate for consideration is Project ECHO (Extension for Community Healthcare Outcomes). Its unique combination of structural design in connecting specialist and community-based clinical sites, foundational education theories, and didactic and case-based learning methods present an innovative and promising new method of promoting both interprofessional and interorganizational collaboration. This paper first provides a description of Project ECHO, its major features, recent expansion during the pandemic, and IPE-related research history. Second, the educational concepts and theories underlying its use and their implications for interprofessional and interorganizational collaboration are reviewed. These include community of practice and single and double-loop learning. Third, the expression of these concepts in how key elements of ECHO are utilized - including the didactic presentation; the case study presentation, discussion, and tele-mentoring; and the power of community and tele-networking - will be explored. Finally, implications and applications for the expansion of ECHO into promoting competency-based education and innovative interprofessional and interorganizational collaboration will be presented.

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