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There was variation in the use of nonphysician faculty to complete these tasks. Allocated faculty time was comparable to estimated time spent performing nonclinical tasks. On average, a 24-resident program devoted 1.9 full-time equivalent faculty salary support to complete nonclinical activities.
Family medicine residency faculty spend significant time completing nonclinical tasks required to meet ACGME requirements and need the protected time to complete these necessary tasks. Direct data on the use of faculty nonclinical time is needed to more accurately define its use.
Family medicine residency faculty spend significant time completing nonclinical tasks required to meet ACGME requirements and need the protected time to complete these necessary tasks. Direct data on the use of faculty nonclinical time is needed to more accurately define its use.
There is a shortage of mental health services in rural America, and little research is focused on rural underserved communities. Our aim was to identify and map clinical mental health services located in the Upper Peninsula of Michigan (UP) and explore primary care physician (PCP) mental health service provision and barriers to access experienced by this population.
We mapped clinically active psychiatrists and inpatient psychiatric units in the UP, and identified high-risk regions based on >30 mile distance to ambulatory services or low inpatient bed to population ratio. We surveyed PCPs in identified high-risk areas regarding provision of mental health services, comfort with providing services, and perceived barriers to care.
Half of UP counties had no psychiatrists, and only two counties had inpatient psychiatric beds. PCPs are attempting to fill gaps in care, and report comfort with treating depression and anxiety, but less comfort with treating with bipolar disorder and substance use. Nearly all PCPs report barriers to accessing mental health resources; 70% report no psychiatrists to whom they can readily refer.
Michigan's UP has a shortage of mental health resources. Proposed strategies to confront this shortage include additional training of PCPs for substance use and bipolar disorder, bolstering the mental health workforce, and improving access to consultative services.
Michigan's UP has a shortage of mental health resources. Proposed strategies to confront this shortage include additional training of PCPs for substance use and bipolar disorder, bolstering the mental health workforce, and improving access to consultative services.
To enhance cancer prevention and survivorship care by local health care providers, a school of public health introduced an innovative telelearning continuing education program using the Extension for Community Healthcare Outcomes (ECHO) model. In ECHO's hub and spoke structure, synchronous videoconferencing connects frontline health professionals at various locations ("spokes") with experts at the facilitation center ("hub"). Sessions include experts' didactic presentations and case discussions led by spoke site participants. The objective of this study was to gain a better understanding of the reasons individuals choose or decline to participate in the Cancer ECHO program and to identify incentives and barriers to doing so.
Study participants were recruited from the hub team, spoke site participants, and providers who attended another ECHO program but not this one. Participants chose to take a survey or be interviewed. The Consolidated Framework for Implementation Research guided qualitative data coding pation and spread health benefits more widely.
We designed an mHealth application (app) user interface (UI) prototype informed by participatory design sessions, persuasive systems design (PSD) principles, and Lorig and Holman's self-management behavior framework to support self-management activities of Hispanic informal dementia caregivers and assessed their perceptions and preferences regarding features and functions of the app.
Our observational usability study design employed qualitative methods and forced choice preference assessments to identify (1) the relationship between user preferences for UI features and functions and PSD principles and (2) user preferences for UI design features and functions and app functionality. We evaluated 16 pairs of mHealth app UI prototype designs. Eight paper-based paired designs were used to assess the relationship between PSD principles and caregiver preferences for UI features and functions to support self-management. PR-957 supplier An Apple iPad WIFI 32GB was used to display another 8 paired designs and assess caregiver prefse for supporting personalized problem identification, goal setting, decision-making, and action planning as strategies for improving caregiver self-management confidence.
A key component for precision medicine is a good prediction algorithm for patients' response to treatments. We aim to implement machine learning (ML) algorithms into the response-adaptive randomization (RAR) design and improve the treatment outcomes.
We incorporated 9 ML algorithms to model the relationship of patient responses and biomarkers in clinical trial design. Such a model predicted the response rate of each treatment for each new patient and provide guidance for treatment assignment. Realizing that no single method may fit all trials well, we also built an ensemble of these 9 methods. We evaluated their performance through quantifying the benefits for trial participants, such as the overall response rate and the percentage of patients who receive their optimal treatments.
Simulation studies showed that the adoption of ML methods resulted in more personalized optimal treatment assignments and higher overall response rates among trial participants. Compared with each individual ML method, the ens can get new treatments through clinical trials.
Preceptorship has been found to ensure a positive and healthy start to a clinician's career. Evidence shows increased staff satisfaction and empowerment and decreased medical errors as a result of preceptorship. There is limited literature that includes allied health professionals, particularly new orthoptic graduates. This study aims to 1) explore the effectiveness of the British and Irish Orthoptic Society (BIOS) preceptorship programme at providing support and confidence in newly graduated orthoptists, 2) explore new graduates' experience of embedding public health in their clinical practice.
Focus groups were organised for mentors and mentees to discuss their experiences with the BIOS preceptorship programme and how it facilitated embedding public health into clinical practice. Constant comparison analysis was used to identify key themes of discussion.
The preceptorship document promoted structure, reflection, and engagement all of which contributed to effective transition for the mentees. However, d by increasing exposure to undergraduate orthoptic students and departments alike.Electrospinning is a versatile technique to produce nanofibrous membranes with applications in filtration, biosensing, biomedical and tissue engineering. The structural and therefore physical properties of electrospun fibers can be finely tuned by changing the electrospinning parameters. The large parameter window makes it challenging to optimize the properties of fibers for a specific application. Therefore, a fundamental understanding of the multiscale structure of fibers and its correlation with their macroscopic behaviors is required for the design and production of systems with dedicated applications. In this study, we demonstrate that the properties of poly(vinylidene fluoride-co-hexafluoro propylene) (PVDF-HFP) electrospun fibers can be tuned by changing the rotating drum speed used as a collector during electrospinning. Indeed, with the help of multiscale characterization techniques such as scanning electron microscopy (SEM), small-angle X-ray scattering (SAXS), and wide-angle X-ray scattering (WAXS),ing.In this work, the effect of different molecular coatings on the alternating magnetic field-induced heating properties of 15 nm maghemite nanoparticles (NPs) in water dispersions was studied at different frequencies (159-782 kHz) and field amplitudes (100-400 G). The original hydrophobic oleate coating was replaced with dimercaptosuccinic acid (DMSA) or polyethylene glycol trimethoxysilane (PEGTMS), while cetrimonium bromide (CTAB) or stearic acid-poloxamer 188 (SA-P188) was intercalated or encapsulated, respectively, to transfer the dispersions into water. Surface modification, based on intercalation processes, induced clustering phenomena with the formation of spherical-like assemblies (CTAB and SA-P188), while ligand-exchange strategies kept the particles isolated. The clustering phenomenon has detrimental effects on the heating performances compared with isolated systems, in line with the reduction of Brown relaxation times. Furthermore, broader comprehension of the heating phenomenon in this dynamic system is obtained by following the evolution of SPA and ILP with time and temperature beyond the initial stage.Control over the synthesis of anisotropic nanoparticles is crucial as slight differences in their size, shape, sharpness, or the number of tips in the case of gold nanostars, has an inordinate influence on their properties and functionality for future applications. Herein, we show that the supplier and purity of polyvinylpyrrolidone (PVP) can significantly alter the synthesis of gold nanostars, demonstrating that impurities, not PVP itself, are the main factor responsible for star-like shape formation. We demonstrate that in the presence of pure PVP and N,N-dimethylformamide, the use of hydrazine leads to the formation of branched nanoparticles. This synthetic approach opens the door to solving issues associated with the use of commercial PVP during the synthesis of gold nanostars.The scholarly knowledge ecosystem presents an outstanding exemplar of the challenges of understanding, improving, and governing information ecosystems at scale. This article draws upon significant reports on aspects of the ecosystem to characterize the most important research challenges and promising potential approaches. The focus of this review article is the fundamental scientific research challenges related to developing a better understanding of the scholarly knowledge ecosystem. Across a range of disciplines, we identify reports that are conceived broadly, published recently, and written collectively. We extract the critical research questions, summarize these using quantitative text analysis, and use this quantitative analysis to inform a qualitative synthesis. Three broad themes emerge from this analysis the need for multi-sectoral cooperation and coordination, for mixed methods analysis at multiple levels, and interdisciplinary collaboration. Further, we draw attention to an emerging consensus that scientific research in this area should by a set of core human values.Recent developments of novel in-vehicle interventions show the potential to transform the otherwise routine and mundane task of commuting into opportunities to improve the drivers' health and well-being. Prior research has explored the effectiveness of various in-vehicle interventions and has identified moments in which drivers could be interruptible to interventions. All the previous studies, however, were conducted in either simulated or constrained real-world driving scenarios on a pre-determined route. In this paper, we take a step forward and evaluate when drivers interact with in-vehicle interventions in unconstrained free-living conditions. To this end, we conducted a two-month longitudinal study with 10 participants, in which each participant was provided with a study car for their daily driving needs. We delivered two in-vehicle interventions - each aimed at improving affective well-being - and simultaneously recorded the participants' driving behavior. In our analysis, we found that several pre-trip characteristics (like trip length, traffic flow, and vehicle occupancy) and the pre-trip affective state of the participants had significant associations with whether the participants started an intervention or canceled a started intervention.
