Cross-cultural adaptation of an innovative approach to learning about difficult conversations in healthcare

Background:\u2003The Program to Enhance Relational and Communication Skills (PERCS) was developed at a large hospital in the United States to enhance clinicians\u2019 preparedness to engage in difficult conversations. Aim:\u2003To describe the implementation of PERCS in an Italian hospital and assess the program's efficacy. Methods:\u2003The Italian PERCS program featured 4-h experiential workshops enrolling 10\u201315 interdisciplinary participants. The workshops were organized around the enactment and debriefing of realistic case scenarios portrayed by actors and volunteer clinicians. Before and after the workshop, participants rated their perceived preparation, communication and relational skills, confidence, and anxiety on 5-point Likert scales. Open-ended questions explored their reflections on the learning. T-tests and content analysis were used to analyze the quantitative and qualitative data, respectively. Results:\u2003146 clinicians attended 13 workshops. Participants reported better preparation, confidence, and communication skills (p\u2009<\u20090.001) after the workshops. The program had a different impact depending on the discipline. Participants valued the emphasis on group feedback, experiential and interdisciplinary learning, and the patient's perspective, and acquired: new communication skills, self-reflective attitude, reframed perspective, and interdisciplinary teamwork. Conclusion:\u2003PERCS proved culturally adaptable to the Italian context and effective in improving participants\u2019 sense of preparation, communication skills, and confidence

Video-based Simulations: Considerations for Teaching Students with Developmental Disabilities

The use of video-based multimedia simulations for teaching functional skills to persons with developmental disabilities remains an unexplored application of technology for this group. This article examines the historical literature in this area, and discusses future considerations, design issues, and implications of using multimedia simulations. Implementation issues are presented, and suggestions regarding design, development, and application of multimedia simulations are offered. Considerations address the importance of appropriate role modeling and the combination of video-based simulation and in vivo training to foster generalization and maintenance in the context of transition to the real world.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Enabling an Equitable Energy Transition Through Inclusive Research

Comprehensive and meaningful inclusion of marginalized communities within the research enterprise will be critical to ensuring an equitable, technology-informed, clean energy transition. We provide five key action items for government agencies and philanthropic institutions to operationalize the commitment to an equitable energy transition

Sedimentology, stratigraphic context, and implications of Miocene intrashelf bottomset deposits, offshore New Jersey

Drilling of intrashelf Miocene clinothems onshore and offshore New Jersey has provided better understanding of their topset and foreset deposits, but the sedimentology and stratigraphy of their bottomset deposits have not been documented in detail. Three coreholes (Sites M27–M29), collected during Integrated Ocean Drilling Program (IODP) Expedition 313, intersect multiple bottomset deposits, and their analysis helps to refine sequence stratigraphic interpretations and process response models for intrashelf clinothems. At Site M29, the most downdip location, chronostratigraphically well-constrained bottomset deposits follow a repeated stratigraphic motif. Coarse-grained glauconitic quartz sand packages abruptly overlie deeply burrowed surfaces. Typically, these packages coarsen then fine upwards and pass upward into bioturbated siltstones. These coarse sand beds are amalgamated and poorly sorted and contain thin-walled shells, benthic foraminifera, and extrabasinal clasts, consistent with an interpretation of debrites. The sedimentology and mounded seismic character of these packages support interpretation as debrite-dominated lobe complexes. Farther updip, at Site M28, the same chronostratigraphic units are amalgamated, with the absence of bioturbated silts pointing to more erosion in proximal locations. Graded sandstones and dune-scale cross-bedding in the younger sequences in Site M28 indicate deposition from turbidity currents and channelization. The sharp base of each package is interpreted as a sequence boundary, with a period of erosion and sediment bypass evidenced by the burrowed surface, and the coarse-grained debritic and turbiditic deposits representing the lowstand systems tract. The overlying fine-grained deposits are interpreted as the combined transgressive and highstand systems tract deposits and contain the deepwater equivalent of the maximum flooding surface. The variety in thickness and grain-size trends in the coarse-grained bottomset packages point to an autogenic control, through compensational stacking of lobes and lobe complexes. However, the large-scale stratigraphic organization of the bottomset deposits and the coarse-grained immature extrabasinal and reworked glauconitic detritus point to external controls, likely a combination of relative sea-level fall and waxing-and-waning cycles of sediment supply. This study demonstrates that large amounts of sediment gravity-flow deposits can be generated in relatively shallow (~100–200 m deep) and low-gradient (~1°–4°) clinothems that prograded across a deep continental shelf. This physiography likely led to the dominance of debris flow deposits due to the short transport distance limiting transformation to low-concentration turbidity currents

Centrality dependence of charged particle production at large transverse momentum in Pb-Pb collisions at sNN=2.76\sqrt{s_{\rm{NN}}} = 2.76 TeV

The inclusive transverse momentum ($p_{\rm T}$) distributions of primary charged particles are measured in the pseudo-rapidity range $|\eta|<0.8$ as a function of event centrality in Pb-Pb collisions at $\sqrt{s_{\rm{NN}}}=2.76$ TeV with ALICE at the LHC. The data are presented in the $p_{\rm T}$ range $0.15<p_{\rm T}<50$ GeV/$c$ for nine centrality intervals from 70-80% to 0-5%. The Pb-Pb spectra are presented in terms of the nuclear modification factor $R_{\rm{AA}}$ using a pp reference spectrum measured at the same collision energy. We observe that the suppression of high-$p_{\rm T}$ particles strongly depends on event centrality. In central collisions (0-5%) the yield is most suppressed with $R_{\rm{AA}}\approx0.13$ at $p_{\rm T}=6$-7 GeV/$c$. Above $p_{\rm T}=7$ GeV/$c$, there is a significant rise in the nuclear modification factor, which reaches $R_{\rm{AA}} \approx0.4$ for $p_{\rm T}>30$ GeV/$c$. In peripheral collisions (70-80%), the suppression is weaker with $R_{\rm{AA}} \approx 0.7$ almost independently of $p_{\rm T}$. The measured nuclear modification factors are compared to other measurements and model calculations.Comment: 17 pages, 4 captioned figures, 2 tables, authors from page 12, published version, figures at http://aliceinfo.cern.ch/ArtSubmission/node/284

Measurement of charm production at central rapidity in proton-proton collisions at s=2.76\sqrt{s} = 2.76 TeV

The $p_{\rm T}$-differential production cross sections of the prompt (B feed-down subtracted) charmed mesons D$^0$, D$^+$, and D$^{*+}$ in the rapidity range $|y|<0.5$, and for transverse momentum $1< p_{\rm T} <12$ GeV/$c$, were measured in proton-proton collisions at $\sqrt{s} = 2.76$ TeV with the ALICE detector at the Large Hadron Collider. The analysis exploited the hadronic decays D$^0 \rightarrow$K$\pi$, D$^+ \rightarrow$K$\pi\pi$, D$^{*+} \rightarrow$D$^0\pi$, and their charge conjugates, and was performed on a $L_{\rm int} = 1.1$ nb$^{-1}$ event sample collected in 2011 with a minimum-bias trigger. The total charm production cross section at $\sqrt{s} = 2.76$ TeV and at 7 TeV was evaluated by extrapolating to the full phase space the $p_{\rm T}$-differential production cross sections at $\sqrt{s} = 2.76$ TeV and our previous measurements at $\sqrt{s} = 7$ TeV. The results were compared to existing measurements and to perturbative-QCD calculations. The fraction of cdbar D mesons produced in a vector state was also determined.Comment: 20 pages, 5 captioned figures, 4 tables, authors from page 15, published version, figures at http://aliceinfo.cern.ch/ArtSubmission/node/307

Anisotropic flow of charged hadrons, pions and (anti-)protons measured at high transverse momentum in Pb-Pb collisions at sNN=2.76\sqrt{s_{\rm NN}}=2.76 TeV

The elliptic, $v_2$, triangular, $v_3$, and quadrangular, $v_4$, azimuthal anisotropic flow coefficients are measured for unidentified charged particles, pions and (anti-)protons in Pb-Pb collisions at $\sqrt{s_{\rm NN}} = 2.76$ TeV with the ALICE detector at the Large Hadron Collider. Results obtained with the event plane and four-particle cumulant methods are reported for the pseudo-rapidity range $|\eta|<0.8$ at different collision centralities and as a function of transverse momentum, $p_{\rm T}$, out to $p_{\rm T}=20$ GeV/$c$. The observed non-zero elliptic and triangular flow depends only weakly on transverse momentum for $p_{\rm T}>8$ GeV/$c$. The small $p_{\rm T}$ dependence of the difference between elliptic flow results obtained from the event plane and four-particle cumulant methods suggests a common origin of flow fluctuations up to $p_{\rm T}=8$ GeV/$c$. The magnitude of the (anti-)proton elliptic and triangular flow is larger than that of pions out to at least $p_{\rm T}=8$ GeV/$c$ indicating that the particle type dependence persists out to high $p_{\rm T}$.Comment: 16 pages, 5 captioned figures, authors from page 11, published version, figures at http://aliceinfo.cern.ch/ArtSubmission/node/186

Particle-yield modification in jet-like azimuthal di-hadron correlations in Pb-Pb collisions at sNN\sqrt{s_{\rm NN}} = 2.76 TeV

The yield of charged particles associated with high-$p_{\rm T}$ trigger particles ($8 < p_{\rm T} < 15$ GeV/$c$) is measured with the ALICE detector in Pb-Pb collisions at $\sqrt{s_{\rm NN}}$ = 2.76 TeV relative to proton-proton collisions at the same energy. The conditional per-trigger yields are extracted from the narrow jet-like correlation peaks in azimuthal di-hadron correlations. In the 5% most central collisions, we observe that the yield of associated charged particles with transverse momenta $p_{\rm T}> 3$ GeV/$c$ on the away-side drops to about 60% of that observed in pp collisions, while on the near-side a moderate enhancement of 20-30% is found.Comment: 15 pages, 2 captioned figures, 1 table, authors from page 10, published version, figures at http://aliceinfo.cern.ch/ArtSubmission/node/350