Use of Standardized Patient Scenarios to Train Medical Assistants in an Ambulatory Rehabilitation Medicine Clinic

Objectives: To improve the efficiency of our outpatient Rehabilitation Medicine clinic without sacrificing high value/quality patient care. To clarify the responsibilities of the MA and identify areas of redundancy in the rooming process. To demonstrate the utility of in-situ simulation for MA training. To reduce the time it takes for MAs to complete all assigned tasks to 10 minutes or less per encounter in at least 50% of patient encounters within two months from the time of intervention. To potentially highlight other areas in which to improve clinic efficiency and overall patient satisfaction (e.g. front desk registration process, resident and attending physician encounters, clinic and exam room accessibility).https://jdc.jefferson.edu/patientsafetyposters/1051/thumbnail.jp

HIV Prevention in Care and Treatment Settings: Baseline Risk Behaviors among HIV Patients in Kenya, Namibia, and Tanzania.

HIV care and treatment settings provide an opportunity to reach people living with HIV/AIDS (PLHIV) with prevention messages and services. Population-based surveys in sub-Saharan Africa have identified HIV risk behaviors among PLHIV, yet data are limited regarding HIV risk behaviors of PLHIV in clinical care. This paper describes the baseline sociodemographic, HIV transmission risk behaviors, and clinical data of a study evaluating an HIV prevention intervention package for HIV care and treatment clinics in Africa. The study was a longitudinal group-randomized trial in 9 intervention clinics and 9 comparison clinics in Kenya, Namibia, and Tanzania (N = 3538). Baseline participants were mostly female, married, had less than a primary education, and were relatively recently diagnosed with HIV. Fifty-two percent of participants had a partner of negative or unknown status, 24% were not using condoms consistently, and 11% reported STI symptoms in the last 6 months. There were differences in demographic and HIV transmission risk variables by country, indicating the need to consider local context in designing studies and using caution when generalizing findings across African countries. Baseline data from this study indicate that participants were often engaging in HIV transmission risk behaviors, which supports the need for prevention with PLHIV (PwP). TRIAL REGISTRATION: ClinicalTrials.gov NCT01256463

Chitosan–Starch–Keratin composites: Improving thermo-mechanical and degradation properties through chemical modification

The lysozyme test shows an improved in the degradability rate, the weight loss of the films at 21 days is reduced from 73 % for chitosan-starch matrix up to 16 % for the composites with 5wt% of quill; but all films show a biodegradable character depending on keratin type and chemical modification. The outstanding properties related to the addition of treated keratin materials show that these natural composites are a remarkable alternative to potentiat-ing chitosan–starch films with sustainable featuresChitosan–starch polymers are reinforced with different keratin materials obtained from chicken feather. Keratin materials are treated with sodium hydroxide; the modified surfaces are rougher in comparison with untreated surfaces, observed by Scanning Electron Microscopy. The results obtained by Differential Scanning Calorimetry show an increase in the endothermic peak related to water evaporation of the films from 92 °C (matrix) up to 102–114 °C (reinforced composites). Glass transition temperature increases from 126 °C in the polymer matrix up to 170–200 °C for the composites. Additionally, the storage modulus in the composites is enhanced up to 1614 % for the composites with modified ground quill, 2522 % for composites with modified long fiber and 3206 % for the composites with modified short fiber. The lysozyme test shows an improved in the degradability rate, the weight loss of the films at 21 days is reduced from 73 % for chitosan-starch matrix up to 16 % for the composites with 5wt% of quill; but all films show a biodegradable character depending on keratin type and chemical modification. The outstanding properties related to the addition of treated keratin materials show that these natural composites are a remarkable alternative to potentiat-ing chitosan–starch films with sustainable featuresUniversidad Autónoma del Estado de México Tecnológico Nacional de México, Instituto Tecnológico de Querétaro Universidad Nacional Autónoma de México Tecnológico Nacional de México, Instituto Tecnológico de Celaya Universidad Autónoma de Cd. Juáre

Pre-Attentive Auditory Processing in Ultra-High-Risk for Schizophrenia with Magnetoencephalography

Background: It is uncertain whether the neurobiological abnormalities in schizophrenia emerge at the first episode of the disorder or are present during the prodromal phase. Recent neuroimaging studies indicate that some brain abnormalities are present in subjects at ultra-high-risk (UHR) for schizophrenia. Pre-attentive auditory deficits, which represent a core feature of schizophrenia, were investigated in individuals at UHR for schizophrenia. Methods: We assessed early auditory processing indexed by the magnetoencephalographic mismatch negativity magnetic counterpart (MMNm) component elicited during a passive oddball paradigm in UHR individuals. Sixteen individuals at UHR for schizophrenia on the basis of clinical criteria and 18 healthy control subjects matched for age, gender, and education participated. A duration-deviant oddball paradigm was used to obtain MMNm dipole moment, which was measured with cortical source modeling. Results: The UHR group showed a smaller right MMNm dipole moment than those of the control group. Group difference was observed in MMNm dipole latency, suggestive of slowed processing. The left MMNm dipole moment was negatively correlated with clinical symptoms measured by the Comprehensive Assessment of At-Risk Mental States positive symptom score. Conclusions: Our findings suggest that deficits in the early stage of auditory processing in individuals at UHR for schizophrenia exist before the onset of psychosis. 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