Caring for our caregivers in body, mind and spirit during the COVID-19 pandemic

New York City became the epicenter of the coronavirus pandemic in March 2020. The surge of critically ill patients combined with widespread social distancing measures created extraordinary challenges for healthcare workers. Many frontline workers experienced significant physical, psychological, and emotional distress. They faced demanding patient care responsibilities while managing personal obligations and health concerns. During the COVID-19 pandemic, it was imperative that NewYork-Presbyterian care for its workforce’s physical, psychological and emotional needs, not only because of our commitment to our colleagues as people, but also because of our obligation to continue to deliver high quality care and experience to the patients, families and communities we serve. Research shows there is a vital link between employee experience and patient experience. Employees who feel supported will be more engaged, which leads to higher quality care and a better patient experience. At NewYork-Presbyterian, we supported our workforce holistically in body, mind and spirit so they could remain strong for the journey ahead and continue to serve our patients, families and communities throughout and at the peak of the coronavirus pandemic. We learned that proactively communicating, supporting physical health and mental health needs and acknowledging bereavement was critical to responding to this crisis. Experience Framework This article is associated with the Staff & Provider Engagement lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this lens

The Energy Sector and Groundwater

No abstract available

Provenancing antiquarian museum collections using multi-isotope analysis

Many of the most significant archaeological sites in Europe were excavated by antiquarians over one hundred years ago. Modern museum collections therefore frequently contain human remains that were recovered during the nineteenth and early twentieth centuries. Here we apply multi-isotope analysis (87Sr/86Sr, δ18O, δ13C, δ15N) and 14C dating to evaluate the provenance of human remains within a collection that is thought to have been recovered from one of the most important archaeological sites in Britain. Excavated in 1910, the site of Coldrum in Kent is a megalithic burial monument that may be one of the earliest sites associated with the transition to farming in Britain. The interpretation of this site is therefore key to understanding how agriculture began. Using isotope analysis we show that although the human skeletal collections attributed to Coldrum do contain some of the earliest dated Neolithic human remains in Britain, they also contain the remains of individuals of fifth to seventh centuries AD date. We evaluate subsistence and mobility patterns of early Neolithic populations and provide new information about the origins of those individuals in the collection that date to the fifth to seventh centuries AD. We demonstrate the utility of employing isotope analysis to provide direct and independent information about the provenance of human remains in museum collections

Evolving web-based test automation into agile business specifications

Usually, test automation scripts for a web application directly mirror the actions that the tester carries out in the browser, but they tend to be verbose and repetitive, making them expensive to maintain and ineffective in an agile setting. Our research has focussed on providing tool-support for business-level, example-based specifications that are mapped to the browser level for automatic verification. We provide refactoring support for the evolution of existing browser-level tests into business-level specifications. As resulting business rule tables may be incomplete, redundant or contradictory, our tool provides feedback on coverage

Patient experience in the behavioral health setting: Key best practices throughout an organizational journey

NewYork-Presbyterian/Westchester Division, a clinical affiliate of Weill Cornell Medicine, is a 260-bed hospital providing inpatient and outpatient behavioral health care for children, adolescents, adults and older adults. From 2004-2010 the hospital’s patient experience scores on the Press Ganey® Inpatient Psychiatry Survey improved from the 14th to 53rd percentile nationally. We primarily attribute this to joining the Planetree® Affilliate Network. Planetree is a mission based not-for-profit organization that partners with healthcare organizations around the world and across the care continuum to represent the patient voice and advance how professional caregivers engage with patients and families. In 2011, hourly rounding was redesigned and tailored for the behavioral health setting. This initiative, coupled with regular Planetree education and an ongoing commitment by staff and the healthcare system to improving patient experience, contributed to a further improvement, with the hospital moving to the top ten percent of psychiatric hospitals nationally in the Press Ganey survey. In this paper, we describe the organizational journey that led to these improvements and identify learning for other hospitals, particularly in a behavioral healthcare setting

Doing trials within trials: a qualitative study of stakeholder views on barriers and facilitators to the routine adoption of methodology research in clinical trials

Abstract Background Randomised controlled trials are the cornerstone of evidence-based health care, yet many trials struggle with recruitment and retention. All too often the methodologies employed to address these problems are not evidence-based, as rigorous methodological research on these issues is rare. The current research sought to identify barriers to the routine implementation of methodology research around recruitment and retention. Methods All registered UK clinical trials unit directors were sent a short questionnaire and invited to interview. Representatives of funding bodies and other stakeholders were also approached. Interviews were recorded and the content analysed. Results Data were grouped into four themes: acceptance of the need for methodological research; trial funding and development; trial processes; and organisational factors. The need to improve the evidence base for trials methodology is well established, but numerous barriers to implementation were perceived. Conclusions The knowledge and expertise required to routinely implement methodology research exists within the current research structures, and there are clear opportunities to develop the evidence base. However, for this to be achieved there is also a need for clear strategic coordination within the sector and promotion of the necessary resources

Decorin protein core affects the global gene expression profile of the tumor microenvironment in a triple-negative orthotopic breast carcinoma xenograft model

Decorin, a member of the small leucine-rich proteoglycan gene family, exists and functions wholly within the tumor microenvironment to suppress tumorigenesis by directly targeting and antagonizing multiple receptor tyrosine kinases, such as the EGFR and Met. This leads to potent and sustained signal attenuation, growth arrest, and angiostasis. We thus sought to evaluate the tumoricidal benefits of systemic decorin on a triple-negative orthotopic breast carcinoma xenograft model. To this end, we employed a novel high-density mixed expression array capable of differentiating and simultaneously measuring gene signatures of both Mus musculus (stromal) and Homo sapiens (epithelial) tissue origins. We found that decorin protein core modulated the differential expression of 374 genes within the stromal compartment of the tumor xenograft. Further, our top gene ontology classes strongly suggests an unexpected and preferential role for decorin protein core to inhibit genes necessary for immunomodulatory responses while simultaneously inducing expression of those possessing cellular adhesion and tumor suppressive gene properties. Rigorous verification of the top scoring candidates led to the discovery of three genes heretofore unlinked to malignant breast cancer that were reproducibly found to be induced in several models of tumor stroma. Collectively, our data provide highly novel and unexpected stromal gene signatures as a direct function of systemic administration of decorin protein core and reveals a fundamental basis of action for decorin to modulate the tumor stroma as a biological mechanism for the ascribed anti-tumorigenic properties

Iris: an Extensible Application for Building and Analyzing Spectral Energy Distributions

Iris is an extensible application that provides astronomers with a user-friendly interface capable of ingesting broad-band data from many different sources in order to build, explore, and model spectral energy distributions (SEDs). Iris takes advantage of the standards defined by the International Virtual Observatory Alliance, but hides the technicalities of such standards by implementing different layers of abstraction on top of them. Such intermediate layers provide hooks that users and developers can exploit in order to extend the capabilities provided by Iris. For instance, custom Python models can be combined in arbitrary ways with the Iris built-in models or with other custom functions. As such, Iris offers a platform for the development and integration of SED data, services, and applications, either from the user's system or from the web. In this paper we describe the built-in features provided by Iris for building and analyzing SEDs. We also explore in some detail the Iris framework and software development kit, showing how astronomers and software developers can plug their code into an integrated SED analysis environment.Comment: 18 pages, 8 figures, accepted for publication in Astronomy & Computin

Stem cell therapy for the treatment of early stage avascular necrosis of the femoral head: a systematic review

BACKGROUND: Avascular necrosis (AVN) of the femoral head (FH) is believed to be caused by a multitude of etiologic factors and is associated with significant morbidity in younger populations. Eventually, the disease progresses and results in FH collapse. Thus, a focus on early disease management aimed at joint preservation by preventing or delaying progression is key. The use of stem cells (SC) for the treatment of AVN of the FH has been proposed. We undertook a systematic review of the medical literature examining the use of SC for the treatment of early stage (precollapse) AVN of the FH, in both pre-clinical and clinical studies. METHODS: Data collected included: Pre-clinical studies – model of AVN, variety and dosage of SC, histologic and imaging analyses. Clinical studies – study design, classification and etiology of AVN, SC dosage and treatment protocol, incidence of disease progression, patient reported outcomes, volume of necrotic lesion and hip survivorship. RESULTS: In pre-clinical studies, the use of SC uniformly demonstrated improvements in osteogenesis and angiogenesis, yet source of implanted SC was variable. In clinical studies, groups treated with SC showed significant improvements in patient reported outcomes; however hip survivorship was not affected. Discrepancies regarding dose of SC, AVN etiology and disease severity were present. CONCLUSIONS: Routine use of this treatment method will first require further research into dose and quality optimization as well as confirmed improvements in hip survivorship