IPE Grand Rounds: A Student-Led Initiative

Interprofessional Education (IPE) Grand Rounds is an innovative student-run initiative designed specifically to increase the clinical relevance of IPE for all health professions students. By creating new opportunities for students from medicine, nursing, physical therapy, occupational therapy, couple and family therapy, physician assistant and pharmacy to interact with health professionals who are actively participating in interprofessional work environments, the IPE Grand Rounds program allows students to develop a more complete picture of what it means to be a member of a collaborative practice team. During these sessions, students and panelists discuss both the benefits of working with team members from professions other than their own, as well as the real-world challenges they face in practice. While exploration of the effectiveness of IPE Grand Rounds in helping medical and other health professions students achieve IPE core competencies is currently underway, initial positive feed-back indicates that this extracurricular experience may help to bridge the gap between interprofessional education curricula and collaborative practice

Introducing Interprofessional Education (IPE) Grand Rounds: Lessons from a New Student-led IPE Initiative

Learning Objectives • Describe 2-3 benefits for enhancing student exposure to real world collaborative practice teams • Develop an action plan for starting an IPE Interest Group at your institution • Describe 3 practical tips for implementing an IPE Grand Round

A 360 Degree View of the Jefferson Health Mentors Program: Students, Administrator and Faculty Weigh in on Seven Years of Interprofessional Education

Learning Objectives •List three strategies for successful implementation of an Interprofessional Education (IPE) curriculum •Develop a roadmap for starting, expanding or evaluating an existing IPE program •Discuss challenges and shared lessons learned with CQI in implementing IPE with a panel hosted by HMP students, administrator and facult

Genetic mechanisms of critical illness in COVID-19.

Host-mediated lung inflammation is present1, and drives mortality2, in the critical illness caused by coronavirus disease 2019 (COVID-19). Host genetic variants associated with critical illness may identify mechanistic targets for therapeutic development3. Here we report the results of the GenOMICC (Genetics Of Mortality In Critical Care) genome-wide association study in 2,244 critically ill patients with COVID-19 from 208 UK intensive care units. We have identified and replicated the following new genome-wide significant associations: on chromosome 12q24.13 (rs10735079, P = 1.65 × 10-8) in a gene cluster that encodes antiviral restriction enzyme activators (OAS1, OAS2 and OAS3); on chromosome 19p13.2 (rs74956615, P = 2.3 × 10-8) near the gene that encodes tyrosine kinase 2 (TYK2); on chromosome 19p13.3 (rs2109069, P = 3.98 ×  10-12) within the gene that encodes dipeptidyl peptidase 9 (DPP9); and on chromosome 21q22.1 (rs2236757, P = 4.99 × 10-8) in the interferon receptor gene IFNAR2. We identified potential targets for repurposing of licensed medications: using Mendelian randomization, we found evidence that low expression of IFNAR2, or high expression of TYK2, are associated with life-threatening disease; and transcriptome-wide association in lung tissue revealed that high expression of the monocyte-macrophage chemotactic receptor CCR2 is associated with severe COVID-19. Our results identify robust genetic signals relating to key host antiviral defence mechanisms and mediators of inflammatory organ damage in COVID-19. Both mechanisms may be amenable to targeted treatment with existing drugs. However, large-scale randomized clinical trials will be essential before any change to clinical practice

From Interprofessional Education to Collaborative Practice: A Jefferson Alumna\u27s Perspective

I graduated from Jefferson College of Nursing at Thomas Jefferson University in May 2015 and began my work as a perioperative nurse the following July. During my time at Jefferson, I not only participated in the Health Mentors Program (HMP), but was also given the opportunity to work closely with JCIPE and a group of students from other health care professions to refine and expand IPE offerings. We formed a student organization, now known as Jefferson Students for Interprofessional Education (JSIPE), which had three over-arching goals: 1. Students will gain exposure to real-world collaborative practice teams 2. Students will learn about health professional roles and expertise in specific clinical settings 3. Students will gain practical tips and advice for working as part of an interprofessional healthcare team For me, participation in JSIPE and HMP achieved all three goals and facilitated my transition into professional practice in a highly collaborative setting. I entered the professional sphere as a “perioperative nurse intern” in a program designed for nurses new to the operating room. Many of us were new graduates, and some of the other nurses were intimidated by the prospect of working in such an intensely interprofessional setting. Although nearly all of them had been exposed to the idea of IPE, none of them felt that they had been prepared for its practical implications. My new co-workers were fascinated by the idea of the IPE Grand Rounds panel discussions that we hosted at Jefferson. They were especially interested in the concept of getting practical tips and advice for working as a part of an interprofessional healthcare team. Since then, I have approached the perioperative education team about arranging an interprofessional panel for future intern classes and am hopeful that it may be incorporated into the program. Although I knew that the opportunities that I had been given at Jefferson would help me as I transitioned into a professional role, I had no idea how directly my IPE experiences would apply to my practice. Every procedure in every operating room could be a case study in collaborative practice. I work as a part of multiple teams made up of nurses, surgeons, pharmacists, surgical technologists, radiology technologists, physician’s assistants, and many others. Although we work together on a daily basis, I am amazed by how little each profession knows about the roles of the others. For example, three nurses who went through the perioperative internship with me had worked previously as surgical technologists. When they began their work as circulators, they were amazed by the amount and variety of work that the job required. Although they had worked with circulators for years in their roles as surgical technologists, they had never truly understood the nurse’s role. They believed that this lack of understanding had negatively impacted their practice in the past. I am extremely grateful that these nurses shared their experiences with the rest of us and helped us to better understand the role of the surgical technologist

Chapter 3: Power within and beyond the state: understanding how power relations shape environmental management

As a fundamentally social activity, environmental management is inescapably bound to questions of power. This chapter reviews some of the diverse ways in which power relations come to bear on the decisions, processes and outcomes associated with environmental management. The review considers power as expressed through formal governmental institutions, power as embedded in social relationships and power as a medium and outcome of civil society practices. Starting from a distinction between corrective and persuasive influence, we explore the application of theories of power to questions of environmental management, considering issues such as inequality in access to environmental goods and exposure to environmental harms and the role of state and non-state actors and organizations in perpetuating and resisting domination. We draw upon insights from the interdisciplinary field of political ecology to illustrate applications of these concepts to problems of environmental management. In addition, we consider how the explicit consideration of power in its myriad forms can inform and improve transdisciplinary research and result in more just and effective outcomes

Memory Representations Supporting Speakers ’ Choice of Referring Expression: Effects of Category Overlap and Shared Experience

Speakers must take their addressee’s knowledge into account in choosing to refer to an object using a name or a description. Do speakers keep track of partner-specific information about the common ground status of names? And if so, what mechanisms support this ability? We present a series of experiments that investigate the nature of the memory representations involved in supporting speakers ’ ability to distinguish shared from privileged information. The results of these experiments suggest that category information can be used as a cue to aid retrieval of ground status, and that shared experience plays an important role in helping speakers to distinguish privileged information from shared information

“All of the things to everyone everywhere”: A mixed methods analysis of community perspectives on equitable access to monoclonal antibody treatment for COVID-19

BACKGROUND: Neutralizing monoclonal antibody (mAb) treatment for COVID-19 prevents hospitalization and death but is underused, especially in racial/ethnic minority and rural populations. Reasons for underuse and inequity may include community member lack of awareness or healthcare access barriers, among others. This study assessed mAbs community awareness and opportunities for improving equitable mAb access. METHODS: A concurrent mixed methods study including surveys and focus groups with adults with high-risk conditions or their proxy decision-makers. Surveys and focus group guides addressed diffusion of innovation theory factors. Descriptive statistics and Fisher’s exact method was used to report and compare survey findings by race and ethnicity. Rapid qualitative methods were used for focus group analysis. RESULTS Surveys from 515 individuals (460 English, 54 Spanish, 1 Amharic), and 8 focus groups (6 English, 2 Spanish) with 69 participants, completed June 2021 to January 2022. Most survey respondents (75%) had heard little or nothing about mAbs, but 95% would consider getting mAb treatment. Hispanic/Latino and Non-Hispanic People of Color (POC) reported less awareness, greater concern about intravenous infusions, and less trust in mAb safety and effectiveness than White, Non-Hispanic respondents. Focus group themes included little awareness but high interest in mAb treatment and concerns about cost and access barriers such as lacking established sources of care and travel from rural communities. Focus groups revealed preferences for broad-reaching but tailored messaging strategies using multiple media and trusted community leaders. CONCLUSIONS: Despite unfamiliarity with mAb treatment, most respondents were open to receiving mAbs or recommending mAbs to others. While mAb messaging should have broad reach “to everyone everywhere,” racial and geographic disparities in awareness and trust about mAbs underscore need for tailored messaging to promote equitable access. Care processes should address patient-level barriers like transportation, insurance, or primary care access. COVID-19 treatment dissemination strategies should promote health equity

Illustrative quotes for qualitative analysis of focus group themes.

Illustrative quotes for qualitative analysis of focus group themes.</p