Interactive Telehealth Video Visits: A New Age for OSCEs

Healthcare in New Mexico is changing with the authorization of insurance reimbursement for telehealth. In order to prepare graduates to provide this care the College of Nursing has added video visit simulations to our Objective Structured Clinical Evaluation (OSCE) program. OSCEs have been extensively used in health science undergraduate and graduate programs across the country, demonstrating a high correlation with actual clinical skills and are crucial in the preparation of competent providers. Scarcity of suitable clinical sites, the high cost of faculty-led site visits, and the variability of clinical experiences create barriers for equitable evaluation of clinical performance. These challenges have prompted innovative clinical evaluations of students in remote sites. A standardized evaluation tool was developed to facilitate consistent assessment. The Focused Assessment of Clinically Targeted Skills (FACTS) checklist provides standardization of evaluation and feedback. The FACTS evaluation tool has been used for direct clinical observation and all OSCE experiences leveling the playing field for consistent student evaluation. This presentation will outline the planning, coordination, implementation, and standardized student evaluation used during video visit OSCEs at the University of New Mexico, College of Nursing

Evolution of the Population of Very Strong MgII Absorbers

We present a study of the evolution of several classes of MgII absorbers, and their corresponding FeII absorption, over a large fraction of cosmic history: 2.3 to 8.7 Gyrs from the Big Bang. Our sample consists of 87 strong (Wr(MgII)>0.3 A) MgII absorbers, with redshifts 0.2<z<2.5, measured in 81 quasar spectra obtained from the Very Large Telescope(VLT)/Ultraviolet and Visual Echelle Spectrograph(UVES) archives of high-resolution spectra (R \sim 45,000). No evolutionary trend in Wr(FeII)/Wr(MgII) is found for moderately strong MgII absorbers (0.3<Wr(MgII)<1.0 A). However, at lower z we find an absence of very strong MgII absorbers (those with Wr(MgII)>1 A) with small ratios of equivalent widths of FeII to MgII. At high z, very strong MgII absorbers with both small and large Wr(FeII)/Wr(MgII) values are present. We compare our findings to a sample of 100 weak MgII absorbers (Wr(MgII)<0.3 A) found in the same quasar spectra by Narayanan et al. (2007). The main effect driving the evolution of very strong MgII systems is the difference between the kinematic profiles at low and high redshifts. At high z, we observe that, among the very strong MgII absorbers, all of the systems with small ratios of Wr(FeII)/Wr(MgII) have relatively large velocity spreads, resulting in less saturated profiles. At low z, such kinematically spread systems are absent, and both FeII and MgII are saturated, leading to Wr(FeII)/Wr(MgII) values that are all close to 1. The high redshift, small Wr(FeII)/Wr(MgII) systems could correspond to sub-DLA systems, many of which have large velocity spreads and are possibly linked to superwinds in star forming galaxies. In addition to the change in saturation due to kinematic evolution, the smaller Wr(FeII)/Wr(MgII) values could be due to a lower abundance of Fe at high z, which would indicate relatively early stages of star formation in those environments.Comment: 20 pages, 14 figures (figure 1 is a set of 87 figures, which is available on the online version), accepted for publication in the MNRA

Biomarkers of Alzheimer’s disease and cerebrovascular disease in relation to depressive symptomatology in individuals with subjective cognitive decline

Background: Subjective cognitive decline (SCD) has gained recent interest as a potential harbinger of neurodegenerative diseases such as Alzheimer’s disease (AD) and cerebrovascular disease (CVD). In addition, SCD can be related to depressive symptomatology. However, the association between AD and CVD biomarkers, depressive symptomatology, and SCD is still unclear. We investigated the association of AD and CVD biomarkers and depressive symptomatology with SCD in individuals with subjective memory complaints (SCD-memory group) and individuals with subjective concentration complaints (SCD-concentration group).// Methods: We recruited a population-based cohort of 217 individuals (all aged 70 years, 53% female, 119 SCD-memory individuals, 23 SCD-concentration individuals, 89 controls). AD and CVD were assessed through cerebrospinal fluid levels of the Aβ42/40 ratio and phosphorylated tau, and white matter signal abnormalities on magnetic resonance imaging, respectively. Associations between biomarkers, depressive symptomatology, and SCD were tested via logistic regression and correlation analyses.// Results: We found a significant association of depressive symptomatology with SCD-memory and SCD-concentration. Depressive symptomatology was not associated with AD and CVD biomarkers. Both the phosphorylated tau biomarker and depressive symptomatology predicted SCD-memory, and the Aβ42/40 ratio and depressive symptomatology predicted SCD-concentration.// Conclusions: The role of depressive symptomatology in SCD may differ depending on the stage within the spectrum of preclinical AD (as determined by amyloid-beta and tau positivity), and does not seem to reflect AD pathology. Our findings contribute to the emerging field of subclinical depressive symptomatology in SCD, and clarify the association of different types of subjective complaints with distinct syndromic and biomarker profiles

Biomarkers of Alzheimer’s Disease and Cerebrovascular Disease in Relation to Depressive Symptomatology in Individuals With Subjective Cognitive Decline

Background :Subjective cognitive decline (SCD) has gained recent interest as a potential harbinger of neurodegenerative diseases such as Alzheimer’s disease (AD) and cerebrovascular disease (CVD). In addition, SCD can be related to depressive symptomatology. However, the association between AD and CVD biomarkers, depressive symptomatology, and SCD is still unclear. We investigated the association of AD and CVD biomarkers and depressive symptomatology with SCD in individuals with subjective memory complaints (SCD-memory group) and individuals with subjective concentration complaints (SCD-concentration group). Methods:We recruited a population-based cohort of 217 individuals (all aged 70 years, 53% female participants, 119 SCD-memory individuals, 23 SCD-concentration individuals, and 89 controls). AD and CVD were assessed through cerebrospinal fluid levels of the Aβ42/40 ratio and phosphorylated tau, and white matter signal abnormalities on magnetic resonance imaging, respectively. Associations between biomarkers, depressive symptomatology, and SCD were tested via logistic regression and correlation analyses. Results: We found a significant association between depressive symptomatology with SCD-memory and SCD-concentration. Depressive symptomatology was not associated with AD and CVD biomarkers. Both the phosphorylated tau biomarker and depressive symptomatology predicted SCD-memory, and the Aβ42/40 ratio and depressive symptomatology predicted SCD-concentration. Conclusions:The role of depressive symptomatology in SCD may differ depending on the stage within the spectrum of preclinical AD (as determined by amyloid-beta and tau positivity), and does not seem to reflect AD pathology. Our findings contribute to the emerging field of subclinical depressive symptomatology in SCD and clarify the association of different types of subjective complaints with distinct syndromic and biomarker profiles