SURFACE WARFARE OFFICER SCHOOL 360-DEGREE ASSESSMENT TOOL: EVALUATION OF THE CURRENT PROGRAM FOR SURFACE WARFARE OFFICERS

The Surface Warfare Officer School Command’s (SWOSCOM) current 360-degree feedback assessment was constructed using a civilian commercial off-the-shelf product and has not undergone a rigorous review since its creation in 2008. Some of the current assessment’s focus areas are not germane to the Surface Warfare Community and have been found to be limited in fully measuring a Naval Surface Warfare Officer’s (SWO) leadership through this and previous studies. This thesis examines potential modifications to significantly improve the assessment to better measure and support the SWO community. The research identified the relevance of existing questions to provide feedback on skills and behaviors that affect leadership performance. Using data collected from SWOSCOM consisting of 100 individual redacted feedback reports, an analysis of variance to determine distinctiveness in perspectives of self, bosses, peers, and subordinates regarding early-career SWOs was conducted. Machine learning techniques were applied to identify skills that might be more effective at providing valuable feedback to young officers. This research provides SWOSCOM with specific areas to target and revise in the current assessment by removing or modifying questions that contribute relatively little to the overall assessment and replacing them with questions that are more tailored to the skills and abilities necessary for a SWO and the community to develop a competitive advantage.Surface Warfare Officer SchoolLieutenant, United States NavyApproved for public release. Distribution is unlimited

Cardiac and Perceptual Responses to Performing Tandem Cardiopulmonary Resuscitation

Introduction: Information regarding the physiological and perceptual response of the human body in the act of performing tandem cardiopulmonary resuscitation (CPR) relative to solo CPR is lacking.  Purpose: The purpose of this investigation is to compare rescuer heart rate (HR), rating of perceived exertion (RPE), and CPR quality during TandemCPR and Solo-CPR.  Methods: Thirteen healthy young adults (aged 26.5±4.3 yrs) were recruited from MSUB campus community.  Participants completed two 6-minute bouts of CPR during a single session. Tandem and solo techniques were counterbalanced, with a 15-minute rest period separating the bouts.  Values for HR and RPE were recorded using a Polar V800 HR monitor and Adult OMNI-RPE scale, respectively.  A Laerdal ResusciAnne CPR manikin was used to record compression score (0-100%), which is a value that incorporates compression rate and depth to illustrate CPR quality.  Mean HR, peak RPE and CPR compression scores were examined with dependent t-tests between CPR techniques.  Statistical significance was accepted at p<0.05.  Results: Sample mean HR per bout was significantly lower in Tandem-CPR than in Solo-CPR (111.2±16.8 vs. 126.1±19.3, p<0.0001).  Peak RPE was significantly lower during Tandem-CPR compared to Solo-CPR (3.2±2.0 vs. 5.0±2.5, p<0.05).  Compression scores were significantly higher for Tandem-CPR when compared to Solo-CPR (96±3% vs. 94±5%, p<0.05). Discussion: Current findings call for a professional recommendation that tandem CPR be used when available, based on perception, performance, and physiological differences. This confirms professional guidelines.  This study does not account for the anecdotally reported stress incited in CPR context; further research should examine this aspect

Urban Parks: The Value of Small Urban Parks, Plazas and Other Outdoor Spaces

4 pp., 21 color photosPeople need parks. Great urban parks are places where communities come together, people interact, and social capital develops. Learn the characteristics of great urban parks and how they are created

Confronting Inequity: Social Justice Dialogue in a Health Science Library

Objective: To demonstrate how a departmental social justice discussion group was successful in achieving its purpose in introducing and discussing health-related social justice narratives and perspectives with personal meaning to each department member. Methods: In the aftermath George Floyd’s death, the Assistant Director of Research and Education Services at a health sciences library proposed devoting a portion of staff meetings to discuss issues in social justice and anti-racism. Each department member would generate a topic and organize readings or links to media in an internal LibGuide. Initially, there was a total of seven discussions, each lasting an average of twenty minutes. Each staff member described their motivation in selecting their topic and accompanying resources and led the subsequent discussion. Results: Discussion topics included white fragility, racial disparities surrounding leg amputations of Black diabetes patients in Mississippi, transracial adoption, local food deserts, white privilege in medical school education, black transgender violence and discrimination, and pipeline institutional racism. The readings and discussions revealed marginalized group perceptions and reality are not necessarily willingly acknowledged or addressed by the privileged group. The topic of food deserts was identified for follow-up action because of the need in the residential area adjacent to the health sciences campus. Conclusions: Participants felt the topics were timely, thought-provoking and useful in understanding current imbalances in social equity in health-related areas. Each department member could identify and share a social justice area of concern. Many of the topics are addressed in critical librarianship scholarship, and lessons from the discussions could be applied to increased understanding of, and service to, marginalized users of their library’s community. Team members agreed to continue the discussions at staff meetings once per month on broader diversity and social justice topics

Damping enhancement in coherent ferrite/insulating-paramagnet bilayers

High-quality epitaxial ferrites, such as low-damping MgAl-ferrite (MAFO), are promising nanoscale building blocks for all-oxide heterostructures driven by pure spin current. However, the impact of oxide interfaces on spin dynamics in such heterostructures remains an open question. Here, we investigate the spin dynamics and chemical and magnetic depth profiles of 15-nm-thick MAFO coherently interfaced with an isostructural $\approx$1-8-nm-thick overlayer of paramagnetic CoCr$_2$O$_4$ (CCO) as an all-oxide model system. Compared to MAFO without an overlayer, effective Gilbert damping in MAFO/CCO is enhanced by a factor of $>$3, irrespective of the CCO overlayer thickness. We attribute this damping enhancement to spin scattering at the $\sim$1-nm-thick chemically disordered layer at the MAFO/CCO interface, rather than spin pumping or proximity-induced magnetism. Our results indicate that damping in ferrite-based heterostructures is strongly influenced by interfacial chemical disorder, even if the thickness of the disordered layer is a small fraction of the ferrite thickness

Blood cultures for the diagnosis of multidrug-resistant and extensively drug-resistant tuberculosis among HIV-infected patients from rural South Africa: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>The yield of mycobacterial blood cultures for multidrug-resistant (MDR) and extensively drug-resistant tuberculosis (XDR-TB) among drug-resistant TB suspects has not been described.</p> <p>Methods</p> <p>We performed a retrospective, cross-sectional analysis to determine the yield of mycobacterial blood cultures for MDR-TB and XDR-TB among patients suspected of drug-resistant TB from rural South Africa. Secondary outcomes included risk factors of <it>Mycobacterium tuberculosis </it>bacteremia and the additive yield of mycobacterial blood cultures compared to sputum culture.</p> <p>Results</p> <p>From 9/1/2006 to 12/31/2008, 130 patients suspected of drug-resistant TB were evaluated with mycobacterial blood culture. Each patient had a single mycobacterial blood culture with 41 (32%) positive for <it>M. tuberculosis</it>, of which 20 (49%) were XDR-TB and 8 (20%) were MDR-TB. One hundred fourteen (88%) patients were known to be HIV-infected. Patients on antiretroviral therapy were significantly less likely to have a positive blood culture for <it>M. tuberculosis </it>(p = 0.002). The diagnosis of MDR or XDR-TB was made by blood culture alone in 12 patients.</p> <p>Conclusions</p> <p>Mycobacterial blood cultures provided an additive yield for diagnosis of drug-resistant TB in patients with HIV from rural South Africa. The use of mycobacterial blood cultures should be considered in all patients suspected of drug-resistant TB in similar settings.</p

Genotypic resistance testing in HIV by arrayed primer extension

The analysis of mutations that are associated with the occurrence of drug resistance is important for monitoring the antiretroviral therapy of patients infected with human immunodeficiency virus (HIV). Here, we describe the establishment and successful application of Arrayed Primer Extension (APEX) for genotypic resistance testing in HIV as a rapid and economical alternative to standard sequencing. The assay is based on an array of oligonucleotide primers that are immobilised via their 5′-ends. Upon hybridisation of template DNA, a primer extension reaction is performed in the presence of the four dideoxynucleotides, each labelled with a distinct fluorophore. The inserted label immediately indicates the sequence at the respective position. Any mutation changes the colour pattern. We designed a microarray for the analysis of 26 and 33 codons in the HIV protease and reverse transcriptase, respectively, which are of special interest with respect to drug resistance. The enormous genome variability of HIV represents a big challenge for genotypic resistance tests, which include a hybridisation step, both in terms of specificity and probe numbers. The use of degenerated oligonucleotides resulted in a significant reduction in the number of primers needed. For validation, DNA of 94 and 48 patients that exhibited resistance to inhibitors of HIV protease and reverse transcriptase, respectively, were analysed. The validation included HIV subtype B, prevalent in industrialised countries, as well as non-subtype B samples that are more common elsewhere

High Rates of Hepatitis C Virus Reinfection and Spontaneous Clearance of Reinfection in People Who Inject Drugs: A Prospective Cohort Study

Hepatitis C virus reinfection and spontaneous clearance of reinfection were examined in a highly characterisedcohort of 188 people who inject drugs over a five-year period. Nine confirmed reinfections and 17 possiblereinfections were identified (confirmed reinfections were those genetically distinct from the previous infection andpossible reinfections were used to define instances where genetic differences between infections could not beassessed due to lack of availability of hepatitis C virus sequence data). The incidence of confirmed reinfection was28.8 per 100 person-years (PY), 95%CI: 15.0-55.4; the combined incidence of confirmed and possible reinfectionwas 24.6 per 100 PY (95%CI: 16.8-36.1). The hazard of hepatitis C reinfection was approximately double that ofprimary hepatitis C infection; it did not reach statistical significance in confirmed reinfections alone (hazard ratio [HR]:2.45, 95%CI: 0.87-6.86, p=0.089), but did in confirmed and possible hepatitis C reinfections combined (HR: 1.93,95%CI: 1.01-3.69, p=0.047) and after adjustment for the number of recent injecting partners and duration of injecting.In multivariable analysis, shorter duration of injection (HR: 0.91; 95%CI: 0.83-0.98; p=0.019) and multiple recentinjecting partners (HR: 3.12; 95%CI: 1.08-9.00, p=0.035) were independent predictors of possible and confirmedreinfection. Time to spontaneous clearance was shorter in confirmed reinfection (HR: 5.34, 95%CI: 1.67-17.03,p=0.005) and confirmed and possible reinfection (HR: 3.10, 95%CI: 1.10-8.76, p-value=0.033) than primary infection.Nonetheless, 50% of confirmed reinfections and 41% of confirmed or possible reinfections did not spontaneouslyclear.Conclusions: Hepatitis C reinfection and spontaneous clearance of hepatitis C reinfection were observed at highrates, suggesting partial acquired natural immunity to hepatitis C virus. Public health campaigns about the risks ofhepatitis C reinfection are required