Evaluation of The Effectiveness of a Direct Observed Therapy Program With Vietnamese Tuberculosis Patients

Tuberculosis (TB) has long been recognized as a major public health problem. The rate of TB is high in immigrants and the frequency of drug resistance is increasing. A major reason for the development of resistant infections as well as relapse is poor adherence to TB treatment. In response to this problem, direct observed therapy (DOT) was introduced to the TB program in Santa Clara County in 1993. The purpose of this study is to compare the completion rates, relapse rates, and sputum conversion rates between a DOT group and a non-DOT group of Vietnamese TB patients. A chart review was completed with a convenience sample of 25 records of DOT patients and 25 records of non-DOT patients. Frequencies and percentages were used to analyze the completion rates and the relapse rates. The results show that the completion of therapy rate was 16% higher in the DOT group and the relapse rate was 8% lower. A t-test indicated that the sputum conversion rate was significantly more rapid in the DOT group than in the non-DOT group (p \u3c.05). It appears that Vietnamese TB patients benefit from the DOT program

The Power of Social Media in the Promotion and Tenure of Clinician Educators

Introduction Social networking sites (or social media [SM]) are powerful web-based technologies used to bolster communication. SM have changed not only how information is communicated but also the dissemination and reception of a variety of topics. This workshop highlighted the benefits of SM for clinician educators. The use of SM was explored as a way to maximize opportunities for clinician educators to network, establish themselves as experts, and build a national reputation leading to promotion. The target audience for this submission is faculty developers who would like to implement a similar workshop, and clinician-educator faculty motivated by promotion and advancement. Methods The training workshop involved an interactive session, with approximately 20 minutes of content, 20 minutes of individual and small-group activities, and 15 minutes of large-group discussion. The effectiveness of the workshop was evaluated by asking participants to complete a postsession survey of SM knowledge, attitude, and action. Results Survey responses (n = 14) demonstrated an increase in participants’ knowledge of SM platforms, ability to identify benefits of SM, skills to disseminate their work, and eagerness to build their personal brand. Discussion This workshop provided a foundation for clinician educators to think strategically about SM use in ways that highlight access to a broader network of colleagues and potential collaborators and that influence the impact of publications and work

The SEAAster Scholars Collective: A Story of Homemaking in Academia

How do we make a home in spaces not built for us? What does an academic home for Southeast Asian American (SEAA) women look and feel like? This is the story of how a collective of SEAA women came together to create an alternative space in higher education. Continuing the radical act of resistance modeled by other Black, Indigenous, and women of color scholars, the SEAAster Scholars Collective uses a feminist epistemological approach to further their mission—to advance knowledge and understanding of the postsecondary educational experiences of SEAA students, staff, and faculty

Graduate Woodwind Quintet: Janet Mac Millan, Flute; Sarkis Halajian, Clarinet; Jacqueline Leicht, Oboe; Terry Grush, Bassoon; William Lawyer, Horn; May 11, 1973

Centennial East Recital HallFriday EveningMay 11, 19738:15 p.m

“I Didn't Know What to Say”: Responding to Racism, Discrimination, and Microaggressions With the OWTFD Approach

Introduction Academic medicine has long faced the challenge of addressing health inequities, reflecting on how these contribute to structural racism, and perpetuating negative social determinants of health. Most recently, we have constructed opportunities for dialogues about racism, discrimination, and microaggressions (RDM). As such, we created a professional development program that encouraged participants to (1) openly discuss RDM and the impact they have in academia, (2) learn about tools to address and respond to RDM, and (3) move towards the creation of inclusive environments. The target audience included institutional leaders, faculty, trainees, professional staff, and health care teams. Methods We sought to meet workshop goals by integrating anti-racist dramaturgical teaching, introducing concepts knowledge, and practicing communication tools. To assess learning and evaluate our workshops, participants completed a pre- and postsurvey. Results Results showed that 30 participants were more comfortable with discussing issues related to race/ethnicity, gender identity/expression, sexual orientation, and spirituality after participating in the workshops. Prior to the two workshops, the percentage of learners who felt confident initiating conversations ranged from 29% to 54%. After the workshops, the percentage of learners who felt confident ranged from 58% to 92%. The greatest increase, 100%, was observed in the levels of confidence in initiating conversations related to race/ethnicity. Discussion Despite medical education's commitment to cultural competence and institutional mission statements that value diversity, equity, inclusion, and justice, professional development opportunities are limited. Participants strongly agreed their participation in such a workshop was relevant and important to their professional work

A Survey of Internal Medicine Residents: Their Learning Environments, Bias and Discrimination Experiences, and Their Support Structures

Purpose: While there is an emerging body of literature that demonstrates how racism and bias negatively impact the experiences of physicians and trainees from underrepresented groups in medicine in the US, little is known about the experiences of internal medicine trainees and their learning environments. The purpose of this study was to examine these learning environments and explore trainees' perceptions of race/ethnicity-related topics. Methods: A 35-item confidential electronic survey was disseminated to trainees from 11 internal medicine training programs in the US. A total of 142 trainees participated. Purposive sampling ensured alignment with 2018 IM trainee demographics by sex, race and ethnicity. Analyses were performed including chi-square, Fisher's exact tests, and logistic regression. Results: Key findings reveal 63% of respondents perceived disparities in the care provided to diverse patients. Two in three respondents were confident that their institution would respond to discrimination, but only 1/3 of respondents perceived appropriate reporting mechanisms. Black/African American trainees reported needing to minimize aspects of their race and were less likely to perceive their institutions as being supportive to people of color. Conclusion: Access to timely information about trainees' experiences with discrimination and bias in graduate medical education is imperative to disrupt systemic racism and health inequities. Findings suggest a perceived difference in health care provided to minoritized groups, a gap in formal mechanisms for reporting racism and discrimination experienced by trainees, and environments that challenge a sense of belonging. Findings add to current literature exposing the experience of underrepresented trainees in the US

Broad diversity of fungi in Hospital Water

Introduction. Some studies have reported the occurrence of microorganisms isolated from water. Considering these microorganisms, fungi are known to occur ubiquitously in the environment, including water, and some are pathogenic and may cause health problems, especially in immunocompromised individuals. The aim of this study was to identify fungi in hospital water samples and to correlate their presence with the concentration of free residual chlorine. Methods. Water samples (100 mL) were collected from taps (n = 74) and water purifiers (n = 14) in different locations in a university hospital. Samples were filtered through a nitrocellulose membrane and placed on Sabouraud dextrose agar and incubated for 24 hours at 30°C. Fungi were identified according to established methods based on macroscopic and microscopic characteristics (filamentous) and physiological tests (yeasts). Free chlorine residual content was measured at the time of sample collection. Results. Seventy species of fungi were identified in the water samples and about 56% of the water samples contained culturable fungi. Cladosporium oxysporum, Penicillium spinulosum, and Aspergillus fumigatus were the most common filamentous fungi. Aureobasidium pullulans and Candida parapsilosis were the most common yeasts. Chemical analyses revealed that free residual chlorine was present in 81.8% of the samples within recommended concentrations. Among samples from water purifiers, 92.9% showed low levels of free residual chlorine (<0.2 mg/L). There was no significant association between chlorine concentrations (either within or outside the recommended range) and the presence of filamentous fungi and yeasts. Conclusions. This study showed that hospital water can be a reservoir for fungi, some of which are potentially harmful to immunocompromised patients. Free residual chlorine was ineffective in some samples.publishersversionpublishe

Labile plasma iron levels predict survival in patients with lower-risk Myelodysplastic syndromes

Red blood cell transfusions remain one of the cornerstones in supportive care of lower-risk patients with myelodysplastic syndromes. We hypothesized that patients develop oxidant mediated tissue injury through the formation of toxic iron species, caused either by red blood cell transfusions or by ineffective erythropoiesis. We analyzed serum samples from 100 lower-risk patients with myelodysplastic syndromes at six-month intervals for transferrin saturation, hepcidin-25, growth differentiation factor 15, soluble transferrin receptor, non-transferrin bound iron and labile plasma iron in order to evaluate temporal changes in iron metabolism and presence of potentially toxic iron species and their impact on survival. Hepcidin levels were low in 34 patients with ringed sideroblasts compared to 66 patients without. Increases of hepcidin and non-transferrin bound iron levels were visible early in follow-up of all transfusion dependent patient groups. Hepcidin levels significantly decreased over time in transfusion independent patients with ringed sideroblasts. Increased soluble transferrin receptor levels in transfusion-independent patients with ringed sideroblasts confirmed the presence of ineffective erythropoiesis and suppression of hepcidin production in these patients. Detectable labile plasma iron levels in combination with high transferrin saturation levels occurred almost exclusively in patients with ringed sideroblasts and all transfusion dependent patient groups. Detectable labile plasma iron levels in transfusion dependent patients without ringed sideroblasts were associated with decreased survival. IN CONCLUSION: toxic iron species occurred in all transfusion dependent patients and in transfusion independent patients with ringed sideroblasts. Labile plasma iron appeared to be a clinically relevant measure for potential iron toxicity and a prognostic factor for survival in transfusion dependent patients. This trial was registered at www.clinicaltrials.gov as #NCT00600860

A SARS-CoV-2 protein interaction map reveals targets for drug repurposing

The novel coronavirus SARS-CoV-2, the causative agent of COVID-19 respiratory disease, has infected over 2.3 million people, killed over 160,000, and caused worldwide social and economic disruption1,2. There are currently no antiviral drugs with proven clinical efficacy, nor are there vaccines for its prevention, and these efforts are hampered by limited knowledge of the molecular details of SARS-CoV-2 infection. To address this, we cloned, tagged and expressed 26 of the 29 SARS-CoV-2 proteins in human cells and identified the human proteins physically associated with each using affinity-purification mass spectrometry (AP-MS), identifying 332 high-confidence SARS-CoV-2-human protein-protein interactions (PPIs). Among these, we identify 66 druggable human proteins or host factors targeted by 69 compounds (29 FDA-approved drugs, 12 drugs in clinical trials, and 28 preclinical compounds). Screening a subset of these in multiple viral assays identified two sets of pharmacological agents that displayed antiviral activity: inhibitors of mRNA translation and predicted regulators of the Sigma1 and Sigma2 receptors. Further studies of these host factor targeting agents, including their combination with drugs that directly target viral enzymes, could lead to a therapeutic regimen to treat COVID-19

Asian American racial identity experiences in intergroup dialogue: A narrative study

The purpose of this constructivist narrative study was to explore how Asian American students experience their racial identity in intergroup dialogue. This study addressed the following guiding research question: how do Asian American students experience their racial identity in the context of intergroup dialogues? Two Asian American students from two intergroup dialogues participated in this study. Data collection included semi-structured individual interviews and course documents, such as journal reflections. Data were analyzed using a hybrid narrative approach that combined the analysis of the content as an entire story (inductive case analysis), of the content of themes within each story, and of the structure of a complete story (cross-case analysis). Full restories of each participant's story were provided. Four themes emerged from these restories to illuminate how students experienced their racial identity in intergroup dialogue. First, racial identities were experienced in a complicated manner that conflated race and ethnicity, within and outside of intergroup dialogue. Second, the salience of racial identity impacted how and what participants shared about their experiences. Third, both participants shared stories of internal conflict related to their racial identities, which were illuminated by their experiences in intergroup dialogue. Lastly, participants shared similar experiences participating in intergroup dialogue, which included holding back, taking risks, and responding to stereotypes. However, these experiences varied in the ways they were explicitly connected to participants' racial identity