The NeoResident Curriculum: A Combined Learning Experience for Pediatric Residents

Purpose and background, including relevant citations: All pediatric residents are required to rotate through the neonatal intensive care unit (NICU). The NICU is a unique unit that provides care for premature and ill neonates. At Children’s Hospital of Richmond at VCU (CHOR VCU), pediatric residents complete 12 weeks in the NICU, 4 weeks each year. As a part of this rotation, these residents are responsible for attending high risk deliveries. At birth about 10% of neonates will require resuscitation (1). Before starting residency, each resident is required to complete the neonatal resuscitation program (NRP). This certification requires renewal every two years. NRP conveys an evidence based approach to the care of the newborn at birth, and is the standard of care in the USA for healthcare professionals who manage newborns in the hospital (2). Studies have shown that retention of skills learned in certification courses such as NRP last 6-12 months (3). Due to when residents are scheduled, they can sometimes go longer than 12 months between rotations in the NICU, therefore they have limited opportunity to maintain their NRP skills with frequent recurrent practice. This has implications not only to the capabilities of the senior residents to feel competent to provide neonatal resuscitation, but also as they must feel competent to contribute to the education and supervision of pediatric interns. Description of Innovative Practice: Implement a self-paced adult learning NICU resident curriculum. The first part of the curriculum is online based with readings and questions. The topics include high yield pathologies that are seen in the NICU everyday. The second part will be NRP simulations conducted twice during their two-week rotations, one at the beginning to refresh NRP skills and a second simulation including practicing placement of umbilical venous catheter lines. The goal of this project is to help pediatric residents have a better understanding of the pathology seen in the NICU and to maintain their NRP competency and prevent NRP skill deterioration over time. Results: This is a new curriculum that is just being enrolled so we do not currently have results. Conclusion, including reflective critique, and next steps for research: Moving forward we will start collecting surveys pre rotation and post rotation. Following PDSA cycles, we will look through the data every three months and implement change where indicated based on survey results to improve the practice. As part of this project, we plan to create a refresher video on the basics of NRP that will be available to all residents at any time for their own review

Rigorous constraints on the matrix elements of the energy-momentum tensor

The structure of the matrix elements of the energy-momentum tensor play an important role in determining the properties of the form factors $A(q^{2})$, $B(q^{2})$ and $C(q^{2})$ which appear in the Lorentz covariant decomposition of the matrix elements. In this paper we apply a rigorous frame-independent distributional-matching approach to the matrix elements of the Poincar\'{e} generators in order to derive constraints on these form factors as $q \rightarrow 0$. In contrast to the literature, we explicitly demonstrate that the vanishing of the anomalous gravitomagnetic moment $B(0)$ and the condition $A(0)=1$ are independent of one another, and that these constraints are not related to the specific properties or conservation of the individual Poincar\'{e} generators themselves, but are in fact a consequence of the physical on-shell requirement of the states in the matrix elements and the manner in which these states transform under Poincar\'{e} transformations.Comment: 11 pages; v2: additional comments added, matches published versio

Theories of practice and public health:understanding (un)healthy practices

Psychological understandings and individualistic theories of human behaviour and behaviour change have dominated both academic research and interventions at the ‘coalface’ of public health. Meanwhile, efforts to understand persistent inequalities in health point to structural factors, but fail to show exactly how these translate into the daily lives (and hence health) of different sectors of the population. In this paper, we suggest that social theories of practice provide an alternative paradigm to both approaches, informing significantly new ways of conceptualising and responding to some of the most pressing contemporary challenges in public health. We introduce and discuss the relevance of such an approach with reference to tobacco smoking, focusing on the life course of smoking as a practice, rather than on the characteristics of individual smokers or on broad social determinants of health. This move forces us to consider the material and symbolic elements of which smoking is comprised, and to follow the ways in which these elements have changed over time. Some of these developments have to do with the relation between smoking and other practices such as drinking alcohol, relaxing and socialising. We suggest that intervening in the future of smoking depends, in part, on understanding the nature of these alliances, and how sets of practices co-evolve. We conclude by reflecting on the implications of taking social practices as the central focus of public health policy, commenting on the benefits of such a paradigmatic turn, and on the challenges that this presents for established methods, policies and programmes

Social media: creating communities of research and practice

Social media has become part of everyday life. By January 2015, over 3 billion internet users had set up more than 3.7 billion active social media accounts (Kemp, cited in Davis and Voyce, 2015). Social media in a professional context offers occupational therapists a powerful communication tool, one they have embraced enthusiastically. An increasing number use it not only to support their continued professional development but also to promote their research among their peers and across international health care networks. There is enormous potential for enabling contact and interaction with colleagues, policy makers, researchers and professional organisations on an equal footing. Recently, even traditional health care organisations, such as the National Health Service (NHS) in the United Kingdom, have facilitated the use of social media by health care professionals, no doubt assisted by its cost efficiencies with reduced cost for time and travel (Lawson and Cowling, 2014). Academic and research organisations likewise recognise that social and online media enrich academic life, whether through using Google Scholar to build research citations, Slideshare to distribute conference presentations, or online groups to collaborate with colleagues

Dynamics of digging in wet soil

Numerous animals live in, and locomote through, subsea soils. To move in a medium dominated by frictional interactions, many of these animals have adopted unique burrowing strategies. This paper presents a burrowing model inspired by the Atlantic razor clam ({\it Ensis directus}), which uses deformations of its body to cyclically loosen and re-pack the surrounding soil in order to locally manipulate burrowing drag. The model reveals how an anisotropic body -- composed of a cylinder and sphere varying sinusoidally in size and relative displacement -- achieves unidirectional motion through a medium with variable frictional properties. This net displacement is attained even though the body kinematics are reciprocal and inertia of both the model organism and the surrounding medium are negligible. Our results indicate that body aspect ratio has a strong effect on burrowing velocity and efficiency, with a well-defined maximum for given kinematics and soil material properties

Women\u27s Dignity, Women\u27s Prisons: Combatting Sexual Abuse in America\u27s Prisons

Staff sexual abuse is rampant throughout the American prison system. This is true despite a federal law—the aspirationally titled Prison Rape Elimination Act (“PREA”)—that has been in place for 20 years and despite the rare conviction of prison officials who are found guilty of rape or sexual abuse of people who are incarcerated. Sexual contact between prison staff and incarcerated people is by definition illegal because the power imbalance between people in custody and those who are under their control makes consent impossible as a matter of law. Staff-on-prisoner sexual abuse takes many forms, including sexual humiliation, sexually degrading language and threats, and various forms of rape. The harm of sexual violence in prison is commonly compounded by violations of privacy and by retaliation against those who speak out. To better understand the pervasiveness and profound harms of staff-on-prisoner sexual abuse, this article—co-written by two survivors who were also jailhouse lawyers—examines the harms and demonstrates the inadequacy of the current legal regime to protect women who are incarcerated. It then proposes that understanding prison sexual abuse as a violation of women’s inherent human dignity and applying the law of dignity rights to cases of staff-on-prisoner sexual abuse would better protect women who are vulnerable to abuse inside and help to end the culture of sexual abuse that pervades American prisons and jails