Person and professional program determinants of health provider student attitudes toward inter-professional teamwork

Health provider student characteristics and professional program were evaluated as predictors of attitudes toward inter-professional (IP) teams. Sixteen months after completing a self-report battery of demographic and non-ability trait measures, participants completed a second survey (N = 213), assessing components of attitudes toward IP teams. Non-ability traits showed comparable within-program predictive validities for affective reactions toward IP behavior. Additionally, results indicated the incremental predictive validity of trait Dominance and Motivational Inter-professional Team Intelligence, over professional program, for IP attitudes and affective reactions toward IP behavior, respectively. The independent, relative, and joint roles of non-ability individual differences and professional program as determinants of IP training outcomes are discussed.MSCommittee Chair: Ruth Kanfer; Committee Member: Phillip L. Ackerman; Committee Member: Rustin Meye

IRT assessment of readiness for interprofessional learning scale (RIPLS) : dimensionality, reliability, and item function

This poster presentation aims to bring evidence from modern psychometric methods to bear on a popularly deployed questionnaire in interprofessional education (IPE) assessment. Specifically, three interrelated problems raised against the Readiness for Interprofessional Learning Scale (RIPLS) are examined in a study with n =280 medical and nursing student participants. Firstly, findings indicate a strong, general factor underlying the RIPLS that supports unidimensional interpretations. Secondly, findings support RIPLS overall reliability, but fail to support subscale reliabilities. Thirdly, findings support the RIPLS potential sensitivity to changes with appropriate lower ranges for our pre-training student sample. Recommendations for refinement to the RIPLS include: use of more appropriate reliability indices; factor generalizability; and a subset of items. More generally, refinement is possible, whereas RIPLS disuse or continued misuse with problematic scales is likely to hinder progress in the field of IPE research

Construct representation of self-report future time perspective for work and retirement scholarship

The dissertation presents evidence on the measurement properties of self-report items in contemporary organizational contexts (Podsakoff & Organ, 1986). Operationally, the dissertation adopts a construct representation approach to construct validity, defined by the response processes engaged for measurement performance in trait assessment (AERA, 2014; Embretson, 1983). For example, self-report measures are known to be affected by a variety of variables, such as semantic and referent features (Cermac & Craik, 1979; Kelly, 1955) and design factors that impact cognitive context (Stone, et al, 2000; The Science of Self-Report). In turn, the response processes impacts the external correlations (Embretson, 2007). To the extent that semantic-referent features and design factors are construct-irrelevant, reduced external correlations can be expected. This dissertation presents evidence from a qualitative review of self-report future time perspective (FTP) instruments across organizational and retirement contexts. A quantitative review compares external correlates of the two instruments. A retrospective-observational study benchmarks the psychometric properties of Carstensen's self-report instrument using modern latent-variable modeling (item-response theory [IRT]). Structural equation modeling (SEM) is further used to test for moderating effects of subjective life expectancy (SLE) on latent predictors of FTP and retirement plans. Evidence from a '3 x 2' mixed-subjects experimental design is also presented indicating the effects of subjective life expectancy (SLE) on measurement error in personality factors, FTP, and retirement plans. Discussion centers on advancing measurement paradigms in psychological and education research, as well as -more generally- adopting an integrated perspective of construct validity for advancing and evaluating substantive research.Ph.D

The longevity of para-aminopropiophenone (PAPP) wild dog baits and the implications for effective and safe baiting campaigns

Considerable effort goes into mitigating the impacts caused by invasive animals and prohibiting their establishment or expansion. In Australia, management of wild dogs (Canis lupus dingo and their hybrids) and their devastating impacts is reliant upon poison baiting. The recent release of baits containing the humane toxin para-aminopropiophenone (PAPP) offers potential improvements for control of wild dogs, but little is known about the environmental persistence of PAPP in manufactured baits that could be used to inform best practice guidelines. We investigated the degradation rate of PAPP wild dog baits (DOGABAIT™) under typical field usage and storage conditions in north-eastern Australia and calculated optimal deployment and withholding periods. The PAPP content of buried baits declines faster than surface-laid baits, but both presentations retained lethal doses to wild and domestic dogs for considerable periods (6–16 weeks). Domestic or working dogs should be suitably restrained or excluded from baited areas for extended periods, particularly under dry conditions, to minimise poisoning risk. The period of persistence of PAPP baits may provide opportunities to improve the duration or longer term efficacy of baiting campaigns, but care is needed to protect domestic and working dogs to ensure responsible and safe use

Impacts of hemispheric solar geoengineering on tropical cyclone frequency

Solar geoengineering refers to a range of proposed methods for counteracting global warming by artificially reducing sunlight at Earth’s surface. The most widely known SG proposal is stratospheric aerosol injection (SAI) which has impacts analogous to those from volcanic eruptions. Observations following major volcanic eruptions indicate that aerosol enhancements confined to a single hemisphere effectively modulate North Atlantic tropical cyclone (TC) activity in the following years. Here we investigate the effects of both single-hemisphere and global SAI scenarios on North Atlantic TC activity using the HadGEM2-ES general circulation model and various TC identification methods. We show that a robust result from all of the methods is that SAI applied to the southern hemisphere would enhance TC frequency relative to a global SAI application, and vice versa for SAI in the northern hemisphere. Our results reemphasize the perils of regional geoengineering and should motivate policymakers to regulate large-scale unilateral geoengineering deployments

Pan-resistome characterization of uropathogenic Escherichia coli and Klebsiella pneumoniae strains circulating in Uganda and Kenya, isolated from 2017-2018

Funding: The Holistic Approach to Unravel Antibacterial Resistance in East Africa is a 3-year Global Context Consortia Award (MR/S004785/1) funded by the National Institute for Health Research, Medical Research Council and the Department of Health and Social Care. The award is also part of the EDCTP2 program supported by the European Union.Urinary tract infection (UTI) develops after a pathogen adheres to the inner lining of the urinary tract. Cases of UTIs are predominantly caused by several Gram-negative bacteria and account for high morbidity in the clinical and community settings. Of greater concern are the strains carrying antimicrobial resistance (AMR)-conferring genes. The gravity of a UTI is also determined by a spectrum of other virulence factors. This study represents a pilot project to investigate the burden of AMR among uropathogens in East Africa. We examined bacterial samples isolated in 2017–2018 from in- and out-patients in Kenya (KY) and Uganda (UG) that presented with clinical symptoms of UTI. We reconstructed the evolutionary history of the strains, investigated their population structure, and performed comparative analysis their pangenome contents. We found 55 Escherichia coli and 19 Klebsiella pneumoniae strains confirmed uropathogenic following screening for the prevalence of UTI virulence genes including fimH, iutA, feoA/B/C, mrkD, and foc. We identified 18 different sequence types in E. coli population while all K. pneumoniae strains belong to ST11. The most prevalent E. coli sequence types were ST131 (26%), ST335/1193 (10%), and ST10 (6%). Diverse plasmid types were observed in both collections such as Incompatibility (IncF/IncH/IncQ1/IncX4) and Col groups. Pangenome analysis of each set revealed a total of 2862 and 3464 genes comprised the core genome of E. coli and K. pneumoniae population, respectively. Among these are acquired AMR determinants including fluoroquinolone resistance-conferring genes aac(3)-Ib-cr and other significant genes: aad, tet, sul1, sul2, and cat, which are associated with aminoglycoside, tetracycline, sulfonamide, and chloramphenicol resistance, respectively. Accessory genomes of both species collections were detected several β-lactamase genes, blaCTX-M, blaTEM and blaOXA, or blaNDM. Overall, 93% are multi-drug resistant in the E. coli collection while 100% of the K. pneumoniae strains contained genes that are associated with resistance to three or more antibiotic classes. Our findings illustrate the abundant acquired resistome and virulome repertoire in uropathogenic E. coli and K. pneumoniae, which are mainly disseminated via clonal and horizontal transfer, circulating in the East African region. We further demonstrate here that routine genomic surveillance is necessary for high-resolution bacterial epidemiology of these important AMR pathogens.Publisher PDFPeer reviewe

Consensus Recommendations for Sick Day Medication Guidance for People With Diabetes, Kidney, or Cardiovascular Disease:A Modified Delphi Process

Rationale &amp; Objective: Sick day medication guidance (SDMG) involves withholding or adjusting specific medications in the setting of acute illnesses that could contribute to complications such as hypotension, acute kidney injury (AKI), or hypoglycemia. We sought to achieve consensus among clinical experts on recommendations for SDMG that could be studied in future intervention studies. Study Design: A modified Delphi process following guidelines for conducting and reporting Delphi studies. Setting &amp; Participants: An international group of clinicians with expertise relevant to SDMG was recruited through purposive and snowball sampling. A scoping review of the literature was presented, followed by 3 sequential rounds of development, refinement, and voting on recommendations. Meetings were held virtually and structured to allow the participants to provide their input and rapidly prioritize and refine ideas.Outcome: Opinions of participants were measured as the percentage who agreed with each recommendation, whereas consensus was defined as &gt;75% agreement. Analytical Approach: Quantitative data were summarized using counts and percentages. A qualitative content analysis was performed to capture the context of the discussion around recommendations and any additional considerations brought forward by participants. Results: The final panel included 26 clinician participants from 4 countries and 10 clinical disciplines. Participants reached a consensus on 42 specific recommendations: 5 regarding the signs and symptoms accompanying volume depletion that should trigger SDMG; 6 regarding signs that should prompt urgent contact with a health care provider (including a reduced level of consciousness, severe vomiting, low blood pressure, presence of ketones, tachycardia, and fever); and 14 related to scenarios and strategies for patient self-management (including frequent glucose monitoring, checking ketones, fluid intake, and consumption of food to prevent hypoglycemia). There was consensus that renin-angiotensin system inhibitors, diuretics, nonsteroidal anti-inflammatory drugs, sodium/glucose cotransporter 2 inhibitors, and metformin should be temporarily stopped. Participants recommended that insulin, sulfonylureas, and meglitinides be held only if blood glucose was low and that basal and bolus insulin be increased by 10%-20% if blood glucose was elevated. There was consensus on 6 recommendations related to the resumption of medications within 24-48 hours of the resolution of symptoms and the presence of normal patterns of eating and drinking. Limitations: Participants were from high-income countries, predominantly Canada. Findings may not be generalizable to implementation in other settings. Conclusions: A multidisciplinary panel of clinicians reached a consensus on recommendations for SDMG in the presence of signs and symptoms of volume depletion, as well as self-management strategies and medication instructions in this setting. These recommendations may inform the design of future trials of SDMG strategies.</p

Environment Impacts the Metabolic Dependencies of Ras-Driven Non-Small Cell Lung Cancer

Cultured cells convert glucose to lactate, and glutamine is the major source of tricarboxylic acid (TCA)-cycle carbon, but whether the same metabolic phenotype is found in tumors is less studied. We infused mice with lung cancers with isotope-labeled glucose or glutamine and compared the fate of these nutrients in tumor and normal tissue. As expected, lung tumors exhibit increased lactate production from glucose. However, glutamine utilization by both lung tumors and normal lung was minimal, with lung tumors showing increased glucose contribution to the TCA cycle relative to normal lung tissue. Deletion of enzymes involved in glucose oxidation demonstrates that glucose carbon contribution to the TCA cycle is required for tumor formation. These data suggest that understanding nutrient utilization by tumors can predict metabolic dependencies of cancers in vivo. Furthermore, these data argue that the in vivo environment is an important determinant of the metabolic phenotype of cancer cells.National Science Foundation (U.S.) (Grant T32GM007287