Evaluation of a Dual First-year Student Advising Program

A College of Engineering at a mid-size public university in the mid-Atlantic region is changing its first year student advising system after a relatively rapid increase in its student population.The college admitted approximately 150 engineering first year students annually between 2000 and 2010. Starting in 2011, larger first year classes were admitted, growing to approximately 380 first year students in Fall 2014. Future classes are expected to remain in the 375 to 400 student range. Before Fall 2014, all first year students were advised entirely by faculty. A relatively high faculty-to-student ratio and strong faculty commitment contributed to successful advising, as measured by high retention from the first to second year (93.4 %) and a high four and six-year graduation rate (55 and 73 %, respectively). As student numbers grew, so did concern about the ability of the faculty system to provide sufficient advising. In Fall 2014 a hybrid system was adopted in which one professional staff member is responsible for advice on course sequencing,college/university policies and procedures, scheduling and campus resources for all first year students. Faculty members continue to provide information and guidance related to industry-driven competencies and career information. The hybrid system also includes more online resources, including student quizzes and an advising Wiki. To provide feedback that can be used to guide and improve the new advising system, two surveys were directly incorporated into the ebook used in the introduction to engineering course taken by all first year students The PathFinder website has been used to provide the ebook and on-line quizzes and homework for all sections of the first year course since Fall 2012. In Fall 2014, two quizzes were added related to advising. The first quiz, administered in October shortly before course registration, prompts students to consider and evaluate their need for and use of university resources, e.g., advising, career management assistance, tutoring, etc. The second survey, administered at the end of the semester, asks students to reflect on how they used university resources during their first semester.The purpose of this paper is to evaluate the new hybrid advising system. This will be accomplished using: (1) the two online quizzes; (2) direct observations by the professional adviser; (3) a focus group with select students at the end of the semester; (4) a survey of the faculty advisors; and (5) analysis of student retention from Fall 2014 to Spring 2015

Perceptions about family-centred care among adult patients with chronic diseases at a general outpatient clinic in Nigeria

Background: Few studies in Africa have described patients’ perceptions about family-centred care (FCC). Aim: The aim of this study was to explore perceptions of FCC among patients with chronic diseases. Setting: The study was conducted at a general outpatient clinic (GOPC) in Jos, north-central Nigeria. Methods: We used a mixed-methods phenomenological study design and conducted structured and semi-structured interviews with 21 adult patients with chronic diseases at a general outpatient clinic in north-central Nigeria. Results: Patients described FCC using progressive levels of family engagement including the doctor inquiring about history of similar disease in the family, information sharing with family members and fostering of family ties. They described current family involvement in their care as either inquiring about their health, accompanying them to the clinic or offering material or social support and health advice. Also, patients considered the value of FCC based on how it meets information needs of the family, influences individual health behaviour and addresses family dynamics. Those who were literate and older than 50 years of age favoured FCC during history taking. Those who were literate, aged lesser than 50 years and had poor disease control showed preference for FCC during treatment decision-making. Conclusion: The acceptability of FCC is a complex synthesis of age, socio-economic status, literacy and disease outcomes. Patients older than 50 years, with good treatment outcomes, and those without formal education may need further education and counselling on this approach to care

Successes, challenges and needs regarding rural health medical education in continental central America: A literature review and narrative synthesis

Introduction: Central American countries, like many others, face a shortage of rural health physicians. Most medical schools in this region are located in urban areas and focus on tertiary care training rather than on community health or primary care, which are better suited for rural practice. However, many countries require young physicians to do community service in rural communities to address healthcare provider shortages. This study aimed to: (a) synthesize what is known about the current state of medical education preparing physicians for rural practice in this region, and (b) identify common needs, challenges and opportunities for improving medical education in this area. Methods: A comprehensive literature review was conducted between December 2013 and May 2014. The stepwise, reproducible search process included English and Spanish language resources from both data-based web search engines (PubMed, Web of Science/Web of Knowledge, ERIC and Google Scholar) and the grey literature. Search criteria included MeSH terms: ‘medical education’, ‘rural health’, ‘primary care’, ‘community medicine’, ‘social service’, in conjunction with ‘Central America’, ‘Latin America’, ‘Mexico’, ‘Guatemala’, ‘Belize’, ‘El Salvador’, ‘Nicaragua’, ‘Honduras’, ‘Costa Rica’ and ‘Panama’. Articles were included in the review if they (1) were published after 1984; (2) focused on medical education for rural health, primary care, community health; and (3) involved the countries of interest. A narrative synthesis of the content of resources meeting inclusion criteria was done using qualitative research methods to identify common themes pertaining to the study goals. Results: The search revealed 20 resources that met inclusion criteria. Only four of the 20 were research articles; therefore, information about this subject was primarily derived from expert opinion. Thematic analysis revealed the historical existence of several innovative programs that directly address rural medicine training needs, suggesting that expertise is present in this region. However, numerous challenges limit sustainability or expansion of successful programs. Common challenges include: (a) physicians’ exposure to rural medicine primarily takes place during social service commitment time, rather than during formal medical training; (b) innovative educational programs are often not sustainable due to financial and leadership challenges; (c) the majority of physician manpower is in urban areas, resulting in few rural physician role models and teachers; and (d) there is insufficient collaboration to establish clinical and educational systems to meet rural health needs. Recurring suggestions for curricular changes include: (a) making primary care training a core component of medical school education; and (b) expanding medical school curricula in crosscultural communication and social determinants of disease. Suggestions for health system changes include: (a) improving living and working conditions for rural physicians; and (b) establishing partnerships between educational, governmental and non-governmental organizations and rural community leadership, to promote rural health training and systems. Conclusions: Expertise in rural medicine and training exists in continental Central America. However, there are numerous challenges to improving medical education to meet the needs of rural communities. Overcoming these challenges will require creative solutions, new partnerships, and evaluation and dissemination of successful educational programs. There is a great need for further research on this topic

Emittance Measurements Relevant to a 250 W(sub t) Class RTPV Generator for Space Exploration

A proposed 250 Wt Radioisotope Thermophotovoltaic (RTPV) power system for utilization in lunar exploration and the subsequent exploration of Mars is described. Details of emitter selection are outlined for use in a maintenance free power supply that is productive over a 14-year mission life. Thorough knowledge of a material s spectral emittance is essential for accurate modeling of the RTPV system. While sometimes treated as a surface effect, emittance involves radiation from within a material. This creates a complex thermal gradient which is a combination of conductive and radiative heat transfer mechanisms. Emittance data available in the literature is a valuable resource but it is particular to the test sample s physical characteristics and the test environment. Considerations for making spectral emittance measurements relevant to RTPV development are discussed. Measured spectral emittance data of refractory emitter materials is given. Planned measurement system modifications to improve relevance to the current project are presented

Meeting report: ‘How do I incorporate research into my family practice?’: Reflections on experiences of and solutions for young family doctors

Background: Family doctors (FDs) focus on biopsychosocial components of health during consultations. However, much of the evidence employed by these doctors is produced by researchers who are not routinely involved in family practice. Family doctors competent in both clinical practice and research are essential to addressing this gap. With the growing recognition of family medicine as the specialty of choice for many young doctors, there is a scarcity of literature that describes their experiences in combining research and daily family practice. Aim: Members from Young Doctor Movements (YDMs) under the auspices of the World Organisation of Family Doctors (WONCA) sought to address this knowledge gap by reflecting on their experiences towards becoming researchers. With the assistance of senior doctors, they explored solutions that can help young FDs incorporate research into their family practice. Methods: Following an online YDM meeting, a summary of the experiences of young FDs as well as strategies useful for incorporating research into their everyday practice as FDs was prepared. Result: Nine thematic areas were derived, including experiences and motivation towards regular research, culture and environment of practice, relevance and gains of research, teamwork and mentorship. Conclusion: Family practices can incorporate research by promoting a personal and organisational research culture, highlighting gains and relevance of making it part of the profession and fostering teamwork, supportive networks and mentorship while making it enjoyable

Faculty development in family medicine education: what is needed?

A growing number of countries are embracing graduate training in the specialty of Family Medicine as a core component of global health systems reform. One significant challenge for new programs is to adequately prepare for educational excellence and leadership. Promising residents are often encouraged to remain in their program as faculty, but may not have had the benefit of specific training in teaching, curriculum development, learner assessment or educational leadership. Faculty Development is a potential avenue to providing these skills to new Family Medicine Faculty and to encourage new graduates to consider teaching. We are currently seeking to further clarify what the current needs and future possibilities are for Family Medicine Faculty Development in Sub-Saharan Africa

Depressed basal hypothalamic neuronal activity in type-1 diabetic mice is correlated with proinflammatory secretion of HMBG1

We recently found indicators of hypothalamic inflammation and neurodegeneration linked to the loss of neuroprotective factors including insulin-like growth factor (IGF-1) and IGF binding protein-2 (IGFBP-3) in mice made diabetic using streptozotocin (STZ). In the current work, a genetic model of type-1 diabetes (Ins2(Akita) mouse) was used to evaluate changes in neuronal activity and concomitant changes in the proinflammatory mediator high-mobility group box-1 (HMBG1). We found basal hypothalamic neuronal activity as indicated by manganese-enhanced magnetic resonance imaging (MEMRI) was significantly decreased in 8 months old, but not 2 months old Ins2(Akita) diabetic mice compared to controls. In tissue from the same animals we evaluated the expression of HMBG1 using immunohistochemistry and confocal microscopy. We found decreased HMBG1 nuclear localization in the paraventricular nucleus of the hypothalamus (PVN) in 8 months old, but not 2 months old diabetic animals indicating nuclear release of the protein consistent with an inflammatory state. Adjacent thalamic regions showed little change in HMBG1 nuclear localization and neuronal activity as a result of diabetes. This work extends our previous findings demonstrating changes consistent with hypothalamic neuroinflammation in STZ treated animals, and shows active inflammatory processes are correlated with changes in basal hypothalamic neuronal activity in Ins2(Akita) mice

“Someone’s got to do it” – Primary care providers (PCPs) describe caring for rural women with mental health problems

Objective: Little is known about how primary care providers (PCPs) approach mental health care for low-income rural women. We developed a qualitative research study to explore the attitudes and practices of PCPs regarding the care of mood and anxiety disorders in rural women. Method: We conducted semi-structured interviews with 19 family physicians, internists, and obstetrician-gynecologists (OBGYNs) in office-based practices in rural central Pennsylvania. Using thematic analysis, investigators developed a coding scheme. Questions focused on 1) screening and diagnosis of mental health conditions, 2) barriers to treatment among rural women, 3) management of mental illnesses in rural women, and 4) ideas to improve care for this population. Results: PCP responses reflected these themes: 1) PCPs identify mental illnesses through several mechanisms including routine screening, indicator-based assessment, and self-identification by the patient; 2) Rural culture and social ecology are significant barriers to women in need of mental healthcare; 3) Mental healthcare resource limitations in rural communities lead PCPs to seek creative solutions to care for rural women with mental illnesses; 4) To improve mental healthcare in rural communities, both social norms and resource limitations must be addressed. Conclusion: Our findings can inform future interventions to improve women\u27s mental healthcare in rural communities. Ideas include promoting generalist education in mental healthcare, and expanding access to consultative networks. In addition, community programs to reduce the stigma of mental illnesses in rural communities may promote healthcare seeking and receptiveness to treatment