The critical elements of effective academic-practice partnerships: a framework derived from the Department of Veterans Affairs Nursing Academy.

BackgroundThe nursing profession is exploring how academic-practice partnerships should be structured to maximize the potential benefits for each partner. As part of an evaluation of the U.S. Department of Veterans Affairs Nursing Academy (VANA) program, we sought to identify indicators of successful partnerships during the crucial first year.MethodsWe conducted a qualitative analysis of 142 individual interviews and 23 focus groups with stakeholders from 15 partnerships across the nation. Interview respondents typically included the nursing school Dean, the VA chief nurse, both VANA Program Directors (VA-based and nursing school-based), and select VANA faculty members. The focus groups included a total of 222 VANA students and the nursing unit managers and staff from units where VANA students were placed. An ethnographic approach was utilized to identify emergent themes from these data that underscored indicators of and influences on Launch Year achievement.ResultsWe emphasize five key themes: the criticality of inter-organizational collaboration; challenges arising from blending different cultures; challenges associated with recruiting nurses to take on faculty roles; the importance of structuring the partnership to promote evidence-based practice and simulation-based learning in the clinical setting; and recognizing that stable relationships must be based on long-term commitments rather than short-term changes in the demand for nursing care.ConclusionsDeveloping an academic-clinical partnership requires identifying how organizations with different leadership and management structures, different responsibilities, goals and priorities, different cultures, and different financial models and accountability systems can bridge these differences to develop joint programs integrating activities across the organizations. The experience of the VANA sites in implementing academic-clinical partnerships provides a broad set of experiences from which to learn about how such partnerships can be effectively implemented, the barriers and challenges that will be encountered, and strategies and factors to overcome challenges and build an effective, sustainable partnership. This framework provides actionable guidelines for structuring and implementing effective academic-practice partnerships that support undergraduate nursing education

Measuring Dust Attenuation Curves of SINGS/KINGFISH Galaxies Using Swift/UVOT Photometry

We present Swift/Ultraviolet Optical Telescope (UVOT) integrated light photometry of the Spitzer Infrared Nearby Galaxies Survey (SINGS) and the Key Insights on Nearby Galaxies: A Far-Infrared Survey with Herschel (KINGFISH) samples of nearby galaxies. Combining the Swift/UVOT data with archival photometry, we investigate a variety of dust attenuation curves derived using MCSED, a flexible spectral energy distribution fitting code. We fit the panchromatic data using three different star formation history (SFH) parameterizations: a decaying exponential, a double power law, and a piecewise function with breaks at physically motivated ages. We find that the average attenuation law of the sample changes slightly based on the SFH assumed. Specifically, the exponential SFH leads to the shallowest attenuation curves. Using simulated data, we also find the exponential SFH fails to outperform the more complex SFHs. Finally, we find a systematic offset in the derived bump strength between SED fits with and without UVOT data, where the inclusion of UVOT data leads to smaller bump strengths, highlighting the importance of the UVOT data. This discrepancy is not seen in fits to mock photometry. Understanding dust attenuation in the local universe is key to understanding high redshift objects where rest-frame far-infrared data is unavailable.Comment: 30 pages, 13 figures, accepted for publication in Ap

Systemic Racism and Health Disparities: A Statement from Editors of Family Medicine Journals

The year 2020 has been marked by historic protests across the United States and the globe sparked by the deaths of George Floyd, Ahmaud Arbery, Breonna Taylor, and so many other Black people. The protests heightened awareness of racism as a public health crisis and triggered an antiracism movement. The editors of several North American family medicine publications have come together to address this call to action and share resources on racism across our readerships.http://deepblue.lib.umich.edu/bitstream/2027.42/163331/1/Final Statement on Systemic Racism- with acknowledgements.pdf-1Description of Final Statement on Systemic Racism- with acknowledgements.pdf : Main ArticleSEL

Undoing gender through performing the other

Following the perspective of gender as a socially constructed performance, consumer research has given light to how individuals take on, negotiate, and express a variety of gender roles. Yet the focus of research has remained on gender roles themselves, largely overlooking the underlying process of gender performativity and consumers’ engagement with it in the context of their everyday lives. Set within a performance methodology and the context of crossplay in live action role-playing games, this paper explores how individuals undo gender on a subjective level, thus becoming conscious and reflexive of gender performativity. The study suggests that individuals become active in undoing gender through engaging in direct, bodily performance of the gender other. Such performance does not challenge or ridicule norms, but pushes individuals to actively figure out for themselves how gender is performed. As a result, individuals become aware of gender performativity and become capable of actively recombining everyday performance

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie

Family Practice Triumphs by the Year 2020: What Will We Have Done Right?

For family practice in the United States to be considered a success in the year 2020, several things will need to be done right between now and then. These include (1) an emphasis on quality of care, (2) a dependence on new technologies to enhance quality, (3) availability of and access to primary care for the entire US population, (4) increased political power for the specialty of family practice, (5) enhanced research and research funding, and (6) learning to work with patients so that they are the masters of their own care. If successful in 2020, family physicians will be perceived as quality physicians who use technology that everyone wants and who use their political power to advocate for patients’ rights to quality health care and the research important to the discipline and quality health care. Family physicians will have become the “go-to doctors” who put patients in charge

Risk Management and Medical Malpractice

Medical malpractice claims are common and may be emotionally difficult for physicians. Most malpractice suits claim negligence. The most frequent types of claims include failure or delay in diagnosis, negligent treatment with drugs, failure to obtain consultation, failure to obtain informed consent, and negligent management of procedures. The most important risk-management strategy is the provision of good medical care. If a claim is filed, physicians should cooperate fully with the malpractice insurance carrier and refrain from discussing the case with colleagues