Design for success: Identifying a process for transitioning to an intensive online course delivery model in health professions education.

Intensive courses (ICs), or accelerated courses, are gaining popularity in medical and health professions education, particularly as programs adopt e-learning models to negotiate challenges of flexibility, space, cost, and time. In 2014, the Department of Clinical Research and Leadership (CRL) at the George Washington University School of Medicine and Health Sciences began the process of transitioning two online 15-week graduate programs to an IC model. Within a year, a third program also transitioned to this model. A literature review yielded little guidance on the process of transitioning from 15-week, traditional models of delivery to IC models, particularly in online learning environments. Correspondingly, this paper describes the process by which CRL transitioned three online graduate programs to an IC model and details best practices for course design and facilitation resulting from our iterative redesign process. Finally, we present lessons-learned for the benefit of other medical and health professions\u27 programs contemplating similar transitions. ABBREVIATIONS: CRL: Department of Clinical Research and Leadership; HSCI: Health Sciences; IC: Intensive course; PD: Program director; QM: Quality Matters

Design Evolution of the Wide Field Infrared Survey Telescope Using Astrophysics Focused Telescope Assets (WFIRST-AFTA) and Lessons Learned

The design of the Wide Field Infrared Survey Telescope using Astrophysics Focused Telescope Assets (WFIRST-AFTA) continues to evolve as each design cycle is analyzed. In 2012, two Hubble sized (2.4 m diameter) telescopes were donated to NASA from elsewhere in the Federal Government. NASA began investigating potential uses for these telescopes and identified WFIRST as a mission to benefit from these assets. With an updated, deeper, and sharper field of view than previous design iterations with a smaller telescope, the optical designs of the WFIRST instruments were updated and the mechanical and thermal designs evolved around the new optical layout. Beginning with Design Cycle 3, significant analysis efforts yielded a design and model that could be evaluated for Structural-Thermal-Optical-Performance (STOP) purposes for the Wide Field Imager (WFI) and provided the basis for evaluating the high level observatory requirements. Development of the Cycle 3 thermal model provided some valuable analysis lessons learned and established best practices for future design cycles. However, the Cycle 3 design did include some major liens and evolving requirements which were addressed in the Cycle 4 Design. Some of the design changes are driven by requirements changes, while others are optimizations or solutions to liens from previous cycles. Again in Cycle 4, STOP analysis was performed and further insights into the overall design were gained leading to the Cycle 5 design effort currently underway. This paper seeks to capture the thermal design evolution, with focus on major design drivers, key decisions and their rationale, and lessons learned as the design evolved

Addressing Thermal Model Run Time Concerns of the Wide Field Infrared Survey Telescope using Astrophysics Focused Telescope Assets (WFIRST-AFTA)

The Wide Field Infrared Survey Telescope using Astrophysics Focused Telescope Assets (WFIRST-AFTA) utilizes an existing 2.4 m diameter Hubble sized telescope donated from elsewhere in the federal government for near-infrared sky surveys and Exoplanet searches to answer crucial questions about the universe and dark energy. The WFIRST design continues to increase in maturity, detail, and complexity with each design cycle leading to a Mission Concept Review and entrance to the Mission Formulation Phase. Each cycle has required a Structural-Thermal-Optical-Performance (STOP) analysis to ensure the design can meet the stringent pointing and stability requirements. As such, the models have also grown in size and complexity leading to increased model run time. This paper addresses efforts to reduce the run time while still maintaining sufficient accuracy for STOP analyses. A technique was developed to identify slews between observing orientations that were sufficiently different to warrant recalculation of the environmental fluxes to reduce the total number of radiation calculation points. The inclusion of a cryocooler fluid loop in the model also forced smaller time-steps than desired, which greatly increases the overall run time. The analysis of this fluid model required mitigation to drive the run time down by solving portions of the model at different time scales. Lastly, investigations were made into the impact of the removal of small radiation couplings on run time and accuracy. Use of these techniques allowed the models to produce meaningful results within reasonable run times to meet project schedule deadlines

Assessment of a novel, capsid-modified adenovirus with an improved vascular gene transfer profile

<p>Background: Cardiovascular disorders, including coronary artery bypass graft failure and in-stent restenosis remain significant opportunities for the advancement of novel therapeutics that target neointimal hyperplasia, a characteristic of both pathologies. Gene therapy may provide a successful approach to improve the clinical outcome of these conditions, but would benefit from the development of more efficient vectors for vascular gene delivery. The aim of this study was to assess whether a novel genetically engineered Adenovirus could be utilised to produce enhanced levels of vascular gene expression.</p> <p>Methods: Vascular transduction capacity was assessed in primary human saphenous vein smooth muscle and endothelial cells using vectors expressing the LacZ reporter gene. The therapeutic capacity of the vectors was compared by measuring smooth muscle cell metabolic activity and migration following infection with vectors that over-express the candidate therapeutic gene tissue inhibitor of matrix metalloproteinase-3 (TIMP-3).</p> <p>Results: Compared to Adenovirus serotype 5 (Ad5), the novel vector Ad5T*F35++ demonstrated improved binding and transduction of human vascular cells. Ad5T*F35++ mediated expression of TIMP-3 reduced smooth muscle cell metabolic activity and migration in vitro. We also demonstrated that in human serum samples pre-existing neutralising antibodies to Ad5T*F35++ were less prevalent than Ad5 neutralising antibodies.</p> <p>Conclusions: We have developed a novel vector with improved vascular transduction and improved resistance to human serum neutralisation. This may provide a novel vector platform for human vascular gene transfer.</p&gt

Baryogenesis at Low Reheating Temperatures

We note that the maximum temperature during reheating can be much greater than the reheating temperature $T_r$ at which the Universe becomes radiation dominated. We show that the Standard Model anomalous $(B+L)$-violating processes can therefore be in thermal equilibrium for 1 GeV \simlt T_{r}\ll 100 GeV. Electroweak baryogenesis could work and the traditional upper bound on the Higgs mass coming from the requirement of the preservation of the baryon asymmetry may be relaxed. Alternatively, the baryon asymmetry may be reprocessed by sphaleron transitions either from a $(B-L)$ asymmetry generated by the Affleck-Dine mechanism or from a chiral asymmetry between $e_R$ and $e_L$ in a $B-L = 0$ Universe. Our findings are also relevant to the production of the baryon asymmetry in large extra dimension models.Comment: 4 pages, version to appear in PRL: references added, new titl

Effectiveness and cost-effectiveness of psychiatric mother and baby units: quasi-experimental study

BACKGROUND: Psychiatric mother and baby units (MBUs) are recommended for severe perinatal mental illness, but effectiveness compared with other forms of acute care remains unknown. AIMS: We hypothesised that women admitted to MBUs would be less likely to be readmitted to acute care in the 12 months following discharge, compared with women admitted to non-MBU acute care (generic psychiatric wards or crisis resolution teams (CRTs)). METHOD: Quasi-experimental cohort study of women accessing acute psychiatric care up to 1 year postpartum in 42 healthcare organisations across England and Wales. Primary outcome was readmission within 12 months post-discharge. Propensity scores were used to account for systematic differences between MBU and non-MBU participants. Secondary outcomes included assessment of cost-effectiveness, experience of services, unmet needs, perceived bonding, observed mother-infant interaction quality and safeguarding outcome. RESULTS: Of 279 women, 108 (39%) received MBU care, 62 (22%) generic ward care and 109 (39%) CRT care only. The MBU group (n = 105) had similar readmission rates to the non-MBU group (n = 158) (aOR = 0.95, 95% CI 0.86-1.04, P = 0.29; an absolute difference of -5%, 95% CI -14 to 4%). Service satisfaction was significantly higher among women accessing MBUs compared with non-MBUs; no significant differences were observed for any other secondary outcomes. CONCLUSIONS: We found no significant differences in rates of readmission, but MBU advantage might have been masked by residual confounders; readmission will also depend on quality of care after discharge and type of illness. Future studies should attempt to identify the effective ingredients of specialist perinatal in-patient and community care to improve outcomes

Psychosocial factors associated with outcomes of sports injury rehabilitation in competitive athletes: a mixed studies systematic review.

The prime focus of research on sports injury has been on physical factors. This is despite our understanding that when an athlete sustains an injury it has psychosocial as well as physical impacts. Psychosocial factors have been suggested as prognostic influences on the outcomes of rehabilitation. The aim of this work was to address the question: are psychosocial factors associated with sports injury rehabilitation outcomes in competitive athletes?Mixed studies systematic review (PROSPERO reg.CRD42014008667).Electronic database and bibliographic searching was undertaken from the earliest entry until 1 June 2015. Studies that included injured competitive athletes, psychosocial factors and a sports injury rehabilitation outcome were reviewed by the authors. A quality appraisal of the studies was undertaken to establish the risk of reporting bias.25 studies were evaluated that included 942 injured competitive athletes were appraised and synthesised. Twenty studies had not been included in previous reviews. The mean methodological quality of the studies was 59% (moderate risk of reporting bias). Convergent thematic analysis uncovered three core themes across the studies: (1) emotion associated with rehabilitation outcomes; (2) cognitions associated with rehabilitation outcomes; and (3) behaviours associated with rehabilitation outcomes. Injury and performance-related fears, anxiety and confidence were associated with rehabilitation outcomes. There is gender-related, age-related and injury-related bias in the reviewed literature.Psychosocial factors were associated with a range of sports injury rehabilitation outcomes. Practitioners need to recognise that an injured athlete's thoughts, feelings and actions may influence the outcome of rehabilitation