Valuing Adjuncts as Liaisons for University Excellence (VALUE) Program

Adjuncts are increasingly becoming more important in higher education and make up nearly onethird of VCU’s teaching faculty. While VCU has made strides in increasing the number of tenuretrack and term professors, the size and needs of certain departments will always make adjunct instructors necessary. A number of schools on both the Monroe Park and MCV campuses utilize professionals from the Richmond community to enhance experiential learning, thereby making a university investment in adjunct faculty a means by which to elevate VCU’s strategic mission. Adjuncts often provide a community perspective that comes from the professional work they do outside of the university setting and as a whole are reflective of VCU’s diverse student population. As a result, they serve a critical role in student success and diversity initiatives. Keeping adjuncts connected with campus resources and engaged with the larger VCU community is also an important step in making the university more inclusive. This project will study opportunities associated with the orientation and support of adjunct faculty at VCU on both Monroe Park and MCV campuses. This project is research-oriented and will serve as an important foundation for developing and implementing a plan for institutionalized adjunct support. To develop a detailed proposal for implementation, our team consulted with several key stakeholders including: academic leaders who hire and support adjuncts in the current decentralized process students who have taken classes with adjunct instructors adjunct faculty who have recently taught at VCU Through a combination of methods, we aim to determine how adjuncts are utilized across the university, identify resources currently provided, and assess additional resource needs in an effort to inform a new orientation and support program for adjunct faculty at VCU

Education and referral criteria: impact on oncology referrals to palliative care.

OBJECTIVE: To describe a quality improvement project involving education and referral criteria to influence oncology provider referrals to a palliative care service. METHODS: A single group post-test only quasi-experimental design was used to evaluate palliative care service (PCS) referrals following an intervention consisting of a didactic presentation, education outreach visits (EOV) to key providers, and referral criteria. Data on patient demographics, cancer types, consult volume, reasons for referral, pre-consult length of stay, overall hospital stay, and discharge disposition were collected pre-intervention, then post-intervention for 7.5 months and compared. SETTING AND SAMPLE: Attending oncologists, nurse practitioner, and house staff from the solid tumor division at a 700-bed urban teaching hospital participated in the project. Two geriatricians, a palliative care nurse practitioner, and rotating geriatric fellows staffed the PCS. RESULTS: The percentage of oncology referrals to PCS increased significantly following the intervention (χ(2) = 6.108, p = .013). 24.9% (390) patients were referred in the 4.6 years pre-intervention and 31.5% (106) patients were referred during 7.5 months post-intervention. The proportion of consults for pain management was significantly greater post-intervention (χ(2) = 5.378, p = .02), compared to pre-intervention, when most referrals were related to end-of-life issues. Lung, pancreatic, and colon were the most common cancer types at both periods, and there were no significant differences in patient demographics, pre-referral length of hospitalization or overall hospital days. There was a trend toward more patients being discharged alive following the intervention. CONCLUSION: A quality improvement project supported the use of education and referral criteria to influence both the frequency and reasons for palliative care referral by oncology providers

The Health Care Costs of Financial Exploitation in Maine

This study sought to determine the Medicare and Medicaid costs experienced by dual eligible older adults in Maine for whom Maine Adult Protective Services (APS) substantiated allegations of elder financial exploitation and to compare them to those of Maine’s general older population. The analysis is an important step forward in estimating the medical costs associated with elder abuse. Elder financial exploitation may result in significant public burden on Medicare and Medicaid, shouldered by taxpayers. Efforts to detect, investigate, prosecute, and mitigate this abuse will benefit not only the victims, but also the financial stewardship of these public programs

Plasma catecholamines and social behavior in male vervet monkeys (Cercopithecus aethiops sabaeus)

Many investigations in humans indicate that epinephrine, norepinephrine and their ratio may correlate with such traits as social competence, academic achievement, and aggression. However, the socioeconomic, dietary, and environmental confounds accompanying most human studies complicate their interpretation. Social status, aggression, and other social behaviors can be reliably assessed in nonhuman primates under conditions controlling for crucial environmental factors. If interpretation of human studies is correct, dominant and subordinate male vervet monkeys should exhibit distinctive patterns of catecholamine secretion. To test this possibility, seventeen adult male monkeys living in six stable social groups were observed for 6 months. Based on their success in agonistic events, subjects were categorized as dominant or subordinate. Alpha scores were calculated from empirically derived factors to provide a noncategorical measure of dominant behavioral style. Plasma epinephrine and norepinephrine samples obtained from anesthetized subjects did not differ between dominant and subordinate males. Alpha scores, however, distinguished high from low norepinephrine/epinephrine ratio groups. These findings are consistent with studies in humans linking high epinephrine, low norepinephrine, and social competence.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30093/1/0000465.pd

Quality of life outcomes for people with serious mental illness living in supported accommodation: Systematic review and meta-analysis

Michele Harrison - ORCID 0000-0001-6088-2998 https://orcid.org/0000-0001-6088-2998Replaced AM with VoR 2020-05-25Purpose: To conduct a systematic review and meta-analysis of Quality of Life (QoL) outcomes for people with serious mental illness living in three types of supported accommodation.Method: Studies were identified that described QoL outcomes for people with serious mental illness living in supported accommodation in 6 electronic databases. We applied a random-effects model to derive the meta-analytic results.Results: 13 studies from 7 countries were included, with 3276 participants receiving; high support (457), supported housing (1576) and floating outreach (1243). QoL outcomes related to wellbeing, living conditions and social functioning were compared between different supported accommodation types. Living condition outcomes were better for people living in supported housing ( = -0.31; CI = [-0.47; -0.16]) and floating outreach ( = -0.95; CI = [-1.30; -0.61]) compared to high support accommodation, with a medium effect size for living condition outcomes between supported housing and floating outreach ( = -0.40; CI = [-0.82; 0.03]), indicating that living conditions are better for people living in floating outreach. Social functioning outcomes were significant for people living in supported housing compared to high support ( = -0.37; CI = [-0.65; -0.09]), with wellbeing outcomes not significant between the three types of supported accommodation.Conclusion: There is evidence that satisfaction with living conditions differs across supported accommodation types. The results suggest there is a need to focus on improving social functioning and wellbeing outcomes for people with serious mental illness across supported accommodation types.https://doi.org/10.1007/s00127-020-01885-x55pubpu

Evaluation of the Prescribing Skills Assessment implementation, performance and medical student experience in Australia and New Zealand

Aims: The UK Prescribing Safety Assessment was modified for use in Australia and New Zealand (ANZ) as the Prescribing Skills Assessment (PSA). We investigated the implementation, student performance and acceptability of the ANZ PSA for final-year medical students. Methods:This study used a mixed-method approach involving student data (n = 6440) for 2017–2019 (PSA overall score and 8 domain subscores). Data were also aggregated by medical school and included student evaluation survey results. Quantitative data were analysed using descriptive and multivariate analyses. The pass rate was established by a modified Angoff method. Thematic analyses of open-ended survey comments were conducted. Results:The average pass rate was slightly higher in 2017 (89%) which used a different examination to 2018 (85%) and 2019 (86%). Little difference was identified between schools for the PSA overall performance or domain subscores. There was low intercorrelation between subscores. Most students provided positive feedback about the PSA regarding the interface and clarity of questions, but an average of 35% reported insufficient time for completion. Further, 70% on average felt unprepared by their school curricula for the PSA, which is in part explained by the low prescribing experience; 69% reported completing ≤10 prescriptions during training. Conclusion:The ANZ PSA was associated with high pass rates and acceptability, although student preparedness was highlighted as a concern for further investigation. We demonstrate how a collaboration of medical schools can adapt a medical education assessment resource (UK PSA) as a means for fulfilling an unmet need.</p

Seismicity of the Atlantis Massif detachment fault, 30°N at the Mid-Atlantic Ridge

Author Posting. © American Geophysical Union, 2012. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Geochemistry Geophysics Geosystems 13 (2012): Q0AG11, doi:10.1029/2012GC004210.At the oceanic core complex that forms the Atlantis Massif at 30°N on the Mid-Atlantic Ridge, slip along the detachment fault for the last 1.5–2 Ma has brought lower crust and mantle rocks to the seafloor. Hydroacoustic data collected between 1999 and 2003 suggest that seismicity occurred near the top of the Massif, mostly on the southeastern section, while detected seismicity along the adjacent ridge axis was sparse. In 2005, five short-period ocean bottom seismographs (OBS) were deployed on and around the Massif as a pilot experiment to help constrain the distribution of seismicity in this region. Analysis of six months of OBS data indicates that, in contrast to the results of the earlier hydroacoustic study, the vast majority of the seismicity is located within the axial valley. During the OBS deployment, and within the array, seismicity was primarily composed of a relatively constant background rate and two large aftershock sequences that included 5 teleseismic events with magnitudes between 4.0 and 4.5. The aftershock sequences were located on the western side of the axial valley adjacent to the Atlantis Massif and close to the ridge-transform intersection. They follow Omori's law, and constitute more than half of the detected earthquakes. The OBS data also indicate a low but persistent level of seismicity associated with active faulting within the Atlantis Massif in the same region as the hydroacoustically detected seismicity. Within the Massif, the data indicate a north-south striking normal fault, and a left-lateral, strike-slip fault near a prominent, transform-parallel, north-facing scarp. Both features could be explained by changes in the stress field at the inside corner associated with weak coupling on the Atlantis transform. Alternatively, the normal faulting within the Massif might indicate deformation of the detachment surface as it rolls over to near horizontal from an initial dip of about 60° beneath the axis, and the strike-slip events may indicate transform-parallel movement on adjacent detachment surfaces.We thank the Deep Ocean Exploration Institute at WHOI, Director of Research at WHOI, WHOI’s Department of Geology and Geophysics, and the National Science Foundation for funding the data collection.2013-04-0