Improving the Quality and Delivery of Substance Use Disorder Resource List

Introduction The state of New Mexico has numerous organizations that help individuals with substance use disorders (SUDs). University of New Mexico Hospital (UNMH) social workers had previously started a list of these resources; however, it was neither updated nor used often. We aim to improve the quality, awareness, and delivery of this list on UNMH internal medicine (IM) inpatient units. Methods To improve the quality of the list we developed a concise SUD resource document using the pre-existing list as a template. We modified the list after feedback from patients, providers and literacy specialists. The final list was organized alphabetically and categorized according to the services offered, with brief descriptions about each facility added. For baseline data on awareness of the list, we administered surveys to available inpatient IM providers. 31st increase the awareness of the list, we educated IM residents on clinical inpatient services at UNMH biweekly about its purpose and availability. We administered surveys before each education session for two months. To improve the accessibility of the list, we regularly supplied each resident workroom with the resource list. After receiving hospital approval, we uploaded the list onto the UNMH electronic medical record system. Results At baseline, we surveyed 37 IM providers. 89% viewed the delivery of resources to patients with SUD as important. Of this group, 55% were aware that the list was available to give patients and only 20% of them knew how to access it. After two months of education, 100% of surveyed providers viewed the delivery of resources to patients with SUD as important. We increased the awareness and knowledge of its accessibility by 18% and 60%, respectively, from baseline. Conclusion Our quality improvement project increased awareness and ease of access of the SUD resource list. These successes demonstrate that a simple delivery method for resource lists can be implemented in a short time. Our next steps include spreading awareness of how to access the list electronically through biweekly education sessions and ongoing surveying, as well as educating other hospital departments. We are currently assessing whether retrospective chart reviews may help determine the frequency of its use

Charged-particle nuclear modification factors in PbPb and pPb collisions at √sNN=5.02 TeV

The spectra of charged particles produced within the pseudorapidity window |η| 20 GeV, RpA exhibits weak momentum dependence and shows a moderate enhancement above unity.[Figure not available: see fulltext.]we acknowledge the enduring support for the construction and operation of the LHC and the CMS detector provided by the following funding agencies: BMWFW and FWF (Austria); FNRS and FWO (Belgium); CNPq, CAPES, FAPERJ, and FAPESP (Brazil); MES (Bulgaria); CERN; CAS, MoST, and NSFC (China); COLCIENCIAS (Colombia); MSES and CSF (Croatia); RPF (Cyprus); SENESCYT (Ecuador); MoER, ERC IUT and ERDF (Estonia); Academy of Finland, MEC, and HIP (Finland); CEA and CNRS/IN2P3 (France); BMBF, DFG, and HGF (Germany); GSRT (Greece); OTKA and NIH (Hungary); DAE and DST (India); IPM (Iran); SFI (Ireland); INFN (Italy); MSIP and NRF (Republic of Korea); LAS (Lithuania); MOE and UM (Malaysia); BUAP, CINVESTAV, CONACYT, LNS, SEP, and UASLP-FAI (Mexico); MBIE (New Zealand); PAEC (Pakistan); MSHE and NSC (Poland); FCT (Portugal); JINR (Dubna); MON, RosAtom, RAS and RFBR (Russia); MESTD (Serbia); SEIDI and CPAN (Spain); Swiss Funding Agencies (Switzerland); MST (Taipei); ThEPCenter, IPST, STAR and NSTDA (Thailand); TUBITAK and TAEK (Turkey); NASU and SFFR (Ukraine); STFC (United Kingdom); DOE and NSF (U.S.A.)

Development of a High Value Care Curriculum for Internal Medicine Sub-Interns

This poster was presented at the University of New Mexico Health Sciences Center Education Day 2015 on October 16th, 2015.Medical students report inadequate teaching in managed care, medical economics, and High Value Care (HVC). HVC is defined as providing quality patient care while simultaneously reducing unnecessary costs to the healthcare system. Internal medicine professional societies have created a curriculum to teach HVCthat has been successfully implemented in several residency programs. The sub-internship rotation is a key clinical experience for fourth year medical students to advance knowledge, develop confidence, improve efficiency, and develop a practice style. Structured didactics were removed from the rotation in prior years so that students could maximize contact time with interns and residents. Traditionally, sub-interns learn about diagnostic testing strategies from their assigned supervising residents and attending physicians. This year, involved faculty selected seminal articles on HVC and adapted components of the AAIM-ACP and MedUcurricula to engage sub-intern medical students in the concepts of HVC

A comparison of medical students and program directors\u27 perceived skill needs for internship\u27

Introduction: Stakeholders in the training of subinterns have varying perspectives on priorities for this important clinical experience. Existing assessments of student goals and internal medicine residency program directors opinions on expectations for readiness to function as an intern have not been compared. Research questions: What have previously gathered surveys indicated about student and program directors priorities for the subinternship rotation? What are the areas of difference and common ground between these assessments? Methods: Students starting internal medicine subinternship at the University of New Mexico between April 2010 and April 2012 and at Ohio State University between July 2012 and July 2013 were surveyed regarding their goals for the rotation. Responses were grouped and tabulated based on thematic analysis. In 2010, the Clerkship Directors in Internal Medicine (CDIM) subinternship task force performed a survey of internal medicine clerkship directors to identify skills expected in new interns. 36 items were scored to reflect perceived level of priority. Additionally, \u27free text\u27 responses could be entered. These were compiled into a separate list of common themes. Results: 40 students completed the survey at the University of New Mexico and 175 at Ohio State University. The goals most often written were increasing medical knowledge (n=186), management skills (105), radiology/EKG interpretation (52), procedures (46), pharmacology (43), efficiency (43), medical emergencies (30), laboratory usage (28), ordering (25) and physical exam skills (18). 282 of 377 program directors completed the 2010 CDIM subinternship task force survey. The highest overall priorities were: time management (n=345), knowing when to seek assistance (315), communicating with nurse/nurse triage (251), communicating in a culturally sensitive manner (227), information management (226), coordinating care with other health care workers (206), ethics of informed consent (204), providing an organized written sign-out (204), providing an organized verbal sign-out (200) and facility in using electronic databases (199). Discussion: Students\u27 and program directors\u27 goals for their subinternship rotation provides useful information about perceived gaps and areas of growth potential. Data gathered in 2013 suggests students mainly want to increase medical knowledge and develop skills in patient management, including operational tasks. Program directors ranked development of recognizing situations and communication skills as the most important domains for new internal medicine interns. These responses may reflect experience with problems borne from lack of these skills. Not surprisingly, both groups surveyed gave a moderate to high level of importance to efficiency.\u2

Herança da resistência do Híbrido de Timor UFV 443-03 à ferrugem-do-cafeeiro Inheritance of coffee leaf rust resistance in Timor Hybrid UFV 443-03

O objetivo deste trabalho foi caracterizar a herança da resistência do Híbrido de Timor UFV 443-03 à ferrugem-do-cafeeiro (Hemileia vastatrix). Para isso, a raça II e o patótipo 001 de ferrugem foram inoculados em 246 plantas da população F2, 115 plantas do retrocruzamento suscetível (RC S) e 87 plantas do retrocruzamento resistente (RC R), originadas do cruzamento entre o genótipo suscetível cv. Catuaí Amarelo IAC 64 e a fonte de resistência Híbrido de Timor UFV 443-03. Para ambos os inóculos, a cv. Catuaí Amarelo IAC 64 foi suscetível, enquanto o Híbrido de Timor UFV 443-03, a planta representante da geração F1 e as plantas do RC R foram resistentes. As plantas F2, quando inoculadas com a raça II, apresentaram dois padrões de segregação significativos: 15:1 e 61:3. A herança da resistência foi confirmada pela inoculação das plantas do RC S, que segregaram na proporção de 3:1, padrão esperado para herança condicionada por dois genes. A hipótese de segregação 7:1 para três genes foi rejeitada. Resultados semelhantes foram obtidos para o patótipo 001. Dois genes dominantes e independentes conferem a resistência genética do Híbrido de Timor UFV 443-03 à raça II e ao patótipo 001 de H. vastatrix.<br>The aim of this work was to characterize the resistance inheritance of the Timor Hybrid UFV 443-03 to coffee leaf rust (Hemileia vastatrix). For this, the race II and pathotype 001 of coffee leaf rust were inoculated in 246 F2 plants, 115 susceptible backcrossing (BCS) plants, and 87 resistant backcrossing (BC R) plants, derived from the crossing between the susceptible genotype 'Catuaí Amarelo' IAC 64 and the resistance source Timor Hybrid UFV 443-03. For both inoculums, the 'Catuaí Amarelo' IAC 64 was susceptible, while the Timor Hybrid, the plant representing F1 generation, and the BC R plants were resistant. The F2 plants inoculated with race II presented two significant segregation ratios: 15:1 and 61:3. The resistance inheritance was verified by the inoculation of the BCS plants, which segregated at a 3:1 ratio, an expected pattern for the inheritance controlled by two genes, whereas the segregation hypothesis of 7:1 for three genes was rejected. Two independent and dominant genes confer the genetic resistance of Timor Hybrid UFV 443-03 to race II and pathotype 001 of H. vastatrix