Making a difference in medical trainees’ attitudes toward Latino patients: A pilot study of an intervention to modify implicit and explicit attitudes

Negative attitudes and discrimination against Latinos exist in the dominant U.S. culture and in healthcare systems, contributing to ongoing health disparities. This article provides findings of a pilot test of Yo Veo Salud (I See Health), an intervention designed to positively modify attitudes toward Latinos among medical trainees. The research question was: Compared to the comparison group, did the intervention group show lower levels of implicit bias against Latinos versus Whites, and higher levels of ethnocultural empathy, healthcare empathy, and patient-centeredness? We used a sequential cohort, post-test design to evaluate Yo Veo Salud with a sample of 69 medical trainees. The intervention setting was an academic medical institution in a Southeastern U.S. state with a fast-growing Latino population. The intervention was delivered, and data were collected online, between July and December of 2014. Participants in the intervention group showed greater ethnocultural empathy, healthcare empathy, and patient-centeredness, compared to the comparison group. The implicit measure assessed four attitudinal dimensions (pleasantness, responsibility, compliance, and safety). Comparisons between our intervention and comparison groups did not find any average differences in implicit anti-Latino bias between the groups. However, in a subset analysis of White participants, White participants in the intervention group demonstrated a significantly decreased level of implicit bias in terms of pleasantness. A dose response was also founded indicating that participants involved in more parts of the intervention showed more change on all measures. Our findings, while modest in size, provide proof of concept for Yo Veo Salud as a means for increasing ethno-cultural and physician empathy, and patient-centeredness among medical residents and decreasing implicit provider bias toward Latinos

Effect of the ultrastructure of chitosan nanoparticles in colloidal stability, quorum quenching and antibacterial activities

We have fabricated two types of crosslinked chitosan-based nanoparticles (NPs), namely (1) ionically crosslinked with tripolyphosphate (TPP), designated as IC-NPs and (2) dually co-crosslinked (ionically and covalently with TPP and genipin, respectively) termed CC-NPs. The two types of NPs were physichochemically characterized by means of DLS-NIBS, synchrotron SAXS and M3-PALS (zeta potential). First, we found that covalent co-crosslinking of ionically pre-crosslinked nanoparticles yielded monodisperse CC-NPs in the size range of ∼200 nm, whereas the parental IC-NPs remained highly polydisperse. While both types of chitosan nanoparticles displayed a core-shell structure, as determined by synchrotron SAXS, only the structure of CC-NPs remained stable at long incubation times. This enhanced structural robustness of CC-NPs was likely responsible of their superior colloidal stability even in biological medium. Second, we explored the antimicrobial and quorum sensing inhibition activity of both types of nanoparticles. We found that CC-NPs had lower long-term toxicity than IC-NPs. In contrast, sub-lethal doses of IC-NPs consistently displayed higher levels of quorum quenching activity than CC-NPs. Thus, this work underscores the influence of the NP’s ultrastructure on their colloidal and biological properties. While the cellular and molecular mechanisms at play are yet to be fully elucidated, our results broaden the spectrum of use of chitosan-based nanobiomaterialsin the development of antibiotic-free approaches against Gram-negative pathogenic bacteria

Looking forward through the past: identification of 50 priority research questions in palaeoecology

1. Priority question exercises are becoming an increasingly common tool to frame future agendas in conservation and ecological science. They are an effective way to identify research foci that advance the field and that also have high policy and conservation relevance. 2. To date, there has been no coherent synthesis of key questions and priority research areas for palaeoecology, which combines biological, geochemical and molecular techniques in order to reconstruct past ecological and environmental systems on time-scales from decades to millions of years. 3. We adapted a well-established methodology to identify 50 priority research questions in palaeoecology. Using a set of criteria designed to identify realistic and achievable research goals, we selected questions from a pool submitted by the international palaeoecology research community and relevant policy practitioners. 4. The integration of online participation, both before and during the workshop, increased international engagement in question selection. 5. The questions selected are structured around six themes: human–environment interactions in the Anthropocene; biodiversity, conservation and novel ecosystems; biodiversity over long time-scales; ecosystem processes and biogeochemical cycling; comparing, combining and synthesizing information from multiple records; and new developments in palaeoecology. 6. Future opportunities in palaeoecology are related to improved incorporation of uncertainty into reconstructions, an enhanced understanding of ecological and evolutionary dynamics and processes and the continued application of long-term data for better-informed landscape management

Integrated New Product Introduction Challenges in Aerospace Manufacturing

The key dynamic in supporting an efficient and effective new product introduction is the nature of the exchange of information between the functions of manufacturing engineering and design engineering. This paper describes a study of this dynamic with particular regard to the role of manufacturing engineering in developing robust production process for the design intent. This study reports related work in this area and establishes the views of participants concerning product introduction process at a major aerospace manufacturer. It is found that integration between the manufacturing and design function driven by communication of qualitative data has brought benefit to the process in terms of quality cost and time. However, a stronger definition regarding the quality and usability of manufacturing process knowledge communicated to the design function is required for more effective and efficient new product introduction in the shortening timescales of the changing industrial environment

Sensitivity of Greenland ice sheet projections to model formulations

Physically based projections of the Greenland ice sheet contribution to future sea-level change are subject to uncertainties of the atmospheric and oceanic climatic forcing and to the formulations within the ice flow model itself. Here a higher-order, three-dimensional thermomechanical ice flow model is used, initialized to the present-day geometry. The forcing comes from a high-resolution regional climate model and from a flowline model applied to four individual marine-terminated glaciers, and results are subsequently extended to the entire ice sheet. The experiments span the next 200 years and consider climate scenario SRES A1B. The surface mass-balance (SMB) scheme is taken either from a regional climate model or from a positive-degree-day (PDD) model using temperature and precipitation anomalies from the underlying climate models. Our model results show that outlet glacier dynamics only account for 6–18% of the sea-level contribution after 200 years, confirming earlier findings that stress the dominant effect of SMB changes. Furthermore, interaction between SMB and ice discharge limits the importance of outlet glacier dynamics with increasing atmospheric forcing. Forcing from the regional climate model produces a 14–31% higher sea-level contribution compared to a PDD model run with the same parameters as for IPCC AR4