The Irreducible Needs of Interprofessional Education – Creating and Sustaining an Institutional Commons for Health Professions Training

Leaders in health professions education schools and programs are under pressure to respond to new accreditation requirements for interprofessional education (IPE). The work of creating and sustaining an IPE program at an academic health center is in many ways analogous to the challenge of creating and sustaining a “commons”—a set of resources shared by many, but owned by none. In this Commentary, the authors borrow from the work of Nobel Laureate Elinor Ostrum to describe the “design principles” necessary to build and maintain the set of common resources needed to successfully implement and sustain an IPE program. They interpret these principles in the context of their own experiences implementing IPE programs and recommend three institutional structural elements necessary to build and sustain an IPE program: (1) a representative governance body, (2) an accountable director or leader, and (3) a structure supporting vertical and horizontal communication and authority

Bowel management in children: how to keep children clean

Objective: The term bowel management refers to an individualized program for fecal incontinent patients. The main principle is the administration of fluid to wash out the colon, either transanally or antegrade through a stoma.Method: A literature search was performed to find the best method to keep fecal incontinent children clean.Results: Bowel management with an individually determined amount of fluid, either by abdominal radiographs or hydrosonography, showed better success rates compared with transanal enemas with an estimated amount of fluid. Furthermore, transanal enemas had higher success rates compared with bowel management with antegrade continence enemas and showed fewer complications.Conclusion: To improve a child’s quality of life an antegrade continence enema can be considered. Before surgery it has to be shown that a bowel management with rectal irrigations works. The indication for a surgical approach for bowel management has to be set carefully. Conservative measures must be tried first.Keywords: anorectal malformation, antegrade continence enema, bowel management, fecal incontinenc

Examining Care Navigation: Librarian Participation in a Teambased Approach?

Objective: This study investigated responsibilities, skill sets, degrees, and certifications required of health care navigators in order to identify areas of potential overlap with health sciences librarianship. Method: The authors conducted a content analysis of health care navigator position announcements and developed and assigned forty-eight category terms to represent the sample’s responsibilities and skill sets. Results: Coordination of patient care and a bachelor’s degree were the most common responsibility and degree requirements, respectively. Results also suggest that managing and providing health information resources is an area of overlap between health care navigators and health sciences librarians, and that librarians are well suited to serve on navigation teams. Conclusion: Such overlap may provide an avenue for collaboration between navigators and health sciences librarians

Confirmation of the Planetary Microlensing Signal and Star and Planet Mass Determinations for Event OGLE-2005-BLG-169

We present Hubble Space Telescope (HST) Wide Field Camera 3 (WFC3) observations of the source and lens stars for planetary microlensing event OGLE-2005-BLG-169, which confirm the relative proper motion prediction due to the planetary light curve signal observed for this event. This (and the companion Keck result) provide the first confirmation of a planetary microlensing signal, for which the deviation was only 2%. The follow-up observations determine the flux of the planetary host star in multiple passbands and remove light curve model ambiguity caused by sparse sampling of part of the light curve. This leads to a precise determination of the properties of the OGLE-2005-BLG-169Lb planetary system. Combining the constraints from the microlensing light curve with the photometry and astrometry of the HST/WFC3 data, we find star and planet masses of M_* = 0.69+- 0.02 M_solar and m_p = 14.1 +- 0.9 M_earth. The planetary microlens system is located toward the Galactic bulge at a distance of D_L = 4.1 +- 0.4 kpc, and the projected star-planet separation is a_perp = 3.5 +- 0.3 AU, corresponding to a semi-major axis of a = 4.0 (+2.2 -0.6) AU.Comment: 21 pages, including 5 figures, published in Ap

Outcomes from a single-intervention trial to improve interprofessional practice behaviors at a student-led free clinic

Background Interprofessional collaboration (IPC) is the practice of two or more healthcare professionals working together and learning from one another to improve health outcomes. IPC is important for quality training, typically improving individual and group level outcomes. Students value the opportunity for leadership and teamwork development when IPC is offered in their curriculum. The Indiana University Student Outreach Clinic (IUSOC) is a student run clinic that provides free primary care services to underserved residents residing in Indianapolis, Indiana. The IUSOC partner leaders identified a need to enhance knowledge about partner roles, scope of practice, and professional training with the hopes of improving quality of care through IPC and utilization of clinic resources. Methods A cluster randomized design consisted of education session days and control days. Participants had an equal selection probability. Student partners from ten different disciplines were involved. Two survey instruments were used for data collection: 1) The Interprofessional Socialization and Valuing Scale and 2) The Professional Consciousness Raising Questionnaire. The former measured the attitudes and beliefs that underlie interprofessional socialization, while the latter assessed pre/post student knowledge of the roles and responsibilities of each partner. Results The control arm of the study was composed of 167 student participants and the intervention arm had 170 participants. Participants in the intervention arm had greater scores for “ability to work with others”, “value in working with others”, and “comfort in working with others.” The intervention arm also had significantly increased odds of correctly identifying the roles responsibilities of the nursing, law, dental, and global health disciplines. Conclusions Results of this study demonstrate that administering a short interprofessional education exercise to healthcare professional students leads to improved IPC through increased interprofessional knowledge about other professions and change in beliefs and values toward the value of interprofessional collaboration among healthcare professionals

The Big Ten IPE Academic Alliance: A regional approach to developing Interprofessional Education and practice

Interprofessional practice and education (IPE) efforts has greatly increased in the past few years, primarily through the leadership of several national and international organizations. These organizations have sponsored forums for information exchange and best practices, which has significantly influenced the development of programs across various educational institutions and practice environments. Several regional groups have emerged, organized around a common purpose and geographic proximity, to share ideas and implement new IPE programs across the cooperating organizations. This article describes the history and growth of one of the newer regional groups, the Big Ten IPE Academic Alliance. Included in this discussion is how the group was created, its governing structure and the various results of its efforts. The intent is to provide expanded guidance how to develop regional groups that are effective vehicles for the successful implementation of IPE within educational and health settings

The Messy Nature of Fiber Spectra: Star-Quasar Pairs Masquerading as Dual Type 1 AGNs

Theoretical studies predict that the most significant growth of supermassive black holes occurs in late-stage mergers, coinciding with the manifestation of dual active galactic nuclei (AGNs), and both major and minor mergers are expected to be important for dual AGN growth. In fact, dual AGNs in minor mergers should be signposts for efficient minor merger-induced SMBH growth for both the more and less massive progenitor. We identified two candidate dual AGNs residing in apparent minor mergers with mass ratios of $\sim$1:7 and $\sim$1:30. SDSS fiber spectra show broad and narrow emission lines in the primary nuclei of each merger while only a narrow [O III] emission line and a broad and prominent H$\alpha$/[N II] complex is observed in the secondary nuclei. The FWHMs of the broad H$\alpha$ lines in the primary and secondary nuclei are inconsistent in each merger, suggesting that each nucleus in each merger hosts a Type 1 AGN. However, spatially-resolved LBT optical spectroscopy reveal rest-frame stellar absorption features, indicating the secondary sources are foreground stars and that the previously detected broad lines are likely the result of fiber spillover effects induced by the atmospheric seeing at the time of the SDSS observations. This study demonstrates for the first time that optical spectroscopic searches for Type 1/Type 1 pairs similarly suffer from fiber spillover effects as has been observed previously for Seyfert 2 dual AGN candidates. The presence of foreground stars may not have been clear if an instrument with more limited wavelength range or limited sensitivity had been used.Comment: 15 pages including appendix and references, 6 figures, 1 table. Accepted for publication in Ap