The MaTE Tool—Enabling Engaged Scholars at a Regional University

Providing institutionally recognized evidence of community engaged scholarship has long been problematic for engaged scholars when applying for recognition through promotion or probation pathways. To combat this, the University of Wollongong [in New South Wales, Australia] developed an online tool for use by engaged scholars to track and measure their engagement activities in a consistent and institutionally recognized form. This article outlines the process that was undertaken to develop the online system for measuring and tracking engagement (the MaTE tool). It outlines the initial recognition of the key issues arising from a comprehensive review of the literature; the drafting process undertaken to develop a prototype for the tool; and the interview stage and subsequent re-drafting process and finalization of the tool. The article concludes with a consideration of future directions for the tool and its further implementation at the university

Culture crash regarding nursing students' experience of implementation of EBP in clinical practice

Dette er en pdf av forlagets publiserte versjon etter avtale. Tidsskriftets side: http://www.vardinorden.no/vin/forsideAims: The aim of this study was to examine nursing students’ experiences of the implementation of evidence-based practice (EBP) in a clinical setting. Background: Educating students in EBP is a challenge to both faculties and clinical practices, because EBP educational interventions may improve knowledge but do not ensure application of EBP in clinical settings. Becoming skilled in the application of EBP requires practice and nurses that motivate students to use EBP. Methods: Fourteen second-year students were divided into three focus groups according to the ward in which they undertook their clinical practice. Each group contained 4–5 students. Findings: The students were able to implement EBP according to the goals of the syllabus, but encountered a clinical setting that was insufficiently prepared, both structurally and in terms of knowledge, to mentor them regarding EBP. The findings indicate a culture crash between the students’learning goals of EBP at the faculty and the application of EBP in practice. Conclusion: The results of this study demonstrated that EBP is feasible in clinical practice, but highlighted the various factors obstructing its implementation. There is a need to find pathways to reduce hindrance in implementation of EBP

Persistent High Incidence of Tuberculosis in Immigrants in a Low-Incidence Country

Immigration from areas of high incidence is thought to have fueled the resurgence of tuberculosis (TB) in areas of low incidence. To reduce the risk of disease in low-incidence areas, the main countermeasure has been the screening of immigrants on arrival. This measure is based on the assumption of a prompt decline in the incidence of TB in immigrants during their first few years of residence in a country with low overall incidence. We have documented that this assumption is not true for 619 Somali immigrants reported in Denmark as having TB. The annual incidence of TB declined only gradually during the first 7 years of residence, from an initial 2,000 per 100,000 to 700 per 100,000. The decline was described by an exponential function with a half-time of 5.7 (95% confidence interval 4.0 to 9.7) years. This finding seriously challenges the adequacy of the customary practice of screening solely on arrival

Therapeutic drug monitoring (TDM) of atazanavir in pregnancy

Purpose of the study: Pregnant women experience physiological changes during pregnancy resulting in clinically significant alterations in antiretroviral pharmacokinetics (PK). Therefore, achieving and maintaining optimal plasma concentrations of antiretroviral drugs is essential for maternal health and minimising the risk of mother-to-child transmission of HIV. The aim of this study is to describe atazanavir/ritonavir (ATV/r) PK during pregnancy. Methods: Pregnant HIV-positive women received ATV/r as part of their routine pre-natal care. Demographic and clinical data were collected, and ATV plasma concentrations [ATV] were determined in the first (T1), second (T2) and third (T3) trimester using HPLC-MS/MS (LLQ=0.05 µg/mL). Postpartum (PP) sampling was performed where applicable. Antepartum (AP) and PP PK parameters were compared using a one-way ANOVA. Summary of results: From January 2007, 44 women (37 black African) were enrolled in the study. All received ATV/r at a standard dose of 1 tablet once daily (300/100 mg od). 24 women were receiving ART prior to pregnancy, and 20 women initiated ATV/r during pregnancy. Median (range) gestation at treatment initiation in these patients was 23.5 weeks (7–35). At the time nearest to delivery 31 patients had an undetectable plasma viral load (pVL), 6 patients had detectable pVL and 2 were unavailable. [ATV] were determined in 11/44 (T1); 25/44 (T2); 35/44 (T3) and 28/44 (PP) patients. Time of TDM sampling, gestation time and [ATV] (geometric mean; 95% CI) are given in the Table. 6 patients were either below or approaching the ATV MEC (0.15 µg/mL) during pregnancy; of these, 4/6 achieved undetectable pVL at the time of delivery (1=pVL of 291 copies/mL; 1 unavailable). [ATV] were significantly lower at T2/T3 relative to T1/PP. Equally, in a paired analysis of 28 patients (T2/T3 vs. PP), [ATV] were significantly reduced at T2/T3 (P=0.003). Conclusions: This study represents one of the larger cohorts of women undergoing TDM for ATV in pregnancy. Lower [ATV] were seen in T2 and T3 when compared to T1. However, such findings were not associated with viral breakthrough or HIV transmissions. Nonetheless, careful monitoring of women in pregnancy is required, and if there is concern for inadequate levels, dose adjustment of ATV upward from 300 mg to 400 mg may be an option

Head and neck paragangliomas: A two‐decade institutional experience and algorithm for management

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141924/1/lio2122.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141924/2/lio2122_am.pd