Developing a feedback-rich culture in academic medicine: the effect of coaching and 360-feedback on physician leadership

Background: This is a time of unprecedented change in healthcare. More physicians are being tasked with stepping into a variety of leadership roles without having received the training needed to be an effective leader. Previous data have demonstrated the effectiveness of both leadership coaching and 360-feedback tools to foster physician well-being and leadership growth. In this proof of concept study, we explore the combined effect of these two tools. The objective of this study was to examine the effect of a brief physician 360 leadership coaching intervention on perception of professional dynamics and acquired leadership skills. Methods: Participants completed a tailored 360-feedback tool to gather input on their leadership skills, then engaged in five bi-weekly leadership coaching sessions. We conducted a post-intervention semi-structured qualitative interview. Qualitative data were coded using an inductive thematic analysis approach. Results: Twenty-three primary care physicians at an academic medical center engaged in the 360 leadership coaching study. Participants reported that the intervention yielded valuable benefits in five coaching sessions. Two overarching themes emerged: a Shift in leadership awareness and Navigating their environment. Leadership awareness included increased clarity of purpose and role, and recognition that routine feedback is critical to leadership development. Navigating their environment included gaining relationship-building communication, organizational awareness and navigation strategies. Conclusions: Combining a tailored 360-feedback tool with a five-session leadership coaching intervention provided physicians with valued support infrastructure for becoming more effective leaders. Physicians described a nuanced understanding of the leadership challenges physicians face, and identified the leadership tools needed to navigate the evolving healthcare delivery landscape. Curricula for physician leadership learning could consider this combination of a customized 360 plus targeted leadership coaching for training physician leaders

Interpreting high [O III]/H β ratios with maturing starbursts

Star-forming galaxies at high redshift show ubiquitously high-ionization parameters, as measured by the ratio of optical emission lines. We demonstrate that local (z < 0.2) sources selected as Lyman break analogues also manifest high line ratios with a typical [O III]/Hβ=3.36+0.14−0.04 – comparable to all but the highest ratios seen in star-forming galaxies at z ∼ 2–4. We argue that the stellar population synthesis code BPASS can explain the high-ionization parameters required through the ageing of rapidly formed star populations, without invoking any AGN contribution. Binary stellar evolution pathways prolong the age interval over which a starburst is likely to show elevated line ratios, relative to those predicted by single stellar evolution codes. As a result, model galaxies at near-solar metallicities and with ages of up to ∼100 Myr after a starburst typically have a line ratio [O III]/Hβ ∼ 3, consistent with those seen in Lyman break galaxies and local sources with similar star formation densities. This emphasises the importance of including binary evolution pathways when simulating the nebular line emission of young or bursty stellar populations

Scaling the wall: overcoming barriers to STEM knowledge mobilization

Improving science literacy is crucial amidst global challenges like climate change, emerging diseases, AI, and rampant disinformation. This is vital not only for future STEM generations but for all, to make informed decisions. Informal science communication efforts such as podcasts, popular science articles, and museum events are an essential part of the infrastructure for mobilizing knowledge and nurturing science literacy. However, in this Perspective, we emphasize the need to grow our capacity for STEM outreach in the formal K-12 classroom. While the majority of informal outreach mechanisms require audience members to seek out content, classrooms include those hard-to-reach target audiences that are not already STEM-engaged. We contrast the multitude of resources that have been developed to support informal outreach in recent decades with a relative paucity of such efforts in the K-12 formal classroom realm. We advocate for a more balanced deployment of resources and efforts between these two vital components of our knowledge mobilization and STEM engagement infrastructure. In particular, we highlight the key role of K-12 teachers as conduits for knowledge dissemination and the need for greater collaboration between scientists and teachers at individual and organizational levels. We also advocate for greater collaboration across programs in both the informal and formal outreach space, and dedicated effort to construct dissemination networks to share outreach materials at scale across disparate programs. The aim of our piece is to generate discussion about how we might refocus goals, funding mechanisms, and policies to grow the science-engaged society necessary to confront future challenges

Adults and Children in Low-Income Households That Participate in Cost-Offset Community Supported Agriculture Have High Fruit and Vegetable Consumption

This paper examines fruit and vegetable intake (FVI) in low-income households that participated in a cost-offset (CO), or 50% subsidized, community-supported agriculture (CSA) program. CSA customers paid farms upfront for a share of the harvest, and received produce weekly throughout the growing season. A cohort of adults and children 2–12 y in a summer CO-CSA were surveyed online twice: August 2015 (n = 41) and February 2016 (n = 23). FVI was measured by the National Cancer Institute’s (NCI) Fruit and Vegetable Screener (FVS) and an inventory of locally grown fruits and vegetables. FVI relative to United States (US) recommendations and averages, and across seasons, were tested with non-parametric tests and paired t-tests (p < 0.05). Both adults and children in the CO-CSA had higher FVI than the US averages, and more often met recommendations for vegetables. Some summer fruits and vegetables were more often eaten when locally in-season. The CO-CSA model warrants further examination as an avenue for improving vegetable consumption among adults and children in low-income households. However, causality between CO-CSA participation and FVI cannot be inferred, as CO-CSA participants may be positive deviants with respect to FVI. A multi-state randomized controlled trial is currently underway to evaluate impacts of CO-CSAs on FVI and related outcomes

The Grizzly, November 14, 1995

Date of Graduation to Change • Election Day \u2795: The Results are in! • European Adventure • Women Taking Action Through Self-Defense • Jamieson to Speak • Job Club on Campus • Pi Nu Epsilon Sponsors Messiah Chat • Can-tastic! • Debate: King of Prussia Renovations • Talk Show Circus • What I Think • How Can You Say That God is the Truth? • The Only True Judge is God • Concert Band and Jazz Ensemble to Perform Saturday • Going Medieval on the Mall • The Tempest a Success • Ethnic-American Writers Series Presents Lisa Jones • The Bookstore is Changing: Voice Your Opinion • Philosophy Major Now Available • Football Falls to Dickinson, 27-12 • Runners Compete at Regional Championships • Local Karate Students Medal at 1995 Mediterranean Games • Field Hockey Team Falls in ECAC Semishttps://digitalcommons.ursinus.edu/grizzlynews/1369/thumbnail.jp

Prevalence and diversity of type VI secretion systems in a model beneficial symbiosis

The type VI secretion system (T6SS) is widely distributed in diverse bacterial species and habitats where it is required for interbacterial competition and interactions with eukaryotic cells. Previous work described the role of a T6SS in the beneficial symbiont, Vibrio fischeri, during colonization of the light organ of Euprymna scolopes squid. However, the prevalence and diversity of T6SSs found within the distinct symbiotic structures of this model host have not yet been determined. Here, we analyzed 73 genomes of isolates from squid light organs and accessory nidamental glands (ANGs) and 178 reference genomes. We found that the majority of these bacterial symbionts encode diverse T6SSs from four distinct classes, and most share homology with T6SSs from more distantly related species, including pathogens of animals and humans. These findings indicate that T6SSs with shared evolutionary histories can be integrated into the cellular systems of host-associated bacteria with different effects on host health. Furthermore, we found that one T6SS in V. fischeri is located within a genomic island with high genomic plasticity. Five distinct genomic island genotypes were identified, suggesting this region encodes diverse functional potential that natural selection can act on. Finally, analysis of newly described T6SSs in roseobacter clade ANG isolates revealed a novel predicted protein that appears to be a fusion of the TssB-TssC sheath components. This work underscores the importance of studying T6SSs in diverse organisms and natural habitats to better understand how T6SSs promote the propagation of bacterial populations and impact host health

Clinical Manifestations of an Outbreak of Monkeypox Virus in Captive Chimpanzees in Cameroon, 2016

Monkeypox virus (MPXV) is a re-emerging virus of global concern. An outbreak of Clade I MPXV affected 20 captive chimpanzees in Cameroon in 2016. We describe the epidemiology, virology, phylogenetics, and clinical progression of this outbreak. Clinical signs included exanthema, facial swelling, peri-laryngeal swelling, and eschar. Mpox can be lethal in captive chimpanzees with death likely resulting from respiratory complications. We advise avoiding anesthesia in animals with respiratory signs to reduce the likelihood of death. This outbreak presented a risk to animal care staff. There is a need for increased awareness and a One Health approach to preparation for outbreaks in wildlife rescue centers in primate range states where MPXV occurs. Control measures should include quarantining affected animals, limiting human contacts, surveillance of humans and animals, use of personal protective equipment, and regular decontamination of enclosures.</p

Hospitalization and emergency department visits among seniors receiving homecare: a pilot study

BACKGROUND: Despite the recent growth in home health services, data on clinical outcomes and acute health care utilization among older adults receiving homecare services are sparse. Obtaining such data is particularly relevant in Ontario where an increasing number of frail seniors receiving homecare are awaiting placement in long-term care facilities. In order to determine the feasibility of a large-scale study, we conducted a pilot study to assess utilization of acute health care services among seniors receiving homecare to determine associated clinical outcomes. METHODS: This prospective cohort study followed forty-seven seniors admitted to homecare by two homecare agencies in Hamilton, Ontario over a 12-month period. Demographic information and medical history were collected at baseline, and patients were followed until either termination of homecare services, death, or end of study. The primary outcome was hospitalization. Secondary outcomes included emergency department visits that did not result in hospitalization and death. Rates of hospitalization and emergency department visits without admission were calculated, and univariate analyses were performed to test for potential risk factors. Survival curves for accumulative rates of hospitalization and emergency department visits were created. RESULTS: 312 seniors were eligible for the study, of which 123 (39%) agreed to participate initially. After communicating with the research nurse, of the 123 who agreed to participate initially, 47 (38%) were enrolled in the study. Eleven seniors were hospitalized during 3,660 days of follow-up for a rate of 3.0 incident hospitalizations per 1,000 homecare-days. Eleven seniors had emergency department visits that did not result in hospitalization, for a rate of 3.3 incident emergency department visits per 1,000 homecare-days. There were no factors significantly associated with hospitalization or emergency department visits when adjustment was made for multiple comparisons. CONCLUSION: The incidence of hospitalization and visits to the emergency department among seniors receiving homecare services is high. Getting satisfactory levels of enrolment will be a major challenge for larger prospective studies