A Journey from Patient Care to Jesuit Higher Education: How a Small Group of Healthcare Professionals Navigated the Transition into Academia

In the fall of 2015, four experienced healthcare clinicians met as strangers at an orientation at a Jesuit institution, Regis University. From the professions of occupational therapy, pharmacy, and physical therapy, we felt comfortable with our clinical practice in patient-centered care and our healthcare work environments. Eager to share our knowledge with our students, we needed guidance to perform the key roles of an educator such as creating a syllabus, writing test items, and advising students. As we began our careers in academia, we felt disoriented and chaotic. We directly sought structure to bridge knowledge gaps, establish a sense of community, and identify essential resources necessary for success in academia. We desired to explore our own interpretation of the Jesuit values before trying to infuse them into our teaching. Through the creation of a small professional learning group that combined emotional support and professional growth, we established a structured approach to learning the roles of a professor and found our identities as academicians. We aim to share our journey and provide recommendations for other healthcare clinicians who are inexperienced with academia in the hopes of easing the transition from clinician to educator at a Jesuit University

Effects on Breathing of Agonists to μ-opioid or GABA\u3csub\u3eA\u3c/sub\u3e Receptors Dialyzed into the Ventral Respiratory Column of Awake and Sleeping Goats

Pulmonary ventilation (V̇I) in awake and sleeping goats does not change when antagonists to several excitatory G protein-coupled receptors are dialyzed unilaterally into the ventral respiratory column (VRC). Concomitant changes in excitatory neuromodulators in the effluent mock cerebral spinal fluid (mCSF) suggest neuromodulatory compensation. Herein, we studied neuromodulatory compensation during dialysis of agonists to inhibitory G protein-coupled or ionotropic receptors into the VRC. Microtubules were implanted into the VRC of goats for dialysis of mCSF mixed with agonists to either μ-opioid (DAMGO) or GABAA (muscimol) receptors. We found: (1) V̇I decreased during unilateral but increased during bilateral dialysis of DAMGO, (2) dialyses of DAMGO destabilized breathing, (3) unilateral dialysis of muscimol increased V̇I, and (4) dialysis of DAMGO decreased GABA in the effluent mCSF. We conclude: (1) neuromodulatory compensation can occur during altered inhibitory neuromodulator receptor activity, and (2) the mechanism of compensation differs between G protein-coupled excitatory and inhibitory receptors and between G protein-coupled and inotropic inhibitory receptors

State-Dependent and -Independent Effects of Dialyzing Excitatory Neuromodulator Receptor Antagonists into the Ventral Respiratory Column

Unilateral dialysis of the broad-spectrum muscarinic receptor antagonist atropine (50 mM) into the ventral respiratory column [(VRC) including the pre-Bötzinger complex region] of awake goats increased pulmonary ventilation (V̇i) and breathing frequency (f), conceivably due to local compensatory increases in serotonin (5-HT) and substance P (SP) measured in effluent mock cerebral spinal fluid (mCSF). In contrast, unilateral dialysis of a triple cocktail of antagonists to muscarinic (atropine; 5 mM), neurokinin-1, and 5-HT receptors does not alter V̇i or f, but increases local SP. Herein, we tested hypotheses that 1) local compensatory 5-HT and SP responses to 50 mM atropine dialyzed into the VRC of goats will not differ between anesthetized and awake states; and 2) bilateral dialysis of the triple cocktail of antagonists into the VRC of awake goats will not alter V̇i or f, but will increase local excitatory neuromodulators. Through microtubules implanted into the VRC of goats, probes were inserted to dialyze mCSF alone (time control), 50 mM atropine, or the triple cocktail of antagonists. We found 1) equivalent increases in local 5-HT and SP with 50 mM atropine dialysis during wakefulness compared with isoflurane anesthesia, but V̇i and f only increased while awake; and 2) dialyses of the triple cocktail of antagonists increased V̇i, f, 5-HT, and SP

Addressing Opioid Misuse and Abuse through Interprofessional Engagement and Education

Purpose: The purpose of this initiative was to develop and implement an interprofessional panel aimed to expose a university audience to the magnitude of opioid misuse and abuse, as well as demonstrate each health professional’s role in curbing the epidemic. Further, this experience was to provide a platform for interprofessional discussion and to share with attendees tangible action items to begin combatting the opioid epidemic. Methods: An interdisciplinary committee of healthcare professionals collaborated to initiate a dialogue around opioid misuse and abuse to highlight the power of interprofessional (IP) collaboration in addressing the opioid epidemic. Each panel member shared a personal vignette about his or her professional experience with the epidemic, then the audience members were asked to participate in a question and answer session. Primary outcomes from this IP experience were derived from an eight-item satisfaction survey. The event was held in April 2016. The interdisciplinary committee marketed this event to all students, faculty, and staff in the Rueckert-Hartman College of Health Care Professionals one month before the event through electronic emails and posters. Results: Forty-four (63%) of participants completed the satisfaction survey of which 88.6% were students of healthcare professions. The satisfaction survey evaluative results were positive and referenced the panel as being an excellent IP event that was helpful, informative, and enjoyable. The results support that the initiative successfully increased understanding of the magnitude of the opioid epidemic for the attendees of this pilot event. The target audience of students expressed a greater awareness of the magnitude of the problem (43.2%) and an increased appreciation of the IP aspects of opioid management strategies (36.4%). Attendees also identified the need for ownership of their role as existing and future health care professionals and the need to work as an IP team to address the problem. Conclusion: An interprofessional panel format as an optional extracurricular event is an effective way to communicate key educational messages about opioid misuse and abuse to a target audience of graduate students at a mid-sized college of health professions

Stress reactivity to an electronic version of the Trier Social Stress Test: a pilot study

Social stressors that rely on the inclusion of confederates (i.e., Trier Social Stress Test, TSST) are often used in clinical laboratory research paradigms to elicit a measurable stress response in participants. Although effective, the TSST is labor intensive and may introduce error variance as a function of confederate race, gender, and/or response characteristics. The present study aimed to develop and validate an electronic version of the TSST (e-TSST). The primary aim was to compare the e-TSST to an e-neutral control condition; the exploratory aim was to compare the magnitude of stress response elicited by the e-TSST to that elicited by the traditional TSST. Forty-three healthy adults were randomized to the e-TSST or e-neutral condition. Subjective (participant-rated distress) and objective [cortisol, heart rate (HR), and blood pressure] indices of stress were collected prior to, and multiple times following, the stressor. Using archival data collected from 19 healthy participants exposed to the traditional TSST in a prior study, stress reactivity was compared between the electronic and traditional versions of the TSST. The e-TSST elicited significant increases in all measures of stress reactivity compared to the e-neutral condition, with the exception of HR. Results showed that the magnitude of subjective distress, BP, and HR responses elicited by the e-TSST did not differ significantly from that elicited by the traditional TSST. The traditional TSST elicited significantly higher cortisol than the e-TSST. Although these findings provide initial support for the development of electronic versions of the TSST, further refinement of the e-TSST is warranted prior to broad adoption of this technology. A refined, reliable e-TSST could allow for increased utilization of the TSST by enhancing convenience, reducing labor costs, and limiting potential error variance introduced by human confederates

Cytotoxic clinical isolates of Pseudomonas aeruginosa identified during the Steroids for Corneal Ulcers Trial show elevated resistance to fluoroquinolones.

BackgroundTo determine the relationship between type three secretion genotype and fluoroquinolone resistance for P. aeruginosa strains isolated from microbial keratitis during the Steroids for Corneal Ulcers Trial (SCUT) and for two laboratory strains, PA103 and PAO1.MethodsConfirmed P. aeruginosa isolates from the SCUT were divided into exoU(+) or exoU(-). The exoU(+) strains contained the gene encoding ExoU, a powerful phospholipase toxin delivered into host cells by the type three secretion system. Isolates were then assessed for susceptibility to fluoroquinolone, cephalosporin, and aminoglycoside antibiotics using disk diffusion assays. Etest was used to determine the MIC of moxifloxacin and other fluoroquinolones. Laboratory isolates in which the exoU gene was added or deleted were also tested.ResultsA significantly higher proportion of exoU(+) strains were resistant to ciprofloxacin (p = 0.001), gatifloxacin (p = 0.003), and ofloxacin (p = 0.002) compared to exoU(-) isolates. There was no significant difference between exoU(+) or exoU(-) negative isolates with respect to susceptibility to other antibiotics except gentamicin. Infections involving resistant exoU(+) strains trended towards worse clinical outcome. Deletion or acquisition of exoU in laboratory isolates did not affect fluoroquinolone susceptibility.ConclusionsFluoroquinolone susceptibility of P. aeruginosa isolated from the SCUT is consistent with previous studies showing elevated resistance involving exoU encoding (cytotoxic) strains, and suggest worse clinical outcome from infections involving resistant isolates. Determination of exoU expression in clinical isolates of P. aeruginosa may be helpful in directing clinical management of patients with microbial keratitis

Relationships Among Disease, Social Support, and Perceived Health: A Lifespan Approach

We examined the relationship between the cumulative presence of major disease (cancer, stroke, diabetes, heart disease, and hypertension), social support, and self‐reported general and emotional well‐being in a community representative sample of predominantly White and African American respondents (N = 1349). Across all ages, greater presence of disease predicted poorer reported general health, and predicted lower emotional well‐being for respondents 40 and above. In contrast, social support predicted better‐reported general and emotional well‐being. We predicted that different types of social support (blood relatives, children, friends, community members) would be relatively more important for health in different age groups based on a lifespan or life stage model. This hypothesis was supported; across all ages, social support was related to better reported general and emotional health, but sources of support differed by age. Broadly, those in younger age groups tended to list familial members as their strongest sources of support, whereas older group members listed their friends and community members. As a whole, social support mediated the effect of disease on reported well‐being, however, moderated mediation by type of support was not significant. The results are consistent with a lifespan approach to changing social ties throughout the life course.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/116357/1/ajcp9758.pd