Twelve tips for teaching brief motivational interviewing to medical students

Background: Shifting from paternalistic to patient-centred doctor-patient relationships has seen a growing number of medical programs incorporate brief motivational interviewing training in their curriculum. Some medical educators, however, are unsure of precisely what, when, and how to incorporate such training. Aims: This article provides educators with 12 tips for teaching brief motivational interviewing to medical students, premised on evidence-based pedagogy. Methods: Tips were drawn from the literature and authors’ own experiences. Results: The 12 tips are: (1) Set clear learning objectives, (2) Select experienced educators, (3) Provide theoretical perspectives, (4) Share the evidence base, (5) Outline the “spirit”, principles, and sequence, (6) Show students what it looks like, (7) Give students a scaffold to follow, (8) Provide opportunities for skill practice, (9) Involve clinical students in teaching, (10) Use varied formative and summative assessments, (11) Integrate and maintain, and (12) Reflect and evaluate. Conclusions: We describe what to include and why, and outline when and how to teach the essential components of brief motivational interviewing knowledge and skills in a medical curriculum

ENV-634: MICROBIAL SUBSURFACE REPOPULATION FOLLOWING IN SITU STAR REMEDIATION

STAR (Self-sustaining Treatment for Active Remediation) is an emerging remediation technology that employs a self-sustaining smouldering reaction to destroy nonaqueous phase liquids (NAPLs) in the subsurface. The reaction front travels at rates of 0.5 to 5 m per day and subjects the soil to temperatures between 400°C and 1200°C (Pironi et al. 2011; Switzer et al. 2009). Consequently, not only does STAR cause an in situ destruction of NAPL, but it dries and sterilizes the soil through which it passes (Pape et al. 2015). Microbial recolonization of these sterile treated zones is important to the overall remediation of the site, since soils require microbial populations to cycle nutrients and provide a supportive base for above ground ecosystems (Nwaishi et al. 2016; Tisdall and Oades 2012). However, the smouldering process also acts to remove organics and nutrients, and lowers the cation exchange capacity of the soil. This creates a difficult environment for microbial repopulation to occur in. Indeed, it has been shown in a microcosm study that microbial recovery following thermal treatment at temperatures above 500 oC is up to three orders of magnitude lower than in soils which received thermal treatment at temperatures below 500 oC (Pape et al. 2015). Nevertheless, it is hypothesized that in situ post–STAR microbial repopulation will show more success, as organics and nutrients will be supplied to the treated zone by the influent groundwater. In this study, the microbial repopulation of an in situ STAR treatment zone is investigated at a field site in New Jersey called Pitt Consol. Final results will include analysis of bacteria and archaea population magnitude and diversity within soil cores taken from the treatment zone before and at regular intervals over six months following STAR treatment, allowing time for groundwater to re-infiltrate the treatment zone and for microbial populations to potentially reestablish. Samples from outside the treatment zones will also be analyzed to provide background data. Further, long term column experiments are looking into the effect of biostimulating the post-STAR treatment zone to enhance recovery time. Microbial abundance and diversity data from both the field observations and biostimulation experiments are expected to be compiled by late spring

Depression Moderates the Relationship between Trait Anxiety, Worry and Attentional Control in Melanoma Survivors

Cancer survivors commonly contend with concurrent cognitive difficulties such as problems with attention and concentration, and psychological distress, including anxiety and depression. However, the associations between attentional and emotional difficulties within the specific context of melanoma survivors remain relatively unexplored. Premised on attentional control theory, the current study employed a cross-sectional design to explore the interplay among trait anxiety (dispositional) and situational anxiety (cancer-related worry), depression and attentional control (ability to inhibit distractors and flexibly shift within and between tasks) in a sample of 187 melanoma survivors aged 18 to 58 years (Mage = 36.83 years, SDage = 5.44 years; 93% female). Data were analyzed using a moderated multiple regression, with anxiety, cancer worry and depression as predictors, and attentional control as the criterion variable. After statistically controlling for the variance of chemotherapy, we found that individuals with higher trait anxiety and higher cancer-related worry reported greater attentional control at low levels of depression, yet poorer attentional control at high depression, relative to individuals with low anxiety. Our findings suggest that anxiety and depression are differentially related to attentional control in melanoma survivors. The results provide a marker for clinicians addressing anxiety and depression in this population. Implications for primary healthcare are discussed.</p

Transition from and MBBS to and MD – Using innovation and thinking outside the square

Background. There has been a trend globally to move from a Bachelor of Medicine, Bachelor of Surgery (MBBS) to a Doctor of Medicine (MD) for primary medical education. This shift has seen many Australian universities change to an MD, mostly from graduate entry programs. This paper describes the novel and unique 3+2 model from one Australian university, that enabled undergraduate entry, student flexibility, and a master’s exit qualification without increasing time. Methods. The method included a curriculum review in 2013 where its problem-based learning curriculum shifted from a seven to a five-semester program; changing the third year to a virtual hospital clinical year using simulation, and introducing in 2016 a new 3+2 curriculum model in the final two years using a 100 point system as a masters level program. Results. The MD model was described in the external evaluation as ‘novel and innovative’, where students can choose from three project options – a research project, or a professional project or an international capstone experience as well as a number of scholarly tasks. The structure is fully integrated with the existing curriculum and assessment process, supported by an innovative technology platform. Conclusion. Now in its third year of implementation this innovative model is breaking new ground in the way in which a masters level MD program could be developed, whilst maintaining undergraduate entry

Sit-to-Stand Symmetry in Individuals with Hip Pathology

Why study hip fracture? • Hip fractures occur in approximately 300,000 individuals over 65 years of age and is on the rise • 53.3% of those who fall, fall again • 50% loss of function in involved lower extremity post fracture • 25% increased mortality rate 1 year post hip fracture An asymmetry in force production has been found to exist between fractured/non- fractured sides during a sit-to-stand task post hip fracture, despite having adequate capacity to perform the task symmetrically. Houck 2011 found the asymmetry is a result of weakness in the fractured lower extremity. Briere 2013 found the asymmetry is a result of motor control dysfunction in the nervous system rather than a pure strength deficit. An explanation for these errors could be that patients rated their perceived effort distribution rather than their force/weight distribution through their lower extremities during a functional sit to stand task

Molecular Dating, Evolutionary Rates, and the Age of the Grasses

Many questions in evolutionary biology require an estimate of divergence times but, for groups with a sparse fossil record, such estimates rely heavily on molecular dating methods. The accuracy of these methods depends on both an adequate underlying model and the appropriate implementation of fossil evidence as calibration points. We explore the effect of these in Poaceae (grasses), a diverse plant lineage with a very limited fossil record, focusing particularly on dating the early divergences in the group. We show that molecular dating based on a data set of plastid markers is strongly dependent on the model assumptions. In particular, an acceleration of evolutionary rates at the base of Poaceae followed by a deceleration in the descendants strongly biases methods that assume an autocorrelation of rates. This problem can be circumvented by using markers that have lower rate variation, and we show that phylogenetic markers extracted from complete nuclear genomes can be a useful complement to the more commonly used plastid markers. However, estimates of divergence times remain strongly affected by different implementations of fossil calibration points. Analyses calibrated with only macrofossils lead to estimates for the age of core Poaceae ∼51-55 Ma, but the inclusion of microfossil evidence pushes this age to 74-82 Ma and leads to lower estimated evolutionary rates in grasses. These results emphasize the importance of considering markers from multiple genomes and alternative fossil placements when addressing evolutionary issues that depend on ages estimated for important group

The Role of Entrepreneur-Venture Fit in Online Home-based Entrepreneurship: A Systematic Literature Review

Home-based businesses and their founders represent an important, but under-researched facet of entrepreneurship. Far from being small, hobby-businesses with little economic impact, home-based business make significant contribution to national economies in terms of both turnover and employment. Online home-based businesses have been recognised as an important and distinct sector of the home-based business domain, offering unique opportunity for innovation and business diversity. The paper presents a systematic literature review of extant research on online home-based entrepreneurs and their businesses. The findings of the review are structured and discussed using the theoretical lens of entrepreneur-venture fit. Use of this lens allows the study to bring coherence to previously fragmented extant studies, providing a basis for future research in this domain. The study also develops a novel model of entrepreneur-venture fit in the specific case of online home-based businesses. This allows us to suggest five positive interactions between entrepreneurial and venture characteristics. It also allows us to suggest a number of previously unidentified negative interactions, which may result in entrepreneurs becoming ‘locked-in’ and suffering multiple sources of stress

Anxiety related distractibility deficits: too much smartphone use is not such a smart call

Smartphones can increase productivity and ease accessing information, however the possible negative implications for high smartphone use or problematic smartphone use (PSU) are not fully understood. The current study examined anxiety-linked memory and attention deficits to determine whether PSU moderates these relationships. Cross-sectional data from 506 young adults aged 18–29 years (68% female) were analysed in separate regression models to investigate whether PSU (Mobile Phone Problem Use scale) moderated the relationship between state and trait anxiety (State-Cognitive and Trait-Cognitive subscales of State Trait Inventory for Cognitive and Somatic Anxiety) and everyday memory and attentional failures (the False Triggering, Forgetfulness and Distractibility subscales of the Cognitive Failures Questionnaire). Our results showed that PSU moderated the combined influence of state and trait anxiety for distractibility, such that those who reported higher PSU and higher trait anxiety reported greater errors of distractibility during higher, but not lower state anxiety. However, our predictions for false triggering and forgetfulness were not supported; the only significant finding was a trend for higher trait anxiety to be related to increased failures of false triggering and forgetfulness. Real-world implications of findings are discussed

Multimodal probes : superresolution and transmission electron microscopy imaging of mitochondria, and oxygen mapping of cells, using small-molecule Ir(III) luminescent complexes

We describe an Ir(III)-based small-molecule, multimodal probe for use in both light and electron microscopy. The direct correlation of data between light- and electron-microscopy-based imaging to investigate cellular processes at the ultrastructure level is a current challenge, requiring both dyes that must be brightly emissive for luminescence imaging and scatter electrons to give contrast for electron microscopy, at a single working concentration suitable for both methods. Here we describe the use of Ir(III) complexes as probes that provide excellent image contrast and quality for both luminescence and electron microscopy imaging, at the same working concentration. Significant contrast enhancement of cellular mitochondria was observed in transmission electron microscopy imaging, with and without the use of typical contrast agents. The specificity for cellular mitochondria was also confirmed with MitoTracker using confocal and 3D-structured illumination microscopy. These phosphorescent dyes are part of a very exclusive group of transition-metal complexes that enable imaging beyond the diffraction limit. Triplet excited-state phosphorescence was also utilized to probe the O2 concentration at the mitochondria in vitro, using lifetime mapping techniques