The Dip: Orchestrating a Clinical Immersion Experience in Interprofessional Education

Research Question: Do health professions students who participate in an interprofessional education experience report improved teamwork skills

A Partnership Model of Clinical Interprofessional Education

Purpose and Background: The University wanted to enhance students’ uniprofessional education by providing an interprofessional experience in a gerontology context in collaboration with a clinical education partner. The project goals were to improve students’ teamwork skills, improve the vitality of their elder teacher, and create a model of interprofessional education for undergraduate and graduate students which would also benefit the clinical partner. Description of Intervention or program: Over three semesters, 44 students formed interprofessional teams of 4-5 students and worked with an elder teacher (resident) of the facility to learn with, from, and about each other. The student teams were supported by clinical mentors and faculty mentors. The students experienced a two-week didactic course focusing on teamwork followed by 14 weeks of clinical immersion in a long-term care setting. Evaluation included tools found in the literature (RIPLS and IEPS) and an assessment developed by the planning team. Additionally, student assignments, meeting summaries, and observer field notes were analyzed. This workshop will include a discussion of the interests and needs of the university and the clinical partner. Results: Students improved the vitality of their elder teachers. Additionally, they reported learning about other professions, practiced client-centered interventions, and became more holistic in their thinking. The partner has requested to have students on site all year round, not only in the spring semester. Conclusion: The project was beneficial to both partner organizations and for all participants. The project will be expanded next academic year to impact more students and elder teachers. Relevance to interprofessional education and practice: This project immerses students on interprofessional teams. It involves the facility staff in supporting the teams and this encourages team–based practice in this setting. Everyone works and everyone learns (Vanderbilt model). Seminar outline/timeframe of presentation and interactive discussion: 5 Min: Introduction and background 15 Min: Description of the collaboration project and how the voices of the clinical partner. Introduce activity: How do you develop a mutually beneficial immersion experience. 15 min: The teams will identify the interests of the university and the community partner. What are the gives and gets of each? We will assign different participant small groups to be either a university or a community partner. 15 min: After they identify their interests, have two groups get together and see if and how well their interests align. 10 min: Large group debriefing, sharing learnings, and next steps Two to three measurable learning objectives relevant to the conference goals: 1. Recognize opportunities/apply strategies to engage patients as partners in developing new models of interprofessional education and care 2. Describe a strategy that engages the clinical partner in the planning and engages the residents as elder teachers in implementation of an interprofessional immersion experience for undergraduate and graduate healthcare students. 3. Design innovative interprofessional curriculum, collaborative practice and quality improvement initiatives with attention to actualizing academic and clinical partnerships. 4. Identify the interests of both the university and the clinical partner in order to design a mutually beneficial IPE immersion experience

Experiences of Older Adults Using Smart Home Technology in a Senior Living Community.

Researchers from a University partnered with a senior housing organization and a technology provider to study the implementation of smart home technologies for seniors living independently. Smart home technologies included in home motion and pressure sensors and an Amazon Echo device. Older adults who received the technology and their designated family members were interviewed to ascertain the impact of the technology on the daily activities and communication

7‑hydroxymitragynine is an active metabolite of mitragynine and a key mediator of its analgesic effects

Mitragynina speciosa, more commonly known as kratom, is a plant native to Southeast Asia, the leaves of which have been used traditionally as a stimulant, analgesic, and treatment for opioid addiction. Recently, growing use of the plant in the United States and concerns that kratom represents an uncontrolled drug with potential abuse liability, have highlighted the need for more careful study of its pharmacological activity. The major active alkaloid found in kratom, mitragynine, has been reported to have opioid agonist and analgesic activity in vitro and in animal models, consistent with the purported effects of kratom leaf in humans. However, preliminary research has provided some evidence that mitragynine and related compounds may act as atypical opioid agonists, inducing therapeutic effects such as analgesia, while limiting the negative side effects typical of classical opioids. Here we report evidence that an active metabolite plays an important role in mediating the analgesic effects of mitragynine. We find that mitragynine is converted in vitro in both mouse and human liver preparations to the much more potent mu-opioid receptor agonist 7-hydroxymitragynine, and that this conversion is mediated by cytochrome P450 3A isoforms. Further, we show that 7-hydroxymitragynine is formed from mitragynine in mice and that brain concentrations of this metabolite are sufficient to explain most or all of the opioid-receptor-mediated analgesic activity of mitragynine. At the same time, mitragynine is found in the brains of mice at very high concentrations relative to its opioid receptor binding affinity, suggesting that it does not directly activate opioid receptors. The results presented here provide a metabolism-dependent mechanism for the analgesic effects of mitragynine and clarify the importance of route of administration for determining the activity of this compound. Further, they raise important questions about the interpretation of existing data on mitragynine and highlight critical areas for further research in animals and humans.</p

Observation of squeezed light from one atom excited with two photons

Single quantum emitters like atoms are well-known as non-classical light sources which can produce photons one by one at given times, with reduced intensity noise. However, the light field emitted by a single atom can exhibit much richer dynamics. A prominent example is the predicted ability for a single atom to produce quadrature-squeezed light, with sub-shot-noise amplitude or phase fluctuations. It has long been foreseen, though, that such squeezing would be "at least an order of magnitude more difficult" to observe than the emission of single photons. Squeezed beams have been generated using macroscopic and mesoscopic media down to a few tens of atoms, but despite experimental efforts, single-atom squeezing has so far escaped observation. Here we generate squeezed light with a single atom in a high-finesse optical resonator. The strong coupling of the atom to the cavity field induces a genuine quantum mechanical nonlinearity, several orders of magnitude larger than for usual macroscopic media. This produces observable quadrature squeezing with an excitation beam containing on average only two photons per system lifetime. In sharp contrast to the emission of single photons, the squeezed light stems from the quantum coherence of photon pairs emitted from the system. The ability of a single atom to induce strong coherent interactions between propagating photons opens up new perspectives for photonic quantum logic with single emittersComment: Main paper (4 pages, 3 figures) + Supplementary information (5 pages, 2 figures). Revised versio

Ethical triage during the COVID-19 pandemic:a toolkit for neurosurgical resource allocation

Background The COVID-19 pandemic confronts healthcare workers, including neurosurgeons, with difficult choices regarding which patients to treat. Methods In order to assist ethical triage, this article gives an overview of the main considerations and ethical principles relevant when allocating resources in times of scarcity. Results We discuss a framework employing four principles: prioritizing the worst off, maximizing benefits, treating patients equally, and promoting instrumental value. We furthermore discuss the role of age and comorbidity in triage and highlight some principles that may seem intuitive but should not form a basis for triage. Conclusions This overview is presented on behalf of the European Association of Neurosurgical Societies and can be used as a toolkit for neurosurgeons faced with ethical dilemmas when triaging patients in times of scarcity.Scientific Assessment and Innovation in Neurosurgical Treatment Strategie

Review: Short-term sea-level changes in a greenhouse world - A view from the Cretaceous

© 2015. This review provides a synopsis of ongoing research and our understanding of the fundamentals of sea-level change today and in the geologic record, especially as illustrated by conditions and processes during the Cretaceous greenhouse climate episode. We give an overview of the state of the art of our understanding on eustatic (global) versus relative (regional) sea level, as well as long-term versus short-term fluctuations and their drivers. In the context of the focus of UNESCO-IUGS/IGCP project 609 on Cretaceous eustatic, short-term sea-level and climate changes, we evaluate the possible evidence for glacio-eustasy versus alternative or additional mechanisms for continental water storage and release for the Cretaceous greenhouse and hothouse phases during which the presence of larger continental ice shields is considered unlikely. Increasing evidence in the literature suggests a correlation between long-period orbital cycles and depositional cycles that reflect sea-level fluctuations, implying a globally synchronized forcing of (eustatic) sea level. Fourth-order depositional sequences seem to be related to a ~. 405. ka periodicity, which most likely represents long-period orbital eccentricity control on sea level and depositional cycles. Third-order cyclicity, expressed as time-synchronous sea level falls of ~. 20 to 110. m on ~. 0.5 to 3.0. Ma timescales in the Cretaceous, are increasingly recognized as connected to climate cycles triggered by long-term astronomical cycles that have periodicity ranging from ~. 1.0 to 2.4. Ma. Future perspectives of research on greenhouse sea-level changes comprise a high-precision time-scale for sequence stratigraphy and eustatic sea-level changes and high-resolution marine to non-marine stratigraphic correlation

Arm bone loading index predicts DXA musculoskeletal outcomes in two samples of post-menarcheal girls

Abstract Objective: A site-specific bone loading index was developed to predict post-menarcheal arm bone mass, geometry, areal density and non-bone lean mass using organized activity records. Methods: Two cohorts of post-menarcheal girls (A= 55, B= 48) met analysis inclusion criteria: 1) Whole body and non-dominant radius DXA scans +1.0 to +2.6 years post-menarche; 2) detailed, organized activity records available for 36 months prior to the focal DXA scan; 3) accompanying anthropometric data. DXA non-dominant arm and radius regions of interest (1/3, Ultradistal (UD)) were evaluated. An arm bone loading index (arm totBLI) was developed and refined to describe &gt;50 activities. Separate regression analyses for Cohorts A&amp;B tested explanatory value of arm totBLI for DXA outcomes, accounting for gynecological age, height and whole body non-bone lean mass. Results: In both cohorts, arm totBLI reflecting 3 years of peri-menarcheal activity exposure exhibited strong explanatory value for post-menarcheal radius and arm outcomes (squared semi-partial r =0.07-0.34, p&lt;0.05), except Arm Area. For both cohorts and most outcomes, arm totBLI explained significant variance, even after adjusting for local muscle mass. Conclusions: In two independent cohorts, arm totBLI may consistently indicate osteogenic and sarcogenic properties of represented activities; additional research is necessary for further refinement and validation

Seasonal Distribution of Ticks in Four Habitats near the Demilitarized Zone, Gyeonggi-do (Province), Republic of Korea

This study describes the seasonal distribution of larvae, nymph, and adult life stages for 3 species of ixodid ticks collected by tick drag and sweep methods from various habitats in the Republic of Korea (ROK). Grasses less than 0.5 m in height, including herbaceous and crawling vegetation, and deciduous, conifer, and mixed forests with abundant leaf/needle litter were surveyed at United States (US) and ROK operated military training sites and privately owned lands near the demilitarized zone from April-October, 2004 and 2005. Haemaphysalis longicornis Neumann adults and nymphs were more frequently collected from April-August, while those of Haemaphysalis flava Neumann and Ixodes nipponensis Kitaoka and Saito were collected more frequently from April-July and again during October. H. longicornis was the most frequently collected tick in grass habitats (98.9%), while H. flava was more frequently collected in deciduous (60.2%) and conifer (57.4%) forest habitats. While more H. flava (54.1%) were collected in mixed forest habitats than H. longicornis (35.2%), the differences were not significant. I. nipponensis was more frequently collected from conifer (mean 8.8) compared to deciduous (3.2) and mixed (2.4) forests.OAIID:oai:osos.snu.ac.kr:snu2013-01/102/0000051105/9SEQ:9PERF_CD:SNU2013-01EVAL_ITEM_CD:102USER_ID:0000051105ADJUST_YN:YEMP_ID:A077262DEPT_CD:551CITE_RATE:.881FILENAME:2013 kjp-51-319 seasonal distribution of ticks in four habitats.pdfDEPT_NM:수의학과SCOPUS_YN:YCONFIRM:

Photon-Atom Coupling with Parabolic Mirrors

Efficient coupling of light to single atomic systems has gained considerable attention over the past decades. This development is driven by the continuous growth of quantum technologies. The efficient coupling of light and matter is an enabling technology for quantum information processing and quantum communication. And indeed, in recent years much progress has been made in this direction. But applications aside, the interaction of photons and atoms is a fundamental physics problem. There are various possibilities for making this interaction more efficient, among them the apparently 'natural' attempt of mode-matching the light field to the free-space emission pattern of the atomic system of interest. Here we will describe the necessary steps of implementing this mode-matching with the ultimate aim of reaching unit coupling efficiency. We describe the use of deep parabolic mirrors as the central optical element of a free-space coupling scheme, covering the preparation of suitable modes of the field incident onto these mirrors as well as the location of an atom at the mirror's focus. Furthermore, we establish a robust method for determining the efficiency of the photon-atom coupling.Comment: Book chapter in compilation "Engineering the Atom-Photon Interaction" published by Springer in 2015, edited by A. Predojevic and M. W. Mitchell, ISBN 9783319192307, http://www.springer.com/gp/book/9783319192307. Only change to version1: now with hyperlinks to arXiv eprints of other book chapters mentioned in this on