Developing a core outcome set for evaluating medication adherence interventions for adults prescribed long-term medication in primary care

BACKGROUND

Approximately half of people prescribed medications do not take them as prescribed. There is a significant unmet need regarding the barriers to medication adherence not being addressed in primary care. There is no agreement on which outcomes should be measured and reported in trials of medication adherence interventions.

OBJECTIVE

To develop a core outcome set (COS) for trials of medication adherence interventions in primary care for adults prescribed medications for long-term health conditions.

METHODS

A list of potentially relevant outcomes from the literature was developed. Using a two-round Delphi survey of stakeholder groups representing patients and their carers; primary care staff; and academic researchers with an interest in medication adherence; each outcome was scored in terms of importance for determining the effectiveness of medication adherence interventions in primary care. This was followed by two consensus workshops, where importance, as well as feasibility and acceptability of measurement, were considered in order to finalise the COS.

RESULTS

One hundred and fifty people took part in Delphi Round 1 and 101 took part in Round 2. Eight people attended the workshops (four attendees per workshop). Seven outcomes were identified as most important, feasible and acceptable to collect in medication adherence trials: Health-related quality of life, number of doses taken, persistence with medicines, starting (initiating) a medicine, relevance of the medication adherence intervention for an individual, mortality, and adverse medicine events.

CONCLUSIONS

This COS represents the minimum outcomes that should be collected and reported in all medication adherence trials undertaken in primary care. When developing and finalizing the COS, feasibility and acceptability of collection of outcomes has been considered. In addition to the COS, medication adherence trials can choose to include outcomes to suit their specific context such as the health condition associated with their medication adherence intervention.

The Usefulness of Dramatics for Teaching Cutaneous Tuberculosis: An Edutainment Approach for Postgraduate Medical Students

About 1.5% of tuberculosis manifestations is cutaneous and accounts for 0.1-0.9% of total OPD patients in India. Forty first-year postgraduate medical students were taught cutaneous TB though conventional PPT, 'Carousel Role Play' and 'Theatre of the Oppressed' technique. The statistically significant effectiveness of theatrical workshops was noted.

Chapter 11: Astrobiology Education, Engagement, and Resources

Although astrobiology is a relatively new field of science, the questions it seeks to answer (e.g., "What is life?" "What does life require?") have been investigated for millennia. In recent decades, formal programs dedicated specifically to the science of astrobiology have been organized at academic, governmental, and institutional scales. Constructing educational programs around this emerging science relies on input from broad expertise and backgrounds. Because of the interdisciplinary nature of this field, career pathways in astrobiology often begin in more specific fields such as astronomy, geology, or biology, and unlike many other sciences, typically involve substantial training outside one's primary discipline. The recent origin of astrobiology as a field of science has led to strong collaborations with education research in the development of astrobiology courses and offers a unique instructional laboratory for further pedagogical studies. This chapter is intended to support students, educators, and early career scientists by connecting them to materials and opportunities that the authors and colleagues have found advantageous. Annotated lists of relevant programs and resources are included as a series of appendices in the supplementary material.

A community-based intervention study involving family gardens with aromatic herbs on changes in dietary and urinary sodium

OBJECTIVE

To measure dietary and urinary changes in sodium (Na) intake and excretion through the implementation of family gardens with aromatic herbs and workshops for cooking, using the herbs as a substitute for salt and seasoning powder.

METHODS

Thirty-five participants from a neighborhood of Mexico City were included. A general questionnaire was administered to collect information on sociodemographic factors. At baseline and 3 months later, a dietary evaluation was conducted, and 24-hour urine samples were collected. Food items reported were classified according to the NOVA classification. Visits to participants´ houses were conducted to measure the amount of salt and seasoning powder added to food during the preparation of meals as well as a home food inventory. All participants were given a family garden with 6 aromatic herbs and a recipe book. The intervention included 7 cooking and 3 garden care workshops. Qualitative information on the experience was also collected. Linear regression models were run in order to estimate the contribution of each NOVA group, salt, and seasoning powder to total dietary Na intake.

RESULTS

Participants were 44 years old on average and were mainly women (91.4%). The participation compliance in the workshops was 69.5%. After 3 months, there was a Na intake mean reduction of 976 mg. There was also a reduction in the excreted urinary Na of 325 mg per day.

CONCLUSION

A positive level of involvement in this program had a direct influence on dietary habits to lower Na consumption.

Recommendations for successful involvement of patient partners in complex intervention research: a collaborative learning process

BACKGROUND

Patient and public involvement in health-related research is a new discipline in Denmark. In 2021, a national conference titled 'Patient and Public Involvement in Complex Intervention Research' provided a forum for discussion between patient partners, researchers and clinicians on involving patients as partners in complex intervention research.

METHODS

We aimed to describe specific challenges to and initiatives for patient partner involvement in order to develop recommendations for creating successful partnerships in complex intervention research. Through a collaborative learning process, 140 researchers identified the most important challenges for them in patient partner involvement and potential initiatives to improve such involvement. At a subsequent workshop, four patient partners identified the challenges and initiatives from their perspective as patient partners. They also gave feedback on the challenges and initiatives suggested by the researchers and helped shape three recommendations for practice. Three of the patient partners were involved in writing this paper.

RESULTS

The five most important challenges identified by researchers were time, recruitment, ethics, power and inequality. Between four and seven initiatives to overcome these challenges were suggested. The three most important challenges identified by patient partners were communication, when you get information that is hard to handle and recruitment. They suggested three to four initiatives for improvement. Patient partners confirmed the importance of all the researcher identified challenges when presented with them, they also provided additional comments on the researchers' initiatives. This led to the formation of recommendations for involving patient partners.

CONCLUSIONS

A collaborative learning process was shown to be a suitable method for patient partner involvement. Consistency was seen between the challenges and initiatives identified by researchers and patient partners. Based on these observations, three recommendations were developed: (1) create specific programmes that aim to involve all kind of patients (including but limited to vulnerable patients) as patient partners, (2) produce ethical guidelines for the involvement of patient partners, and (3) develop a national strategy for patient partner involvement. To build on these recommendations, a joint workshop with both researchers and patient partners is needed.

Exploring stakeholders' experiences in co-creation initiatives for clinical nursing education: a qualitative study

BACKGROUND

Co-creation is an emerging approach in nursing education, wherein academics engage in multi-stakeholder collaborations to generate knowledge, ideate solutions, promote sustainability, and enhance educational quality. However, knowledge on stakeholders' experiences in participation in co-creation initiatives for nursing education is scarce. This study aimed to explore the experiences of student nurses, nurse educators, and e-learning designers in co-creation initiatives to design and develop a digital educational resource for clinical nursing education.

METHODS

The study adopted an exploratory qualitative design. Data were collected via three separate semi-structured focus group interviews with student nurses (n = 7), nurse educators (n = 8), and e-learning designers (n = 3) who participated in co-creation workshops. Collected data were then thematically analyzed.

RESULTS

Three themes related to the participants' experiences emerged: (1) The co-creation workshops were enjoyable, useful, and instructive; (2) power imbalances influenced the students' engagement; and (3) contextual factors influenced the participants' overall engagement.

CONCLUSIONS

This study shows that co-creation through workshops is a novel, enjoyable, and instructive approach that facilitates knowledge exchange. It also highlights the needs and experiences of stakeholders, especially student nurses. However, the use of co-creation in nursing education presents some challenges. Recognizing and managing power differentials are essential for successful co-creation in clinical nursing education, alongside a mindset of collaboration and mutuality. Future research is required to systematize knowledge about the benefits and impacts of the processes and outcomes of co-creation initiatives, including stakeholders' motivation, barriers, and facilitators to participation in co-creation, to improve the quality of clinical nursing education.

Improving paramedic responses for patients dying at home: a theory of change-based approach

BACKGROUND

Paramedics are increasingly being called to attend patients dying from advanced incurable conditions. However, confidence to deal with such calls varies, with many feeling relatively unskilled in this aspect of their role. A number of interventions have been piloted to improve their skills in end-of-life care (EoLC) but without a fully specified theoretical model. Theory of Change models can provide theoretical and testable links from intervention activities to proposed long-term outcomes and indicate the areas for assessment of effectiveness. This study aimed to develop an intervention for improving paramedic EoLC for patients in the community.

METHODS

A Theory of Change approach was used as the overarching theoretical framework for developing an intervention to improve paramedic end-of-life skills. Nine stakeholders - including specialist community paramedics, ambulance call handlers and palliative care specialists - were recruited to five consecutive online workshops, ranging between 60 and 90 min. Each workshop had 2-3 facilitators. Over multiple workshops, stakeholders decided on the desired impact, short- and long-term outcomes, and possible interventions. During and between these workshops a Theory of Change model was created, with the components shared with stakeholders.

RESULTS

The stakeholders agreed the desired impact was to provide consistent, holistic, patient-centred, and effective EoLC. Four potential long-term outcomes were suggested: (1) increased use of anticipatory and regular end-of-life medications; (2) reduced end-of-life clinical and medication errors; (3) reduced unnecessary hospitalisations; (4) increased concordance between patient preferred and actual place of death. Key interventions focused on providing immediate information on what to do in such situations including: appraising the situation, developing an algorithm for a treatment plan (including whether or not to convey to hospital) and how to identify ongoing support in the community.

CONCLUSIONS

A Theory of Change approach was effective at identifying impact, outcomes, and the important features of an end-of-life intervention for paramedics. This study identified the need for paramedics to have immediate access to information and resources to support EoLC, which the workshop stakeholders are now seeking to develop as an intervention.

Health sciences library workshops in the COVID era: librarian perceptions and decision making

Objective

We sought to determine how the COVID-19 pandemic impacted academic health sciences library workshops. We hypothesized that health sciences libraries moved workshops online during the height of the pandemic and that they continued to offer workshops virtually after restrictions were eased. Additionally, we believed that attendance increased.

Methods

In March 2022, we invited 161 Association of American Health Sciences Libraries members in the US and Canada to participate in a Qualtrics survey about live workshops. Live workshops were defined as synchronous; voluntary; offered to anyone regardless of school affiliation; and not credit-bearing. Three time periods were compared, and a chi square test of association was conducted to evaluate the relationship between time period and workshop format.

Results

Seventy-two of 81 respondents offered live workshops. A chi square test of association indicated a significant association between time period and primary delivery method, chi-square (4, N=206) = 136.55, p< .005. Before March 2020, 77% of respondents taught in person. During the height of the pandemic, 91% taught online and 60% noted higher attendance compared to pre-pandemic numbers. During the second half of 2021, 65% of workshops were taught online and 43% of respondents felt that attendance was higher than it was pre-pandemic. Overall workshop satisfaction was unchanged (54%) or improved (44%).

Conclusion

Most health sciences librarians began offering online workshops following the onset of the COVID-19 pandemic. More than half of respondents were still teaching online in the second half of 2021. Some respondents reported increased attendance with similar levels of satisfaction.

Critical thinking education for dental schools in Asia: Perceptions of educators

Teaching competence in critical thinking is an important element of undergraduate dental curricula. The pedagogy for critical thinking education in Asia requires further discussion and neither the current situation nor the possible challenges are widely known from the perspectives of dental educators. Therefore, seven educators from four countries gathered online in the summer of 2021 to share the current situation and possible challenges. All the participants considered "critical thinking" was "important" (43%) or "very important" (57%), however, 86% mentioned that they faced challenges in delivering education in critical thinking. The challenges to delivering critical thinking education were insufficient time in the curriculum and lack of human resources; lack of information on appropriate teaching methods for the student population; and no established methods of assessment. How to teach and assess critical thinking therefore requires more brainstorming, and raising the awareness of educators to implement this education might be necessary.

Co-Learning Curriculum in Quality Improvement for Surgical Residents- Five-Year Experience from the University of Toronto

OBJECTIVE

We describe our five-year experience with a novel co-learning curriculum in quality improvement (CCQI)¹ for the largest reported cohort of surgical residents. The program introduces trainees to principles of quality improvement (QI)² and empowers them to complete collaborative projects with mentorship from faculty experts.

DESIGN

Each iteration consists of three interactive seminars. Residents are required to complete and present a QI project in the third seminar. To assess the impact of the program, graduates of the 2020-2021 iteration were surveyed using validated tools to examine changes in confidence and knowledge of QI principles.

SETTING

Department of Surgery, University of Toronto, Toronto, ON, Canada.

PARTICIPANTS

Participation ranged from 57 to 63 residents yearly, from diverse surgical disciplines including General Surgery, Plastic Surgery, Obstetrics and Gynecology, amongst others. Multiple small groups consisted of 4-6 residents from each speciality, mentored by a faculty lead from the same specialty.

RESULTS

Approximately 300 first-year surgical residents have participated in the CCQI since 2015, with over 60 completed QI projects. A total of 41(66%) and 51(82%) residents completed the survey in its pre- and post-course administration in 2020-2021, respectively. There was a significant increase in confidence scores with respect to describing a QI issue, building a team, and testing the change, amongst other aspects. There was also a statistically significant increase in mean knowledge scores for both scenarios of the Quality Improvement Knowledge Application Tool. 69% and 73% of residents reported "some improvement" in their knowledge, and confidence in applying QI principles to patient care, respectively. A majority of residents (73%) found the QI curriculum somewhat valuable, with 23% reporting it to be very valuable to their residency and future surgical career.

CONCLUSIONS

We describe successful long-term implementation of a novel co-learning curriculum in quality improvement. Residents derive value from this curriculum with a meaningful increase in confidence and knowledge of QI as an integral part of surgical practice.

Exploring How and Why to Develop Patient-Centered Packaging: A Multiple-Case Study with Pharmaceutical Companies

Background

Patient centricity has gained attention ranging from regulatory authorities to patient advocacy groups, calling for pharmaceutical companies to revise their traditional business approach to drug development by including the development of solutions that are meaningful in patients’ lives. Medication packaging is one area where empirical evidence is lacking about the incorporation of patient centricity. This study aimed to explore patient centricity applied to pharmaceutical companies’ packaging, and to identify the specific challenges faced and lessons learned when developing patient-centered packaging.

Methods

The study followed a multiple-case study research approach based on five cases of patient-centered packaging development in mid- and large-sized pharmaceutical companies.

Results

Patient-centered packaging is often associated with the intuitive and self-explanatory use of the medication by patients. Patient-centered packaging comes with challenges, but also offers opportunities for the creation of better solutions for patients and learning for the teams involved. To overcome these challenges, it is essential to build a business case that justifies such development, one where patient needs are present from the start and aligned with other imperative deadlines of drug development, with stakeholders onboard.

Conclusion

Patient-centered packaging is the exception rather than the norm in packaging development due to a conventional approach where packaging plays an ancillary role to drug protection. The cases presented here challenge this approach and can inspire other companies to carry out patient-centered packaging development. The cases are also relevant to other actors who are interested in continuously promoting the dialogue about patient centricity in healthcare.

A community-engaged approach to understanding environmental health concerns and solutions in urban and rural communities

Background

Focus groups and workshops can be used to gain insights into the persistence of and potential solutions for environmental health priorities in underserved areas. The objective of this study was to characterize focus group and workshop outcomes of a community-academic partnership focused on addressing environmental health priorities in an urban and a rural location in Alabama between 2012 and 2019.

Methods

Six focus groups were conducted in 2016 with 60 participants from the City of Birmingham (urban) and 51 participants from Wilcox County (rural), Alabama to discuss solutions for identified environmental health priorities based on previous focus group results in 2012. Recorded focus groups were transcribed and analyzed using the grounded theory approach. Four follow-up workshops that included written survey instruments were conducted to further explore identified priorities and determine whether the priorities change over time in the same urban (68 participants) and rural (72 participants) locations in 2018 and 2019.

Results

Consistent with focus groups in 2012, all six focus groups in 2016 in Birmingham identified abandoned houses as the primary environmental priority. Four groups listed attending city council meetings, contacting government agencies and reporting issues as individual-level solutions. Identified city-level solutions included city-led confiscation, tearing down and transferring of abandoned property ownership. In Wilcox County, all six groups agreed the top priority was drinking water quality, consistent with results in 2012. While the priority was different in Birmingham versus Wilcox County, the top identified reason for problem persistence was similar, namely unresponsive authorities. Additionally, individual-level solutions identified by Wilcox County focus groups were similar to Birmingham, including contacting and pressuring agencies and developing petitions and protesting to raise awareness, while local policy-level solutions identified in Wilcox County included government-led provision of grants to improve septic systems, and transparency in allocation of funds. Workshops in 2018 and 2019 further emphasized water quality as the top priority in Wilcox County, while participants in Birmingham transitioned from abandoned houses as a top priority in 2018 to drinking water quality as a new priority in 2019.

Conclusions

Applying a community-engaged approach in both urban and rural locations provided better understanding of the unique opportunities and challenges for identifying potential interventions for environmental health priorities in both locations. Results can help inform future efforts to address locally defined environmental health issues and solutions.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11799-1.

The Society for Prevention Research 20 Years Later: a Summary of Training Needs

The Society for Prevention Research (SPR) aims to continually provide relevant professional development training opportunities to advance scientific investigation of ways to improve the health, well-being, and social and educational outcomes of individuals and communities. Our study, led by the Training Needs Assessment Task Force, designed a quantitative questionnaire informed by semistructured, qualitative interviews of 13 key prevention science informants. The questionnaire was deployed to all SPR members, of which 347 completed it. Questions about training topics were asked along 8 categories: (1) theory; (2) preventive interventions; (3) research methods, design, and evaluation; (4) teaching and mentoring; (5) practical and interpersonal skills; (6) communication; (7) project management; and (8) data analysis. Across all categories, respondents reported a high level of interest in receiving training: more than 80% were interested in training in data analytic methods; about 70% indicated interest in theory, preventive interventions, and research methods, design, and evaluation; about 65% were interested in at least 1 communication and project management topic; and 60% showed interest in at least 1 practical and interpersonal skills topic. Training-related interests varied across career level and race/ethnicity, with early-career individuals and people of color typically indicating the most interest. Participants were most likely to endorse self-initiated learning and webinars. SPR preconference training workshops were strongly endorsed for data analysis and preventive intervention topics. Recommendations from our study include a need for SPR to more strongly support self-initiated learning opportunities and continue preconference training programs, with special focuses in statistical methods and preventive interventions and regular assessment of members’ training preferences.

Quantitative skills in undergraduate neuroscience education in the age of big data

For over a half-Century, the mathematics requirement for graduation at most undergraduate colleges and universities has been one year of calculus and a semester of statistics. Many universities and colleges offer a neuroscience major that may or may not add additional mathematics, statistics, or data science requirements. Today in the age of Big Data and Systems Neuroscience, many students are ill-equipped for the future without the tools of computational competency that are necessary to tackle the large data sets generated by contemporary neuroscience research. Required courses in statistics still focus on parametric statistics based on the normal distribution and do not provide the computational tools required to analyze big data sets. Undergraduates in STEM fields including neuroscience need to enroll in the Data Science courses that are required in the social sciences (e.g., economics, political science and psychology). Contemporary systems neuroscience is routinely done by interdisciplinary research teams of statisticians, engineers, and physical scientists. Emerging "NeuroX-omics" such as connectomics have emerged along with genomics, proteomics, and transcriptomics, all of which deploy systems analysis techniques based on mathematical graph theory. Connectomics is the 21st Century's functional neuroanatomy. Whole brain connectome research appears almost monthly in the Drosphila, zebra fish, and mouse literature, and human brain connectomics is not far behind. The techniques for connectomics rely on the tools of data science. Undergraduate neuroscience students are already squeezed for credit hours given the high-prescribed science curriculum for biology majors and premedical students, in addition to required courses in social sciences and humanities. However, additional training in mathematics, statistics, computer science, and/or data science is urgently needed for undergraduate neuroscience majors just to understand the contemporary research literature. Undoubtedly, the faculty who teach neuroscience courses are acutely aware of the problem and most of them freely acknowledge the importance of quantitative analytical skills for their students. However, some faculty members may feel that their own math and statistics knowledge or other analytical skills have atrophied beyond recall or were never fulfilled in the first place. In this commentary I suggest that this problem can be ameliorated, though not solved, through organizing workshops, journal clubs, or independent studies courses in which the students and the instructors learn and teach each other in short-course format. In addition, web-available teaching materials such as targeted video clips are plentifully available on the internet. To attract and maintain student interest, qauntitative instruction and learning should occur in neuroscience context.

Insights into the anthropogenic load and occupational health risk of heavy metals in floor dust of selected workplaces in an industrial city of Iran

The levels of Cd, Cr, Cu, Fe, Mn, Pb and Zn were determined in floor dusts from mechanical (MRWs) and battery repairing workshops (BRWs) in Yazd, Iran. The study aimed to evaluate the anthropogenic contribution to the presence of heavy metals (HMs), the possible sources and the related risks that could arise from occupational exposure in the studied workplace microenvironments. Among the analyzed heavy metals, Cu, Pb and Zn exhibited enhanced concentrations in the floor dusts. The EF calculations showed an extremely severe enrichment of HMs, especially for Cd, Cu and Pb, while floor dusts were characterized as "extremely polluted" with regards to those metals. In any case, both EF and I_geo values were significantly higher in the BRWs. These results were also supported by NIPI and PLI values, while contour maps of PLI values in both MRWs and BRWs outlined workshops in N-NE part of Yazd as more impacted compared to other spatial locations. Principal component analysis (PCA) and Pearson's correlation outscored workshops activities as the principal sources of heavy metals. The health risk assessment suggested considerable non-carcinogenic risks regarding Pb in the BRWs which exhibited HQ_ing (mean 2.91) and HI (mean 3.03) values higher than safe level. Regarding carcinogenic risks, CR values for both Cd and Cr were below the safe level (1.0 × 10^-6). The occupational exposure to Pb was evaluated through the predicted BLL values, where with averages of 3.33 μg/dl and 21.4 μg/dl for MRWs and BRWs workers, respectively, indicated a severe Pb exposure for BRWs workers.

The impact of the world Workshops on oral health and disease in HIV and AIDS (1988-2020)

The first World Workshop on Oral AIDS was held in San Diego in 1988, organized by John and Deborah Greenspan who saw the need and advantages of getting together all those health workers globally who were interested in oral aspects of HIV with a common purpose of advancing the field collectively and collaboratively. Since that time and over the following 30 years, World Workshops on oral HIV have been held every four years or so. The aims of the first and all subsequent Workshops were to bring together clinicians and non-clinical scientists who have an interest in the oral manifestations of HIV disease, to share worldwide perspectives, knowledge and understanding of oral health and disease in HIV infection, to agree on global definitions and classifications of oral diseases and to identify research needs taking account of the worldwide perspectives and opportunities. Thus, there have been clinical science, social science and basic science aspects of each World Workshop. The Workshops have achieved their aims and have had impact in all three fields, leading to robust research agendas, changes in national HIV policies and international collaborations. They have led to policy declarations of access to oral care as a basic human right for both HIV-positive and HIV-negative individuals and advancing the rights of all HIV-positive healthcare workers to perform clinical practice.

The American Brachytherapy Society prostate brachytherapy LDR/HDR simulation workshops: Hands-on, step-by-step training in the process of quality assurance

PURPOSE

Education and training on prostate brachytherapy for radiation oncology and medical physics residents in the United States is inadequate, resulting in fewer competent radiation oncology personnel to perform implants, and is a factor in the subsequent decline of an important, potentially curative cancer treatment modality for patients with cancer. The American Brachytherapy Society (ABS) leadership has recognized the need to establish a sustainable medical simulation low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy workshop program that includes physician-physicist teams to rapidly translate knowledge to establish high-quality brachytherapy programs.

METHODS

The ABS, in partnership with industry and academia, has held three radiation oncology team-based LDR/HDR workshops composed of physician-physicist teams in Chicago in 2017, in Houston in 2018, and in Denver in 2019. The predefined key metric of success is the number of attendees who returned to their respective institutions and were actively performing brachytherapy within 6 months of the prostate brachytherapy workshop.

RESULTS

Of the 111 physician/physicist teams participating in the Chicago, Houston, and Denver prostate brachytherapy workshops, 87 (78%) were actively performing prostate brachytherapy (51 [59%] HDR and 65 [75%] LDR).

CONCLUSIONS

The ABS prostate brachytherapy LDR/HDR simulation workshop has provided a successful education and training structure for medical simulation of the critical procedural steps in quality assurance to shorten the learning curve for delivering consistently high-quality brachytherapy implants for patients with prostate cancer. An ABS initiative, intended to bend the negative slope of the brachytherapy curve, is currently underway to train 300 new competent brachytherapy teams over the next 10 years.

Longitudinal mixed methods study assessing caregivers of seniors across diverse populations: research protocol

Background

Canada’s aging population is increasing, along with the number of caregivers providing support to seniors. Caregiving is a taxing responsibility that often results in loneliness and distress. Creating awareness of available supports for caregivers is essential for their health and to provide the best support to the care recipients. This study aims to better understand and improve the caregiving experience for caregivers from diverse ethnic communities and the LGBTQI2S+ communities. The goal is to improve the well-being and resilience of caregivers and optimize outcomes for care recipients by delivering educational workshops that resemble the design of existing workshops currently offered by the participating social service agency. Content will be adapted based on identified participant learning needs. These workshops will be offered to the English-speaking community, diverse newcomer ethnic groups and the LGBTQI2S+ community.

Methods

This mixed-methods, longitudinal study includes two streams of caregivers; Stream One consists of English-speaking caregivers and care recipients while Stream Two includes individuals from the Afghan, Iranian, Somali-, Tamil- and Spanish-speaking populations and those belonging to LGBTQI2S+ communities. Each stream has two phases; Phase One includes needs assessments using focus groups and semi-structured interviews with caregivers and care recipients while Phase Two includes a pre-test post-test evaluation of educational workshops. The anticipated sample size for Phase One is 30 caregivers from the English-speaking community, 150 from the five linguistic/cultural communities combined and 30 from the LGBTQI2S+ group. For Phase Two, we plan to recruit 250 caregivers from the English-speaking community, 250 from the five linguistic/cultural communities, and 50 from the LGBTQI2S+ group.

Discussion

To provide caregivers with optimal support, we must acknowledge the caregivers and care recipients from diverse communities. Currently, at least two focus groups have been conducted with caregivers from each of the seven targeted groups and workshops have begun for all communities. Recruitment has been a challenge for all groups, but our team continues to conduct outreach with caregivers and will use our learning to inform the delivery of educational caregiver workshops.

Efficacy of quality improvement and patient safety workshops for students: a pilot study

BACKGROUND

While the Association of American Medical Colleges encourages medical schools to incorporate quality improvement and patient safety (QI/PS) into their curriculum, medical students continue to have limited QI/PS exposure. To prepare medical students for careers that involve QI/PS, the Institute for Healthcare Improvement chapter at an allopathic medical school and school of allied health professions initiated self-directed learning by offering student-led workshops to equip learners with skills to improve the quality and safety of healthcare processes.

METHODS

In this prospective cohort study, workshops were hosted for medical students between 2015 and 2018 on five QI/PS topics: Process Mapping, Root-Cause Analysis (RCA), Plan-Do-Study-Act (PDSA) Cycles, Evidence Based Medicine (EBM), and Patient Handoffs. Each workshop included a hands-on component to engage learners in practical applications of QI/PS skills in their careers. Change in knowledge, attitudes, and behaviors was assessed via pre- and post-surveys using 5-point Likert scales, and analyzed using either the McNemar test or non-parametric Wilcoxon signed-rank test. Surveys also gathered qualitative feedback regarding strengths, future areas for improvement, and reasons for attending the workshops.

RESULTS

Data was collected from 88.5% of learners (n = 185/209); 19.5% of learners reported prior formal instruction in these topics. Statistically significant improvements in learners' confidence were observed for each workshop. Additionally, after attending workshops, learners felt comfortable teaching the learned QI/PS skill to colleagues (mean pre/post difference 1.96, p < 0.0001, n = 139) and were more likely to pursue QI/PS projects in their careers (mean pre/post difference 0.45, p < 0.0001, n = 139). Lastly, learners demonstrated a statistically significant increase in knowledge in four out of five skills workshop topics.

CONCLUSION

Few medical students have formal instruction in QI/PS tools. This pilot study highlights advantages of incorporating an innovative, student-directed modified 'flipped classroom' methodology, with a focus on active experiential learning and minimal didactic instruction.

A Cost Analysis of Traditional Professional Development and Coaching Structures in Schools

Current achievement data indicate a public health concern, whereby the majority of students are not proficient in reading or math. Teacher professional development is frequently the preventive mechanism schools utilize to improve instruction, student achievement, and subsequent long-term economic and health-related outcomes. This study used the ingredients method to examine the costs associated with two common structures of professional development: traditional workshops and coaching. Results suggested that the cost per educator per contact hour ranged from $138.29 to $158.45 for workshops and was $169.43 for coaching, in 2017-2018 US dollars. The distribution of costs indicated that local districts incurred the majority of the costs for traditional workshops (i.e., range of 74.76% to 81.03%), whereas regional providers incurred the majority of the costs for coaching (i.e., 58.75%). Marginal costs, or the costs for one additional participant at one traditional workshop, ranged from $663.64 to $1132.78 and were $441.32 for coaching an additional peer teacher within one school building. Marginal costs increased to $2060.21 when coaching an additional peer teacher in an additional building. Implications for practice and suggestions for future research are discussed.

Global network of computational biology communities: ISCB's Regional Student Groups breaking barriers

Regional Student Groups (RSGs) of the International Society for Computational Biology Student Council (ISCB-SC) have been instrumental to connect computational biologists globally and to create more awareness about bioinformatics education. This article highlights the initiatives carried out by the RSGs both nationally and internationally to strengthen the present and future of the bioinformatics community. Moreover, we discuss the future directions the organization will take and the challenges to advance further in the ISCB-SC main mission: "Nurture the new generation of computational biologists".

Application of the ecosystem service concept at a small-scale: The cases of coralligenous habitats in the North-western Mediterranean Sea

The understanding of ecosystem services is essential to support sustainable use and preservation of ecosystems. Coralligenous habitats, main contributors of the Mediterranean marine biodiversity, are yet understudied in term of services provided. This study presents an original small-scale approach to investigate the services provided by coralligenous habitats of a French study area consisting of two marine sites (Marseille and Port-Cros sites) in order to cover two contrasted anthropogenic pressure despite the small-scale. Our results are based on the opinions of 43 experts who ranked 15 services in terms of existence and level of importance for human well-being: supporting ecological functions were considered the most important, then provisioning and cultural services. Regulating services were considered uncertain due to a lack of knowledge. The small-scale approach highlighted a need for a referential frame to determine the existence of services (e.g. geographical and temporal scales, benefits and beneficiaries levels).

What it means 'to teach' as a radiologist in the modern era: a personal perspective

Whether employed in a private practice, a community or academic setting, or even a hybrid practice, radiologists fill many roles in the course of a day. Teaching is one of the most important roles in the dissemination of knowledge and the continued renewal of the health, vibrancy and advancement of our field. In this article the author reviews some of the various facets of what radiology teaching and learning look like in the current era. Highlighted topics include workstation teaching, workshop and small group education, interdisciplinary activities and mentorship.

Polycyclic aromatic hydrocarbons (PAHs) in the settled dust of automobile workshops, health and carcinogenic risk evaluation

There are studies available on the occurrence of PAHs in indoor settled dust from residential and different occupational settings in literature but limited data is available on their occurrence and potential health risk assessment in automobile workshops. In recent decades Saudi Arabia has experienced tremendous growth in the petroleum industry and as a result, the automobile industry is booming. People working in automobile workshops are at a greater risk of exposure to chemicals releasing from the petroleum products. The main objective of this study was to report PAHs in settled dust from different automobile workshops of Jeddah, Saudi Arabia, and evaluate health risk for workers through dust exposure. Pyrene (1585-13500ng/g), Benz[a]anthracene (<LOQ-5065ng/g), and Phenanthrene (280-4860ng/g) were the major PAHs and ∑₁₂PAHs concentrations ranged between 7620 and 30800ng/g. Profile of PAHs was different in dust from small and heavy vehicle workshops. For workers, health risk assessment was calculated based on benzo[a]pyrene equivalent carcinogenic power (BaPE), incremental lifetime cancer risk (ILCR), and daily exposure to PAHs via dust ingestion. The median concentration of BaPE was 285ng/g, ILCR was up to 6.78×10^-3 (exceeded reference values of USEPA (range between 1×10^-6 and 1×10^-4)), and worker's exposure via dust ingestion on daily bases reached up to 33ng/kgbw/day for ∑₁₂PAHs. This study showed people working in automobile workshops in the studied area are getting expose to high levels of PAHs via dust ingestion, inhalation, and dermal contact.

CAPSULE

This is the first study reporting PAHs in automobile workshops settings from Middle East. The incremental lifetime cancer risk to workers via dust exposure exceeded set limits of USEPA.

History of the antibody workshops

At a critical period in the history of contemporary immunology, a handful of biochemists and fringe immunologists formed a group known as the Antibody Workshop. They had a major impact on the field by attracting molecular biologists who worked to reduce the study of cellular and organ level immunology to the molecular level. This had a dramatic effect on the field both conceptually and practically by providing the targets for clinical manipulation. The story of the origin and development of this group over time is recounted here.

Best practice guidance for the use of strategies to improve retention in randomized trials developed from two consensus workshops

Objectives

To develop best practice guidance for the use of retention strategies in randomized clinical trials (RCTs).

Study Design and Setting

Consensus development workshops conducted at two UK Clinical Trials Units. Sixty-six statisticians, clinicians, RCT coordinators, research scientists, research assistants, and data managers associated with RCTs participated. The consensus development workshops were based on the consensus development conference method used to develop best practice for treatment of medical conditions. Workshops commenced with a presentation of the evidence for incentives, communication, questionnaire format, behavioral, case management, and methodological retention strategies identified by a Cochrane review and associated qualitative study. Three simultaneous group discussions followed focused on (1) how convinced the workshop participants were by the evidence for retention strategies, (2) barriers to the use of effective retention strategies, (3) types of RCT follow-up that retention strategies could be used for, and (4) strategies for future research. Summaries of each group discussion were fed back to the workshop. Coded content for both workshops was compared for agreement and disagreement. Agreed consensus on best practice guidance for retention was identified.

Results

Workshop participants agreed best practice guidance for the use of small financial incentives to improve response to postal questionnaires in RCTs. Use of second-class post was thought to be adequate for postal communication with RCT participants. The most relevant validated questionnaire was considered best practice for collecting RCT data. Barriers identified for the use of effective retention strategies were: the small improvements seen in questionnaire response for the addition of monetary incentives, and perceptions among trialists that some communication strategies are outdated. Furthermore, there was resistance to change existing retention practices thought to be effective. Face-to-face and electronic follow-up technologies were identified as retention strategies for further research.

Conclusions

We developed best practice guidance for the use of retention strategies in RCTs and identified potential barriers to the use of effective strategies. The extent of agreement on best practice is limited by the variability in the currently available evidence. This guidance will need updating as new retention strategies are developed and evaluated.

ISCB-Student Council Narratives: Strategical development of the ISCB-Regional Student Groups in 2016

Regional Student Groups are groups established and managed by the ISCB-Student Council in different regions of the world. The article highlights some of the initiatives and management lessons from our 'top-performing' Spotlight Regional Student Groups (RSGs), RSG-Argentina and RSG-UK, for the current year (2016). In addition, it details some of the operational hurdles faced by RSGs and possible solutions.

[How we harmonize HSCT clinical practices among the SFGM-TC centers]

In hematopoietic transplantation, clinical patient care is localized and practices differ from one country to another and even from center to center. International guidelines are not always well adapted to the evolution of daily clinical practice, and they do not address all issues, especially practical ones. Therefore, in the absence of well-established guidelines, each center tends to make do by developing local procedures. In the attempt to harmonize localized clinical practices between different centers belonging to the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC), our society set up in 2010 what would become an annual workshop series, bringing together practitioners from all member centers. Each workshop group is responsible for discussing a specific issue and then drafting, in the form of an article, a set of guidelines that address the issue practically. With the aim of covering all practical issues and providing widely-usable guidelines when international consensus is lacking, the SFGM-TC has succeeded in establishing national guidelines by those who use them. So as to be easily localized by all centers, the guidelines are written in French. In this article, we set out the process by which the workshops are conducted and how the final guidelines produced are approved each year.

[Are there too many conferences for general and visceral surgery in Germany? : A survey of DGAV members]

BACKGROUND

Human and financial resources are increasingly bound due to economic pressure and the working hours Act whereby the already restricted further training times are further limited. The industry also has less funding available for sponsorship of conferences and workshops. Against this background the question arises whether a reduction or focusing of the conferences is necessary; therefore, the aim of this survey was to obtain an opinion from members of the German Society of General and Visceral Surgery (DGAV) and possibly to derive a need for action to submit to the board members.

METHODS

From 7 February to 18 March 2015 an online survey was conducted by the DGAV with their members regarding the number of necessary congress events in Germany.

RESULTS

A total of 670 responses were received (return rate 16 %). In total, 56 % of participants felt that there are too many conferences. A differentiation according to the position of the respondent and the level of the associated hospital resulted in the following: 69.3 % of the participating head physicians (HP) shared this opinion, compared to 48.6 % of senior physicians (SP) and 34.4 % of residents (RP). Of the participants from basic and standard care hospitals (B/SC) 50 % shared this opinion, compared to 59.2 % from maximum care hospitals (MC) and 63.6 % from university hospitals (UH). In addition, a total of 75 % of the participants (HP 82.9 %, SP 78.4 %, RP 70.5 %) were in favor of keeping the congress of the DGAV (annual meeting of the German Society for Digestive and Metabolic Diseases in conjunction with the Autumn meeting of the DGAV) in its previous form, regardless of the underlying level of care of the associated hospital (B/SC 77 %, MC 79 %, UC 68 %).

CONCLUSION

More experienced surgeons in particular tended to favor a reduction of events with a focus on the major conferences; however, younger colleagues preferred a wider spectrum of meetings. In order to comply with both positions a wide range of events should be continued to be provided in the future so that surgeons can choose which to attend according to the individual preferences.

Hands-on workshops as an effective means of learning advanced technologies including genomics, proteomics and bioinformatics

Genomics and proteomics have emerged as key technologies in biomedical research, resulting in a surge of interest in training by investigators keen to incorporate these technologies into their research. At least two types of training can be envisioned in order to produce meaningful results, quality publications and successful grant applications: (1) immediate short-term training workshops and (2) long-term graduate education or visiting scientist programs. We aimed to fill the former need by providing a comprehensive hands-on training course in genomics, proteomics and informatics in a coherent, experimentally-based framework. This was accomplished through a National Heart, Lung, and Blood Institute (NHLBI)-sponsored 10-day Genomics and Proteomics Hands-on Workshop held at National Jewish Health (NJH) and the University of Colorado School of Medicine (UCD). The course content included comprehensive lectures and laboratories in mass spectrometry and genomics technologies, extensive hands-on experience with instrumentation and software, video demonstrations, optional workshops, online sessions, invited keynote speakers, and local and national guest faculty. Here we describe the detailed curriculum and present the results of short- and long-term evaluations from course attendees. Our educational program consistently received positive reviews from participants and had a substantial impact on grant writing and review, manuscript submissions and publications.

Training workshops positively impact beliefs about contingency management in a nationwide dissemination effort

In 2011, the Veterans Administration called for nationwide implementation of contingency management (CM) in its intensive outpatient substance use disorders treatment programs, and this study evaluated the impact of the initial 1 and ½ day training workshops on knowledge and perceptions about CM among 159 clinical leaders from 113 clinics. Workshop attendance significantly increased CM-related knowledge (d=1.88) and changed attendees' perceptions of CM (ds=0.26-0.74). Endorsement of barriers to CM adoption decreased and positive impressions of CM increased. These perceptions about CM emerged as key correlates of post-training preparedness to implement CM. Results suggest that training workshops can be an effective avenue for increasing CM-related knowledge, as well as addressing persistent misperceptions about CM that may impede adoption efforts. Continued efforts to introduce educational materials and offer training and consultation opportunities may increase understanding about this evidence-based intervention among clinicians, thereby leading to improved patient outcomes.

Population education through poetry

The State Council of Education Research and Training (SCERT) in Haryana has adopted a stimulating approach in propagating messages of population -- through poetry. Through a project called Students Poetical Symposiums, the first phase convened around 20 teacher poets to participate in a workshop. In this workshop, 300 poems regarding six population themes were developed by the teachers. In the second phase, the developed poems were finalized by the experts and 108 poems were selected for publication in a booklet. The poems were classified according to the following themes: population and its effects on resources, effects of population growth, population growth and environment, population growth and economic aspect, population and social aspect, and population and emotional aspect. Each of these sections has 18 poems. The booklet also provides the users with guidelines for conducting Students' Poetical Symposiums. In the third phase, 36 schools were selected and oriented about this project. Students Poetical Symposiums were organized first at school level and later at the district level. More than 500 student poets recited the poems on the population education themes during 42 symposiums at the school and district levels to an audience numbering around ten thousand, comprising both students and the public.

Zambia moves towards reproductive health

Several events in Zambia this year have marked the development of an integrated approach to reproductive health. A team met in March to draw up a national safe motherhood policy, plus strategies and guidelines. These were completed by April and are being distributed for comments. Clinical guidelines for safe motherhood in health centers have also been developed. These aim to reduce mortality and morbidity among mothers and infants by helping health workers to provide quality care to women at every stage of pregnancy and delivery. A reproductive health workshop was held in Ngwerere in May to create awareness of the concept of reproductive health, identify reproductive health problems in the area, propose solutions and outline activities. The 75 participants included community health workers, community leaders, teachers, youth leaders, and community members, as well as health workers and policymakers. The workshop was conducted in the local language so that those present were able to participate fully. June 1997 saw the official launch of Zambia's new policy framework, guidelines and strategy on family planning within reproductive health. The country's Minister of Health, Dr. Katele Kalumba, said the family planning guidelines were a sign of the government's commitment to providing a basic health care package for all Zambians. To promote widespread discussion of the whole concept of reproductive health, local newspapers printed feature articles with the headline "Let's talk reproductive health." The articles raised a variety of sensitive issues that ranged from safe sex and adolescent sexuality to safe motherhood and HIV prevention. Plans are going ahead in Zambia for drawing up a national training curriculum for safe motherhood and family planning. The curriculum for health workers will cover both pre-service and in-service training.