scholarly journals 956. Neurosurgical Infectious Disease Curriculum for Infectious Disease Fellows and Application of a Novel Surgical Infectious Disease Framework

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S570-S571
Author(s):  
Jessica O’Neil ◽  
Christian Larsen ◽  
Molly L Paras

Abstract Background Infectious disease (ID) consultations from surgical services account for 30-41% of all ID consults at academic medical centers. However, adult ID fellows in the United States complete residency training in Internal Medicine and may have limited prior exposure to patients on surgical services. We surveyed 16 first and second-year fellows of the combined Massachusetts General Hospital/Brigham and Women’s Hospital ID Fellowship to evaluate their self-perceived ability to approach ID consults from surgical services. While 75% self-reported confidence in their ability to approach general surgery consultations, only 33% reported confidence with neurosurgical related consultations. Methods We created a novel framework for approaching surgical ID consult questions (Figure 1). We then developed two interactive case-based discussion sessions for first-year fellows to address common neurosurgical consult scenarios (post craniotomy/ craniectomy surgical site infections and cerebral spinal fluid shunt infections). The session materials, including images of common surgical approaches and risk factors for infection, were reviewed by a neurosurgeon content expert. An ID faculty member facilitated the discussions. Each discussion took place during a 30-minute teleconference. The learners then completed a self-assessment survey to evaluate the extent to which they could meet the educational objectives (Table 1) using a 1-5 Likert scale. Figure 1. Surgical Infectious Diseases Framework Table 1. Educational Objectives for Case 1 and 2 Results All sixteen learners (eight per case) completed the educational objective self-assessment surveys. The educational objectives were achieved with all questions reaching a mean response of 4 or greater indicating that the mean of learners agreed (4) or strongly agreed (5) that they were able to meet the outlined educational objectives after participating in the discussion session for Case 1 (Figure 2) and Case 2 (Figure 3). Figure 2. Educational Objective Self-Assessment Scores for Case 1 Figure 3. Educational Objective Self-Assessment Scores for Case 2 Conclusion Based on self-assessment surveys, our educational objectives were achieved. In turn, these first-year fellows may be better prepared to address ID consults from neurosurgical services in the future. While the case-based discussions were designed to address specific neurosurgical ID cases, our standardized framework could be adapted to a variety of surgical ID cases. Disclosures Molly L. Paras, MD, Deckermed (Other Financial or Material Support, Payment for book chapter)

Author(s):  
Yochai Benkler ◽  
Robert Faris ◽  
Hal Roberts

This chapter presents the book’s macrolevel findings about the architecture of political communication and the news media ecosystem in the United States from 2015 to 2018. Two million stories published during the 2016 presidential election campaign are analyzed, along with another 1.9 million stories about Donald Trump’s presidency during his first year. The chapter examines patterns of interlinking between online media sources to understand the relations of authority and credibility among publishers, as well as the media sharing practices of Twitter and Facebook users to elucidate social media attention patterns. The data and mapping reveal not only a profoundly polarized media landscape but stark asymmetry: the right is more insular, skewed towards the extreme, and set apart from the more integrated media ecosystem of the center, center-left, and left.


2021 ◽  
Vol 22 (12) ◽  
pp. 6241
Author(s):  
Roxanne N. Stone ◽  
Stephanie M. Frahs ◽  
Makenna J. Hardy ◽  
Akina Fujimoto ◽  
Xinzhu Pu ◽  
...  

Osteoarthritis is a major concern in the United States and worldwide. Current non-surgical and surgical approaches alleviate pain but show little evidence of cartilage restoration. Cell-based treatments may hold promise for the regeneration of hyaline cartilage-like tissue at the site of injury or wear. Cell–cell and cell–matrix interactions have been shown to drive cell differentiation pathways. Biomaterials for clinically relevant applications can be generated from decellularized porcine auricular cartilage. This material may represent a suitable scaffold on which to seed and grow chondrocytes to create new cartilage. In this study, we used decellularization techniques to create an extracellular matrix scaffold that supports chondrocyte cell attachment and growth in tissue culture conditions. Results presented here evaluate the decellularization process histologically and molecularly. We identified new and novel biomarker profiles that may aid future cartilage decellularization efforts. Additionally, the resulting scaffold was characterized using scanning electron microscopy, fluorescence microscopy, and proteomics. Cellular response to the decellularized scaffold was evaluated by quantitative real-time PCR for gene expression analysis.


1994 ◽  
Vol 20 (4) ◽  
pp. 439-455
Author(s):  
Barbara B. Blechner ◽  
Christie L. Hager ◽  
Nancy R. Williams

Health law and medical ethics are both integral parts of undergraduate medical curricula. The literature has addressed the importance of teaching law and ethics separately in medical school settings, yet there have been few descriptions of teaching law and ethics together in the same curriculum. A combined program in law and ethics required for first-year medical and dental students was developed and implemented by Professor Joseph (Jay) M. Healey, Jr., at the University of Connecticut Schools of Medicine and Dental Medicine from 1975 until his death in 1993. This Article describes the thirty-hour, interactive, case-based course he created. The course, Legal and Ethical Aspects of Medicine and Dental Medicine (LEA), has continued after Jay 's death, and is one of his many legacies to us. LEA consists of fifty-six actual and hypothetical cases written by Jay from which basic legal and ethical principles are extracted by participants and reinforced by instructors.


2021 ◽  
pp. 155982762110181
Author(s):  
Sam Sugimoto ◽  
Drew Recker ◽  
Elizabeth E. Halvorson ◽  
Joseph A. Skelton

Background. Many diseases are linked to lifestyle in the United States, yet physicians receive little training in nutrition. Medical students’ prior knowledge of nutrition and cooking is unknown. Objective. To determine incoming medical students’ prior nutrition knowledge, culinary skills, and nutrition habits. Methods. A dual-methods study of first-year medical students. Cross-sectional survey assessing prior knowledge, self-efficacy, and previous education of cooking and nutrition. Interviews of second-year medical students explored cooking and nutrition in greater depth. Results. A total of 142 first-year medical students participated; 16% had taken a nutrition course, with majority (66%) learning outside classroom settings. Students had a mean score of 87% on the Nutritional Knowledge Questionnaire versus comparison group (64.9%). Mean cooking and food skills score were lower than comparison scores. Overall, students did not meet guidelines for fiber, fruit, vegetables, and whole grains. Interviews with second-year students revealed most learned to cook from their families; all believed it important for physicians to have this knowledge. Conclusions. Medical students were knowledgeable about nutrition, but typically self-taught. They were not as confident or skilled in cooking, and mostly learned from their family. They expressed interest in learning more about nutrition and cooking.


2002 ◽  
Vol 12 (4) ◽  
pp. 1-4 ◽  
Author(s):  
Alan M. Scarrow

Payment for physician services in the United States is directly tied to the payment system implemented in the Medicare system. The use of a code to categorize medical and surgical services, as well as a relative value system to assess physician services and reimburse them accordingly, is now well established. In light of this, it is important for physicians to possess knowledge of how this coding and reimbursement system was established, how it is updated, what means are available to modify it, and how it is used in practice. The author addresses these issues, offering a primer for the neurosurgeon on the Medicare system as it relates to physician payment.


2018 ◽  
Vol 19 (2) ◽  
pp. 195-209 ◽  
Author(s):  
Zachary W. Taylor

This study examines first-year undergraduate admissions materials from 325 bachelor-degree granting U.S. institutions, closely analyzing the English-language readability and Spanish-language readability and translation of these materials. Via Yosso’s linguistic capital, the results reveal 4.9% of first-year undergraduate admissions materials had been translated into Spanish, 4% of institutional admissions websites embed translation widgets, and the average readability of English-language content is above the 13th-grade reading level. Implications for research and practice are discussed.


Author(s):  
Sarah L. Jackson ◽  
Sahar Derakhshan ◽  
Leah Blackwood ◽  
Logan Lee ◽  
Qian Huang ◽  
...  

This paper examines the spatial and temporal trends in county-level COVID-19 cases and fatalities in the United States during the first year of the pandemic (January 2020–January 2021). Statistical and geospatial analyses highlight greater impacts in the Great Plains, Southwestern and Southern regions based on cases and fatalities per 100,000 population. Significant case and fatality spatial clusters were most prevalent between November 2020 and January 2021. Distinct urban–rural differences in COVID-19 experiences uncovered higher rural cases and fatalities per 100,000 population and fewer government mitigation actions enacted in rural counties. High levels of social vulnerability and the absence of mitigation policies were significantly associated with higher fatalities, while existing community resilience had more influential spatial explanatory power. Using differences in percentage unemployment changes between 2019 and 2020 as a proxy for pre-emergent recovery revealed urban counties were hit harder in the early months of the pandemic, corresponding with imposed government mitigation policies. This longitudinal, place-based study confirms some early urban–rural patterns initially observed in the pandemic, as well as the disparate COVID-19 experiences among socially vulnerable populations. The results are critical in identifying geographic disparities in COVID-19 exposures and outcomes and providing the evidentiary basis for targeting pandemic recovery.


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