Near-peer mentorship: a pilot programme to improve support for new doctors

BMJ Leader ◽  
2019 ◽  
Vol 3 (1) ◽  
pp. 11-14
Author(s):  
Alexandra Peterson ◽  
Hannah Monaghan
Keyword(s):  
Medical Student ◽  
Online Survey ◽  
Cost Model ◽  
Low Cost ◽  
Peer Mentor ◽  
Peer Mentorship ◽  
Educational Supervisor ◽  
One Year ◽  
The One ◽  
The Impact

IntroductionTransition from medical student to Foundation Year 1 (FY1) doctor is often challenging. New doctors commonly report feeling stressed and unsupported.1–4 In order to improve support for FY1s, we piloted a peer mentorship scheme. We evaluated the impact of having a near-peer mentor in Foundation Year 2 (FY2) in addition to the traditional Educational Supervisor on FY1s’ experience of their first year of practice.Methods190 Foundation Year doctors (FYs) volunteered (95 FY1s, 95 FY2s). FY1-FY2 dyads were assigned according to similar rotation assignments in the FY1 year. Dyads were encouraged to communicate informally as well as meet face-to-face three times over the one-year mentorship period. Feedback was sought regularly via online survey.ResultsResponse to a one-year evaluation survey was 32/95 FY1s, 65/95 FY2s. 94% of respondents reported having both mentor and Educational Supervisor was beneficial. 84.4% of FY1s reported ‘having a peer mentor helped [them] feel supported in the transition from medical student to FY1.' 99% of respondents recommended the programme should continue.The programme is currently running for a second year. 61% of 2017/2018 FY1 participants (58/95) have volunteered as FY2-mentors in 2018/2019.ConclusionsNear-peer mentorship enhances support for FY1 doctors. This intervention was widely accepted and received positive evaluations from participants. We provide a simple, low-cost model that could be replicated and adapted to improve support for doctors in training.

scholarly journals Evaluation of Antiviral Therapy Performed after Curative Therapy in Patients with HBV-Related Hepatocellular Carcinoma: An Updated Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Peng Yuan ◽  
Peng Chen ◽  
Yeben Qian
Keyword(s):  
Hepatocellular Carcinoma ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Curative Therapy ◽  
B Virus ◽  
Effect Of Treatment ◽  
Long Term Prognosis ◽  
One Year ◽  
The One ◽  
The Impact

Background.The long-term prognosis after curative therapy for hepatitis B virus- (HBV-) related hepatocellular carcinoma (HCC) remains unsatisfactory due to the high incidence of recurrence. The effect of treatment with nucleotide analogues (NAs) in patients with HBV-related HCC after curative therapy remains unclear.Objective.To assess the impact of using NAs after curative therapy.Method.A computerized literature search was performed; eligible studies were identified from databases. The pooled risk ratios (RRs) and 95% CIs were calculated using Review Manager 5.3.Result.The meta-analysis included a total of 15 studies with 8060 patients. The one-year and three-year recurrence (one-year recurrence: RR 0.41 [95% CI 0.28 to 0.61];P<0.00001; three-year recurrence: RR 0.63 [95% CI 0.43 to 0.94];P=0.001) and the one-, three-, and five-year overall survival (OS) and disease-free survival (DFS) were significantly better in the treatment group.Conclusion.NAs can reduce the recurrence and improve the prognosis of HBV-related HCC after curative therapy.

scholarly journals 3446 The OHSU Physician-Scientist Experience: Integrating intensive translational research training for medical students into a competency-based educational framework

2019 ◽  
Vol 3 (s1) ◽  
pp. 74-75
Author(s):  
Karen W. McCracken ◽  
Peter Mayinger ◽  
Cynthia Morris
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Clinical Research ◽  
Translational Research ◽  
Research Experience ◽  
Research Opportunities ◽  
Competency Based ◽  
Physician Scientist ◽  
One Year ◽  
The One

OBJECTIVES/SPECIFIC AIMS: The aim of this program is to provide early support to motivated medical students interested in a career as a physician-scientist in a framework of competency-based medical education. The CTSA creates an opportunity to provide clinical research education and protected time for research for medical students in clinical and translational research. METHODS/STUDY POPULATION: This physician-scientist experience offers research opportunities in a wide variety of research disciplines, focused on clinical and translational investigations. The program offers both five-month and one-year blocks of protected research time. The five-month option is integrated into the four- year medical curriculum. The one-year option requires enrollment in an established Master of Clinical Research degree. Both options provide research experience under the mentorship of a physician-scientist. The five-month option aligns with UME competencies categorized under the six ACGME Domains of Competence. The one-year option includes coursework in research design, biostatistics, research ethics, data management, scientific communication, and proposal development within the CTSA-based education program. All students in the program attend a bimonthly journal club and seminar series starting in year one and extending through the research experience. This includes discussion of the importance of mentorship, selecting a residency, scientific writing and presentation, and personal narratives of physician-scientists and their pathways to this career. All students will be followed to determine career outcome. RESULTS/ANTICIPATED RESULTS: Between 2015 and 2018, 67 students entered the program 46% selected the year out, and 56% selected the 5-month option. Students selecting this program constitute about 10% of the medical student population overall. We have had 17 graduates of the program to date. 55% of the cohort is women which parallels the OHSU medical student population. Long-term follow-up of at least 10 years will be needed to determine career outcomes. We assess student productivity by traditional measures of submitted abstracts, manuscripts, and presentations as well as longer term outcomes such as career orientation in medicine such as entry into a research-oriented residency and ultimately into an academic medicine or research. DISCUSSION/SIGNIFICANCE OF IMPACT: The OHSU physician-scientist experience successfully matches medical students with a diverse set of research mentors focused on the CTSA. Although institutional structures determine the variety of specific research opportunities, the integration of physician-scientist training into a CTSA-based training program expands the reach of training programs such as the TL1.

The impact of business strategy on leadership

2015 ◽  
Vol 8 (2) ◽  
pp. 110-126 ◽  
Author(s):  
Thomas G. Marx
Keyword(s):  
Organizational Performance ◽  
Business Strategy ◽  
Online Survey ◽  
Rating Scales ◽  
Low Cost ◽  
Content Type ◽  
Best Value ◽  
The Impact ◽  
Market Strategies ◽  
Practical Implications

Purpose – The purpose of this paper is to test the proposition that business strategy affects leadership functions, skills, traits, and styles, and to assess the implications of these effects for the practice of both leadership and strategic planning. Design/methodology/approach – This is an empirical study based on over 450 responses to an online survey. Continuous rating scales allowed the use of regression analysis to test the impacts of different strategies on leadership. Findings – The results provide strong empirical evidence that Product (Differentiation vs Low Cost strategies), Best Value, and Blue Ocean strategies have significant effects on leadership. Market strategies (Broad vs Niche strategies) have limited impacts. The greater complexity of Product, Best Value, and Blue Ocean strategies underlie these findings. Research limitations/implications – This study explores the effects of strategy on leadership. Future studies need to explore if these effects are moderated by external, competitive conditions, and if strategy mediates the impacts of leadership on organizational performance. Practical implications – The practical implications of these findings are that leaders must adjust their behavior and leadership styles to effectively implement alternative strategies, and planners must assess their organization’s leadership capabilities when formulating strategy. Originality/value – There have been numerous studies of the impacts of external/internal conditions on leadership, but this is one of the first studies of the critical impacts of strategy on leadership.

scholarly journals Parents´ Knowledge about the Effects of Oral Hygiene, Proper Nutrition and Fluoride Prophylaxis on Oral Health in Early Childhood

2018 ◽  
Vol 22 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Aleksandrija Djordjevic
Keyword(s):  
Early Childhood ◽  
Oral Health ◽  
Oral Hygiene ◽  
Rural Areas ◽  
Urban Areas ◽  
Education Institution ◽  
Preventive Dentistry ◽  
One Year ◽  
The One ◽  
The Impact

SummaryBackground/Aim: Health education, as one of the important aspects of preventive dentistry, plays an important role in promoting and achieving good oral health. The aim of this study was to determine the influence of parents´ knowledge about the effects of oral hygiene, proper nutrition and fluoride prophylaxis on oral heath in early childhood. Material andMethods: Parents were asked to fill a questionnaire which consisted of three sections, oral hygiene, fluoride prophylaxis and nutrition. The study included 136 parents of children, aged between 3-6 years. The survey was conducted in pedagogical-education institution - PE “Our happiness” - Leposavic, Kosovo and Metohia, Serbia. Results: More than 58% parents from urban areas and 63% parents from rural areas were informed that the teeth should be brushed at least twice a day (p=0.007). Only 31.11% of parents from urban and 15.22% of parents from rural areas were informed that a child should visit dentists for the first time, at the one year of age (p=0.083). The analysis of the questionnaire section regarding the nutrition and oral health, showed that parents from rural areas were better informed than parents from urban areas. Awareness about fluoride and their role in preventive dentistry was poor, as only 3% of children from urban and 1% of children from rural areas were using tablets based on fluoride while only 1% of children from urban and none from rural areas were using fluoride mouth rinses. Conclusions: The study showed that parents have the knowledge about the impact of oral hygiene, food and fluoride prophylaxis on the oral health but unfortunately they do not apply their knowledge in practice.

scholarly journals Thoughts Unlocked by Technology—a Survey in Germany About Brain-Computer Interfaces

NanoEthics ◽  
2021 ◽  
Author(s):  
J. R. Schmid ◽  
O. Friedrich ◽  
S. Kessner ◽  
R. J. Jox
Keyword(s):  
Online Survey ◽  
Brain Activity ◽  
Disruptive Technology ◽  
Human Machine Interaction ◽  
Initial Development ◽  
Wide Range ◽  
Classic Form ◽  
The One ◽  
High Level ◽  
The Impact

AbstractA brain-computer interface (BCI) is a rapidly evolving neurotechnology connecting the human brain with a computer. In its classic form, brain activity is recorded and used to control external devices like protheses or wheelchairs. Thus, BCI users act with the power of their thoughts. While the initial development has focused on medical uses of BCIs, non-medical applications have recently been gaining more attention, for example in automobiles, airplanes, and the entertainment context. However, the attitudes of the general public towards BCIs have hardly been explored. Among the general population in Germany aged 18–65 years, a representative online survey with 20 items was conducted in summer 2018 (n = 1000) and analysed by descriptive statistics. The survey assessed: affinity for technology; previous knowledge and experience concerning BCIs; the attitude towards ethical, social and legal implications of BCI use and demographic information. Our results indicate that BCIs are a unique and puzzling way of human–machine interaction. The findings reveal a positive view and high level of trust in BCIs on the one hand but on the other hand a wide range of ethical and anthropological concerns. Agency and responsibility were clearly attributed to the BCI user. The participants’ opinions were divided regarding the impact BCIs have on humankind. In summary, a high level of ambivalence regarding BCIs was found. We suggest better information of the public and the promotion of public deliberation about BCIs in order to ensure responsible development and application of this potentially disruptive technology.

scholarly journals Economics of an Additive Manufactured Heat Exchanger for Concentrating Solar Power

2022 ◽  
Author(s):  
Tracey Ziev ◽  
Erfan Rasouli ◽  
Ines Noelly-Tano ◽  
Ziheng Wu ◽  
Srujana Yarasi Rao ◽  
...  
Keyword(s):  
High Efficiency ◽  
Solar Power ◽  
Cost Model ◽  
Low Cost ◽  
Operating Conditions ◽  
Concentrated Solar Power ◽  
Future Technologies ◽  
The Cost ◽  
Alternative Current ◽  
The Impact

Developing low cost, high efficiency heat exchangers (HX) for application in concentrated solar power (CSP) is critical to reducing CSP costs. However, the extreme operating conditions in CSP systems present a challenge for typical high efficiency HX manufacturing processes. We describe a process-based cost model (PBCM) to estimate the cost of fabricating an HX for this application using additive manufacturing (AM). The PBCM is designed to assess the effectiveness of different designs, processes choices, and manufacturing innovations to reduce HX cost. We describe HX design and AM process modifications that reduce HX cost from a baseline of$780/kW-thto$570/kW-th. We further evaluate the impact of alternative current and potential future technologies on HX cost, and identify a pathway to further reduce HX cost to$270/kW-th.

scholarly journals Recurring infection with ecologically distinct human papillomavirus (HPV) types explains high prevalence and diversity

2017 ◽  
Author(s):  
Sylvia Ranjeva ◽  
Edward B. Baskerville ◽  
Vanja Dukic ◽  
Luisa Villa ◽  
Eduardo Lazcano-Ponce ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Hpv Prevalence ◽  
Increased Risk ◽  
High Prevalence ◽  
Hpv Types ◽  
One Year ◽  
The One ◽  
The Impact

AbstractThe high prevalence of human papillomavirus (HPV), the most common sexually transmitted infection, arises from the coexistence of over 200 genetically distinct types. Accurately predicting the impact of vaccines that target multiple types requires understanding the factors that determine HPV diversity. The diversity of many pathogens is driven by type-specific or “homologous” immunity, which promotes the spread of variants to which hosts have little immunity. To test for homologous immunity and to identify mechanisms determining HPV transmission, we fitted nonlinear mechanistic models to longitudinal data on genital infections in unvaccinated men. Our results provide no evidence for homologous immunity, instead showing that infection with one HPV type strongly increases the risk of infection with that type for years afterwards. For HPV16, the type responsible for most HPV-related cancers, an initial infection increases the one-year probability of reinfection by 20-fold, and the probability of reinfection remains 14-fold higher two years later. This increased risk occurs in both sexually active and celibate men, suggesting that it arises from auto-inoculation, episodic reactivation of latent virus, or both. Overall our results show that high HPV prevalence and diversity can be explained by a combination of a lack of homologous immunity, frequent reinfections, weak competition between types, and variation in type fitness between host subpopulations. Due to the high risk of reinfection, vaccinating boys that have not yet been exposed may be crucial to reduce prevalence, but our results suggest that there may also be large benefits from vaccinating previously infected individuals.

scholarly journals Sinus heart rate post pulmonary vein ablation and long-term risk of recurrences

2020 ◽  
Author(s):  
Gesa von Olshausen ◽  
Ott Saluveer ◽  
Jonas Schwieler ◽  
Nikola Drca ◽  
Hamid Bastani ◽  
...  
Keyword(s):  
Heart Rate ◽  
Pulmonary Vein ◽  
Heart Rate Change ◽  
Rate Change ◽  
Study Cohort ◽  
The Mean ◽  
One Year ◽  
The One ◽  
The Impact

Abstract Purpose Cather ablation is known to influence the autonomic nervous system. This study sought to investigate the association of sinus heart rate pre-/post-ablation and recurrences in patients with atrial fibrillation undergoing pulmonary vein isolation (PVI). Methods Between January 2012 and December 2017, data of 482 patients undergoing their first PVI were included. Sinus heart rate was recorded before (PRE), directly post-ablation (POST) and 3 months post-ablation (3 M). All patients were screened for atrial tachyarrhythmia recurrences during the one-year follow-up. Results In the total study cohort, the mean resting sinus heart rate at PRE [mean 57.9 bpm (95% CI 57.1–58.7 bpm)] increased by over 10 bpm to POST [mean 69.4 bpm (95% CI 68.5–70.3 bpm); p < 0.001] followed by a slight decrease at 3 M [mean 67.3 bpm (95% CI 66.4–68.2 bpm)] but still remaining higher compared to PRE (p < 0.001). This pattern was observed in patients with and without recurrences at POST and 3 M (both p < 0.001 compared to PRE). However, at 3 M the mean sinus heart rate was significantly lower in patients with compared to patients without recurrences (p = 0.031). In this regard, patients with a heart rate change < 11 bpm (PRE to 3 M) or, as an alternative parameter, patients with a heart rate < 60 bpm at 3 M had a significantly higher risk of recurrences compared to the remaining patients (Hazard ratio (HR) 1.82 (95% CI 1.32–2.49), p < 0.001 and HR 1.64 (95% CI 1.20–2.25), p = 0.002, respectively). Conclusion Our study confirms the impact of PVI on cardiac autonomic function with a significant sinus heart rate increase post-ablation. Patients with a sinus heart rate change < 11 bpm (PRE to 3 M) are at higher risk for recurrences during one-year post-PVI.

scholarly journals 74. Interrupted Time Series Analysis of the Impact of Fluoroquinolone Cascade Reporting

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S55-S55
Author(s):  
Matthew Nestler ◽  
John D Markley ◽  
Andrew Noda ◽  
Emily Godbout ◽  
Jihye Kim ◽  
...  
Keyword(s):  
Time Series ◽  
Regression Model ◽  
Interrupted Time Series ◽  
Positive Change ◽  
Post Intervention ◽  
E Coli ◽  
Significant Positive Change ◽  
One Year ◽  
The One ◽  
The Impact

Abstract Background Cascade reporting is a form of selective reporting where antibiotic susceptibility results are revealed in a sequential order to optimize antibiotic use. On May 1, 2019, Virginia Commonwealth University Health implemented cascade reporting for ciprofloxacin and levofloxacin for E. coli from urine cultures. We hypothesize that suppressing fluoroquinolone (FQ) results for urine isolate E. coli susceptibility panels using cascade reporting led to a decrease in the overall rate of inpatient FQ use. Methods We compared inpatient FQ use (in days of therapy (DOT)/1000 patient days (PD)) for the one-year pre-cascade period (May 2018-April 2019) to the one-year post cascade period (May 2019-April 2020). Inpatient FQ use for May 2018-April 2020 was modeled as an interrupted time series (ITS) using ordinary least squares regression. The regression model followed the form of Y = B0 +B1T + B2 X + B3 XT with Y = (DOT/1,000 PD), T = time in months, X = cascade reporting represented with a binary digit, and XT= time since cascade reporting was implemented. Results were examined for autocorrelation and lag effects. Analysis conducted using Microsoft Excel and Python Statsmodel library v0.11.1. Results A segmented regression model was successfully fitted with R^2 = 0.73 (Figure 1). The pre-intervention slope (T), intervention change (X), and post-intervention slope (XT) were -3.9, -2.3, and 3.8 DOT respectively. A significant positive change in pre versus post intervention slope was detected (p = 0.01). Conclusion Results showed no significant change in FQ DOT/1000 PD when cascade reporting was implemented in May 2019. This may be due to empiric prescribing of FQs in the inpatient setting, due to the fact the rate of FQ use was already decreasing prior to cascade reporting adoption, or due to other factors. We detected a significant positive change in the slope of FQ from -4 to 4 DOT/1000 PD each month post-cascade reporting. Our hospital has had a decrease in FQ use over the past 8 years so this may be due to a ‘floor’ effect where the true minimum of necessary FQ use was reached; further investigation is warranted. We believe our data will be of interest to other Antimicrobial Stewardship Programs considering cascade reporting. Disclosures All Authors: No reported disclosures

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