Empirical Assessment of the Long-Term Impact of an Embedded Systems Programming Requalification Programme

Digital transformation has increased the demand for skilled Information Technology (IT) professionals, to an extent that universities cannot satisfy it with newly graduated students. Furthermore, the economical downturn has created difficulties and scarcity of opportunities in other areas of activity. This combination of factors led to the need to consider requalification programmes that enable individuals with diverse specialisations and backgrounds to realign their careers to the IT area. This has led to the creation of many coding bootcamps, providing intensive full-time courses focused on unemployed people or unhappy with their jobs, and individuals seeking a career change. A multidisciplinary group of higher education teachers, in collaboration with several industry stakeholders, have designed and promoted an embedded systems programming course, using an intensive project-based learning approach comprising 6 months of daylong classes and a 9 months internship. Having finished two editions of the programme, a questionnaire was presented to the students that finished successfully, in order to evaluate the long-term benefits to graduates and companies. This paper presents a brief discussion of the programme organisation and pedagogical methodologies, as well as the results of the questionnaire, conducted following a Goal–Question–Metric (GQM) approach. The results demonstrate very positive outcomes, both for graduates and companies.

Promoting a Syndemic Approach for Cardiometabolic Disease Management During COVID-19: The CAPISCO International Expert Panel

Efforts in the fight against COVID-19 are achieving success in many parts of the world, although progress remains slow in other regions. We believe that a syndemic approach needs to be adopted to address this pandemic given the strong apparent interplay between COVID-19, its related complications, and the socio-structural environment. We have assembled an international, multidisciplinary group of researchers and clinical practitioners to promote a novel syndemic approach to COVID-19: the CArdiometabolic Panel of International experts on Syndemic COvid-19 (CAPISCO). This geographically diverse group aims to facilitate collaborative-networking and scientific exchanges between researchers and clinicians facing a multitude of challenges on different continents during the pandemic. In the present article we present our “manifesto”, with the intent to provide evidence-based guidance to the global medical and scientific community for better management of patients both during and after the current pandemic.

Knowing me, Knowing you: Humanitas in work-integrated learning during adversity

Work-Integrated Learning (WIL) is a variety of learning opportunities that can extend beyond the application of theory to practice, to include complex situational, personal, material, and organisational factors. Central to forming successful WIL experiences is the partnership, support, and collaboration extended by all key stakeholders. The Covid-19 pandemic disrupted WIL experiences, with many developed partnerships and sustained practices being abruptly impacted. In 2020, a multidisciplinary group of Australasian WIL academics, administrators and students joined in weekly virtual coffee chats to share concerns and experiences during this rapidly changing educational landscape. These conversations led to establishing a Small Significant Online Network Group (SSONG) and became the basis for this article. We explored the lessons learned from WIL practitioners to be better informed of the practice of WIL and, generally, to examine the role of collaborations in higher education. Using a collaborative autoethnographic approach, this study incorporated written reflections on WIL experiences during COVID-19 lockdowns, followed by Zoom conversations to gain deeper insights. All data was aggregated and analysed thematically, both inductively and deductively, to interpret the practice experiences of individuals in their socio-cultural contexts. This article intends to demonstrate how creative solutions, such as adopting a HUMANE framework, become valuable paradigms. These enhance and nurture relationships between all WIL stakeholders, to enrich and sustain WIL experiences for all.

Sepsis Code: dodging mortality in a tertiary hospital

Background. In the hospital of La Princesa, the “Sepsis Code” (CSP) began in 2015, as a multidisciplinary group that provides health personnel with clinical, analytical and organizational tools, with the aim of the detection and early treatment of patients with sepsis. The objective of this study is to evaluate the impact of CSP implantation on mortality and to determine the variables associated with an increase in it. Material and methods. A retrospective analytical study of patients with CSP alert activation from 2015 to 2018 was conducted. Clinical-epidemiological variables, analytical parameters, and severity factors such as admission to critical care units (UCC) and the need for amines were collected. Statistical significance was established at p < 0.05. Results. We included 1,121 patients. The length of stay was 16 days and 32% required admission to UCC. Mortality showed a statistically significant linear downward trend from 24% in 2015 to 15% in 2018. The predictive mortality variables with statistically significant association were lactate > 2 mmol/L, creatinine > 1.6 mg/dL and the need for amines. Conclusions. The implementation of Sepsis Code decreases the mortality of patients with sepsis and septic shock. The presence of a lactate > 2 mmol/L, creatinine > 1.6 mg/dL and/or the need to administer amines in the first 24 hours, are associated with an increase in mortality in the patient with sepsis.

Expansion of telehealth curriculum: National survey of clinical education leaders

Introduction In response to the COVID pandemic and the rapid changes in delivery of and education on telehealth services, the Research Committee of the Alliance of Clinical Education (ACE) surveyed its multidisciplinary group of medical educators to determine how telehealth was being taught pre-COVID versus during-COVID. Methods An online survey was developed by the ACE Research Committee and sent via email to the ACE delegation. The objective of the survey was to determine changes in telehealth curriculum for medical students due to the rapid transition to telehealth, and the barriers for developing and delivering a telehealth curriculum. Results Forty-nine percent of recipients (31/63) responded representing eight different disciplines in addition to institutional curriculum developers. Most programs had no formal didactics and no clinical experiences in telehealth prior to the pandemic. Most respondents added didactics and clinical telehealth encounters during COVID, although few schools required this of all students. Discussion Given the barriers of faculty training to pivot to telehealth, and the potential benefits to healthcare cost and patient satisfaction, there is a need for more formal study on best practices for teaching telehealth to prepare our future physicians.

685. Evaluating the Role of Medication-assisted Treatment (MAT) in the Management of Infectious Endocarditis in People Who Inject Drugs (PWID)

Background An estimated 1.29-2.59 million people practice intravenous drug use (IVDU) in the United States making it a growing risk factor for infective endocarditis (IE). In people who inject drugs (PWID), IE accounts for 5-10% of total yearly deaths. IE often requires weeks of intravenous therapy with extensive medical follow-up. The purpose of this study was to evaluate if medication-assisted treatment (MAT) increased treatment retention and survival to optimize addiction assistance and IE treatment efforts. Methods A single-center, retrospective chart review was approved for patients admitted with an ICD-10 code of IE. A multidisciplinary group was created in April, 2019 aimed to improve endocarditis patient outcomes, formed of complex case coordination, infectious disease, cardiology, and pharmacy pain management service members. The historical period was January 1, 2018-March 31, 2019 and the IE pathway (IEP) group was April 1, 2019-June 30, 2020. Patients were excluded if there was no documentation of IVDU (Figure 1). The primary outcome was successful endocarditis therapy, defined per study protocol. Secondary outcomes include: against medical advice (AMA) departures, discharge naloxone prescriptions, clinical opioid withdrawal score (COWS) and patient reported pain. Figure 1. Study Population Methods for study population inclusion and exclusion Results A total of 419 IE patients were evaluated with 166 patients meeting inclusion criteria. The primary outcome was achieved in 51.2% of historical group and 48.8% of the IEP group (p=0.302). AMA departures and inpatient mortality were similar between the two groups. There was increased presence of the pharmacy pain management service with decreased time to consult in the IEP group (Figure 2). Last documented COWS were increased in the IEP group (p=0.002), while last reported patient pain scores decreased (p=0.030). More patients were started on MAT and discharged with naloxone in the IEP group (Table 3). Readmission was found to be higher in the IEP group (p=0.046). Post hoc analysis evaluating outcomes for patients seen by the endocarditis pathway team were similar between the two groups (Table 4). Figure 2. Secondary Outcome (Consult Services) The secondary outcomes of the study population are described comparing the presence and time to various consult services. **P-value indicates statistical significance. Abbreviations: n, number; ID, infectious disease; CT, cardiothoracic Table 3. Secondary Outcomes Table 4. Post Hoc Analysis Conclusion The multidisciplinary group was effective helping to guide the inpatient care of PWID and improve symptom management, but this did not translate to increased successful IE therapy or fewer readmissions. Disclosures All Authors: No reported disclosures

Pre-symptomatic intervention for autism spectrum disorder (ASD): defining a research agenda

Autism spectrum disorder (ASD) impacts an individual’s ability to socialize, communicate, and interact with, and adapt to, the environment. Over the last two decades, research has focused on early identification of ASD with significant progress being made in understanding the early behavioral and biological markers that precede a diagnosis, providing a catalyst for pre-symptomatic identification and intervention. Evidence from preclinical trials suggest that intervention prior to the onset of ASD symptoms may yield more improved developmental outcomes, and clinical studies suggest that the earlier intervention is administered, the better the outcomes. This article brings together a multidisciplinary group of experts to develop a conceptual framework for behavioral intervention, during the pre-symptomatic period prior to the consolidation of symptoms into diagnosis, in infants at very-high-likelihood for developing ASD (VHL-ASD). The overarching goals of this paper are to promote the development of new intervention approaches, empirical research, and policy efforts aimed at VHL-ASD infants during the pre-symptomatic period (i.e., prior to the consolidation of the defining features of ASD).

A Qualitative Study on Nudging and Palliative Care: “An Attractive but Misleading Concept”

The debate about the ethical decision-making process in the healthcare context has been enriched with a theory called “nudging”, which has been defined as the framing of information that can significantly influence behaviour without restricting choice. The literature shows very limited data on the opinion and experience of palliative care healthcare professionals on the use of nudging techniques in their care setting. The aim of this study is to explore the beliefs of experienced palliative care professionals towards nudging. We performed a qualitative study using textual data collected through a focus group. It was audio-recorded, and the transcripts were subjected to a thematic analysis. It was performed within an oncological research hospital with a small and multidisciplinary group of healthcare professionals specialised in PC. Participants reported two overarching positions grounded in two main themes: (1) translating nudging in the PC setting and (2) towards a neutral space. The participants found few justifications for the use of nudging in the PC field, even if it can be very attractive and reassuring. Participants also expressed concerns about the excessive risk of developing pure paternalism.

Learning to See Cancer in Early Detection Research

This article explores how scientists learn to detect ‘pre-cancer’, a new diagnostic category defined by the risk of developing the titular disease. This process entails the observation of ‘raw signals’ that stand for potential molecular and metabolic changes in animal and human tissues and their validation as ‘candidate biomarkers’. I draw on ethnographic fieldwork conducted alongside a multidisciplinary group of researchers—physicists, biologists, mathematicians, computer scientists, and engineers, among others—all of whom worked as part of a research programme investigating the early signs and detection of cancer in the UK. ‘Signals’ detected through scientific experiments are intimately entangled with the sensing technologies and analytical techniques used. As previously unknown microscopic realities emerge, scientists seek to negotiate the uncertainty surrounding the identification and validation of signals as candidate biomarkers before they can be tested in clinical trials.