"StopScopeCreep", Using Interprofessional Education to Tackle the Territorialism Conflict: Presenter(s): Judson Mead, Idaho State University, United States

In 2020, the American Medical Association initiated an information campaign entitled "StopScopeCreep". The program was a response to broadening scopes of practice of health care professionals during the COVID-19 pandemic. Territorialism between health professions has been ongoing for decades yet rarely addressed in the education of health professionals. Together with the Idaho College of Osteopathic Medicine, the physician assistant program at Idaho State University designed an Interprofessional Education (IPE) activity to help students learn how to navigate the conflicts of territorialism among health professions. The IPE activity involved a mixed group of health care students: DO, PA, pharmacy, and speech pathology. This presentation will share and assess the concept of using IPE for teaching students about territorialism while creating a model to foster productive dialogues between students in medicine. Students were presented reading material and a lecture on the topic, followed by a small group discussion. Students scored their awareness of the topic prior to and after the IPE. They were also asked to describe how the presentation and IPE changed their perspective on the topic. Results from the 2021 IPE showed that 54% of students said their awareness of the topic improved, 40% did not improve, and 4% worsened. Overall the feedback was very positive. Many students felt the activity was engaging, educational and effective at establishing positive communication between student groups. Findings: from an IPE in 2022 will be included during the oral presentation. Results showed that providing controversial and relevant subjects can engage students in discussion, educate them on complicated issues in healthcare and provide an avenue to educate fellow future colleagues on their roles in medicine. The IPE designed on scope of practice provides an effective model for other educators to conduct similar educational activities on controversial topics. [ABSTRACT FROM AUTHOR] Copyright of Patient Education & Counseling is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A 6-Year Retrospective Study on the Postoperative Admission of Skull-Base Meningioma Resection Patients to the Neuroscience Ward versus ICU

Background: The intensive care unit (ICU) has traditionally been the default recovery unit after skull-base meningioma resections. Objective(s): To retrospectively assess the outcomes of 44 skull-base meningioma patients from the period of 2016 to 2022: particularly, the outcomes, during the crisis standards of care declared by the state of Idaho during the COVID-19 pandemic. Method(s): We retrospectively analyzed the clinical outcomes of 44 skull-base meningioma patients treated by resection from 2016 to 2022 who had a length of stay (LOS) of less than 7 days. Result(s): The average LOS came out to be 1.77 days in the neuroscience ward, after discharge from the PACU. Additionally, only one 30-day readmission was recorded during the time period. The expected financial cost to patients was found to have significantly decreased by over $10,000. Conclusion(s): Admitting skull-base meningioma patients straight to the neuroscience ward is on average associated with 1.77 LOS and over $10,000 in reduced expected costs to a patient. Additionally, it can be a viable approach during crisis standards of care.

Covid Icu Bed Occupancy Inversely Related to the States' Booster Rates: A Myth or a Reality

INTRODUCTION: The current CDC guidelines recommend COVID-19 vaccine boosters for all eligible individuals to enhance protection. Resources have been allocated to research done regarding the COVID-19 vaccine, and we speculate that there is a correlation between COVID booster rates and number of COVID patients in the ICU. We hypothesize that the states with a higher percentage of the population that received the booster shot will have decreased COVID ICU bed utilization and vice versa. METHOD(S): The percentage of people who received the COVID-19 booster vaccine and the number of ICU beds occupied by patients with COVID-19 per 10,000 population, both stratified by states, were reviewed to determine the pattern of correlation. The data for both the variables was sourced from Becker's Healthcare as it used information from the CDC's data tracker to rank states by their booster rates. The rankings were last updated based on data from July 20th, 2022. The state of Idaho was excluded because the data was not available. Limitations of the study included reporting lags between the states and CDC, the emergence of numerous variants of the virus, and a lack of a standardized timeline across the states. RESULT(S): Pearson Correlation Coefficient was used to determine the pattern of correlation between COVID booster rates and the number of COVID patients in the ICU for all US states. Booster rates was set as x and ICU patients was set as y. The data was analyzed while using the formula r = SIGMA((X - My)(Y - Mx)) / ((SSx)(SSy)). X Values were calculated with SIGMA = 2407.7, Mean = 48.154 and SIGMA(X - Mx)2 = SSx = 2308.544. Y Values were calculated with SIGMA = 5112, Mean = 102.24 and SIGMA(Y - My)2 = SSy = 835103.12. The coefficient of determination, R2, was 0.0611. Our obtained R was -0.25 which means no strong correlation was found. The data was analyzed independently by two statisticians and the same results were obtained. The results failed to confirm our hypothesis and suggested that there was no correlation between COVID booster rates and the number of COVID patients in the ICU. CONCLUSION(S): Based on our results, no correlation was found between the states' COVID booster rates and ICU bed occupancy. Further studies are needed to quantify this association if any as highly virulent COVID strains pose a threat to humanity.

Household Transmission of SARS-CoV-2 from Humans to Pets, Washington and Idaho, USA.

SARS-CoV-2 likely emerged from an animal reservoir. However, the frequency of and risk factors for interspecies transmission remain unclear. We conducted a community-based study in Idaho, USA, of pets in households that had >1 confirmed SARS-CoV-2 infections in humans. Among 119 dogs and 57 cats, clinical signs consistent with SARS-CoV-2 were reported for 20 dogs (21%) and 19 cats (39%). Of 81 dogs and 32 cats sampled, 40% of dogs and 43% of cats were seropositive, and 5% of dogs and 8% of cats were PCR positive. This discordance might be caused by delays in sampling. Respondents commonly reported close human‒animal contact and willingness to take measures to prevent transmission to their pets. Reported preventive measures showed a slightly protective but nonsignificant trend for both illness and seropositivity in pets. Sharing of beds and bowls had slight harmful effects, reaching statistical significance for sharing bowls and seropositivity.

HIGHLIGHTS FROM THE FOURTH DIVERSITY SUMMIT: NEW LOCATION, NEW TOPICS

The first word that comes to mind is POWERFUL. The messages from the speakers and the discussions were moving, powerful, and motivating." Shared as a written comment in the follow up survey to the Fourth Summit on Diversity in the Minerals, Metals, and Materials Professions (DMMM4), this perspective reflected a common theme expressed throughout the two-day summit, co-located with the TMS 2022 Annual Meeting & Exhibition (TMS2022). Building on the work accomplished in the previous three DMMM Summits, the 2022 iteration gave attendees the opportunity to engage in important discussions with speakers, panelists, and each other on achieving true inclusion in the workplace. Holding a DMMM Summit concurrent with a TMS annual meeting was a new twist on this signature TMS program, which had been previously organized as a standalone specialty conference. Originally slated to take place in conjunction with TMS2021, DMMM4 was included as part of annual meeting registration to provide access to members who would not typically be funded to travel to a non-technical meeting. As with everything in life, these plans changed in the wake of the COVID-19 pandemic.

Medical Boards: Impact of Growing Virtual Care and Need for Integrated Approach to Enhance Quality and Safety

The increased amount of virtual care during the COVID-19 pandemic has exacerbated the challenge of providing appropriate medical board oversight to ensure proper quality of care delivery and safety of patients. This is partly due to the conventional model of each state medical board (SMB) holding responsibility for medical standards and oversight only within the jurisdiction of that state board and partly due to regulatory waivers and reduced enforcement of privacy policies. Even with a revoked license in one state, significant number of physicians have continued to practice by obtaining a medical license in a different state. Individualized requests were sent to 63 medical boards with questions related to practice of telemedicine and digital health by debarred or penalized medical doctors. The responses revealed major deficiencies and the urgent need to adopt a nationwide framework and to create an anchor point to serve as the coordinator of all relevant information related to incidents of improper medical practice. The ability to cause damage to large number of patients is significantly more now. Federal and state agencies urgently need to provide more attention and funding to issues related to quality of care and patient care in the changing ecosystem that includes medical specialists at a distance and the use of evolving digital health services and products. The creation, maintenance, and use of an integrated information system at national and multinational levels is increasingly important.

BY THE WAY

After 21 years, he resigned and embarked on more than 100 cruises in 3 years, eventually Jg settling down after sailing on the largest cruise ship at the time in 2000. An 80-mile detour from the nearest interstate, the attraction features cars stacked up to mimic the famous British site. *Cabazon Dinosaurs: Cabazon, CA. Since 1975, this California roadside attraction has been home to more than 50 dinosaur friends, including Dinny the Dinosaur, a 150-ft brontosaurus that houses a museum in its belly. Built in 1881, this six-story example of novelty architecture is constructed of wood and tin sheeting.

INTERSTATE TELEMEDICINE FOR UROLOGIC ONCOLOGY CARE DURING THE COVID-19 PANDEMIC

INTRODUCTION AND OBJECTIVE: Access to urologic care can be a significant challenge to rural patients. Due to policy changes related to telemedicine during COVID-19, restrictions on interstate telemedicine were waived by several states beginning in March 2020. The aim of this study is to evaluate telemedicine as a means of extending care to patients in rural areas in a cost-effective manner. We collected information on in-person and telemedicine visits for instate and out-of-state patients to provide insight on delivery of care to rural patients. METHODS: From August 2019 to October 2021, all patients seen for urologic cancer care and related complaints (e.g., elevated PSA) at the University of Washington and Seattle Cancer Care Alliance in-person and via telemedicine were sent a survey after each visit. The survey queried patients about travel time, travel costs, and days of work missed. We compared out-of-state (OOS) patients (patients residing in Oregon, Alaska, Idaho, or Montana) seen in-person with those seen via telemedicine. RESULTS: We collected complete surveys for 1094 patient visits, both in-person (N=207) and telemedicine (N=887), excluding repeat visits for established patients. Among established OOS patients, those receiving care via telemedicine had decreased patientestimated travel costs per appointment compared with those receiving care in-person (80.4% telemedicine vs 4.4% in-person visits patients reported no cost). Similarly, 82.1% of patients receiving care via telemedicine, vs 6.7% of in-person visits, reported $0 in cost for their visit. Telemedicine patients reported fewer missed days of work compared with in-person patients (2+ days of work missed for 7.9% of telemedicine patients vs 40.7% of in-person patients). Median selfreported costs for in-person visits among OOS patients were significantly higher than costs reported by Washington State residents (median $500 vs $50, respectively, p= <0.05). CONCLUSIONS: Telemedicine appointments for urologic oncology care for OOS patients increase access to subspecialty care for rural patients at lower cost. Extending OOS exemptions beyond the COVID-19 telemedicine waivers would permit continued delivery of high-quality urologic cancer care to rural patients.

Idaho FY22: Recommendations, Appropriations, and Partisanship

This paper presents an overview of the State of Idaho's FY 2022 budget recommendations and appropriations in the context of demographic changes, economic conditions, and politics. The Executive Budget for FY 2022 notes Governor Little's historical support of education, job growth, economic opportunity, and fostering an environment for Idaho to avoid citizen migration to other states. However, this policy, along with the COVID-19 exodus, has resulted in a large influx of people from other states with the commensurate housing and infrastructure demands. As most Idaho budgets tend to move incrementally in support of education and infrastructure in the context of very healthy revenues, the state is likely to weather, though with some ambivalence, economic fluctuations. However, partisan tensions threaten education and safety net programming.

Genomic surveillance for SARS-CoV-2 for New Mexico and the Mountain West

OBJECTIVES/GOALS: Understanding how SARS-CoV-2 is evolving as well as spreading within and between communities is vital for the design of rational, evidence-based control measures. Continuous genomic surveillance is imperative to identify and track variants and can be paired with clinical data, to identify associations with severity or vaccine breakthroughs. METHODS/STUDY POPULATION: In June of 2021, we established UNM as a CDC-funded hub for genomic surveillance of SARS-CoV-2 for New Mexico and 3 other Rocky Mountain region states (Wyoming, Idaho, Montana). Through our Rocky Mountain COVID Consortium (RMCC), we have sequenced over 6,000 genomes of SARS-CoV-2 from RMCC partners. For New Mexico we integrate county and zip code data to provide more granular insights into how SARS-CoV-2, and particular variants, are transmitting within the state. We also pair this data with vaccine breakthrough cases identified by the NMDOH, as well as with clinical outcome data. RESULTS/ANTICIPATED RESULTS: We sequenced over 6,000 SARS-CoV-2 genomes from New Mexico (n=3091), Idaho (n=1538), Arkansas (n=1101), Wyoming (n=251), and Montana (n=33). We used this data to infer the transmission dynamics, identify variants, and map the spread of the virus. We identified a novel local variant that spread across New Mexico in early 2021, but was quickly replaced by the Alpha variant. In all RMCC states, the Delta variant overtook Alpha and has become nearly the only variant currently circulating in these states. We identified sequenced isolates from vaccine breakthrough cases in NM and demonstrate their role in onward transmission. We can identify shifts at a county or zip-code level in circulating lineages which may correspond to clinical outcomes or fluctuating case counts. DISCUSSION/SIGNIFICANCE: This integrated genomic data can be used by policy and decision makers within the New Mexico Department of Health and our RMCC partners to guide their public health response to the COVID-19 pandemic.

Interstate Drone League (iDrone National) to promote hands-on remote STEM learning using cloud-based virtual meeting platforms in the global pandemic (COVID-19)

[...]of technological improvements, e-learning platforms are rapidly evolving and becoming a fundamental tool for many educational activities worldwide to gain a competitive edge (Sanchez, R. & Hueros, A., 2010). The main advantage of Google Sites (Google Sites, 2020) is the versatility to develop a course website using the existing templates. [...]a user can build their own project hubs, team sites, and public-facing websites by dragging content where needed. Zoom's video-first, unified communication platform is an excellent alternative to hosting an in-person event during the global pandemic (COVID-19). Since Zoom offers a solution tailored to fit our planned online camp, we took full advantage of the existing technology to maximize our impactful digital event, iDrone Online. According to the survey results, about 70% of participants from both in-person (offline) and virtual (online) camps classified themselves as having a strong STEM identity.

Bridging the Gap: A Picture of State Transportation Funding in the United States

For years, states have struggled with chronic gaps between transportation revenues and investment needs due to aging infrastructure, cost inflation, and declining motor fuel tax revenue. States have confronted constrained resources in the face of changing demographics and growing demand and have, as a result, developed a wide array of approaches to providing transportation funding and financing options including state fuel taxes, vehicle fees, sales taxes, and tolls. Shifts in the makeup of state highway program revenue sources over the past several years reflect changing dynamics: bond revenue and state revenue have increased while highway user fees and federal investments have declined. Here, Howard discusses how states are advancing revenue measures and options for the future.

Performance Characteristics of the Abbott Architect SARS-CoV-2 IgG Assay and Seroprevalence in Boise, Idaho.

Coronavirus disease 2019 (COVID-19), the novel respiratory illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated with severe morbidity and mortality. The rollout of diagnostic testing in the United States was slow, leading to numerous cases that were not tested for SARS-CoV-2 in February and March 2020 and necessitating the use of serological testing to determine past infections. Here, we evaluated the Abbott SARS-CoV-2 IgG test for detection of anti-SARS-CoV-2 IgG antibodies by testing 3 distinct patient populations. We tested 1,020 serum specimens collected prior to SARS-CoV-2 circulation in the United States and found one false positive, indicating a specificity of 99.90%. We tested 125 patients who tested reverse transcription-PCR (RT-PCR) positive for SARS-CoV-2 for whom 689 excess serum specimens were available and found that sensitivity reached 100% at day 17 after symptom onset and day 13 after PCR positivity. Alternative index value thresholds for positivity resulted in 100% sensitivity and 100% specificity in this cohort. We tested specimens from 4,856 individuals from Boise, ID, collected over 1 week in April 2020 as part of the Crush the Curve initiative and detected 87 positives for a positivity rate of 1.79%. These data demonstrate excellent analytical performance of the Abbott SARS-CoV-2 IgG test as well as the limited circulation of the virus in the western United States. We expect that the availability of high-quality serological testing will be a key tool in the fight against SARS-CoV-2.