ABSTRACT
OBJECTIVE: During the current pandemic, COVID-19 has been detected in patients using real-time reverse transcriptase-polymerase chain reaction (RT-PCR) that confirms the presence of SARS-CoV-2 RNA. The demand for increased testing, particularly for asymptomatic individuals required alternative approaches to single-patient RT-PCR testing, such as pooling. METHODS: This study explored the impact of dilution on the detectability of SARS-CoV-2 in asymptomatic patients using RT-PCR and demonstrated that pooling can be effective in low prevalence populations. RESULTS: The RT-PCR results for the 3:1, 5:1, and 7:1 aliquot samples showed little differences in CT values, confirming detection capability at these dilutions. CONCLUSION: Based on the results of the present study, a pooled approach with up to 5:1 sample aliquots and using the current RT-PCR methodology likely will detect SARS CoV2 RNA among asymptomatic patients.
Subject(s)
COVID-19 Nucleic Acid Testing/methods , COVID-19/diagnosis , RNA, Viral/genetics , Reverse Transcriptase Polymerase Chain Reaction/methods , SARS-CoV-2/genetics , Asymptomatic Diseases , Buffers , COVID-19/virology , Humans , Specimen Handling/methodsABSTRACT
BACKGROUND: The ACGME mandates that residency programs provide training related to high value care (HVC). The purpose of this study was to explore HVC education in general surgery residency programs. METHODS: An electronic survey was distributed to general surgery residents in geographically diverse programs. RESULTS: The response rate was 29% (181/619). Residents reported various HVC components in their curricula. Less than half felt HVC is very important for their future practice (44%) and only 15% felt confident they could lead a QI initiative in practice. Only 20% of residents reported participating in a root cause analysis and less than one-third of residents (30%) were frequently exposed to cost considerations. CONCLUSION: Few residents feel prepared to lead quality improvement initiatives, have participated in patient safety processes, or are aware of patients' costs of care. This underscores the need for improved scope and quality of HVC education and establishment of formal curricula.
Subject(s)
General Surgery/education , Internship and Residency/organization & administration , Needs Assessment/statistics & numerical data , Patient Care/standards , Quality Improvement , Adult , Curriculum/standards , Curriculum/statistics & numerical data , Female , General Surgery/economics , General Surgery/standards , General Surgery/statistics & numerical data , Health Care Costs , Humans , Internship and Residency/standards , Internship and Residency/statistics & numerical data , Male , Patient Care/economics , Patient Safety/economics , Patient Safety/standards , Practice Guidelines as Topic , Surveys and Questionnaires/statistics & numerical dataABSTRACT
In order to capture key personal and social resources individuals are able to access in their efforts to overcome substance misuse, we introduced the construct of recovery capital into the literature. The purpose of this paper is to further explore the construct and include discussions of implications unexplored in our previous writings. In this paper we reveal the relationship between access to large amounts of recovery capital and substance misuse maintenance and introduce the concept of negative recovery capital. In doing so, we examine the relationships between negative recovery capital and gender, age, health, mental health, and incarceration.
