Teaching global interdependence to health professions students during the Anthropocene epoch: Findings from documentary analysis of an interprofessional education course.

AIM(S): To examine the effects of new course material that incorporated the Anthropocene and The Centers for Disease Control's (CDC) 'Climate Effects on Health' framework into an IPE course to enhance students' understanding global interdependence. BACKGROUND: Teaching global interdependence with a suitable framework and relevant content in an introductory Interprofessional Education course in undergraduate programs is challenging when these early learners who do not have significant clinical experience. Therefore, it is necessary to adapt these courses to provide a framework that all students can relate to regardless of previous experience. DESIGN: The design for this study was qualitative document analysis. METHOD: The required introductory IPE course was for students on the programs offered by the College of Health Sciences and the School of Nursing. Students (n = 142) from seven health professions programs, including athletic training (n=9), nursing (n=70), nutrition and dietetics (n=8), occupational therapy (n=15), physical therapy (n=31), radiation therapy (n=2) and magnetic resonance imaging and pre-professional students from other majors (n=5) were enrolled in this IPE course. The study used data derived from the final reflections submitted by the students. The CQI analysis focused on students enrolled in a dedicated interprofessional course related to health professions. RESULTS: Ways interprofessional teams can address global challenges like the Anthropocene, climate-related illnesses and severe weather events were revealed in student responses. Three themes that emerged from the student responses included: public health collaborations, holistic health promotion and policy advocacy. CONCLUSION: Incorporating the concept of Anthropocene and the 'Climate Effects on Health' framework into an IPE course can be a promising approach to shaping students' perception and enhancing their knowledge about global interdependence. By doing so, students can gain a deeper understanding of how human activities have an impact on the climate and ecology of the planet and how severe weather can lead to various health problems.

Inter-Organizational Collaboration: The Process of Creating a Joint Statement.

BACKGROUND: Students with disabilities benefit from a team-based approach to support their needs. Individuals from occupational therapy (OT), physical therapy (PT), and speech-language pathology (SLP) partnered to form an interprofessional (IP) workgroup to address the topic of student-centered collaborative goal writing in the context of school-based practice. METHOD: This IP workgroup engaged in a collaborative process centered around a shared goal which integrated reflection and discussion sur¬rounding barriers to teaming, collaborative goal writing, and summarizing best practices from the healthcare and special education literature. This process required development of a shared goal, common language, and collaboration across professions and organizations. RESULTS: The workgroup process created a consensus document, the Joint Statement on Interprofessional Collaborative Goals in School-Based Practice, to provide guidance for school-based practitioners to support student success. Following inter-organizational expert review, the statement was endorsed by three professional organizations and disseminated to practitioners via their respective organizational websites. CONCLUSIONS: This paper outlines the innovative process used by an interprofessional, inter-organizational workgroup to develop and disseminate a consensus document outlining practical guidelines for interprofessional teams working in the educational setting. Additionally, this workgroup created associated professional development materials and presented them to OTs, PTs, and SLPs at a national level.

Transforming Interprofessional Education Through Integration with a University Core Curriculum.

BACKGROUND: Over the past several decades, enhanced health outcomes have been connected to effective collaboration among stakeholders. Academic institutions have looked to Interprofessional Education (IPE) to enable effective collaboration and improve health outcomes. However, these programs are not often integrated and aligned with general education/core curricula at their institutions. METHODS: IPE faculty engaged in a collaborative process of integrating IPE courses and outcomes with a new university-wide core curriculum for all undergraduate students. This initiative required revising and realigning IPE courses, updating pedagogy, and developing new teaching teams. RESULTS: This process produced a Core Framework, outcomes, essential criteria, and enhanced work across the institution to align IPE competencies to university student learning outcomes. The process also strengthened IP learning as a contributing partner to the overall goals and outcomes of a St. Louis University graduate. CONCLUSIONS: The paper describes the iterative process, initial outcomes and the transformation that has occurred during the development of shared goals, shared language, broadening the dialogue and understanding of IPE at the wider university level. Aligning IPE with the Core has strengthened the IPE courses to be more highly valued across the health professions and contributed to even stronger transformational learning experiences of the students and faculty.

Longitudinal Assessment of Students' Perceived Collaboration Skills at an Institution with a Structured Interprofessional Education Curriculum.

Interprofessional education (IPE) has grown in popularity in recent years, but much work remains to be done regarding its evaluation and longitudinal impact, as well as in codifying the attributes of IPE that prepare learners for "collaboration-ready" practice. The present study sought to assess collaboration skill retention or change among graduating seniors who completed an introductory IPE course in 2017, comparing present collaboration skill levels to past levels before and directly after the introductory IPE course using the Self-Assessed Collaboration Skills (SACS) instrument. Additionally, further validation of a collaboration skills instrument was conducted, and qualitative data were gathered to identify collaboration-relevant curricular design elements and generate feedback for continuous program improvement. A final sample of 106 respondents from a variety of professions provided quantitative data, while 91 provided qualitative data. Results suggested that participants retained collaboration skills over the course of their undergraduate education (i.e., 2020 levels as compared to pre-IPE levels in 2017), that IPE evaluation instrumentation requires more cross-contextual and cross-institutional validation, and that students recognize the value in intentional IPE course sequencing for clinical practice. The findings from this study contribute to the further enhancement of IPE outcomes assessment and the design of IPE experiences for fostering collaboration skills among health professional students.

A Nursing Workforce Diversity Project: Strategies for Recruitment, Retention, Graduation, and NCLEX-RN Success.

AIM: The purpose of this article is to describe a collaborative project designed to recruit and retain students from underrepresented minorities and disadvantaged backgrounds into nursing education. BACKGROUND: Ethnic minorities remain underrepresented in the nursing workforce in comparison to the general population. The numbers of minorities enrolled in nursing education programs are insufficient to meet the health care workforce diversity needs of the future. METHOD: High school students were provided with a preprofessional education program to prepare them for admission into a nursing program. Retention strategies were implemented for newly admitted and enrolled nursing education students. RESULTS: Twenty-one high school students enrolled in a nursing education program. The students enrolled in the nursing education program graduated and passed the licensure examination. CONCLUSION: Early recruitment and multiprong retention programs can be successful in diversifying the registered nurse workforce.

Using a real-life case scenario to integrate additional health professions students into an existing interprofessional team seminar.

The World Health Organization stated that the goal of interprofessional education (IPE) is to prepare students as collaboration-ready members of interprofessional care teams. Educators try to create meaningful and relevant learning experiences for multiple health professions students. A longitudinal Interprofessional Team Seminar (IPTS) course includes over 650 students from seven health professions at the professional training level. Recommendations from the National Athletic Trainers' Association (NATA) promote the inclusion of athletic training (AT) students in IPE initiatives. A new IPTS module included AT students focusing on the attributes of rapidly forming and different care teams as the patient transitions from an on-field injury, to acute care, inpatient care, and rehabilitative care, and back to activities of daily living. Qualitative review of reflections from the students assessed the impact of these IPTS modules. The intentional design of this course, focusing on behaviours of collaborative practice and supporting students to be collaboration ready, effectively introduced and highlighted profession-specific strengths and unique contributions to team-based care.

Exploring interprofessional education in the family medicine clerkship: a CERA study.

BACKGROUND AND OBJECTIVES: The need for interprofessional education (IPE) to improve teamwork skills has been recognized by several national organizations. The purpose of this study was to investigate IPE integration in family medicine clerkships and factors associated with IPE's success. METHODS: A survey of clerkship directors at US allopathic medical schools was conducted through the Council of Academic Famiily Medicine Educational Research Alliance (CERA). Respondents were asked (1) whether IPE was part of the curriculum, (2) the educational methods used, (3) which health professions students and faculty participated in IPE, (4) what outcomes were measured, (5) the types of faculty development provided, and (6) the barriers encountered when implementing IPE. RESULTS: The response rate was 66% (88/134), and 38% reported incorporating IPE into the clerkship with most offering IPE in clinical activities. A wide variety of health professions students and faculty participated in clerkship IPE activities. One third of the respondents offered faculty development. Most agreed that third party funding (85%), IPE team training (94%), clearly defined roles (94%), and dedicated time during clinical care for team meetings (93%) were vital for IPE to succeed. Many programs did not measure IPE-specific outcomes (49%). Eighty percent reported at least one barrier to implementing IPE. The most common barriers were scheduling conflicts (46%) and lack of IPE experience (40%). No one reported a lack of institutional support for IPE. CONCLUSIONS: Few clerkships offered IPE. However, family medicine is in a unique position to highlight the value of interprofessional teamwork for students and should recognize and promote IPE opportunities.

A comparison of student attitudes and perceptions before and after an introductory interprofessional education experience.

There is increasing acknowledgement that interprofessional education (IPE) holds promise for preparing health professionals as collaborative-ready practitioners. The effects of IPE on learning outcomes are critical in determining the value of such programs. Attitudes are recognized as a significant element in developing behaviors. This study was designed to determine attitudes and perceptions of students toward collaborative learning in an interprofessional context. Three hundred and five students completed a questionnaire regarding attitudes and perceptions toward interprofessional collaboration before and after an introductory IPE course. Also 202 graduating health professional students without IPE completed the same questionnaire. The questionnaire included questions from the University of West England Interprofessional Questionnaire (UWE IQ) and Readiness for Interprofessional Learning Scale (RIPLS). Independent samples t-tests revealed significant positive changes before and after the IPE course for UWEIQ IP-Learning subscale (p = 0.012) and RIPLS (p = 0.05). This study provides some evidence that students who participate in an introductory IPE course early in their professional preparation not only keep positive attitudes toward interprofessional learning, but improve them. As a result, they are expected to be more engaged in learning this important knowledge that should help them to become interprofessional collaborative-ready practitioners.

Comparison of artificial sebum with human and hamster sebum samples.

To understand drug delivery to the sebum filled hair and sebaceous follicles, it is essential to use an artificial sebum as a surrogate of the human sebum for the investigation of drug transport properties. Artificial sebum L was developed in-house based on the chemical similarity to human sebum. The partition and diffusion of model compounds (ethyl 4-hydroxybenzoate, butyl 4-hydroxybenzoate, and hexyl 4-hydroxybenzoate) were measured in human sebum, hamster ear and body sebum (a commonly used animal model), and four representative artificial sebum samples (N, S, F, and L) in which artificial sebums, N, S and F were selected based on the available literature. DSC and NMR studies were also conducted on all sebums to compare their melting properties and chemical compositions. In vitro studies show that the partition coefficients of the three model compounds in artificial sebum L were similar to that of human sebum, whereas the hamster ear and body sebum, and other three artificial sebum samples were different from that of human sebum. Additionally, the in vitro sebum flux (microg/(cm(2)min) of three model compounds through artificial sebum L was closer to that of human sebum when compared with the other three artificial sebum (N, S and F), hamster body and hamster ear sebum. The results of this study indicate that the artificial sebum L could be used as an alternative to human sebum, as the physicochemical properties of this artificial sebum is relatively similar to human sebum.

Physical and biological considerations for the use of nonaqueous solvents in oral bioavailability enhancement.

This review addresses the use of nonaqueous solvents as components of oral formulations in discovery and preclinical studies. Pharmacology, pharmacokinetic, and safety studies are frequently conducted with solution formulations that use a solvent to solubilize poorly aqueous soluble drugs. The physical chemical basis for solubilization and the precipitation of solubilized drug following administration both contribute to the utility of nonaqueous solvent solutions as oral vehicles. While many of these solvents are considered nontoxic, they are not completely inert biologically. The effects of common nonaqueous solvents on the structural integrity of the epithelia, the inherent permeability of and flux across the GI membrane, the activity of efflux and metabolic enzymes, and the effects on GI motility and GI transit times will be described through an examination of available literature. The practical relevance of these factors to the development of early formulations will be examined critically and suggestions made for the suitability of nonaqueous solvents for a variety of purposes.

Prediction of drug degradants using DELPHI: an expert system for focusing knowledge.

DELPHI is an expert system that has been developed to predict possible degradants of pharmaceutical compounds under stress testing conditions. It has been programmed with the objective of finding relevant degradation pathways, identifying degradant structures, and providing tools to the analytical chemist to assist in degradation identification. The system makes degradant predictions based on the chemical structure of the drug molecule and precedent from a broad survey of the literature. A description of DELPHI's treatment of molecular perception is described as are many features of the heuristic degradation rules it uses to capture and apply chemical degradation knowledge. DELPHI's utility for capturing institutional knowledge is discussed in relation to an analysis of degradation prediction results for 250 molecules of diverse chemical structure collected over 5 years of use. As such, it provides a reliable, convenient, and rapid tool for evaluating potential pathways of chemical instability of pharmaceuticals.

Structure-based design of peptidomimetic antagonists of p56(lck) SH2 domain.

Starting from the tetrapeptide Ac-pYEEI-NHMe and using a structure-based approach, we have designed and synthesised a peptidomimetic ligand for p56(lck) SH2 domain containing a conformationally restricted replacement for the two glutamate residues. We have explored replacments for the isoleucine residue in the pY+3 pocket and thus identified 1-(R)-amino-3-(S)-indaneacetic acid as the most potent replacement. We also report the X-ray crystal structures of two of the antagonists.

Silicon-29 NMR Studies of Tetraalkylammonium Silicate Solutions. 1. Equilibria, (29)Si Chemical Shifts, and (29)Si Relaxation.

The addition of tetraalkylammonium cations to aqueous silicate solutions enhances the abundance of symmetric, cagelike, polysilicate anions including the cubic octamer, Si(8)O(20)(8)(-). The equilibrium ratio of tetramethylammonium (TMA) cations to the octameric silicate anion is 8:1 for solutions with a concentration ratio [OH(-)]:[Si] >/= 1:1. Evidence indicates that organocations directly associate with cagelike polyanions to form a protective shell of hydrophobic hydration that impedes hydrolysis of the central anion.

Silicon-29 NMR Studies of Tetraalkylammonium Silicate Solutions. 2. Polymerization Kinetics.

The kinetics of formation of the silicate cubic octamer, Q(3)(8), in aqueous tetramethylammonium (TMA) silicate solutions was investigated by (29)Si NMR. The rate equation for solutions at pH 13.2-13.6 is d[Q(3)(8)]/dt = k(f) [H(+)](1.6)(+/-)(0.1)[TMA(+)](0.36)(+/-)(0.08)[Si](0.8)(+/-)(0.3) where k(f) = (2.2 +/- 0.8) x 10(16) mol(-)(1.8) kg(1.8) s(-)(1) at 296 K. The findings prove unequivocally that alkylammonium cations participate directly in the formation and subsequent stabilization of cagelike polysilicate anions. This implies a radically different mechanistic role than "templating" for alkylammonium cations in the synthesis of molecular sieves.