Source-free collaborative domain adaptation via multi-perspective feature enrichment for functional MRI analysis.

Resting-state functional MRI (rs-fMRI) is increasingly employed in multi-site research to analyze neurological disorders, but there exists cross-site/domain data heterogeneity caused by site effects such as differences in scanners/protocols. Existing domain adaptation methods that reduce fMRI heterogeneity generally require accessing source domain data, which is challenging due to privacy concerns and/or data storage burdens. To this end, we propose a source-free collaborative domain adaptation (SCDA) framework using only a pretrained source model and unlabeled target data. Specifically, a multi-perspective feature enrichment method (MFE) is developed to dynamically exploit target fMRIs from multiple views. To facilitate efficient source-to-target knowledge transfer without accessing source data, we initialize MFE using parameters of a pretrained source model. We also introduce an unsupervised pretraining strategy using 3,806 unlabeled fMRIs from three large-scale auxiliary databases. Experimental results on three public and one private datasets show the efficacy of our method in cross-scanner and cross-study prediction.

Peering into the team role kaleidoscope: the interplay of personal characteristics and verbal interactions in collaborative problem solving.

The objective of this study is to explore the relationship between personality and peer-rated team role behavior on the one hand and team role behavior and verbal behavior on the other hand. To achieve this, different data types were collected in fifteen professional teams of four members (N = 60) from various private and public organizations in Flanders, Belgium. Participants' personalities were assessed using a workplace-contextualized personality questionnaire based on the Big Five, including domains and facets. Typical team role behavior was assessed by the team members using the Team Role Experience and Orientation peer rating system. Verbal interactions of nine of the teams (n = 36) were recorded in an educational lab setting, where participants performed several collaborative problem-solving tasks as part of a training. To process these audio data, a coding scheme for collaborative problem solving and linguistic inquiry and word count were used. We identified robust links and logical correlation patterns between personality traits and typical team role behaviors, complementing prior research that only focused on self-reported team behavior. For instance, a relatively strong correlation was found between Altruism and the Team builder role. Next, the study reveals that role taking within teams is associated with specific verbal interaction patterns. For example, members identified as Organizers were more engaged in responding to others' ideas and monitoring execution.

Predicting collaborative practice between midwives and obstetricians: A regression analysis.

INTRODUCTION: Effective collaborative practice between midwives and obstetricians improves patient safety and obstetrical outcomes, but its implementation remains challenging. Therefore, its determinants need to be better understood. This study examined factors impacting collaborative practice (CP) between these professional groups. METHODS: This study was a cross-sectional survey that took place in Swiss hospital labor wards in 2021. Collaborative practice perceptions of 70 midwives (57.4% response rate) and 44 obstetricians (29.0% response rate) were assessed using the Interprofessional Collaboration Scale, with the score serving as the main outcome. A total of 13 individual, behavioral, and organizational predictors were analyzed by multiple linear regression. RESULTS: Participants rated collaborative practice with a median score of 3.1 (IQR: 2.8-3.4) out of a maximum score of 4.0. Results showed that five predictors significantly influenced collaborative practice: type of profession (ß= -0.180; 95% CI: -0.296 - -0.040, p=0.011), trust/respect (ß=0.343; 95% CI: 0.085-0.040, p=0.000), shared visions/goals (ß=0.218; 95% CI: 0.030-0.204, p=0.009), workplace (ß=0.253; 95% CI: 0.089-0.445, p=0.004) and shared power (ß=0.163; 95% CI: 0.042-0.222, p=0.015). The model explained 66% of the variance (adjusted R2) in collaborative practice in labor wards. CONCLUSIONS: This study has identified key factors influencing CP in Swiss labor wards: workplace characteristics that require tailored CP models, and a power-sharing culture that fosters trust, respectful interactions and shared goals, requiring active exchange between midwives and obstetricians.

A multisector community-engaged collaborative for mental health integration in primary care and housing developments: Protocol for a stepped-wedge randomized controlled trial (the Harlem Strong Program).

BACKGROUND: Addressing mental health disparities following COVID-19 requires adaptive, multi-sectoral, equity-focused, and community-based approaches. Mental health task-sharing in gateway settings has been found to address mental health care gaps in low- and middle-income countries, but is not a common practice in the U.S., especially in non-medical settings, such as low-income housing developments (LIH). This research study will evaluate the effectiveness of a multisectoral community-engaged collaborative for task-sharing mental health care on consumer, provider, and implementation outcomes, as well as identify barriers and facilitators for implementation. METHODS: In this stepped-wedge randomized controlled trial with technology supplementation, LIH and primary care sites will be randomly assigned to one of five sequences of three implementation strategies: (1) Education and Resources (E&R), which involves online training and resources on basic mental health task-sharing skills, (2) Multisectoral Community Collaborative Care (MCC), which consists of all E&R resources plus additional community responsive implementation supports and participation in a multisectoral coalition and (3) MCC + Technology, which combines the MCC condition resources with a community crowdsourced technology solution to support implementation. The primary outcome is the effectiveness in meeting consumers' needs through direct service (e.g., adequately addressing depression and anxiety symptoms), and through implementation to increase access to mental health care (reach). The secondary outcome examines additional consumer outcomes including health functioning and social risks, as well as implementation outcomes including provider skills, program adoption, and factors related to barriers and facilitators of quality implementation. A total of 700 consumers receiving mental health care at 20 sites will be surveyed at baseline, 6-, and 12-month follow-ups. Additionally, 100 providers will be evaluated at baseline, 6-, 12-, and 24-month follow-ups before training and after randomization. DISCUSSION: We hypothesize that MCC and MCC + Technology conditions will demonstrate significantly higher efficacy in changing primary outcomes compared to E&R, and the MCC + Technology supplement will show significantly higher levels of reach of mental health tasks compared to the MCC condition alone. These findings will demonstrate the feasibility of mental health integration into accessible, non-medical community settings such as LIH. Moreover, it will help establish a multilevel system solution based on community engagement and planning with a multisectoral collaboration that can be sustained community-wide. TRIAL REGISTRATION: NCT05833555 on Clinicaltrials.gov. Registered April 26, 2023.

Advancing Models of Care in Transplant Psychiatry: A Review and Considerations for Enhancing the Multidisciplinary Approach.

PURPOSE OF REVIEW: Psychosocial considerations in transplant candidacy evaluation, waitlist, and post-transplant period is tremendously important to overall transplant care. Integration of mental health services in multidisciplinary transplant teams improves adherence to medical regimens, enhances quality of life, and reduces the risk of post-transplant complications. RECENT FINDINGS: Despite this, psychiatrists are often under-utilized by transplant centers, with engagement typically limited to transplant candidacy evaluations or reactive consults in a traditional CL model. In this review, we aim to 1) highlight the relevance of psychiatry throughout the transplant course, 2) outline the role of a CL psychiatrist in advancing patient care and supporting multidisciplinary teams in transplant, 3) develop an understanding of CL service models in both the inpatient and ambulatory setting and 4) consider the utility of innovating current transplant psychiatry practices.

Cesarean delivery, labor duration and mothers' mortality risk over 50 years of follow-up: Cesarean delivery and maternal mortality.

BACKGROUND: Pregnancy complications have been recognized as a window to future health. Though cesarean delivery is common, it is unknown whether labor duration and mode of delivery are associated with maternal long-term mortality. OBJECTIVES: To examine whether labor duration and mode of delivery were associated with all-cause and cause-specific mortality. STUDY DESIGN: Participants were mothers from the multisite Collaborative Perinatal Project cohort (1959-1966; n=43646, limited to last Collaborative Perinatal Project delivery). We ascertained all-cause and specific causes of death as of 2016 via linkage to the National Death Index and Social Security Death Master File. Hazard ratios testing mode of delivery and labor duration were estimated using Cox proportional hazards models adjusted for demographic and clinical characteristics. We further stratified analyses by parity. RESULTS: Among participants with a recorded delivery mode, 5.9% (2486/42335) had a cesarean delivery. Participants who had a cesarean were older (26.9 versus 24.3 years), with higher BMI (24.0 versus 22.7 kg/m2), were less likely to be nulliparous (21% versus 30%), and more likely to have a household income of at least $6000 (22% versus 17%), to smoke ≥1 pack/day (18% versus 15%), to have diabetes mellitus (12% versus 1%) and to have a prior medical condition (47% versus 34%), compared to participants with a vaginal delivery. Delivery mode was similar by race/ethnicity, marital status, and education. Median labor duration was 395 minutes among participants who had an intrapartum cesarean delivery and 350 minutes among participants delivered vaginally. By 2016, 52.2% of participants with a cesarean delivery and 38.5% of participants with a vaginal delivery had died. Cesarean versus vaginal delivery was significantly associated with increased risk for all-cause mortality (hazard ratio = 1.16 (95% confidence interval: 1.09, 1.23); in nulliparas, hazard ratio = 1.27 (95% confidence interval: 1.09, 1.47); in multiparas, hazard ratio = 1.13 (95% confidence interval: 1.06, 1.21)) as well as increased risk of death from cardiovascular disease, diabetes, respiratory disease, infection, and kidney disease. Associations with death from cardiovascular disease, infection and kidney disease were stronger for multiparas than nulliparas, though the association with death from diabetes was stronger among nulliparas. Labor duration was not significantly related to overall mortality. CONCLUSIONS: In a historic United States cohort with a low cesarean delivery rate, cesarean delivery was an indicator for subsequent increased mortality risk, particularly related to cardiovascular disease and diabetes. Future studies with long-term follow-up are warranted given the current high prevalence of cesarean delivery.

Sustaining the Usefulness and Appeal of an Older Adult-led Makerspace through Developing and Adapting Resources.

Researchers are studying makerspaces as one way to support older adults in learning about and using new technologies and tools. In this paper, through a long-term (34 months), ethnographic approach, we study the ways that older adults arranged sociotechnical resources to sustain the community use of a makerspace. Our analysis identifies three interconnected resources that were developed: an adaptive staffing approach that could withstand constant personnel shifts and shortages; structured activities to draw interest and overcome challenges associated with learning to use the machines; and reference materials to support individuals in independent usage of the space. We describe the issues that arose as time went on with each of these resource types, and how individuals affiliated with the makerspace adapted the resources to address these issues. In the discussion, we extend best practices by reflecting on strategies that worked well in the makerspace, such as drawing interest through introductory classes, as well as different purposes for reference materials to support technology use.

The Role of the Medical Director and Psychiatric Medical Director in Child Welfare Serving Agencies.

Collaboration between the child welfare system and health care practitioners has become increasingly necessary in order to meet the often-significant health needs of system-involved youth. Child welfare medical directors and psychiatric medical directors have been implemented as a means to address this need in several state child welfare systems. Building on the core principles of the National Guidelines for Child and Youth Behavioral Health Crisis Care, medical and psychiatric medical directors can help ensure youth receive the least-restrictive, most appropriate level of behavioral health care; prioritizing care involvement with caregivers in community-based settings.

Concept of flexible no-code automation for complex sample preparation procedures.

Driven by demographic changes and dwindling Science Technology Engineering Mathematics enrolments, our research introduces no-code automation as a strategic response, aimed at mitigating labor shortages while enhancing productivity and safety in the laboratory environment. Employing a user-friendly, no-code software platform, we automated a complex HPTLC assay, enabling laboratory personnel to configure and modify workflows without requiring specialized programming skills. The manuscript outlines the deployment of a collaborative robot (cobot), a programmable logic controller (PLC), and the utilization of self-developed open-source hardware components to establish automated stations for sample handling, incubation, spraying, detection, and storage within the assay process. The research addresses challenges such as the handling of fragile HPTLC plates and the seamless integration of automated stations, solved through innovative design solutions and adaptive programming methods. This investigation demonstrates the feasibility and efficiency of no-code automation in overcoming skilled labor deficits.

Topology-aware scalable resource management in multi-hop dense networks.

The current society is becoming increasingly interconnected and hyper-connected. Communication networks are advancing, as well as logistics networks, or even networks for the transportation and distribution of natural resources. One of the key benefits of the evolution of these networks is to bring consumers closer to the source of a resource or service. However, this is not a straightforward task, particularly since networks near final users are usually shaped by heterogeneous nodes, sometimes even in very dense scenarios, which may demand or offer a resource at any given moment. In this paper, we present DEN2NE, a novel algorithm designed for the automatic distribution and reallocation of resources in distributed environments. The algorithm has been implemented with six different criteria in order to adapt it to the specific use case under consideration. The results obtained from DEN2DE are promising, owing to its adaptability and its average execution time, which follows a linear distribution in relation to the topology size.

A longitudinal study of interprofessional education experiences among health professional graduates.

Effective teamwork and collaboration among health professionals is a well-recognized strategy toward enhancing patient outcomes. However, there is a lack of understanding on how to best prepare health professionals for collaborative practice. The aim of this research is to gain a better understanding of how graduates of five health professions (dentistry, medicine, nursing, pharmacy, physiotherapy) perceive and experience interprofessional education for collaborative practice (IPECP) throughout their health professions journey, with a focus on transition to practice. This longitudinal study employed an interpretive, narrative methodology to understand interprofessional identity development of 24 individuals who had recently graduated from a health professions program (dentistry, medicine, nursing, pharmacy, physiotherapy) at a Canadian university. Participant experiences were analyzed using narrative analysis. Participants' narratives provided insight into the context, factors and curricular experiences needed for interprofessional identity development and preparedness for collaborative practice. Participants identified the importance of socialization and connection with others, collaborative role models and exposure to collaborative experiences and settings for interprofessional practice. Participants expressed some dissatisfaction with their earliest IPECP experiences and most valued their exposure to 'real-life' practice examples and clinical scenarios. Participants desired more authentic experiences of interprofessional collaboration during their programs. Improving health professionals' interprofessional socialization and collaborative experiences within IPECP is critical to improving patient outcomes. Study findings can inform future curricula and IPECP strategies that create conditions to enhance collaborative practice and ensure the preparedness of a future health workforce with a strong collaborative identity.

Exploring the impact of collaborative learning on the development of critical thinking and clinical decision-making skills in nursing students: A quantitative descriptive design.

This study aims to introduce collaborative learning as a method in the Mental Health and Diseases Nursing course for actively enrolled fourth-year nursing students. The objective is to assess the impact of collaborative learning on critical thinking and clinical decision-making among nursing students. Collaborative learning involves the use of small groups to help students identify effective ways of working together to enhance their learning outcomes. A quantitative research methodology was employed in this study. To evaluate the effectiveness of the collaborative learning program, a within-subject repeated-measures design was implemented. This study was conducted in the nursing department of a university in Turkey. The study included 96 female students (92.3 %) and 8 male students (7.7 %). Data collection involved the sociodemographic data form, the California Critical Thinking Disposition Inventory (CCTDI), and the Clinical Decision-Making in Nursing Scale (CDMNS). The students' pre-program CDMNS median score was 146.00 (117.00-177.00), and the post-program CDMNS median score was 147.50 (115.00-175.00). While there was an increase in the students' clinical decision-making scores after the program, this increase was not statistically significant (p > 0.05). The pre-program median score for CCTDI was 223.26 (176.87-296.02), and the post-program median score was 227.88 (188.87-359.00). The students' critical thinking disposition scores showed a statistically significant increase after the program (p < 0.05). The study results revealed notable enhancements among students who participated in courses utilizing the collaborative learning method. These enhancements included heightened academic performance, elevated levels of critical thinking, increased self-confidence, and improved clinical decision-making abilities.

How do different goals affect students' internal collaboration script configurations? Results of an epistemic network analysis study.

Introduction: Research has suggested that how learners act in CSCL environments is considerably influenced by their internal collaboration scripts. These scripts are knowledge structures that reside in an individual's memory and consist of play, scene, scriptlet, and role components. In its "internal script configuration principle," the Script Theory of Guidance suggests that as learners work in a CSCL environment, these components are dynamically (re-)configured, and that this (re-)configuration is influenced by the goals of the individual learner. However, this principle has not yet been tested empirically. Methods: In this study, upon entering a CSCL environment, we therefore experimentally manipulated the goals that students pursued while learning. In one condition, we induced learning goals while in the other condition, no goals were induced. A total of 233 pre-service teachers collaborated in dyads on the task to analyze an authentic, problematic classroom situation by aid of educational evidence. We measured their internal scripts both at pre-test (i.e., before collaboration and before goal induction) and post-test (i.e., after collaboration and goal induction), focusing on the scriptlet level. Results: Results show that goal induction had no effects on the kinds of scriptlets participants selected during collaboration. However, results from Epistemic Network Analysis show that learning goal induction led to significantly different combinations of scriptlets (especially to more relations between scriptlets that are indicative of pursuing learning goals) than no goal induction. Furthermore, participants from the learning goal induction acquired significantly more knowledge about educational theories and evidence than students from the control condition. Conclusion: This study is among the first to provide direct evidence for the internal script configuration principle and demonstrates the effectiveness of inducing learning goals as a scaffold to support students' knowledge acquisition processes in CSCL.

Problem perception and problem regulation during online collaborative learning: what is important for successful collaboration?

Background: University students frequently prepare for exams or presentations in self-organized study groups. For this purpose, they often use videoconferencing software. During their collaboration, they need to regulate emerging problems to ensure effective learning. We suppose that regulation is facilitated when (1) the group perceives their regulation problems homogeneously, (2) they choose regulation strategies that have the potential to solve the problems immediately, and (3) they execute these strategies with sufficient intensity. Aims: We investigated which problems occur during online collaborative learning via videoconferencing and how homogeneity of problem perceptions, immediacy of the chosen strategies, and intensity of strategy use are related to regulation success. Sample: University students (N = 222) from two lectures in pre-service teacher education and educational sciences in 99 study groups. Methods: Students collaborated in a self-organized manner, that is, without a teacher present, to study the material of one lecture using videoconferencing software. After the collaboration, group members rated, individually, the intensity of different problems during collaboration, reported which strategies they used to overcome their biggest problem, and rated the success of their problem regulation, their satisfaction with their collaboration, as well as their learning gain. In addition, they answered a knowledge test. Results: We found that most students rated technical issues as their biggest problem. Multilevel modeling showed that homogeneous problem perception moderated by problem intensity-contrary to immediate and intensive strategy use-predicted successful problem regulation and satisfaction with the collaboration but not knowledge gain. Case analyses illustrate the assumed mechanism that a homogeneous problem perception facilitates socially shared regulation. Conclusion: We conclude that even in only slightly structured learning contexts, students might only need to jointly identify their problems, whereas the best possible regulation of these problems seems less relevant. Therefore, training students to foster regulation competencies might prioritize identifying problems.

Variations in the germinal center response revealed by genetically diverse mouse strains.

The humoral response is complex and involves multiple cellular populations and signaling pathways. Bacterial and viral infections, as well as immunization regimens, can trigger this type of response, promoting the formation of microanatomical cellular structures called germinal centers (GCs). GCs formed in secondary lymphoid organs support the differentiation of high-affinity plasma cells and memory B cells. There is growing evidence that the quality of the humoral response is influenced by genetic variants. Using 12 genetically divergent mouse strains, we assessed the impact of genetics on GC cellular traits. At steady state, in the spleen, lymph nodes and Peyer's patches, we quantified GC B cells, plasma cells and follicular helper T cells. These traits were also quantified in the spleen of mice following immunization with a foreign antigen, namely, sheep red blood cells, in addition to the number and size of GCs. We observed both strain- and organ-specific variations in cell type abundance, as well as for GC number and size. Moreover, we find that some of these traits are highly heritable. Importantly, the results of this study inform on the impact of genetic diversity in shaping the GC response and identify the traits that are the most impacted by genetic background.

A Comprehensive Review of the Mechanism and Modification Strategies of V2O5 Cathodes for Aqueous Zinc-Ion Batteries.

Aqueous zinc-ion batteries (AZIBs) have attracted wide attention due to their affordability, inherent safety, and environmental friendliness, recognized as one of the most ideal next generation energy storage systems. Vanadium-based cathodes have garnered significant interest in the field of AZIBs, presenting vast application prospects in stationary energy storage. Among them, layered vanadium pentoxide (V2O5) stands out a promising material due to its high theoretical capacity, drawing extensive research efforts. However, the research on V2O5 is greatly hindered by issues such as cathode material dissolution, low conductivity, and byproduct formation. Therefore, this review starts from the characteristics of V2O5 materials, summarizes the energy storage mechanism of Zn2+, and elucidates the main challenges faced by V2O5. Subsequently, current modification strategies are summarized based on these challenges, along with the relationships between the issues and strategies. Finally, further challenges and directions faced by each modification strategy are proposed. It is expected to provide researchers with information to quickly familiarize themselves with the current applications and inspiring prospects of V2O5 in AZIBs.

Collaborative Online International Learning (COIL): A Teaching and Learning Experience in Nursing.

BACKGROUND: Collaborative Online International Learning (COIL) involves international online activities that allow the support of transversal competencies in diverse and multicultural environments without moving from home. This paper presents the learning experiences and satisfaction of undergraduate nursing students at the University of Girona (Spain) from a COIL activity involving clinical simulation in collaboration with the University of Coventry (United Kingdom). METHODS: Qualitative study of content analysis. Twelve students from each of the two universities participated in the data collection process using reflective diaries. RESULTS: The data analysis highlighted five topics related to the COIL activity involving clinical simulation: (a) initial attitudes towards the COIL activity; (b) main learning through the COIL activity; (c) positive aspects of the COIL activity; (d) weaknesses of the COIL activity and proposals for improvement; and (e) overall evaluation of the COIL activity. CONCLUSIONS: The main learning outcomes referred to by students were the relationships between transversal competencies and the skills for life, language skills, cultural skills, and more specific skills related to clinical standards. The students were most satisfied with the teaching activities and specified positive aspects and weaknesses that will add value to future versions of the activities.

Promoting Collaborative Scholarship During the COVID-19 Pandemic Through an Innovative COVID-19 Data Explorer and Repository at Yale School of Medicine: Development and Usability Study.

BACKGROUND: The COVID-19 pandemic sparked a surge of research publications spanning epidemiology, basic science, and clinical science. Thanks to the digital revolution, large data sets are now accessible, which also enables real-time epidemic tracking. However, despite this, academic faculty and their trainees have been struggling to access comprehensive clinical data. To tackle this issue, we have devised a clinical data repository that streamlines research processes and promotes interdisciplinary collaboration. OBJECTIVE: This study aimed to present an easily accessible up-to-date database that promotes access to local COVID-19 clinical data, thereby increasing efficiency, streamlining, and democratizing the research enterprise. By providing a robust database, a broad range of researchers (faculty and trainees) and clinicians from different areas of medicine are encouraged to explore and collaborate on novel clinically relevant research questions. METHODS: A research platform, called the Yale Department of Medicine COVID-19 Explorer and Repository (DOM-CovX), was constructed to house cleaned, highly granular, deidentified, and continually updated data from over 18,000 patients hospitalized with COVID-19 from January 2020 to January 2023, across the Yale New Haven Health System. Data across several key domains were extracted including demographics, past medical history, laboratory values during hospitalization, vital signs, medications, imaging, procedures, and outcomes. Given the time-varying nature of several data domains, summary statistics were constructed to limit the computational size of the database and provide a reasonable data file that the broader research community could use for basic statistical analyses. The initiative also included a front-end user interface, the DOM-CovX Explorer, for simple data visualization of aggregate data. The detailed clinical data sets were made available for researchers after a review board process. RESULTS: As of January 2023, the DOM-CovX Explorer has received 38 requests from different groups of scientists at Yale and the repository has expanded research capability to a diverse group of stakeholders including clinical and research-based faculty and trainees within 15 different surgical and nonsurgical specialties. A dedicated DOM-CovX team guides access and use of the database, which has enhanced interdepartmental collaborations, resulting in the publication of 16 peer-reviewed papers, 2 projects available in preprint servers, and 8 presentations in scientific conferences. Currently, the DOM-CovX Explorer continues to expand and improve its interface. The repository includes up to 3997 variables across 7 different clinical domains, with continued growth in response to researchers' requests and data availability. CONCLUSIONS: The DOM-CovX Data Explorer and Repository is a user-friendly tool for analyzing data and accessing a consistently updated, standardized, and large-scale database. Its innovative approach fosters collaboration, diversity of scholarly pursuits, and expands medical education. In addition, it can be applied to other diseases beyond COVID-19.

Implementation of collaborative care for depression in VA HIV clinics: Translating Initiatives for Depression into Effective Solutions (HITIDES): protocol for a cluster-randomized type 3 hybrid effectiveness-implementation trial.

BACKGROUND: Depression is the most diagnosed mental health condition among people living with HIV. Collaborative care is an effective intervention for depression, typically delivered in primary care settings. The HIV Translating Initiatives for Depression into Effective Solutions (HITIDES) clinical intervention involves a depression care team housed off-site that supports depression care delivery by HIV care providers. In a randomized controlled trial, HITIDES significantly improved depression symptoms for veterans living with HIV and delivered cost savings. However, no HIV clinics in the Veterans Health Administration (VHA) have implemented HITIDES; as such, it is unclear what implementation strategies are necessary to launch and sustain this intervention. METHODS: This hybrid type-3 effectiveness-implementation trial examines the implementation and effectiveness of HITIDES in 8 VHA HIV clinics randomly assigned to one of two implementation arms. Each arm uses a different implementation strategy package. Arm 1 includes an intervention operations guide; an on-site clinical champion who, with the help of a peer community of practice, will work with local clinicians and leadership to implement HITIDES at their site; and patient engagement in implementation tools. Arm 2 includes all strategies from Arm 1 with assistance from an external facilitator. The primary implementation outcomes is reach; secondary outcomes include adoption, implementation dose, depressive symptoms, and suicidal ideation. We will conduct a budget impact analysis of the implementation strategy packages. We hypothesize that Arm 2 will be associated with greater reach and adoption and that Arm 1 will be less costly. DISCUSSION: Preliminary work identified implementation strategies acceptable to veterans living with HIV and HIV care providers; however, the effectiveness and cost of these strategies are unknown. While the depression care team can deliver services consistently with high quality, the ability of the depression care team to engage with HIV care providers at sites is unknown. Findings from this study will be used to inform selection of implementation strategies for a broad rollout to enhance depression and suicide care for people living with HIV. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT05901272, Registered 10 May 2023, https://clinicaltrials.gov/study/NCT05901272.

Correlation between learning styles and attitudes toward interprofessional education among medical students: a cross-sectional study.

BACKGROUND: Interprofessional teamwork improves patient care quality, safety, and health outcomes. Interprofessional education (IPE) is crucial in today's medical education to prepare students for the workforce as integral members of a collaborative team. The diversity of IPE learners indicates the importance of exploring the relationship between learning styles and attitudes toward IPE. The purpose of this study was to investigate the relationship between learning styles and attitudes toward IPE. METHODS: A cross-sectional study was conducted between August 2023 and September 2023 in 49 colleges located in the south-eastern region of China. A convenience sampling approach was employed, selecting 500 students majoring in Clinical Medicine and Nursing. The students completed an online questionnaire, which included sociodemographic characteristics, educational characteristics, interprofessional educational characteristics, learning styles, and the readiness for interprofessional learning scale, and Kolb's learning style inventory. Descriptive statistics, Spearman's correlation, and multiple linear regression analysis were used to analyze the data. RESULTS: The most learners are diverger (93.2%), followed by assimilator (3.4%), accommodator (2.6%), and Converger (0.8%). The total score on the RIPLS was 69.70 (7.42), ranging from 48 to 88. A statistical relationship could be established between learning styles and attitudes toward IPE. CONCLUSION: Abstract conceptualization and active experimentation learning modes and convergers were closely linked with positive attitudes toward IPE. Gender, age, and study stress can affect attitudes toward IPE. This study highlights the need for medical education curricula to integrate innovative teaching methods such as PBL, role-playing, scenario simulation and clinical early exposure to strengthen professional identity, and improve abilities related to interprofessional learning.