Evaluating Maternal and Child Health and Leadership Competencies of Emerging MCH Leaders: The MCHC/RISE-UP Experience.

PURPOSE: This study examines maternal and child health core competencies and leadership characteristics of undergraduate students following participation in the Maternal and Child Health Careers/Research Initiatives for Student Enhancement-Undergraduate Program (MCHC/RISE-UP). MCHC/RISE-UP is a 10-week public health leadership program designed to promote diversity in public health workforce through mentored research, community engagement and advocacy, and clinical experiences for undergraduate students. DESCRIPTION: The MCHC/RISE-UP is a national consortium of University Centers for Excellence in Developmental Disabilities including, (1) Kennedy Krieger Institute (Kennedy Krieger, lead institution) partnering with Morgan State University, a Historically Black University, (2) the University of South Dakota partnering with Tribal Serving Institutions; and (3) the University of Southern California Children's Hospital-Los Angeles and their partner institution, California State University Los Angeles, a Hispanic Serving Institution. ASSESSMENT: Eighty-four junior and senior undergraduates and recent baccalaureate degree students who participated in the MCHC/RISE-UP worked on 48 maternal and child health projects. Following the MCHC/RISE-UP, students demonstrated statistically significant improvements in all maternal and child health core competencies. Transformational leadership characteristics also increased (mean increase 9.4, 95% CI 7.2-11.8; p < 0.001). At closing interview, over twice as many students endorsed a public health career goal compared to program admission (17.9 vs. 57.7%; p = 0.022). CONCLUSION: Multi-institutional collaborative public health leadership programs may extend the reach and recruitment of diverse students into the maternal and child health field. Experiential, didactic, and mentored learning opportunities may enhance student integration of maternal and child health competencies and transformational leadership characteristics.

Isolation and individualization of conceptus and maternal tissues from abortions and placentas for parentage testing in cases of rape and abandoned newborns.

Abortion specimens are often submitted to forensic laboratories as the only piece of physical evidence in rape and incest cases. The recovery of conceptus tissues from this evidence permits the use of paternity testing to evaluate suspects. In cases of abandoned newborns, the recovery of maternal tissue from the placenta allows for the direct comparison of genetic profiles between the suspected mother and the biological mother. We report on the identification and isolation of conceptus tissues from embryonic- and fetal-period abortions, and maternal tissues from delivered placentas, by gross and low-magnification examination with manual dissection. Hundreds of single-source samples have been successfully recovered by this method and short tandem repeat typed using standard forensic procedures. We additionally describe extraembryonic tissues that can be recovered and typed in the absence of the embryo proper. We conclude that an expertise and protocols can be developed by forensic laboratories for the routine analysis of this evidence.

Health care serial murder: a patient safety orphan.

Two recent instances of alleged health care serial murder raise questions about the priority of efforts to address this problem and the adequacy of current health care safety systems for preventing such intentionally caused adverse events.

Predictors of adherence to an antidepressant medication regimen among patients diagnosed with depression in Taiwan.

This study explored the predictors of medication adherence among Taiwanese people with major depression and dysthymic disorder. Previous research indicates that depressed patients vary in compliance with their medication regimen. Poor compliance reduces the therapeutic effect of medication. Self-report questionnaires were used for this cross-sectional study conducted with 181 outpatients diagnosed with major depression or dysthymic disorder. About 50% of depressed patients reported good medication adherence. The predictors of adherence were patient income, treatment efficacy, and understanding the importance of continuing medication. Professionals should use collaborative communication and cultural values clarification with depressed patients and their families to improve the awareness of illness and to increase the likelihood of medication compliance.

Serial murder by healthcare professionals.

The prosecution of Charles Cullen, a nurse who killed at least 40 patients over a 16-year period, highlights the need to better understand the phenomenon of serial murder by healthcare professionals. The authors conducted a LexisNexis search which yielded 90 criminal prosecutions of healthcare providers that met inclusion criteria for serial murder of patients. In addition we reviewed epidemiologic studies, toxicology evidence, and court transcripts, to provide data on healthcare professionals who have been prosecuted between 1970 and 2006. Fifty-four of the 90 have been convicted; 45 for serial murder, four for attempted murder, and five pled guilty to lesser charges. Twenty-four more have been indicted and are either awaiting trial or the outcome has not been published. The other 12 prosecutions had a variety of legal outcomes. Injection was the main method used by healthcare killers followed by suffocation, poisoning, and tampering with equipment. Prosecutions were reported from 20 countries with 40% taking place in the United States. Nursing personnel comprised 86% of the healthcare providers prosecuted; physicians 12%, and 2% were allied health professionals. The number of patient deaths that resulted in a murder conviction is 317 and the number of suspicious patient deaths attributed to the 54 convicted caregivers is 2113. These numbers are disturbing and demand that systemic changes in tracking adverse patient incidents associated with presence of a specific healthcare provider be implemented. Hiring practices must shift away from preventing wrongful discharge or denial of employment lawsuits to protecting patients from employees who kill.

Serial murder by healthcare professionals.

The prosecution of Charles Cullen, a nurse who killed at least 40 patients over a 16-year period, highlights the need to better understand the phenomenon of serial murder by healthcare professionals. The authors conducted a LexisNexis search which yielded 90 criminal prosecutions of healthcare providers that met inclusion criteria for serial murder of patients. In addition we reviewed epidemiologic studies, toxicology evidence, and court transcripts, to provide data on healthcare professionals who have been prosecuted between 1970 and 2006. Fifty-four of the 90 have been convicted; 45 for serial murder, four for attempted murder, and five pled guilty to lesser charges. Twenty-four more have been indicted and are either awaiting trial or the outcome has not been published. The other 12 prosecutions had a variety of legal outcomes. Injection was the main method used by healthcare killers followed by suffocation, poisoning, and tampering with equipment. Prosecutions were reported from 20 countries with 40% taking place in the United States. Nursing personnel comprised 86% of the healthcare providers prosecuted; physicians 12%, and 2% were allied health professionals. The number of patient deaths that resulted in a murder conviction is 317 and the number of suspicious patient deaths attributed to the 54 convicted caregivers is 2113. These numbers are disturbing and demand that systemic changes in tracking adverse patient incidents associated with presence of a specific healthcare provider be implemented. Hiring practices must shift away from preventing wrongful discharge or denial of employment lawsuits to protecting patients from employees who kill.

Predischarge psychoeducational needs in Taiwan: comparisons of psychiatric patients, relatives, and professionals.

A survey was conducted to assess the predischarge psychoeducational needs of psychiatric inpatients and their relatives compared to the perception of their needs by mental health professionals in Taiwan. A questionnaire survey adapted from Mueser et al. was used with a sample of 300 participants for this descriptive study. Patients and relatives reported a strong interest in learning more about psychiatric medications and strategies for managing common problems, respectively. Mental health professionals were more concerned with patients coping with depression and suicidal thoughts, which reflect current issues in Taiwan. Mental health professionals in Taiwan need to better understand their clients' needs in order to provide more effective predischarge psychoeducation.