Search

Use of generation theory is pervasive within health professions education (HPE) literature, yet its application perpetuates unfounded generalizations that disadvantage learners. The objectives of this thematic analysis are first, to understand how generation theory is applied to 'Generation Z' HPE students and second, to propose a more productive framework for approaching evolutions within HPE. A literature search was conducted to identify HPE publications pertaining to Gen Z learners. A thematic analysis was undertaken to identify a priori themes and uncover new themes. Qualitative analysis revealed evidence of three a priori themes as well as four newly identified themes across our sample. The near ubiquity of essentialism and generational othering across our sample illustrates the ongoing challenges posed by generationalism in HPE discourse. While traces of generational humility and generational situatedness suggest a more holistic response to evolving student populations, we nevertheless discourage the continued use of generation theory to guide HPE pedagogy and instead urge educators to resist essentializing generalizations by thinking comprehensively about what evolutions in HPE must occur if we are to best prepare our students to practice in present and future healthcare settings. Practice points As new cohorts of health professions students ('Gen Z') matriculate, generation theory remains a compelling frame for conceptualizing changes in health professions education (HPE) despite a robust body of research critiquing its reliance on essentializing stereotypes. Examples of essentialism and generational othering, which perpetuate reductive stereotypes about generational cohorts, frequently recur in the published literature about Gen Z HPE students. Generational situatedness may mitigate the reductive essentializing of generationalism in HPE. A structural approach promises to better prepare students to practice in present and future healthcare settings than adapting HPE to meet the presumed needs of generational learners. [ABSTRACT FROM AUTHOR]

New code design methods and Viterbi detector architectures are presented for high-rate trellis-coded partial-response (TCPR) systems. The methods, which extend the matched-spectral-null (MSN) coding technique, use novel code constraints and time-varying detector trellis structures to reduce path memory requirements by as much as a factor of two, relative to previously reported codes, while retaining the other attractive features of MSN codes. The design methods and corresponding time-varying trellis structures are illustrated with several examples.

A digital servo processing system within the Venus PRML read/write channel is described. The processor provides for closed loop DC offset and gain control, robust digital peak detection, and integration of up to six servo bursts. Incorporated features optimize performance with asymmetric MR heads.

Children's environmental health (CEH) has a 25-year history at the US Environmental Protection Agency (EPA), during which the agency has advanced CEH through research, policy, and programs that address children's special vulnerability to environmental harm. However, the Trump administration took many actions that weakened efforts to improve CEH. The actions included downgrading or ignoring CEH concerns in decision-making, defunding research, sidelining the Children's Health Protection Advisory Committee, and rescinding regulations that were written in part to protect children. To improve CEH, federal environmental statutes should be reviewed to ensure they are sufficiently protective. The administrator should ensure the EPA's children's health agenda encompasses the most important current challenges and that there is accountability for improvement. Guidance documents should be reviewed and updated to be protective of CEH and the federal lead strategy refocused on primary prevention. The Office of Children's Health Protection's historically low funding and staffing should be remedied. Finally, the EPA should update CEH data systems, reinvigorate the role of the Children's Health Protection Advisory Committee, and restore funding for CEH research that is aligned with environmental justice and regulatory decision-making needs. ( Am J Public Health . 2022;112(1):124-134. https://doi.org/10.2105/AJPH.2021.306537).

The Trump administration has severely curtailed the work of the United States Environmental Protection Agency (EPA). The EPA has rolled back environmental protections, lost ground on addressing climate change and environmental justice, and shed large numbers of experienced staff. All of this has accelerated a longer-term decline in EPA resources, expertise, and authority. Here, we present perspectives of EPA employees and retirees on reconfiguring and strengthening the agency to address current and future environmental health problems, based on qualitative data obtained through 100 semi-structured interviews with 76 current and former EPA employees. Interviewees emphasized a number of internal and external issues, including a hyper-partisan context in which the agency operates, lack of public understanding of the extent of domestic and global environmental problems, budget shortfalls, staffing and leadership challenges, reduced scientific capacity and use of science in decision-making, insufficient attention to environmental justice, and lagging technology. We argue that reforms cannot only be expert-driven but must also come from the public, incorporating community driven solutions and focusing on remedying environmental injustice.

Background: Blood products may be transfused into neonates at temperatures at or below room temperature. The benefits and risks of warming blood to 37°C are not defined in this population or with the equipment used in neonates. Physiologic warming might enhance product effectiveness or decrease transfusion-associated hypothermia., Study Design and Methods: We utilized an in vitro model of neonatal transfusions, with a syringe pump, blood tubing, and 24-gauge catheter and compared current practice (cold products) vs an inline blood warmer. Transfusions were performed rapidly (30 minutes) and slower (120 minutes) to model emergent vs routine situations. We tested red blood cells, fresh-frozen plasma, apheresis platelets (PLTs), and cold-stored low-titer group O whole blood. We used infrared detectors and inline probes to measure temperatures at the origin and at the simulated patient. We assessed warmer-induced damage by measuring plasma hemoglobin and hematocrit (seeking hemolysis), fibrinogen (seeking activation of coagulation), and PLT count and TEG-MA (seeking PLT destruction or dysfunction)., Results: The cold-stored products were 4.2 ± 1.0°C (mean ± SD) at the origin and 21.5 ± 0.1°C at the patient. With the inline warmer, products were 37.8 ± 0.6°C at the warmer and 32.6 ± 1.7°C at the patient during a 30-minute infusion, but were 34.5 ± 2.1 with a foil sheath covering the terminal tubing. We found no warmer-induced damage using any metric., Conclusion: In simulated neonatal intensive care unit (NICU) transfusions, an inline blood warmer can deliver blood products at near-physiologic temperatures with no detected damage. We suggest in vivo testing of warmed NICU transfusions, assessing product effectiveness and hypothermia risk reduction., (© 2020 AABB.)

The Trump administration has undertaken an assault on the Environmental Protection Agency (EPA), an agency critical to environmental health. This assault has precedents in the administrations of Ronald Reagan and George W. Bush. The early Reagan administration (1981-1983) launched an overt attack on the EPA, combining deregulation with budget and staff cuts, whereas the George W. Bush administration (2001-2008) adopted a subtler approach, undermining science-based policy. The current administration combines both these strategies and operates in a political context more favorable to its designs on the EPA. The Republican Party has shifted right and now controls the executive branch and both chambers of Congress. Wealthy donors, think tanks, and fossil fuel and chemical industries have become more influential in pushing deregulation. Among the public, political polarization has increased, the environment has become a partisan issue, and science and the mainstream media are distrusted. For these reasons, the effects of today's ongoing regulatory delays, rollbacks, and staff cuts may well surpass those of the administrations of Reagan and Bush, whose impacts on environmental health were considerable.

A case report of an unresponsive chemist presenting to the emergency department is presented; in retrospect, the patient was discovered to have intentionally ingested cyanide. A review of literature regarding ingestions in laboratory and health care personnel reveals five common points encountered in these personnel: barbiturates, carbon monoxide, cyanide, azides, and methemoglobin-inducing chemicals. Key diagnostic findings, in the absence of history of exposure, are discussed for these five agents.

Previous work demonstrated that mixed function oxidase activities of hepatic microsomes from cold- and warm-acclimated rainbow trout were similar when assayed at temperatures to which fish were acclimated. This "ideal temperature compensation" was partially explained by constitutive differences in microsomes. In the work reported here, rainbow trout were acclimated at 10 or 18 degrees C for 4 weeks and then ip injected with 10 mumol [3H] or [14C]benzo[a]pyrene (BP)/kg in one of two temperature regimens. First, fish were acclimated and exposed at the same temperature and killed after 4, 24, or 48 hr. Concentrations of [3H]BP equivalents in liver, bile, and fat but not in plasma, muscle, intestine, gill, or kidney increased with time. There were no differences in hexane or ethyl acetate extractable [3H] or [14C]BP tissue concentrations in 10 and 18 degrees C-acclimated fish exposed at their acclimation temperatures. At 24 hr after injection, biliary excretion of [3H]BP equivalents was about twofold higher at 18 degrees C than at 10 degrees C. Therefore, warmer temperature stimulated biliary excretion without a marked effect on in vivo BP metabolism. In the second regimen, 10 and 18 degrees C-acclimated fish were shifted to 14 degrees C, injected with [3H] or [14C]BP 1 hr later, and killed after an additional 24 hr. There were no differences in tissue concentrations of total [3H]BP equivalents between acclimation groups at 14 degrees C. However, the biliary concentration of [14C]BP not extracted by ethyl acetate was significantly higher in bile from 10 degrees C-acclimated fish than from 18 degrees C-acclimated fish when both groups were exposed at 14 degrees C.(ABSTRACT TRUNCATED AT 250 WORDS)

1. The possibility that temperature acclimation (to 10 or 18 degrees C for 28 days) would alter the cytochromes P-450 of rainbow trout was addressed. 2. The specific content of LM4b (P-450 IA1), the trout isozyme responsible for activation of polynuclear aromatic hydrocarbons, was lower in 18 degrees C fish than it was in 10 degrees C fish. 3. Kinetic analysis of aryl hydrocarbon hydroxylase indicated that, while thermal acclimation caused no change in Vmax, it lowered the apparent Km of this enzyme for benzo[a]pyrene when assayed at acutely shifted temperatures. 4. Thermal acclimation of fish may have significance when feral populations are subjected to acute temperature shifts.

The dynamics of the intestinal helminth fauna of wood ducks (Aix sponsa) and the relationship between changes in food habits and helminth populations during the bird's reproductive cycle were studied in southeast Missouri. A total of 11 species of helminths, comprised of four species of trematodes and seven species of cestodes, were recovered from the digestive tracts of 155 wood ducks. All species except one were found in both sexes. Significant differences were found in parasite numbers by season (spring vs. fall), sex, and stage of the reproductive cycle. Helminth infection in both sexes was higher in the spring than during fall courtship; however, the magnitude of the seasonal difference was considerably greater in females. Females contained significantly more helminths than males during spring, but no sex-related differences were detected in the fall. Seasonal changes and sex-related differences in parasite numbers corresponded closely with the consumption of invertebrates that serve as intermediate hosts. The average number of parasites in females was similar during fall courtship and pre-egg-laying, suggesting that little or no new infection occurred during winter. The most intensive infections were found in laying females and were attributed to hyperphagia and increased invertebrate consumption during egg production. A large decrease in the parasite numbers in females between incubation and fall courtship indicated that most of the helminths acquired by laying females were lost during summer; therefore, the long-term effects of the increased infection are probably negligible.