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At the beginning of the COVID-19 pandemic, the Georgia Institute of Technology made the decision to keep the university doors open for on-campus attendance. To manage COVID-19 infection rates, internal resources were applied to develop and implement a mass asymptomatic surveillance program. The objective was to identify infections early for proper follow-on verification testing, contact tracing, and quarantine/isolation as needed. Program success depended on frequent and voluntary sample collection from over 40,000 students, faculty, and staff personnel. At that time, the nasopharyngeal (NP) swab, not saliva, was the main accepted sample type for COVID-19 testing. However, due to collection discomfort and the inability to be self-collected, the NP swab was not feasible for voluntary and frequent self-collection. Therefore, saliva was selected as the clinical sample type and validated. A saliva collection kit and a sample processing and analysis workflow were developed. The results of a clinical sample-type comparison study between co-collected and matched NP swabs and saliva samples showed 96.7% positive agreement and 100% negative agreement. During the Fall 2020 and Spring 2021 semesters, 319,988 samples were collected and tested. The program resulted in maintaining a low overall mean positivity rate of 0.78% and 0.54% for the Fall 2020 and Spring 2021 semesters, respectively. For this high-throughput asymptomatic COVID-19 screening application, saliva was an exceptionally good sample type. [ABSTRACT FROM AUTHOR]

Background: In this study, we applied behavioral economics to optimize elementary school lunch choices via parent-driven decisions. Specifically, this experiment tested an optimal defaults paradigm, examining whether strategically manipulating the health value of a default menu could be co-opted to improve school-based lunch selections. Methods: The design was a randomized comparison of optimal versus suboptimal (standard) default lunch menus for all first-graders in a school district for a period of 1 week. We hypothesized that making the default lunch option healthier, while providing parents the opportunity to access and choose from the standard school menu for their child, would yield more frequent selection of healthier items than when the default option was suboptimal. Results: Overall, 127 (93%) first-grade children's families participated. Among those families randomized to receive the nutritionally optimized default menu, all but one remained with these options; of those parents randomized to the standard menu (suboptimal default), all parents remained with these options (?[superscript 2] = 123.06, df = 1, p < 0.001). Conclusions: The mere positioning of choices, without restricting options, significantly affected which menu items the children received during the test period. Results are proof of concept for a strategy to increase health-promoting school lunch content, procedures, and policies.

A shift toward same-day discharge (SDD) in primary elective total knee arthroplasty (TKA) and total hip arthroplasty (THA) has created a need to optimize patient selection and improve same-day recovery pathways. The objectives of this study were (1) to identify our institution's most common causes for failed SDD, and (2) to evaluate risk factors associated with failed SDD. A retrospective review of SDD patients undergoing primary TKA or THA from January 2021 to September 2022 was conducted. Reasons for SDD failure were recorded and differences between successful and failed SDD cases were assessed via a multivariate logistic regression. Overall, 85.3% (651 of 753) of patients included were successful SDDs. Failed SDD occurred in 16.8% (74 of 441) of TKA and 11.8% (38 of 322) of THA cases. Primary reasons included failure to clear physical therapy (33.0%, 37 of 112), postoperative hypotension (20.5%, 23 of 112), and urinary retention (16.9%, 19 of 112). Analysis revealed that overall failed SDD cases were more likely to have had prior opioid use and a longer surgical time. Failed TKA SDD cases were more likely to have had a longer surgical time and not have receive a preoperative nerve block, while failed THA SDD cases were more likely to be older. The SDD selection criteria and pathways continue to evolve, with multiple factors contributing to failed SDD. Improving patient selection algorithms and optimizing post-operative pathways can enhance the ability to successfully choose SDD candidates. III. [ABSTRACT FROM AUTHOR]

Field studies conducted by UC and under controlled greenhouse conditions by the U.S. Department of Agriculture's Agricultural Research Service indicate that rice is more sensitive to salinity than current guidelines suggest. This information is particularly important to rice growers who have experienced salinity problems after holding water on fields for longer time periods to reduce pesticide loading into the Sacramento River. Our field experiments show that an average seasonal salinity of the field water in excess of 1.9 deciSiemens per meter (dS/m) can reduce grain yields; current guidelines indicate that salinity affects rice yield at or above 3.0 dS/m. Salinity had a negative impact on a number of yield components including stand establishment; panicles, tillers and spikelets per plant; floret sterility; individual grain size; and even delayed heading. The emergence and early seedling growth stages were most sensitive to salinity, as was the three-leaf to panicle-initiation stages. Irrigation management practices should be adopted to minimize salinity during these critical growth stages.

Water management practices in Califonia rice production can affect salinity in the field. This is particularly important because rice is one of the most sensitive crops to salinity. We extensively monitored salinity patterns in dozens of rice fields in Colusa and Glenn counties, in order to determine how salinity varies from basin to basin and to compare salinity patterns under different irrigation systems. We found that the fields most vulnerable to salinity damage were those with higher soil salinity and using irrigation water sources initially high in salinity, particularly nondistrict sources that are combinations of well and drain water. Long water holding periods, while effective in reducing pesticide concentrations in rice fields, can contribute to salinity increases in bottom basins. Salinity can increase with either conventional or static irrigation management systems, but the salinity pattern in the field will be different.

The purpose of this study was to compare recurrent instability rates between patients with on-track Hill-Sachs lesions who underwent arthroscopic labral repair (ALR) alone and those who underwent ALR with remplissage (ALR-R). Our hypothesis was that ALR-R would decrease the rate of recurrent instability, especially among patients at high risk of recurrent instability after ALR, such as contact athletes with near-track Hill-Sachs lesions. We performed a multicenter, retrospective analysis of patients aged 14-50 years with on-track Hill-Sachs lesions who underwent ALR-R or ALR without remplissage between January 2014 and December 2019 with minimum 2-year follow-up. The exclusion criteria included prior ipsilateral shoulder surgery, >15% glenoid bone loss (GBL), off-track Hill-Sachs lesion, concomitant shoulder procedure, and connective tissue disorder. Age, sex, follow-up, and contact sports participation were recorded. GBL, Hills-Sachs interval (HSI), glenoid track, and distance to dislocation (DTD) were determined from preoperative magnetic resonance imaging scans. Affected-shoulder range of motion, Western Ontario Shoulder Instability Index scores, Subjective Shoulder Value scores, and recurrent dislocation and/or revision surgery status were also collected. A subgroup analysis was performed on "high-risk" patients (defined as participants in contact sports with DTD <10 mm) from each cohort. The ALR-R cohort included 56 patients, and the ALR cohort included 127. ALR-R patients had greater GBL (P =.004) and a greater HSI (P <.001). In the ALR-R cohort, only 1 patient (1.8%) had a recurrent dislocation and there were no revision operations. In comparison, in the ALR cohort, 14 patients (11.0%) had recurrent dislocations (P =.040) and 8 (6.3%) underwent revision operations (P =.11). Univariate analysis showed that remplissage protected against recurrent dislocation (P =.040) whereas younger age (P =.004), contact sports participation (P =.001), and increased GBL (P =.048) were associated with recurrent dislocation. Multivariate analysis showed that HSI (P =.001) and contact sports participation (P =.002) predicted recurrent dislocation. Among high-risk patients, only 1 patient (4.2%) in the ALR-R group had a recurrent instability event vs. 6 (66.7%) in the ALR group (P <.001). The high-risk ALR-R subgroup also had significantly better final Western Ontario Shoulder Instability Index (P =.008) and Subjective Shoulder Value (P =.001) scores than the high-risk ALR subgroup. Anterior shoulder instability patients with on-track Hill-Sachs lesions have lower recurrent dislocation rates after ALR plus remplissage when compared with ALR alone. This is especially true for high-risk patients, such as contact athletes with a DTD <10 mm. [ABSTRACT FROM AUTHOR]

Uses Canadian census data to examine effects of gender differences in educational attainment on the gender earnings gap for full-time, full-year Canadian workers. These educational attainment differences account for virtually none of the gender earnings gap in 1985 and 1990. Gender differences in field of study matter somewhat more. (Contains 17 references.) (MLH)

Data from 249 providers of pharmacy continuing education and for 6,670 programs for 1989 are summarized and compared with data from 1980 and 1985. Results show more providers, a 2.5-fold increase in programs offered, slightly lower tuition per program, continued decrease in program length, and increased availability of correspondence programs. (MSE)

This study reports the results of a national survey of American Council on Pharmaceutical Education-approved provider continuing education offerings during 1985. The study was designed to identify frequently presented topics, characterize types of programs offered, describe the providers offering programs, and detail continuing education activities on a regional basis. (Author/CT)

A wide variety of pharmacy programs was offered in 1980 throughout the country by a wide variety of providers: pharmacy schools; local, state, and national professional associations; manufacturers; hospitals; private entrepreneurs; consortia; and publishers. Reasonable tuition, varied topics, and varied formats and methodology were available. (MSE)

A curricular approach to pharmacy continuing education as the optimum method for continuous learning of practitioners is described. Achievement, performance, and experiential learning assessment and the relationships between them and continuing education are discussed. (Author/MLW)

A study aimed at determining the perceived needs of a selected sample of Iowa pharmacists for externally available advanced study is discussed. Eight percent of the population proposed to pursue advanced degrees, while another 6 percent desired to participate in the educational opportunities without pursuing a degree. (Author/MLW)

Three years of financial data on pharmacy continuing education programs are examined. Direct and indirect costs and income per registrant, instructional unit, and program are detailed, as well as measures of staff productivity and expenses per program type. Suggestions for integrating financial planning into overall programing are made. (SK)

Reports the results of a survey of the use of videotape programming in continuing pharmaceutical education. Examines sources of media, participant interest, problems, costs, and implications of technological developments for continuing education professionals. (SK)

Literature points to a gap which exists in the preparedness of new nursing/midwifery graduates for clinical practice. In Ireland, a two year programme was established in 2013 for all new graduates employed by the public health system. This paper provides a report on the evaluation of the programme which aimed to gauge the impact of the programme on student experience, stakeholder opinion and on health service delivery. A mixed methods approach, combining qualitative and quantitative methodologies, was utilised. Students who undertook the programme, along with non-student stakeholders, were invited to participate. The quantitative element involved an online evaluation survey which was administered to all students participating in the programme, while the qualitative element involved interviews with the participants. Students believed the programme to be relevant to their practice and positively evaluated the use of blended learning, the support of tutors and the contribution to their professional development. Non-student stakeholders also positively evaluated the programme, but the direct impact on clinical practice was not particularly evident. The evaluation offers a positive view of this initiative and broadly supports the concept of early graduate education programmes. A number of recommendations are offered for the development of future programmes. [ABSTRACT FROM AUTHOR]

Objective: the objective was to examine and describe clinical handover practices in Irish maternity services. Design: the study design incorporated interviews and focus group discussions with a purposive sample of healthcare practitioners working in Irish maternity services. Setting: five maternity hospitals and fourteen co-located maternity units. Participants: midwives, obstetricians and other healthcare professionals, specifically physiotherapists and radiologists, midwifery students and health care assistants working in maternity services. Findings: the study participants provided nuanced and differentiated accounts of clinical handover practices, which indicated a general absence of formal policy and training on clinical handover and the practice of midwifery and medical teams holding separate clinical handovers based on their separate, respective needs for transferring information and clinical responsibility. Participants spoke of barriers to effective clinical handover, including unsuitable environments, lack of dedicated time and fatigue during duty shift clinical handover, lack of supportive information technology (IT) infrastructure, and resistance of some staff to the adoption of new technologies to support clinical handover. Key conclusions: whether internal and external to clinical handover events, the barriers to effective clinical handover represent threats to patient safety and quality of care, since effective clinical handover is essential to the provision of safe quality care. Implications for practice: clear and effective communication between collaborating professionals within maternity teams is essential. [ABSTRACT FROM AUTHOR]