KEEP IT Research Articles

Results from the Delivery of a Community Health Worker Training to Advance Competencies in Cancer Genomics.

Less than half of eligible Black women are assessed for genetic risk and only 28% engage in recommended hereditary breast and ovarian cancer (HBOC) risk-reducing interventions. CHWs are trusted individuals that work as a liaison between health systems and the community to improve access to services and support cancer prevention efforts, though they are an overlooked resource to support genetic risk assessment. To address the need and training gaps for CHWs, we developed and assessed an online training program to build CHW's competencies in cancer genomics and use of health information technologies to navigate high-risk individuals to appropriate genetic services. The curriculum and 10 training modules were developed through engaging a panel of experts in a three-round Delphi process. Recruitment focused on CHWs who worked in clinical settings or groups providing outreach or health services to Black women. We assessed: changes in knowledge and attitudes about HBOC and genomics, as well as the perceptions about the quality and implementation of the training. Forty-six individuals expressed interest in the training after recruitment. Thirty eight individuals were eligible for the training and 26 completed the course. We found improvements in knowledge and genomics competencies immediately post-course, but the majority of these improvements were not sustained at 3-month follow-up. The training was highly rated for its relevance to CHW work and overall delivery. Top rated sessions included HBOC overview and family history collection. On average, participants reported discussing HBOC with 17 individuals at 3-month follow-up. Championing a diverse cancer and genomics workforce can help address the goals of the National Cancer Plan to improve early detection and health equity. Through this training, CHWs gained critical cancer and genomics knowledge that was then applied to their primary roles.

Development of a Hereditary Breast and Ovarian Cancer and Genetics Curriculum for Community Health Workers: KEEP IT (Keeping Each other Engaged Program via IT) Community Health Worker Training.

We developed a curriculum for community health workers (CHWs) using an innovative, community-engaged focus group and Delphi process approach. Equipping CHWs with knowledge of hereditary breast and ovarian cancer syndrome(HBOC) and genetics could help enhance identification of women at risk for HBOC, referral, and navigation through genetic services. We conducted focus groups with five CHWs and a three-round Delphi process with eight experts. Inthe first round of the Delphi process, participants rated and commented on draft curriculummodules. The second round involved live video discussion to highlight points of confusion and concern in the modules. The curriculum was revised and refined based on quantitative and qualitative data and reassessed by the experts in Round 3. Ultimately, agreement was achieved on eight of 10 modules when assessing for clarity of learning objectives, seven out of 10 when assessing for adult learning theory, and nine out of 10 when assessing for participants' ability to learn desired knowledge. We plan to virtually deliver this curriculum to CHWs to enhance their HBOC and genomic competencies. By equipping CHWs to understand and participate in genomics education, we can enable more equitable participation in genomics-informed clinical care and research. Beyond this curriculum, the Delphi methodology can further be used to design content for new CHW curriculums.

HF02-04 KEEPING IT REEL: PHOTOGRAPHY AND CINEMATOGRAPHY IN UROLOGY

You have accessJournal of UrologyCME1 Apr 2023HF02-04 KEEPING IT REEL: PHOTOGRAPHY AND CINEMATOGRAPHY IN UROLOGY Kit Yuen, Alexis Steinmetz, and Ronald Rabinowitz Kit YuenKit Yuen More articles by this author , Alexis SteinmetzAlexis Steinmetz More articles by this author , and Ronald RabinowitzRonald Rabinowitz More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003242.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The ability to photograph, film, and eventually record human pathology and surgical procedures has greatly influenced urologic training and practice. Given that urology routinely uses endoscopy and minimally invasive techniques, it is no surprise that the history of film is closely intertwined with the field. METHODS: A review of textbooks, manuscripts, online texts, was performed on the development and application of photography and cinematography in urology. RESULTS: The precursor to the first camera—camera obscura—was described in 2674 BCE in China. A decade before the first photographic camera was invented in 1816, German physician Phillip Bozzini developed the forerunner of the urologic endoscope, the Lichtleiter. It consisted of a silver funnel illuminated by candlelight reflecting off angled mirrors. In 1867, Julius Bruck developed the diaphanoscope, a water-cooled glass tube inserted into the rectum or vagina to transilluminate the bladder. Thomas Stein constructed the Photo-endoskop in 1874, capable of producing an instant negative picture; he captured photos of the urethral mucosa. Maximilian Nitze was intrigued by endovesical photography as cystoscopic findings were difficult to reproduce with drawings. He applied an internal light source to his cystoscope using an electrically-heated platinum wire behind a quartz shield and went on to present “Photography of the Human Urinary Bladder” at the Berlin Medical Society in 1894. Co-founder of the AUA History Forum, Wirt Dakin, filmed the first urologic movie in 1916—an open prostatectomy performed on the roof of the LA General County Hospital. He presented his work at the 1917 AUA meeting in Chicago. The first successful black and white film of the human bladder was presented at the 1929 German Cinema Society meeting. Inspired by a German WWII cystoscope with a Leica camera attachment and frustrated by the difficulty of photographing bladder tumors, urologist James Gow worked with Harold Hopkins to improve the cystoscope. Karl Storz had developed flexible fiberoptics to provide a light source without generating a significant amount of heat within the body; the rod-lens cystoscope that launched in 1967 in Munich combined their innovations and produced photographs of excellent quality. By the 1960s cameras were used to televise endoscopy images, and color film for video endoscopy became available in 1972. Urologic journals now include dedicated sections to photography and videography as means of advancing the field. CONCLUSIONS: In the past two centuries, film has rapidly advanced as a cornerstone of urologic training and practice. Source of Funding: NA © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e251 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kit Yuen More articles by this author Alexis Steinmetz More articles by this author Ronald Rabinowitz More articles by this author Expand All Advertisement PDF downloadLoading ...

Learning to teach

While preparing to teach my first lecture as a new faculty member, I told myself: “You have many research presentations under your belt; you'll nail this!” It didn't take long for me to realize that I was way off base. A few minutes in, the students looked tired, distracted, and in no mood to listen—a stark contrast to my research talk audiences, which seemed attentive at least. At one point, I noticed a few students giggling. “Do I look or talk funny?” I wondered. When I saw that the giggling students were on Facebook, I was relieved. But later I realized that, too, was a sign that I had failed to command their attention. ![][1] ILLUSTRATION: ROBERT NEUBECKER > “Actively engaging students is essential for holding their attention.” In grad school, I had served as a teaching assistant, helping guide undergraduate students during hands-on lab sessions. But I was never responsible for teaching a class on my own, and I never had any formal training. When I became a faculty member, I had to take on a daunting course load, teaching 50 lectures and as many labs per semester. It felt as though I'd been dropped in the deep end of a pool with no swimming lessons. Class by class, my doubts about my teaching abilities mounted, along with my fears that students were not absorbing the key details in my lectures. I started to reflect on my own experiences as a student and tried to recall the things that helped me learn, as well as the things that didn't. The researcher in me also began to search for scientific evidence to guide me. I sought help from experts in pedagogy, as well as colleagues who had more teaching experience than I did. They told me about tools that they used during lectures and resources on campus for new teachers. Within 1 year, there was a marked change in my teaching. I began to use new skills and tools that kept my students engaged. One student wrote in a teaching evaluation that my approach to teaching “made the information exciting” and “challenged students to pay attention.” Teaching gradually became a source of satisfaction rather than anxiety. Here are some of the lessons that have helped me become a more effective teacher. SEEK HELP. Teaching is a skill and as such needs to be learned. Many scientists assume that their graduate degree or postdoctoral experience qualifies them to be a teacher. The reality is far from that. Most universities have support systems for new teachers, but it is usually up to the instructor to actively seek help. I'd recommend taking formal university courses on teaching methods and participating in workshops. They can help you build networks with fellow educators, swap ideas, and share challenges. KEEP IT INTERACTIVE. Actively engaging students is essential for holding their attention and nurturing critical thought. In a small class, asking students to partner with a classmate to brainstorm an answer to a question can help keep them focused. Then, you can bring everyone together and ask the students to share their ideas. Bigger classes pose a greater challenge, but there, too, the right tools can help engage students. For instance, you can ask multiple choice questions and use electronic clickers to register the students' responses. Or you can tell the students to pass a soft toy around the classroom, each taking a turn to ask or answer a question when the toy comes to them. BE COMPASSIONATE. Students are more likely to learn if they feel the teacher genuinely cares about them and respects them. So treat every student with understanding and compassion, and make it clear to them that they can come to you for help. It is also important to be mindful of the diversity in student backgrounds and approaches to learning. Some students may not feel comfortable raising their hand in lecture, for instance, so I use an anonymous Google document where they can leave questions for me. Teaching isn't always easy or intuitive, but it's your responsibility to help your students learn. Put in the time to create an environment that maximizes learning for everyone. [1]: /embed/graphic-1.gif

Malaria prevention—keep it simple and logical

Due to various activities—including those by the World Bank and the Bill & Melinda Gates Foundation—we are happy to see a global decrease in malaria cases. But too many still suffer and die from malaria so malaria prevention or at least to prevent deaths by malaria is of paramount importance, still. And this is not true for the indigenous population only but for travellers as well. Balancing the risk of disease with that of possible side effects of chemoprophylaxis is a difficult task which mostly leads to split decisions even in experts (as was shown in a thrilling Pro-Con debate at the CISTM14 in Quebec in May 2015). This lack of guidance left and still leaves many colleagues (including qualified travel medicine practitioners) quite puzzled—not to talk about those on target—i.e. the travellers. For sustainable guidance my deep believe is: KEEP IT SIMPLE—otherwise counselling doctors (not all of whom are experts in tropical medicine or malariology) as well as travellers will get lost in confusion for sure1 (‘The compliance is inversely proportional to the complexity of the prescription’—Haynes and Sackett 1976). Insect bite precautions (IBP) from dusk until dawn are the mainstay of malaria prophylaxis—so this is of paramount importance for each traveller going to malaria endemic areas no matter how high the risk actually is. The first crucial decision of the binary decision tree is the definition of high risk of exposure (but may consider high risk of complications in vulnerable travellers as well). Whereas some sources say that there is no method of quantifying the risk2 in other sources high risk is defined by a risk …

KEEPING IT REAL

Don't know your plonk from your Pinot? AuthentiQ is a new app that scans your wine bottle to detect whether it's the real thing

Icing Operations - De-Icing Policy

The accumulation of ice, frost and snow on aircraft surfaces can drastically reduce the climb and maneuvering capabilities of an aircraft. The removal of such contamination prior to take off MUST be strictly adhered to in accordance with regulations and standards. The policy with respect to aircraft icing contamination should be “MAKE IT CLEAN AND KEEP IT CLEAN”. All personnel associated with the dispatch and/or operation of aircraft share the responsibility for ensuring that no aircraft is dispatched unless it is clear of ice, snow or frost.

A UNIVERSITY, IF YOU CAN KEEP IT

Click to increase image sizeClick to decrease image size Acknowledgements I would like to thank Catherine W. Phelan, Joli Jensen and anonymous reviewers for valuable feedback on a draft of this essay. Notes 1. An excellent, concise explanation of US land-grant universities is available online at http://www.wvu.edu/~exten/about/land.htm. 2. The ones bringing in research dollars, usually federal funds, that pay for indirect costs.

Losers Can Win at Weight Maintenance

LOSING WEIGHT AND KEEPING IT OFF is a tough business—no one succeeds without really trying. But some long-held beliefs about the difficulties of maintaining weight loss are changing. As a result, experts are developing a more complete picture of weight loss maintenance and a more hopeful message for millions who are overweight or obese. Experts who presented data on maintaining weight loss during the Endocrine Society’s annual meeting in Toronto last month said the proportion of overweight individuals who succeed at long-term weight loss—losing at least 10% of body weight and keeping the weight off for 1 year—is higher than many might expect, about 20% (McGuire MT et al. Int J Obes Relat Metab Disord. 1999;23[12]:1314-1319). An even more optimistic outlook appears in a recent study. Researchers from the Centers for Disease Control and Prevention report that nearly 60% of 1310 individuals in the National Health and Nutrition Examination Survey who lost 10% of body weight maintained 95% of the loss for 1 year (Weiss EC et al. Am J Prev Med. 2007;33[1]: 34-40). “Weight maintenance following weight loss is doable,” lead author Edward C. Weiss, MD, MPH, said in a statement. Holly Wyatt, MD, an associate professor at the University of Colorado Health Sciences Center, Denver, agreed. “A lot of people say you can’t succeed at maintaining weight loss long-term,” she noted during a press briefing at the meeting in Toronto. “We do have some data now that say that’s not true.” METABOLIC ROLE Wyatt said the theory that weight loss lowers the resting metabolic rate (RMR), which in turn pushes the body to regain lost pounds, is not a catchall explanation for weight regain. She examined the existing medical literature and found several studies that contradict the theory. Among them is a study of 24 overweight, postmenopausal women who, after 4 phases of weight loss and weight maintenance, lost a mean of 12.9 kg (Weinsier RL et al. Am J Clin Nutr. 2000; 72[3]:1088-1094). After measuring changes in the women’s RMR and thyroid hormone levels compared with 24 control participants, researchers from the University of Alabama School of Medicine, Birmingham, and the Mayo Clinic, in Rochester, Minn, reported a temporary decline in RMR and thyroid hormones in the study participants. However, measures of both returned to baseline after the women stopped losing weight. The RMR in the women who had lost weight was not significantly different than in controls, and women with lower RMRs were not more likely than those with higher rates to regain more weight over the next 4 years. “The idea that absolutely, your body is fighting you, I don’t think really holds out in the literature,” said Wyatt. “Other things like our environment or other behaviors may overpower [metabolic] change.”

KEEPING IT CLEAN

WATER . It's one of the simplest, most abundant molecules in the world. Increasingly, though, water supplies are undergoing extreme swings. Violent storms and floods bring it in ferocious abundance. Or drought and desertification create crippling shortages. The mismatch of need and abundance reaches across the globe, from developed to developing countries. In the U.S., for example, water levels have dropped dramatically at Hoover Dam and Lake Mead, as a booming population draws heavily on water supplies. Meanwhile, the aquifers of the Great Plains are being depleted by irrigation. Officials in Yemen, on the tip of the Saudi Arabian peninsula, are concerned about the dwindling water reserves supplying the capital city, Sanaa. A rapidly expanding population and increasing use of water for irrigation are fast drawing down the citys water reserves. In fact, officials there are beginning to contemplate moving the historic capital and most of its population to the Red Sea Coast, ...

KEEPING IT IN THE FAMILY

KEEPING IT IN THE FAMILY

CONTROL: GETTING IT AND KEEPING IT IN BUSINESS PROCESS OUTSOURCING

Proposals to outsource corporate functions often meet with resistance because of control issues and concerns about proprietary information. But proponents of outsourcing are quick to note that many of these reservations dwell on perceptions and apprehensions, rather than on the track record of outsourced projects. In fact, veterans of successful arrangements observe that outsourcing frees up valuable management time and thus enables an enhanced form of control.The key is to supplement direct, supervisory control mechanisms like service control agreements and performance tracking with indirect, enabling controls—senior team affiliation, performance visibility, interface management, and employee allegiance—and then lay the groundwork for these enabling controls early in the outsourcing relationship. Rather than getting locked into static controls, forward‐looking managers adopt a broad control framework to go beyond achieving the expected improvements and create the potential to add new value. The result is an outsourcing relationship that can accommodate change, move in a new direction, and seize emerging opportunities.

The Interminable Son

The Interminable Son

Virtual Office Hours Project links Students, Professors At UCLA

YES! KEEP IT! is one student's emphatic evaluation of a department of chemistry and biochemistry educational project at the University of California, Los Angeles. The comment is representative of...

Recording Committee Meetings KEEPING IT SIMPLE

Using ingenuity, and a word processor, a format for recording committee meetings meets standards and requirements in a concise, easy manner. This step-by-step process provides a method to record the minutes proper, the attendance log and the work status. All information is stored in the computer for easy reference.

KEEPING IT SHORT

WeatherVolume 44, Issue 5 p. 194-194 Free Access KEEPING IT SHORT First published: May 1989 https://doi.org/10.1002/j.1477-8696.1989.tb07022.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume44, Issue5May 1989Pages 194-194 RelatedInformation

KEEP IT IN HAND

KEEP IT IN HAND

KEEP IT IN MIND.

KEEP IT IN MIND.

KEEP IT IN MIND.

KEEP IT IN MIND.

KEEPING IT ON THE SQUARE

KEEPING IT ON THE SQUARE