Mid-year Report Research Articles

73. ETIOLOGY OF UNABLE TO ASSESS ENTRUSTABLE PROFESSIONAL ACTIVITIES IN A NATIONAL STUDY

Background Assessment using entrustable professional activities (EPAs) is currently under study as a joint effort of the American Board of Pediatrics and program director community. However, limited evidence exists for the feasibility of EPA-based assessment in pediatrics. Aim Among pediatric residency programs that implemented EPA-based assessment over 3 academic years (2015-16, 2016-17, 2017-18), determine how often programs were “unable to assess” a resident on a given EPA. Methods 23 programs reported clinical competency committee (CCC) determined EPA supervision level assignments for all residents in their program for a subset of 5-6 of the 17 general pediatrics EPAs biannually (Fall and Spring), except interns who were only assessed at the end of the academic year (Spring). They indicated “unable to assess” whenever applicable. Results Across the 5 data collection cycles, there were 29,643 opportunities to assign an EPA supervision level to 1987 residents from all three post-graduate years. Of these, 4140 assignments (14%) were deemed “unable to assess.” Across all EPAs, this determination was made less often in mid-year reports than year-end reports (p=.005). Post-graduate year 3 (PGY3) residents and PGY2 residents had significantly lower frequencies of “unable to assess” assignments when compared with PGY1 residents (Figure). EPAs with the lowest rates of “unable to assess” included: EPA 4 (patients with acute, common dx) at 0.4%, EPAs 10 (initial resuscitation/stabilization) and 16 (handovers) at 0.9%, EPA 11 (manage information) at 4%, and EPA 13 (practice management) at 5%. EPAs with the highest rates of “unable to assess” included EPA 8 (transition to adult care) at 43%, EPA 17 (procedures) at 27%, EPA 14 (quality improvement) at 20%, and EPAs 12 (make referrals) and 9 (behavioral and mental health) at 14%. Conclusions “Unable to assess” assignments are related to the given EPA, training year, and timing of assessment within the academic year. CCCs may be less likely to assign EPA supervision levels at timepoints viewed as higher stakes, such as transition from one training year to the next. Future work should explore this further and consider the etiology behind high levels of inability to assess some EPAs in particular.

The Activist Lab and the MOULA Program.

The Activist Lab at the University of South Florida College of Public Health is an exciting initiative that serves to build interdisciplinary advocacy and leadership skills for public health students and the community. The Lab is led by a very active student advisory group that with the Director develops the advocacy strategies and focus areas for change. The Activist Lab's More Opportunities to Use Learned Advocacy, or MOULA program, allows students to work side by side with local agencies to support their advocacy efforts. A recent student works with the local Guardian ad Litem program to determine needs and services for children in the foster care system who have also been trafficked. The student is working with attorneys, social workers, families, advocates, and others so that the best needs of the children are met. Students must apply and be selected for the MOULA program based on their responses as to how they could meet the agency's needs. The best responses and matches with the agencies are then determined. Students who participate in MOULA do midyear and final-year reports, evaluate their experiences, are evaluated by the agency mentor, develop a presentation on their experiences, and are interviewed on one of the Activist Lab podcast episodes. The Activist Lab and initiatives such as MOULA provide an opportunity for students to learn and advance critical public health advocacy skills and will help strengthen these skills for future success.

Education matters/ ASEG RF supports four new projects/ ASEG RF mid-year project reports

Education matters/ ASEG RF supports four new projects/ ASEG RF mid-year project reports

The Effect of Midyear Report Cards on Colonoscopy Quality Measures.

Introduction Since 2011, our institution has distributed annual reports, in June, to providers with personalized data regarding adenoma detection rate (ADR), colonoscope withdrawal time (CW), and cecal intubation (CI) rate, using standardized reporting systems. We examined the impact of distribution of individualized reports at the midpoint of each year on colonoscopy outcomes in the latter half of each year. Methods Providers with endoscopy privileges, performing ≥20 colonoscopies/year, at our center throughout a five-year period (2011-2015) were included. The three metrics recorded and reported were ADR, CW, and CI using standard benchmark rates. The mean values of each metric from January through June (1st half) and July through December (2nd half) were calculated. Curve estimation test was used to determine the significance of ADR in the respective time period. Results Fifteen providers were eligible for the study. Collective ADR in the 1st half of all years was 26.9% and in the second half of all years was 28.1% (p = 0.476). CW for all years was more than 9 minutes while CI was above 90% for all providers. There was no significant increase in the CI and CW during the 5-year study period. Overall, ADR increased from 26.43% (2011) to 33.47% (2015) (p = 0.137). When examining ADR during each of the 12 months following the June report cards, there was no month-to-month trend observed (p = 0.893). Conclusion Endoscopists at our institutions met/exceeded the quality metrics in the first half of each year from the beginning of the study. Routine reporting may maintain, but not improve, outcomes. Long-term studies to determine if periodic feedback to endoscopists improves the quality of endoscopy as per national standards for detection of early colorectal cancers are required.

President's mid-year report

President Faith Wainwright reports on her first six months in office, highlighting three principal themes: engagement with UN Sustainable Development Goals, the importance of sharing knowledge within our professional communities, and the various forms that 'leadership' can take within the profession.

President's mid-year report: an industry under scrutiny

President's mid-year report: an industry under scrutiny

Midyear Report: Continuing the Anniversary Celebration

Biopreservation and BiobankingVol. 15, No. 3 From the Editor's DeskMidyear Report: Continuing the Anniversary CelebrationJim VaughtJim VaughtSearch for more papers by this authorPublished Online:1 Jun 2017https://doi.org/10.1089/bio.2017.29023.jjvAboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View article"Midyear Report: Continuing the Anniversary Celebration." Biopreservation and Biobanking, 15(3), p. 175FiguresReferencesRelatedDetails Volume 15Issue 3Jun 2017 InformationCopyright 2017, Mary Ann Liebert, Inc.To cite this article:Jim Vaught.Midyear Report: Continuing the Anniversary Celebration.Biopreservation and Biobanking.Jun 2017.175-175.http://doi.org/10.1089/bio.2017.29023.jjvPublished in Volume: 15 Issue 3: June 1, 2017Online Ahead of Print:May 22, 2017PDF download

Tu1724 - The Effect of Mid-Year Report Cards on Colonoscopy Quality Measures

Tu1724 - The Effect of Mid-Year Report Cards on Colonoscopy Quality Measures

Biopreservation and Biobanking Mid-Year Report.

Biopreservation and Biobanking Mid-Year Report.

Budget transparency in Croatian counties, cities and municipalities (November 2015 – March 2016)

This paper presents the results of a budget transparency analysis for local government units in Croatia, measured by the number of key budget documents published on their respective official websites in the period November 2015-March 2016. The five key documents include: the 2014 year-end report, the 2015 mid-year report, as well as the 2016 budget proposal, enacted budget and citizens budget. The analysis takes into account only the documents available in the relevant period on the days of examining the official websites, while subsequently published documents are excluded. According to this methodology, the level of transparency can range between 0 and 5. Despite being unsatisfactory, the overall average level of budget transparency in local government units improved from 1.75 in the previous to 2.35 in the current research cycle. Counties are very transparent (4.3) on average, while cities are lagging behind (3.05) on average and municipalities are distinctly non-transparent (2.04 on average). Although as many as nine cities and almost a fifth of municipalities did not publish a single document, it is encouraging that: nearly half of all local government units published a larger number of budget documents than in the previous research cycle; that the most transparent local units also include relatively small and poor ones; and that some of the relatively small and poor municipalities have welldesigned and easily searchable websites. The analysis results for all counties, cities and municipalities are presented below and can also be further examined on the interactive map.

How teacher emotional support motivates students: The mediating roles of perceived peer relatedness, autonomy support, and competence

Multilevel mediation analyses test whether students' mid-year reports of classroom experiences of autonomy, relatedness with peers, and competence mediate associations between early in the school year emotionally-supportive teacher-student interactions (independently observed) and student-reported academic year changes in mastery motivation and behavioral engagement. When teachers were observed to be more emotionally-supportive in the beginning of the school year, adolescents reported academic year increases in their behavioral engagement and mastery motivation. Mid-year student reports indicated that in emotionally-supportive classrooms, adolescents experienced more developmentally-appropriate opportunities to exercise autonomy in their day-to-day activities and had more positive relationships with their peers. Analyses of the indirect effects of teacher emotional support on students' engagement and motivation indicated significant mediating effects of autonomy and peer relatedness experiences, but not competence beliefs, in this sample of 960 students (ages 11–17) in the classrooms of 68 middle and high school teachers in 12 U.S. schools.

Baseline Indicators and Implementation Strategies in a Statewide Correctional Nurse Competencies Program: Mid-Year Report

This 3-year, public-academic workforce development project aimed to establish indicators for quality correctional nursing care to empirically test the translation of correctional nursing standards into practical and applied competencies. Approaches to document indicators and achieve implementation of a correctional nurse competency system include (a) knowledge transfer and exchange, (b) system mapping, (c) adherence to implementation plan and strategy, and (d) practice-based action research. Indicators were established. Twenty-five percent (n = 111) of nurses maintained clinical credentials beyond the basic requirements; 86% (n = 381) of nurses received continuing nursing education certificates, 98% (n = 434) of nurses were satisfied with the program, and 43% (n = 9,052) of inmate/patients were satisfied with clinical care. Quality ratings of program educators averaged 4.79 on a 5-point scale. Innovation is supported by adding continuous improvement components to the implementation of a correctional nurse competency system effort. Team members' consensus decision making enabled them to apply their domain-specific knowledge to assess the success of the implementation strategy.

AB1182-HPR Development and Implementation of A Multidisciplinary Management Tool of Biological Therapies in Arthropathies

BackgroundBiologic Drugs have solid evidence in the treatment of the arthropathies, with similar efficacy data among different anti-TNF agents but are also associated with elevated direct costs.Due to this fact,...

Radiology and Congress: A Midyear Report

The first session of the 112th United States Congress has passed the 6-month mark, and with the impending distraction of upcoming major election campaigns, it's a good time to take stock of issues related to health care in general and radiology in particular. Evaluating the progress, or lack thereof, of this Congress will enable us to more clearly define how we will address radiology's important issues and what strategies we can use to achieve our goals.

Unlimited Possibilities for Fiscal Transparency Improvement

Unlimited Possibilities for Fiscal Transparency Improvement

Mid-year report: Finishers cautiously optimistic: Despite tighter profit margins and softening sectors, savvy finishers still find investing feasible

Mid-year report: Finishers cautiously optimistic: Despite tighter profit margins and softening sectors, savvy finishers still find investing feasible

Chikungunya Fever, Mauritius, 2006

To the Editor: When an outbreak of chikungunya fever swept across several Indian Ocean islands in 2005 and 2006, the international public health community’s attention was drawn to chikungunya virus (genus Alphavirus, family Togaviridae). Among those areas affected was the Republic of Mauritius, located ≈900 km east of Madagascar, which has an estimated population of 1,250,000 and comprises the main island of Mauritius (area ≈1,865 km2) and several outlying islands including Rodrigues (≈180 km2). Mauritius Island had an initial outbreak of ≈3,500 suspected cases of chikungunya fever from April through June 2005 (1). With the onset of the drier season of winter, transmission of the virus subsided, but increased again during 2006. An outbreak began on Rodrigues Island in February 2006. The intensity of chikungunya fever outbreaks on Mauritius and Rodrigues Islands led us to explore the extent to which these outbreaks might have contributed to overall death rates. Chikungunya virus is transmitted to humans primarily by the bite of infected Aedes spp. mosquitoes. Aedes aegypti was effectively eliminated from the island of Mauritius during a malaria control campaign from 1949 through 1951 (2). However, A. albopictus is widely distributed on the island in rural and urban habitats (3); thus, A. albopictus may be the most likely vector for chikungunya virus. Common peridomestic breeding places in Mauritius include small pots and vases (used to decorate the outside of homes) and discarded rubber tires (3). Chikungunya fever was first recognized in 1952 after an outbreak on the Makonde Plateau of Tanganyika Territory (4), currently part of Tanzania. The word chikungunya is from a local dialect that translates to “that which bends up” in reference to the stooped posture often seen in patients with severe arthralgia (5). Human infections with chikungunya virus are associated with sudden onset of symptoms including headache, fever, rash, and muscle and joint pain (5). Before the outbreak in the Indian Ocean islands, deaths had not been associated with infections. However, Reunion Island reported >200 deaths during the 2006 chikungunya epidemic (January–April 2006) (6), and India conservatively estimated 1,194 deaths since the virus reemerged in December 2005 (7). To determine whether a similar situation occurred in Mauritius, we compared expected number of deaths with observed number of deaths and estimated number of chikungunya cases from January through December 2006. Crude death rates (CDRs) and number of deaths were obtained from the Annual Digest of Statistics 2005 and 2006 (8). We calculated expected number of deaths for each month in 2006 by multiplying mean CDR (per 1,000 midyear population) of each month for the previous 10 years (1996–2005) by midyear population for 2006. Estimated number of cases of chikungunya fever in 2006 for the Island of Mauritius was obtained from the Chikungunya Unit of the Ministry of Health and Quality of Life and includes both suspected and confirmed cases. A case was considered suspected if the patient had >2 of the following 3 symptoms: fever, rash, and joint pain. Cases were confirmed by cell culture. CDRs for the Republic of Mauritius ranged from 6.7 to 7.0 during 1996–2005 (mean 6.8) but increased to 7.3 in 2006, which represented a 4.3% (95% confidence interval [CI] 2.2%–8.5%) increase from 2005 (CDR 7.0). According to the 2006 midyear Population and Vital Statistics Report for the Republic of Mauritius (8), the number of deaths from January through June 2006 increased by 16.7% (95% CI 11.0%–23.5%) over the number of deaths in 2005, and 19.8% (95% CI 13.5%–26.9%) more deaths occurred among elderly persons (age >60 years). These numbers include all potential causes of deaths. However, increased CDRs occurred only during the months of the chikungunya fever epidemic on Rodgrigues and Mauritius Islands. CDRs on the Island of Mauritius in March, April, and May 2006 were significantly greater than expected (p 80 in May (9). Figure Expected and observed numbers of deaths and estimated number of chikungunya cases on Mauritius Island. Asterisks indicate a statistically significant (p<0.01) difference between expected and observed number of deaths for the specified months. ... The increase in CDRs reported for the Republic of Mauritius during the chikungunya epidemic is similar to the findings reported for the neighboring island of Reunion (10). Excess deaths in Reunion and the Republic of Mauritius coincided with the epidemic curve of the chikungunya fever outbreak, which suggested an association between these 2 factors. No other events that may have negatively affected the health of persons living in the Republic of Mauritius in 2006 were reported. However, because information on cause of death is unavailable, studies are needed to confirm that the chikungunya fever outbreak contributed to increased CDRs in 2006.

Homeland and Climatic Security at the Crossroads of Science and Policy: GSA–USGS Congressional Science Fellow Midyear Report

Homeland and Climatic Security at the Crossroads of Science and Policy: GSA–USGS Congressional Science Fellow Midyear Report

Congressional Science Fellow Midyear Report

Congressional Science Fellow Midyear Report

President's Column: Mid-year Report of VLA Activities

President's Column: Mid-year Report of VLA Activities