On-site Training Research Articles

Infection control measures in neonatal units: implementation of change in the Gaza-Strip

Introduction: Low-income countries rarely report infection control measures although they are key to reducing mortality and morbidity in healthcare. This audit examined healthcare personnel’s adherence to infection control measures before entry to the NICU and in both minor and major procedures’ bundles. Furthermore, it examined the effect of subsequent authorization and dissemination of infection control guidelines followed by education and training sessions on the adherence of healthcare personnel to infection control policies.Methods: This prospective observational study was conducted in two NICUs at two separate hospitals in the Gaza-Strip, Palestine. The initial observation period was June–August 2016 during which healthcare professionals’ adherence to infection control policies was assessed by direct observation. This was followed by NICU feedback dissemination and on-site educational and training sessions. Then, the reaudit, following the same protocol, was carried out throughout February 2017.Results: There was a statistically significant improvement in the adherence to infection control measures among healthcare personnel. Significant improvements were found in both minor and major procedure infection control protocols’ adherence rates. However, when comparing the general neonatal handling adherence rate between both audits, no significant change was noted.Discussion: This study highlights the effectiveness of using audit feedback and on-site educational and training sessions in the enhancement of adherence to infection control policies, demonstrating significant improvement in areas covered by the staff training program. Therefore, including regular infection control training combined with feedback in the curriculum of healthcare professionals can improve the sustainability of infection control programs. Further studies must examine the impact of such training also on the incidence of healthcare-associated infection rates as well as morbidity and mortality within neonatal units.

A Study on Perception of Health Care Workers In Relation To HIV/AIDS in Jamnagar District -

Background: The World Health Organization (WHO) estimates that about 2.5% of HIV cases among healthcare workers worldwide are due to result of such exposures. While treating HIV positive patients or persons with unknown status and with high risk behavior, health professionals are at risk of getting HIV/AIDS at every stage as one of the occupational hazards. Aim: The perceptions in relation with prevention of HIV/AIDS amongst health care workers. Materials and Methods: A hospital based cross-sectional observational study carried out among 100 PG students, 50 medical officers, 210 nurses, 40 lab technicians and 100 primary health workers from district hospital as well as from peripheral CHCs and PHCs. Multistage stratified random sampling was done. Data was analyzed by Epi Info software. Results: The overall percentage of health functionaries having faith in Universal Precautions as a preventive tool in present study was 75%.Of those who had knowledge about Universal Precautions; only 49.45% of the PG students, 22% of the Medical officers, 28.3% of the Nurses, 17.40% of the Lab. technicians and 33.3% of the Health workers had favored using Universal Precautions with each patient. Conclusion: At the end of the study we can be able to find out various false perceptions and beliefs amongst health care worker in relation to prevention of HIV/AIDS at day to day work. Supportive supervision and onsite training and corrections are needed. Periodic Joint Training particularly in practical aspect for all level of health care workers is need of hour. Key words: perception, HIV, AIDS, Doctors, Nurses, lab technicians, universal work precaution

Structured on-the-job training to improve retention of newborn resuscitation skills: a national cohort Helping Babies Breathe study in Tanzania

BackgroundNewborn resuscitation is a life-saving intervention for birth asphyxia, a leading cause of neonatal mortality. Improving provider newborn resuscitation skills is critical for delivering quality care, but the retention of these skills has been a challenge. Tanzania implemented a national newborn resuscitation using the Helping Babies Breathe (HBB) training program to help address this problem. Our objective was to evaluate the effectiveness of two training approaches to newborn resuscitation skills retention implemented across 16 regions of Tanzania.MethodsAn initial training approach implemented included verbal instructions for participating providers to replicate the training back at their service delivery site to others who were not trained. After a noted drop in skills, the program developed structured on-the-job training guidance and included this in the training. The approaches were implemented sequentially in 8 regions each with nurses/ midwives, other clinicians and medical attendants who had not received HBB training before. Newborn resuscitation skills were assessed immediately after training and 4–6 weeks after training using a validated objective structured clinical examination, and retention, measured through degree of skills drop, was compared between the two training approaches.ResultsEight thousand, three hundred and ninety-one providers were trained and assessed: 3592 underwent the initial training approach and 4799 underwent the modified approach. Immediately post-training, average skills scores were similar between initial and modified training groups: 80.5 and 81.3%, respectively (p-value 0.07). Both groups experienced statistically significant drops in newborn resuscitation skills over time. However, the modified training approach was associated with significantly higher skills scores 4–6 weeks post training: 77.6% among the modified training approach versus 70.7% among the initial training approach (p-value < 0.0001). Medical attendant cadre showed the greatest skills retention.ConclusionsA modified training approach consisting of structured OJT, guidance and tools improved newborn resuscitation skills retention among health care providers. The study results give evidence for including on-site training as part of efforts to improve provider performance and strengthen quality of care.

Advancing Use of Key Integrated Pest Management Practices in Schools

Since 2011, Oregon State University has conducted integrated pest management (IPM) training specific to public schools. School personnel receive onsite training on key IPM practices as well as associated materials. To determine which practices and materials school employees are using as a result of the program, we administered a survey to 2016 training attendees. We found that all returning attendees had been implementing practices and using materials as a result of the training. The most common practice was sealing holes to keep pests out. Additionally, the majority of respondents reported a reduction in pesticide use. Our approach may serve as a reference for Extension specialists in developing school IPM programs in other states.

Integration of Onsite Long-Acting Reversible Contraception Services Into School-Based Health Centers.

With recent recommendations from professional organizations, long-acting reversible contraception (LARC) methods are considered appropriate first-line contraception for adolescents. Many school-based health centers (SBHCs) in New York City (NYC) have recently added onsite LARC insertion and management to their contraceptive options. We aimed to explore key elements needed to implement LARC training and services into the SBHC setting and to identify successful factors for program implementation. Semistructured qualitative interviews were conducted with 19 providers and staff at 7 SBHCs in high schools in the Bronx and analyzed using Dedoose. Support and leadership from administration; comprehensive onsite training of providers and staff; developing an effective staffing model for procedure sessions; and patient-centered contraceptive counseling were 4 key themes named by respondents as crucial to the program implementation process. Integrating LARC services onsite at SBHCs is feasible and positively received by providers and staff. With good leadership, staffing, training, and appropriate contraceptive counseling, both SBHCs and other primary clinics that serve adolescents can integrate LARC insertion, removal, and management into routine contraceptive care. This in turn can increase youth access to these methods.

The Effect of a Multicomponent Intervention on Quality of Life in Residents of Nursing Homes: A Randomized Controlled Trial (COSMOS)

ObjectivesTo investigate if the multicomponent intervention of the COSMOS trial, combining communication, systematic pain management, medication review, and activities, improved quality of life (QoL) in nursing home patients with complex needs. DesignMulticenter, cluster-randomized, single-blinded, controlled trial. SettingThirty-three nursing homes with 67 units (clusters) from 8 Norwegian municipalities. ParticipantsSeven hundred twenty-three patients with and without dementia (≥65 years) were cluster randomized to usual care or intervention in which health care staff received standardized education and on-site training for 4 months with follow-up at month 9. MeasurementsPrimary outcome was change in QoL as measured by QUALIDEM (QoL dementia scale); QUALID (QoL late-stage dementia scale), and EQ-VAS (European QoL–visual analog scale) from baseline to month 4. Secondary outcomes were activities of daily living (ADL), total medication, staff distress, and clinical global impressions of change (CGIC). ResultsDuring the active intervention, all 3 QoL measures worsened, 2 significantly (QUALID P = .04; QUALIDEM P = .002). However, follow-up analysis from month 4 to 9 showed an intervention effect for EQ-VAS (P = .003) and QUALIDEM total score (P = .01; care relationship P = .02; positive affect P = .04, social relations P = .01). The secondary outcomes of ADL function, reduction of medication (including psychotropics) and staff distress, improved significantly from baseline to month 4. Intervention effects were also demonstrated for CGIC at month 4 (P = .023) and 9 (P = .009), mainly because of deterioration in the control group. Conclusion and implicationsTemporarily, the QoL decreased in the intervention group, leading to our hypothesis that health care staff may be overwhelmed by the work-intensive COSMOS intervention period. However, the decrease reversed significantly during follow-up, indicating a potential learning effect. Further, the intervention group improved in ADL function and received less medication, and staff reported less distress and judged COSMOS as able to bring about clinically relevant change. This suggests that nonpharmacologic multicomponent interventions require long follow-up to ensure uptake and beneficial effects.

Development of the Learning Achievement Scale from On-site Training in Students of Three-year Nursing Schools：Consideration of its Reliability and Validity

Development of the Learning Achievement Scale from On-site Training in Students of Three-year Nursing Schools：Consideration of its Reliability and Validity

Influence of Occupational Safety and Health Training toward Staff Practices at Fast Food Restaurant in Malaysia

Among food service establishments in Malaysia, fast food restaurant (FFR) was found having zero rate of accident that causes permanent disability and death at workplace. Result of preliminary study of this study showed occupational safety and health training gave high influence to safety and health practices among staff of the FRR. A quantitative research was conducted to identify level of influence of four major areas of the occupational safety and health training (workplace hazards and emergency procedure, personel hygiene and the use of personal protection equipment (PPE), food safety, and cleaning procedure) toward the practices of 225 FRR staff. The staff were selected randomly from various FFRs in Malaysia. Results of the preliminary study indicated overall mean level of influence of those four research variables toward staff practices at workplace was high with mean value=4.35 and standard deviation=0.37. The study suggests for the FFR management to provide future training with holistic content. This study also suggests to Malaysia Ministry of Health to establish guidelines for compulsory on-site similar occupational safety and health training to food handlers in all food service establishments for effective food safety practices as well as for the benefit of public health.

Experimentation environment for industrial control systems cybersecurity: On-site and remote training

Abstract The digital transformation of industries implies the need of new training efforts. In this context, cybersecurity of industrial control systems (ICS) poses specific challenges. The current practice of ICS cybersecurity training is generally restricted to the isolated management of industrial and network devices or extensive use of network traffic emulation/simulation, providing the students a limited understanding of the problem. For that reason, in this paper, we present an approach based on the replication of a simple industrial control system. For that purpose, a control cabinet, which covers the lowest levels of the automation pyramid, and a set of virtual machines (VMs) are used. The aim is to provide a flexible experimentation environment where all elements can be reconfigured. Through the deployment of the appropriate network structure, students can carry out device configurations or assume different roles in the industrial control system, from the points of view of automation or security. The experimentation environment is also designed to provide a comprehensive remote access to hardware, software and communication networks in a reliable way (flexibility), without posing a threat to the security and safety of the environment (isolation) or requiring time-consuming maintenance (easy recovery of VMs and equipment). Through the architecture defined, students can reach the VMs used in each task, which are isolated from the outer network and can be easily managed and maintained. Finally, some educational activities are presented, where the proposed approach is used for training of students with different backgrounds.

Impact of novel blood culture collection bundle to reduce blood culture contamination rates: An important continuous quality improvement indicator of laboratory medicine

Introduction: Blood cultures play a very important role in the diagnostic algorithm for managing patients with sepsis. Contamination of blood cultures complicate patient care resulting in unnecessary antibiotic use, prolonged hospital stays and more financial burden on the patient. Hence, microbiology laboratories strive to keep contamination rates within <3% as per international standards. Aim: To monitor blood culture contamination rate and reduce contamination using a novel blood culture collection (BCC) bundle. Materials and Methods: A prospective interventional study carried out in a newly set up Microbiology laboratory of a 200 bed tertiary care hospital in North Mumbai. Blood cultures from various clinical areas of the hospital were processed using the BacT/Alert system (BioMereiux, Marcy l'etiole, France). All positive blood cultures were co-related clinically and assigned as pathogens or contaminants. Blood culture contamination rates were actively monitored and BCC bundle was introduced to reduce contamination, which comprised six steps to follow while performing BCC. Active surveillance, audits of the collection process and root cause analysis (RCA) of blood culture contamination were done simultaneously. This was followed by feedback to phlebotomists, nurses and doctors. Periodic and need-based onsite training of health-care workers was also done. Results: Different types of Health Care Workers were performing the procedure. The most common contaminant grown were Gram-positive cocci 159 (25.5%), followed by Gram-negative bacilli 58 (9.32%), and Bacillus spp. 37 (5.95%). It was observed that skin disinfection and incorrect order of draw were two main reasons for the contamination. Over a period of 18 months, BCC bundle implementation reduced the contamination from 17% to 4%. Conclusion: RCA, training, surveillance and audits are essential to improve the quality of blood culture results. Implementation of the BCC bundle benefits both the microbiology laboratory and the clinical teams by decreasing the growth of contaminants and improving the utility of blood culture for better management of patients in sepsis bringing in favorable outcomes.

Feasibility of Real-Time Mobile Phone Case Notification by Village Malaria Workers in Rural Myanmar: A Mixed Methods Study

Malaria burden has markedly decreased in Myanmar and is on course for elimination by 2030. Interrupting of local transmission is essential, and timely notification within 24 hours of disease occurrence by frontline village malaria workers (VMWs) is a crucial initial component of timely follow-up by response teams. Here we studied the feasibility of real-time case notification using mobile phones among VMWs in the remote Banmauk Township, Sagaing Region, Myanmar. A structured quantitative and qualitative questionnaire was used for data collection after implementing the intervention for six months between May and October 2018. Ten VMWs from the National Malaria Control Programme (NMCP) in ten scattered villages from the township were randomly recruited and given one day of on-site training on reporting methods and how to use their own mobile phone. VMWs received 5,000MMK (approximately 3USD) per month remuneration. The baseline demographics of VMWs were not significantly different. Twenty-four out of 25 (96%) malaria patients were notified within 24 hours by the ten VMWs during the study period. All submitted information were said to be complete and correct. VMWs suggested the system as simple and acceptable despite some challenges. In the qualitative study, almost all VMWs were satisfied with the system and willing to use it in the future. This mobile phone reporting system is more efficient and easier to use than other more complicated online mobile applications. However, only a few indicators can be submitted using this approach and the system cannot be used in areas without network coverage.

Outcomes of a Statewide Learning Collaborative to Implement Mental Health Services in Pediatric Primary Care.

Mental health concerns are common in pediatric primary care, but practitioners report low levels of comfort managing them. A primary care intervention addressing organizational and individual factors was developed to improve the management of common mental health conditions. Twenty-nine practices participated in a statewide learning collaborative over 18 months. On-site training was used to teach communication and brief intervention skills and develop an organizational context supportive of mental health. Clinician confidence was measured pre- and postintervention. Medicaid claims data were used to estimate the intervention's effects on identification of mental health conditions and prescribing practices. Mean clinician confidence scores increased by 20% (95% confidence interval [CI]=15% to 25%), from 2.92 at baseline to 3.55 postintervention. In the first month of the preintervention year, 6.65% of patients with an office visit had at least one visit for a mental health condition, rising to 9% postintervention; this trend was driven by detection and treatment of attention-deficit hyperactivity disorder (ADHD). Rates of prescribing ADHD medication to patients with visits for ADHD increased by 0.12 percentage points per month (CI=0.02 to 0.22, p=0.022). Rates of prescribing second-generation antipsychotics to all patients with office visits decreased by 0.014 percentage points per month (CI=-.03 to -.00, p=0.028), relative to preintervention trends. This study suggests that a multicomponent intervention addressing individual staff and organizational factors together can promote identification and treatment of child mental health conditions in primary care. Future research is required to better understand the core components, impact on health outcomes, and sustainability.

Embracing the flipped classroom: the planning and execution of a faculty workshop

A great deal of interest has emerged recently in the flipped classroom (FC), a student-centered teaching approach. After attending a presentation by the first author on the FC, a faculty member of a medical school in Mexico arranged for a 3-day workshop for 13 faculty members. The goal of the workshop was to train faculty to use the FC strategy in their classrooms to increase student engagement in learning. The workshop was in the FC style, where the participants would assume the role of students. Pre- and posttraining surveys were administered to examine participants' current teaching practices and to evaluate their perceptions of the FC. The participants overwhelmingly reported the need to change their lecture-based teaching, as it was not engaging students. Their large class size, lack of technology, training, and uncertainty of the effectiveness of new teaching methods had hindered participants from changing their teaching technique. The on-site training not only allowed the entire department to work closely and discuss the new teaching approach, but also reinforced the idea of changing their teaching strategy and embracing FC teaching method. After the workshop, participants reported being determined to use the FC strategy in their classrooms and felt more prepared to do so. The post-survey results indicated that participants valued the FC training in the flipped style and wanted more of the hands-on activities. In conclusion, the 3-day faculty workshop on the FC was successful, since every participant was motivated to use this teaching method.

Comprehensive cancer control planning in the Pacific: the Cancer Council of the Pacific Islands a multi-national regional coalition.

In the early 1990s, a comprehensive cancer control (CCC) approach was developed in the United States (US). In 2003, the US-Affiliated Pacific Islands (USAPI) adopted the CCC approach through a regional coalition, the Cancer Council of the Pacific Islands (CCPI). Using the CCC approach, the CCPI developed jurisdiction-specific cancer coalitions and initiated their respective cancer plans. The evolution of the CCC approach and the history of the CCPI regional coalition are reviewed. The outcomes of the regional approach for cancer control in the USAPI are described to illustrate the possibilities, value-added and innovation of using a CCC strategy in a multi-national coalition based in a resource-limited environment. The CCC approach enabled the CCPI to (1) harmonize cancer control efforts between the six USAPI jurisdictions, (2) represent the USAPI cancer needs as a single voice, and (3) develop a regional cancer control strategy. Outcomes include (1) a regional cancer registry, (2) three sequential regional CCC plans, (3) leveraged resources for the USAPI, (4) enhanced on-site technical assistance and training, (5) improved standards for cancer screening, (6) evidence-based cancer control interventions adapted for the USAPI. The regional CCPI coupled with the CCC approach is an effective engine of change. The CCC strategies enabled navigation of the political, geographic, cultural, and epidemiologic Pacific environment. The regional partners have been able to harmonize cancer control efforts in resource-limited settings. Regional cancer coalitions may be effective in the global arena for cancer control between communities, states, or countries.

Improving immunization capacity in Ethiopia through continuous quality improvement interventions: a prospective quasi-experimental study

BackgroundStrong scientific evidence is needed to support low-income countries in building effective and sustainable immunization programs and proactively engaging in global vaccine development and implementation initiatives. This study aimed to implement and evaluate the effectiveness of system-wide continuous quality improvement (CQI) interventions to improve national immunization programme performance in Ethiopia.MethodsThe study used a prospective, quasi-experimental design with an interrupted time-series analysis to collect data from 781 government health sectors (556 healthcare facilities, 196 district health offices, and 29 zonal health departments) selected from developing and emerging regions in Ethiopia. Procedures included baseline quality assessment of immunization programme and services using structured checklists; immunization systems strengthening using onsite technical support, training, and supportive supervision interventions in a Plan-Do-Check-Act cycle over 12 months; and collection and analysis of data at baseline and at the 6th and 12th month of interventions using statistical process control and the t-test. Outcome measures were the coverage of the vaccines pentavalent 3, measles, Bacillus Calmette–Guérin vaccine (BCG), Pneumococcal Conjugate Vaccine (PCV), as well as full vaccination status; while process measures were changes in human resources, planning, service delivery, logistics and supply, documentation, coordination and collaboration, and monitoring and evaluation. Analysis and interpretation of data adhered to SQUIRE 2.0 guidelines.ResultsPrior to the interventions, vaccination coverage was low and all seven process indicators had an aggregate score of below 50%, with significant differences in performance at healthcare facility level between developing and emerging regions (P = 0.0001). Following the interventions, vaccination coverage improved significantly from 63.6% at baseline to 79.3% for pentavalent (P = 0.0001), 62.5 to 72.8% for measles (P = 0.009), 62.4 to 73.5% for BCG (P = 0.0001), 65.3 to 81.0% for PCV (P = 0.02), and insignificantly from 56.2 to 74.2% for full vaccination. All seven process indicators scored above 75% in all regions, with no significant differences found in performance between developing and emerging regions.ConclusionsThe CQI interventions improved immunization capacity and vaccination coverage in Ethiopia, where the unstable transmission patterns and intensity of infectious diseases necessitate for a state of readiness of the health system at all times. The approach was found to empower zone, district, and facility-level health sectors to exercise accountability and share ownership of immunization outcomes. While universal approaches can improve routine immunization, local innovative interventions that target local problems and dynamics are also necessary to achieve optimal coverage.

An Innovative Integrated Capacity Building Project for Stem Cell Transplantation in the Southern Lazio Region

Autologous stem cell transplantation (ASCT) is a standard treatment for many hematological disorders. Since ASCT needs technical and professional skills, a start-up process should imply the application of a specific methodology to reduce time and costs, and to optimize the results. We describe here an innovative and integrated process leading to the start-up of a transplant activity in the Hematology Unit of the general hospital of Frosinone, southern Lazio, Italy. The method had previously been employed successfully by one of us in a critical context (Mediterr J Hematol Infect Dis. 2017 Apr 15;9). Since 1996, the Hematology Unit in Frosinone gained experience in treating malignant and non malignant disorders, but HSCT could not be performed so patients were referred to other institutions in the country with remarkable costs and discomfort. The innovative aspect of our project is the application of a capacity building methodology aimed at establishing a quality system prior to the initiation of the clinical transplant activity. Capacity building is a continuous process addressed to individuals, organizations and institutions aiming at developing abilities and achieve objectives. A preliminary step was to check sustainability,ie whether the institution was suitable to support an ASCT activity, and to assess the level of expertise of the medical and nurse staff involved in the process. In fact, our Hospital was lacking some of the facilities required to perform ASCT, such as apheresis and stem cell manipulation. To overcome the obstacle, an agreement with the close Latina Hospital that has consolidated experience in ASCT was established, gaining access to their facilities and expertise. In June 2018 we held a first training course addressed to physicians and nurses that covered different aspects of ASCT. A scientific advisor led the process of editing clinical protocols and procedures. Simultaneously a quality system was built based on clinical guidelines that follow the international FACT-JACIE standards. In this phase, the document management system, the outcome indicators and the main rules of the transplant program were created. In order to improve the educational program we planned a second training phase based on on-site coaching. To better accomplish the task, physicians and nurses are now asked to highlight the practical aspects of the process that require further development trough a simple questionnaire. During this second training phase, selected physicians and nurses with experience in transplantation will undertake an open discussion about the aspects requiring further evaluation. The goal is to perform our first autologous transplant within four months since the start of the project. We believe that the capacity building process through on-site training and coaching represents an innovative effective method for developing autonomous skills needed to conduct a sustainable HSCT program. DisclosuresNo relevant conflicts of interest to declare.

Using a muscle pump activator device to stimulate healing for non-healing lower leg wounds in long-term care residents.

Chronic non‐healing wounds are a burden in the Long‐Term Care (LTC) sector, increasing costs, morbidity, and mortality and causing pain and suffering. The objective of this LTC Innovation pilot was to test the value of a promising new neuromuscular stimulation device in elevating the experience and satisfaction of the residents, engaging and empowering the nursing staff, and improving healing and/or reducing costs. Small, wireless, and worn at the knee, this muscle pump activator is self‐contained, wearable, and battery‐powered to increase lower‐leg blood circulation (up to 60% of that achieved by walking). It has no wires, weighs just 10 g, and is easy to use. Nurses in four LTC homes identified residents with non‐healing lower leg wounds. Consent was obtained, and on‐site training was delivered. Eleven residents were recruited. Only seven met the inclusion criteria for venous/mixed or diabetic foot ulcers. Of the seven who met the criteria and were adherent with best practices and the muscle pump activator, four healed 100%, and one healed 90%. Two patients with other aetiologies, who were also adherent, healed. All adherent residents had an average weekly decrease in wound size of 9.75% and were extremely happy with the results. Three residents who were non‐adherent had a 9.25% increase in wound size per week. One patient with diabetic foot ulcers developed skin changes at the end of life and passed away. Nursing staff and cognisant residents can easily adjust the pulse of muscle pump activator, and application and removal are simple. Most residents feel engaged with the therapy “because they feel it working”. The LTC corporation feels that it is a great adjunctive solution for many types of lower‐leg wounds (venous, mixed, diabetic, pressure) in addition to best practices in the LTC and Retirement home sectors.

The European Bioinformatics Institute in 2018: tools, infrastructure and training.

The European Bioinformatics Institute (https://www.ebi.ac.uk/) archives, curates and analyses life sciences data produced by researchers throughout the world, and makes these data available for re-use globally (https://www.ebi.ac.uk/). Data volumes continue to grow exponentially: total raw storage capacity now exceeds 160 petabytes, and we manage these increasing data flows while maintaining the quality of our services. This year we have improved the efficiency of our computational infrastructure and doubled the bandwidth of our connection to the worldwide web. We report two new data resources, the Single Cell Expression Atlas (https://www.ebi.ac.uk/gxa/sc/), which is a component of the Expression Atlas; and the PDBe-Knowledgebase (https://www.ebi.ac.uk/pdbe/pdbe-kb), which collates functional annotations and predictions for structure data in the Protein Data Bank. Additionally, Europe PMC (http://europepmc.org/) has added preprint abstracts to its search results, supplementing results from peer-reviewed publications. EMBL-EBI maintains over 150 analytical bioinformatics tools that complement our data resources. We make these tools available for users through a web interface as well as programmatically using application programming interfaces, whilst ensuring the latest versions are available for our users. Our training team, with support from all of our staff, continued to provide on-site, off-site and web-based training opportunities for thousands of researchers worldwide this year.

Development of a data collection and management system in West Africa: challenges and sustainability

BackgroundDeveloping and sustaining a data collection and management system (DCMS) is difficult in malaria-endemic countries because of limitations in internet bandwidth, computer resources and numbers of trained personnel. The premise of this paper is that development of a DCMS in West Africa was a critically important outcome of the West African International Centers of Excellence for Malaria Research. The purposes of this paper are to make that information available to other investigators and to encourage the linkage of DCMSs to international research and Ministry of Health data systems and repositories.MethodsWe designed and implemented a DCMS to link study sites in Mali, Senegal and The Gambia. This system was based on case report forms for epidemiologic, entomologic, clinical and laboratory aspects of plasmodial infection and malarial disease for a longitudinal cohort study and included on-site training for Principal Investigators and Data Managers. Based on this experience, we propose guidelines for the design and sustainability of DCMSs in environments with limited resources and personnel.ResultsFrom 2012 to 2017, we performed biannual thick smear surveys for plasmodial infection, mosquito collections for anopheline biting rates and sporozoite rates and year-round passive case detection for malarial disease in four longitudinal cohorts with 7708 individuals and 918 households in Senegal, The Gambia and Mali. Major challenges included the development of uniform definitions and reporting, assessment of data entry error rates, unstable and limited internet access and software and technology maintenance. Strengths included entomologic collections linked to longitudinal cohort studies, on-site data centres and a cloud-based data repository.ConclusionsAt a time when research on diseases of poverty in low and middle-income countries is a global priority, the resources available to ensure accurate data collection and the electronic availability of those data remain severely limited. Based on our experience, we suggest the development of a regional DCMS. This approach is more economical than separate data centres and has the potential to improve data quality by encouraging shared case definitions, data validation strategies and analytic approaches including the molecular analysis of treatment successes and failures.

Advancing Holistic Review for Faculty Recruitment and Advancement.

The challenges to developing a physician and scientific workforce that both reflects and provides quality care for the complex and richly diverse population of the United States are considerable. One medical school (Baylor College of Medicine) sought to adapt the Holistic Review in Admissions process developed by the Association of American Medical Colleges and apply it to faculty. In the fall of 2016, academic leaders received on-site training and completed several workshop exercises. The goal was for the leaders to build consensus around a holistic review framework for hiring and advancing faculty that is based on the institution's mission, vision, and values. This training occurred during Baylor's ongoing strategic planning and helped inform improvements in the faculty recruitment and hiring process, in the guidelines for faculty appointment and promotion, and in the pilot of an administrative leadership candidate rating tool, the "experiences-attributes-academic metrics model." The model that developed from the pilot translates the holistic review concept into a tool for identifying, hiring, and promoting faculty members and administrative leaders that is aligned to the values of Baylor. The utility of this framework lies in the clear delineation of metrics and qualifications along with the prioritization of attributes and experiences. This innovation is being piloted and evaluated to determine its effect on advancing the institutional mission of Baylor.