Development and Pilot Implementation of a Mobile Vaccination Program to Reduce Pediatric Influenza Vaccination Disparities.

Severe pediatric influenza outcomes disproportionately affect racial minority groups, yet flu vaccination rates are often lower in these populations. Community Engagement Studios were conducted among parents/caregivers who refused flu vaccination for their children to discuss vaccination decision-making. A pilot program, , was created for pediatric patients in Nashville, Tennessee, and 4 events were conducted during the 2021 to 2022 flu season.

Violence, Discrimination, Psychological Distress, and HIV Vulnerability Among Men Who Have Sex With Men in Memphis, Tennessee.

Gay, bisexual, and other men who have sex with men (MSM) are disproportionally impacted by HIV. Discrimination, violence, and psychological distress (PD) may influence engagement with HIV prevention services and amplify HIV vulnerability among this priority population. These dynamics are understudied in the Southern United States.

Examiner perceptions of the MRCGP recorded consultation assessment for general practice licensing during COVID-19: cross-sectional study.

Background: The Recorded Consultation Assessment (RCA) was developed rapidly during the COVID-19 pandemic to replace the Clinical Skills Assessment (CSA) for UK general practice licensing. Our aim was to evaluate examiner perceptions of the RCA.

Methods: We employed a cross-sectional design using a questionnaire survey of RCA examiners with attitudinal (relating to examiners thoughts and perceptions of the RCA) and free text response options.

Candidate perceptions of the UK Recorded Consultation Assessment: cross-sectional data linkage study.

The Recorded Consultation Assessment (RCA) was rapidly developed to replace the Clinical Skills Assessment (CSA) for UK general practice licencing during COVID-19. We aimed to evaluate candidate perceptions of the RCA and relationships with performance. We conducted a cross-sectional survey of RCA candidates with attitudinal, demographic, and free text response options, undertaking descriptive and factor analysis of quantitative data with qualitative thematic analysis of free text.

Compounding Racialized Vulnerability: COVID-19 in Prisons, Jails, and Migrant Detention Centers.

Context: Carceral institutions are among the largest clusters of COVID-19 in the United States. In response, activists and detainees have rallied around decarceration demands: the release of detainees and inmates to prevent exposure to COVID-19. This article theorizes the compounding racial vulnerability that has led to such a marked spread behind bars, mainly among race-class subjugated (RCS) communities.

Validating the Matching of Patients in the Linkage of a Large Hospital System's EHR with State and National Death Databases.

Background: Though electronic health record (EHR) data have been linked to national and state death registries, such linkages have rarely been validated for an entire hospital system's EHR.

Objectives: The aim of the study is to validate West Virginia University Medicine's (WVU Medicine) linkage of its EHR to three external death registries: the Social Security Death Masterfile (SSDMF), the national death index (NDI), the West Virginia Department of Health and Human Resources (DHHR).

Methods: Probabilistic matching was used to link patients to NDI and deterministic matching for the SSDMF and DHHR vital statistics records (WVDMF).

Coronary Artery Disease Phenotype Detection in an Academic Hospital System Setting.

Background: The United States, and especially West Virginia, have a tremendous burden of coronary artery disease (CAD). Undiagnosed familial hypercholesterolemia (FH) is an important factor for CAD in the U.S.

Metatranscriptomic Analyses of Diel Metabolic Functions During a Bloom in Western Lake Erie (United States).

This study examined diel shifts in metabolic functions of spp. during a 48-h Lagrangian survey of a toxin-producing cyanobacterial bloom in western Lake Erie in the aftermath of the 2014 Toledo Water Crisis. Transcripts mapped to the genomes of recently sequenced lower Great Lakes isolates showed distinct patterns of gene expression between samples collected across day (10:00 h, 16:00 h) and night (22:00 h, 04:00 h).

Performance in candidates declaring versus those not declaring dyslexia in a licensing clinical examination.

Context: High-stakes medical examinations seek to be fair to all candidates, including an increasing proportion of trainee doctors with specific learning differences. We aimed to investigate the performance of doctors declaring dyslexia in the clinical skills assessment (CSA), an objective structured clinical examination for licensing UK general practitioners.

Methods: We employed a cross-sectional design using performance and attribute data from candidates taking the CSA between 2010 and 2017.

Can general practice trainees engage with leadership activities during their GP training placements? - An evaluation of an intervention in South East Scotland.

Leadership is one of the GMC's Generic Professional Capabilities for all medical specialties, but engagement in leadership activities is not currently routinely built into general practice (GP) training. We explored whether GP trainees in their first year of speciality training (ST1) could engage with a leadership activity in their practice placement. GP trainees were invited to participate in a voluntary leadership activity, with a small menu of optional activities to choose from.

Hypoxia imaging in upper gastrointestinal tumors and application to radiation therapy.

Survival for upper gastrointestinal tumors remains poor, likely in part due to treatment resistance associated with intratumoral hypoxia. In this review, we highlight advances in nuclear medicine imaging that allow for characterization of in vivo tumor hypoxia in esophageal, pancreatic, and liver cancers. Strategies for adaptive radiotherapy in upper gastrointestinal tumors are proposed that would apply information gained through hypoxia imaging to the creation of personalized radiotherapy treatment plans able to overcome hypoxia-induced treatment resistance, minimize treatment-related toxicities, and improve patient outcomes.

NHS Scotland's community GP fellowship - a qualitative study of the first year.

NHS Scotland faces the challenges of an ageing population and a GP recruitment problem. Research has shown that hospital admissions can be reduced if community services can offer enhanced support, in keeping with the Scottish Government's 2020 Vision for healthcare. This study presents the findings of an evaluation of the first year of a three-year community GP fellowship which included working in primary care and secondary care and an educational programme.

Consistency and reliability of judgements by assessors of case based discussions in general practice specialty training programmes in the United Kingdom.

Case based discussions (CbDs) are a mandatory workplace assessment used throughout general practitioner (GP) specialty training; they contribute to the annual review of competence progression (ARCP) for each trainee. This study examined the judgements arising from CbDs made by different groups of assessors and whether or not these assessments supported ARCP decisions. The trainees selected were at the end of their first year of GP training and had been identified during their ARCPs to need extra training time.

Validating the extract, transform, load process used to populate a large clinical research database.

Background: Informaticians at any institution that are developing clinical research support infrastructure are tasked with populating research databases with data extracted and transformed from their institution's operational databases, such as electronic health records (EHRs). These data must be properly extracted from these source systems, transformed into a standard data structure, and then loaded into the data warehouse while maintaining the integrity of these data. We validated the correctness of the extract, load, and transform (ETL) process of the extracted data of West Virginia Clinical and Translational Science Institute's Integrated Data Repository, a clinical data warehouse that includes data extracted from two EHR systems.

Piloting a quality improvement (QI) project in final year general practice trainees: setting up and evaluating the processes.

There is limited evidence on the effectiveness of educational initiatives designed to support and encourage training doctors to undertake quality improvement projects (QIP) at their workplace. The purpose of this study was to examine the feasibility of the RCGP proposal to implement a QIP in the final year of training. An educational intervention was designed and delivered to a group of GP trainees six months before the end of their training.

Are there practical opportunities for developing leadership skills during GP training and beyond? A survey of GP trainees and trainers in South East Scotland.

Background: There is currently a lack of formal training in leadership skills, particularly during GP training. This study aimed to explore the current training and practical opportunities which exist, specifically exploring the views of GP trainees and trainers.

Methods: An electronic questionnaire was sent to 266 GP trainees and trainers in south-east Scotland.

Do role-players affect the outcome of a high-stakes postgraduate OSCE, in terms of candidate sex or ethnicity? Results from an analysis of the 52,702 anonymised case scores from one year of the MRCGP clinical skills assessment.

The MRCGP clinical skills assessment (CSA), a high-stakes OSCE examination whereby GPs exit their training, uses trained role-players to depict patients (though not to mark candidates). Just as subgroups of examiners can potentially affect the results of subgroups of candidates through biases expressed in discriminatory marking, so possibly could subgroups of role-players alter the difficulty for different candidate groups. This study looks at the contribution of role-players to such possible systematic unfairness in the assessment.

Cross-comparison of MRCGP & MRCP(UK) in a database linkage study of 2,284 candidates taking both examinations: assessment of validity and differential performance by ethnicity.

Background: MRCGP and MRCP(UK) are the main entry qualifications for UK doctors entering general [family] practice or hospital [internal] medicine. The performance of MRCP(UK) candidates who subsequently take MRCGP allows validation of each assessment. In the UK, underperformance of ethnic minority doctors taking MRCGP has had a high political profile, with a Judicial Review in the High Court in April 2014 for alleged racial discrimination.

Signposting GP trainees to relevant learning opportunities in hospital posts:the Super-condensed Curriculum Guide.

UK three-year GP specialty training programmes consist of 18 months in hospital posts and 18 months in general practice. Within the hospital setting, clinical supervisors of GP trainees may have difficulty determining which learning opportunities available within the post are most relevant to training for a future career in general practice. Feedback from GP trainees has indicated that there is a lack of consistency in hospital posts regarding relevance of training for general practice.

MRCGP CSA: are the examiners biased, favouring their own by sex, ethnicity, and degree source?

Background: Concern exists regarding differential performance of candidates in postgraduate clinical assessments by ethnicity, sex, and country of primary qualification. Could examiner bias be responsible?

Aim: To explore whether candidate demographics affect examiners' judgements, by investigating candidates' case performances by candidates' and examiners' demographics.

Design And Setting: Data on 4000 candidates (52,000 cases) sitting the MRCGP clinical skills assessment in 2011-2012.

A new competency model for general practice: implications for selection, training, and careers.

Background: Recent structural and policy changes in the UK health service have significantly changed the job responsibilities for the GP role.

Aim: To replicate a previous job analysis study to examine the relevance of current competency domains and selection criteria for doctors entering training.

Design And Method: A multisource, multimethod approach comprising three phases: (1) stakeholder consultation (n = 205) using interviews, focus groups and behavioural observation of practising GPs; (2) a validation questionnaire based on results from phase 1 (n = 1082); followed by (3) an expert panel (n = 6) to review and confirm the final competency domains.