Synesis as a framework to enable safety interventions in complex healthcare environments.

Background: Despite wide adoption in the healthcare of safety event report (SER) systems, there is a paucity of unified structures for prompt analysis and action while retaining reporter confidentiality. We used a synesis framework to change siloed reviews of safety reports to a comprehensive appraisal of quality, safety, productivity and reliability to facilitate interventions.

Methods: After a needs assessment survey, we launched serial plan-do-study-act cycles to (1) enhance teams' ability to access SERs, (2) facilitate regular multidisciplinary review of SERs to identify actionable opportunities, (3) allocate action priority using failure mode and effects analysis, and (4) launch actions and summarise data.

Dopamine projections to the basolateral amygdala drive the encoding of identity-specific reward memories.

To make adaptive decisions, we build an internal model of the associative relationships in an environment and use it to make predictions and inferences about specific available outcomes. Detailed, identity-specific cue-reward memories are a core feature of such cognitive maps. Here we used fiber photometry, cell-type and pathway-specific optogenetic manipulation, Pavlovian cue-reward conditioning and decision-making tests in male and female rats, to reveal that ventral tegmental area dopamine (VTA) projections to the basolateral amygdala (BLA) drive the encoding of identity-specific cue-reward memories.

Dissolved organic matter production from herder application and in-situ burning of crude oil at high latitudes: Bioavailable molecular composition patterns and microbial community diversity effects.

Chemical herders and in-situ burning (ISB) are designed to mitigate the effects that oil spills may have on the high latitude marine environment. Little information exists on the water solubilization of petroleum residues stemming from chemically herded ISB and whether these bioavailable compounds have measurable impacts on marine biota. In this experiment, we investigated the effects of Siltech OP40 and crude oil ISB on a) petroleum-derived dissolved organic matter (DOM) composition and b) seawater microbial community diversity over 28 days at 4 °C in aquarium-scale mesocosms.

A bidirectional corticoamygdala circuit for the encoding and retrieval of detailed reward memories.

Adaptive reward-related decision making often requires accurate and detailed representation of potential available rewards. Environmental reward-predictive stimuli can facilitate these representations, allowing one to infer which specific rewards might be available and choose accordingly. This process relies on encoded relationships between the cues and the sensory-specific details of the rewards they predict.

Using quality oncology practice initiative metrics for physician incentive compensation.

Purpose: To demonstrate the use of American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) measures as part of a financial incentive plan for an academic health center-based hematology-oncology division.

Methods: An 11-member QOPI-certified hematology-oncology division participated in a pilot variable compensation (VC) plan with group-specific targets selected based on prior below-average performance. Twenty percent of overall VC was linked to success in two QOPI categories: completion of treatment summaries within 90 days of end of chemotherapy and assessment of patients' emotional well-being by second office visit.