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Nutrition plays a key role in training for, and competing in, competitive sport, and is essential for reducing risk of injury and illness, recovering and adapting between bouts of activity, and enhancing performance. Consumption of a Mediterranean diet (MedDiet) has been demonstrated to reduce risk of various non-communicable diseases and increase longevity. Following the key principles of a MedDiet could also represent a useful framework for good nutrition in competitive athletes under most circumstances, with potential benefits for health and performance parameters. In this review, we discuss the potential effects of a MedDiet, or individual foods and compounds readily available in this dietary pattern, on oxidative stress and inflammation, injury and illness risk, vascular and cognitive function, and exercise performance in competitive athletes. We also highlight potential modifications which could be made to the MedDiet (whilst otherwise adhering to the key principles of this dietary pattern) in accordance with contemporary sports nutrition practices, to maximise health and performance effects. In addition, we discuss potential directions for future research.
Engineered products have economic, environmental, and social impacts, which comprise the major dimensions of sustainability. This paper seeks to determine the interaction between design parameters when the social impacts are incorporated into the design process. Social impact evaluation is increasing in importance similar to what has happened with environmental impact consideration in recent years in the design of engineered products. Concurrently, research into new airship design has increased, however airships have yet to be reintroduced at a large scale and for a range of applications in society. Although airships have the potential for positive environmental and economic impacts, the social impacts are still rarely considered. This paper presents a case study of the hypothetical introduction of airships in the Amazon to help local farmers transport their produce to market. It explores the design space in terms of the airship's social impacts connected to the design parameters. The social impacts are found to be dependent not only on the social factors and airship design parameters, but also on the farmer-airship system, suggesting that socio-technical systems design will benefit from integrated social impact metric analysis.
Our aim is to improve the accessibility of Psychiatry to other specialties when being contacted for review and advice, both in hours and out of hours.
From clinical contact and informal conversations, other specialties sometimes have difficulties contacting psychiatry for advice/review. The aim of this is quality improvement project is to determine how accessible we are to other specialties and work on improving how we communicate with the general hospital.
We created a questionnaire for colleagues from other specialties to fill in from 26/9/19 for 6 weeks. We gathered information regarding their grade, work site, previous contact with psychiatry, whether they knew where to find our contact information and if they could identify the correct method to ask for advice from general adult psychiatry (GAP), Psychiatry of old age (POA) , and out of hours psychiatry (OOH). We also asked colleagues to put in free text comments regarding their experience in contacting psychiatry. We also asked if our colleagues were aware of how to perform an Emergency Detention Certificate as this is advice we sometimes give which does not always need our input immediately.
There was a total of 39 responses, 29 from Ninewells Hospital (NW) and 10 from Perth Royal Infirmary (PRI). There was a mixture of staff grades from Foundation Doctors to Consultants. 23/39 colleagues knew where to find contact information for Psychiatry, 14/39 colleagues correctly answered how to contact GAP (Phone), 15/39 colleagues correctly answered how to contact POA (Email), 15/39 colleagues correctly identified who to contact OOH, and 16/34 colleagues who could do emergency detentions (FY2+) knew how to do one. Free text comments often referred back to the difficulty of finding the right grade of staff first try, Feedback from PRI where there was no dedicated Liaison Service and relies on a duty doctor system was less positive, with terms ‘tricky’, ‘difficulty’, ‘awkward’ used in majority of responses.
From our results we can conclude that contacting Psychiatry in NHS Tayside can be confusing for other specialties. Taking this forward, we will utilize the ‘referral finder’ system in NHS Tayside and review the existing information available, and to update the contact information for our subspecialties to make contact ourselves more streamlined and accessible. We will also review appropriate clinical protocols that we can link to our page on referral finder to help save time for our colleagues as well.
Various methods have been employed in the development of communication skills. This pilot study was designed to assess the acceptability, feasibility and cost-effectiveness of a specially designed workshop exploring the use of drama and theatre in enhancing the self-reported communication skills of psychiatry trainees. As a secondary aim, it assessed if the value of the improvements translated both into clinical practice and to training situations, including success in the Royal College of Psychiatrists (RCPsych) Clinical Assessment of Skills and Competencies (CASC) examination.
A three-day drama and theatre workshop was organised in the West Midlands Deanery in conjunction with specialist instructors from performing arts at the Hearth Centre, Birmingham. The Tension State technique developed by Jacques Lecoq and Forum Theatre approach, were some of the methods employed to enable participants to develop the softer, but essential communication skills required for effective practice. Work was also undertaken focussing on self-regulation. Fourteen trainees completed the first day of the workshop. This pilot study utilised a mixed methodology to evaluate participants’ views of the perceived impact of using drama and theatre to enhance their communication skills. Feedback was obtained from organisers and facilitators specifically relating to feasibility and cost effectiveness. Data were collected from participants using pre and post-workshop questionnaires and focus groups.
All participants reported a positive and enjoyable experience, indicating that the approach was acceptable to those involved. The facilitators deemed this more novel approach to enhancing communication skills feasible, and cost effective and concluded that there was scope to incorporate it into routine psychiatry training in the area. It was however identified that the content of the workshop could be condensed, reducing the length therefore to two days. There was a notable increase in participants’ self-reported confidence in their communication skills post compared to pre-workshop. Trainees reported utilising the techniques in day-to-day practice. All of those participants who undertook the CASC examination during the workshop were successful, although it would be too presumptive to assume a causative effect. The workshop was completed without any adverse events and there were no concerns from a safety perspective.
Drama and theatre, as a novel approach, appears to have noticeable benefits in enhancing the communication skills of psychiatry trainees. The success of this pilot study in demonstrating acceptability, feasibility and cost effectiveness, suggests that drama and theatre techniques could be easily incorporated into psychiatry training and potentially other medical education programmes.
To explore and provide contextual meaning around issues surrounding food insecurity, namely factors influencing food access, as one domain of food security.
A community-based, qualitative inquiry using semi-structured face-to-face interviews was conducted as part of a larger sequential mixed-methods study.
Cayo District, Belize, May 2019–August 2019.
Thirty English-speaking individuals (eight males, twenty-two females) between the ages of 18–70, with varying family composition residing within the Cayo District.
Participants describe a complex interconnectedness between family- and individual-level barriers to food access. Specifically, family composition, income, education and employment influence individuals’ ability to afford and access food for themselves or their families. Participants also cite challenges with transportation and distance to food sources and educational opportunities as barriers to accessing food.
These findings provide insight around food security and food access barriers in a middle-income country and provide avenues for further study and potential interventions. Increased and sustained investment in primary and secondary education, including programmes to support enrollment, should be a priority to decreasing food insecurity. Attention to building public infrastructure may also ease burdens around accessing foods.
To describe risk factors associated with inappropriate antibiotic prescribing to children.
Cross-sectional, retrospective analysis of antibiotic prescribing to children, using Kentucky Medicaid medical and pharmacy claims data, 2017.
Population-based sample of pediatric Medicaid patients and providers.
Antibiotic prescriptions were identified from pharmacy claims and used to describe patient and provider characteristics. Associated medical claims were identified and linked to assign diagnoses. An existing classification scheme was applied to determine appropriateness of antibiotic prescriptions.
Overall, 10,787 providers wrote 779,813 antibiotic prescriptions for 328,515 children insured by Kentucky Medicaid in 2017. Moreover, 154,546 (19.8%) of these antibiotic prescriptions were appropriate, 358,026 (45.9%) were potentially appropriate, 163,654 (21.0%) were inappropriate, and 103,587 (13.3%) were not associated with a diagnosis. Half of all providers wrote 12 prescriptions or less to Medicaid children. The following child characteristics were associated with inappropriate antibiotic prescribing: residence in a rural area (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.07–1.1), having a visit with an inappropriate prescriber (OR, 4.15; 95% CI, 4.1–4.2), age 0–2 years (OR, 1.39; 95% CI, 1.37–1.41), and presence of a chronic condition (OR, 1.31; 95% CI, 1.28–1.33).
Inappropriate antibiotic prescribing to Kentucky Medicaid children is common. Provider and patient characteristics associated with inappropriate prescribing differ from those associated with higher volume. Claims data are useful to describe inappropriate use and could be a valuable metric for provider feedback reports. Policies are needed to support analysis and dissemination of antibiotic prescribing reports and should include all provider types and geographic areas.
Gulielmus Laurus, a recusant exile and neo-Latin poet from Yorkshire has left a variety of evidence for his existence from 1587 through to the late 1590s, mostly in published verse in which he reflects on his life and experience, protests against the Anglican settlement, and asserts his faith. The article attempts to piece together his biography from the meagre information he gives, and offers two alternative interpretations of the data: one in which he was born around 1565, and one, marginally preferable, which makes him about ten years older. His poems are highly personal documents which reveal his interactions with the ‘republic of letters’ in Belgium, Germany and France, and the intense practical and psychological pressures of life as a friendless exile.
Cow’s milk is a naturally nutrient-dense foodstuff. A significant source of many essential nutrients, its inclusion as a component of a healthy balanced diet has been long recommended. Beyond milk’s nutritional value, an increasing body of evidence illustrates cow’s milk may confer numerous benefits related to health. Evidence from adult populations suggests that cow’s milk may have a role in overall dietary quality, appetite control, hydration and cognitive function. Although evidence is limited compared with the adult literature, these benefits may be echoed in recent paediatric studies. This article, therefore, reviews the scientific literature to provide an evidence-based evaluation of the associated health benefits of cow’s milk consumption in primary-school-aged children (4–11 years). We focus on seven key areas related to nutrition and health comprising nutritional status, hydration, dental and bone health, physical stature, cognitive function, and appetite control. The evidence consistently demonstrates cow’s milk (plain and flavoured) improves nutritional status in primary-school-aged children. With some confidence, cow’s milk also appears beneficial for hydration, dental and bone health and beneficial to neutral concerning physical stature and appetite. Due to conflicting studies, reaching a conclusion has proven difficult concerning cow’s milk and cognitive function; therefore, a level of caution should be exercised when interpreting these results. All areas, however, would benefit from further robust investigation, especially in free-living school settings, to verify conclusions. Nonetheless, when the nutritional-, physical- and health-related impact of cow’s milk avoidance is considered, the evidence highlights the importance of increasing cow’s milk consumption.
Plate tectonics drives variation in sea-level, over intervals of approximately107–108 years. These variations may have significant effects on the pace of (biological) evolution through the elimination of terrestrial niches and the expansion of shallow-water marine niches. However, within the solar system, only the Earth experiences this kind of tectonism. Venus displays regional tectonism, characterized by rising diapirs within the plastic mantle. Impinging on the lithosphere, these plumes produce a range of structures of varying dimensions; the uplift of which would raise sea-level, were Venus to have oceans. Using Magellan observations of Venus, we model the impact of regional tectonism on sea-level for given areas of Venusian ocean, then compare the effect with terrestrial tectonic processes for similar oceanic area. We show that despite variation in the geographical extent of Venusian-style tectonic processes, the styles of regional tectonism on Venus can produce the same order of magnitude changes in sea-level, for a given area of ocean, as plate tectonics. Consequently, we examine some of the impacts of marine transgression on habitability and the evolution of life.
As an evolutionary lineage cycads are rare, and the extinction risk is high for many species. The genus Ceratozamia, one of the most diverse in Mexico, is experiencing drastic reductions of its habitat. Ceratozamia is widely distributed along the Sierra Madre Oriental, a complex mountain range, in a region characterized by high ecological and cultural diversity. Since 1990, various conservation and management strategies have been applied to this taxon in Mexico but evidence for the effectiveness of these measures is lacking. Ceratozamia in the Mexican Sierra Madre Oriental is highly diverse and endemic, offering a model for analysing geographical distribution patterns with ecological niche modelling. It also presents an opportunity for assessing the success of conservation and management strategies that have been implemented in this area. Here, we examined three aspects that are considered fundamental for the development and evaluation of conservation strategies: (1) taxonomy, (2) ecology and (3) sociocultural anthropology. Our findings suggest a pessimistic outlook for the long-term survival of Ceratozamia species in their natural environment, indicating the need to review the current IUCN Cycad Action Plan for the genus. To improve the protection of Ceratozamia and other taxonomic and/or ecological assemblages, we encourage a multidisciplinary approach, with increased collaboration between natural and social scientists.
ABSTRACT IMPACT: This work has begun to provide the foundation for better ensuring that translational research funded and supported by our IDeA-CTR grant is more directly addressing community- and stakeholder-authored health priorities. OBJECTIVES/GOALS: In order to effectively engage diverse, societal perspectives, we aimed to determine the relevance and feasibility of purposefully aligning translational research with health priorities adopted by the RI Department of Health, health-focused organizations, and community leaders. METHODS/STUDY POPULATION: Individuals from 27 community organizations in RI were asked, ‘What are your health related goals for your community’ and submitted responses online for 2 weeks. Participants generated 71 goals which they sorted into meaningful clusters and rated for importance and feasibility. Clusters were contrasted with RI health priorities to gauge alignment and saturation. In the next phase of this project, researchers and service users funded by Advance-CTR will be asked in routinely administered surveys how their current work may align with RI health goals and whether their future work can feasibly be connected to those priorities. RESULTS/ANTICIPATED RESULTS: Using Group Concept Mapping software, the 71 health goals identified by community organization representatives were fit into an 8-cluster model. Results suggested highest importance placed on Accessible & Healthy Housing (M=4.12, SD=0.29), Community (M=4.08, SD=0.28), Youth (M=4.04, SD=0.49) and Mental Health (M=4.03, SD=0.46). State agency priorities were found to overlap substantially with clusters defined by community leaders. We expect researchers will rate clusters differently, and find some community-endorsed health goals more relevant to their work than others. Perceived feasibility of tailoring future research to state health goals is expected to vary widely by item and researcher. DISCUSSION/SIGNIFICANCE OF FINDINGS: We intend to: 1) facilitate discussions about successes and challenges of translating community-authored priorities into research, and 2) foster better understanding between researchers and the communities they aim to serve on the role of CTR for addressing health challenges in the state.
ABSTRACT IMPACT: Identifying the causative antigen in membranous glomerulopathy cohorts enables the development of serum assays to detect and monitor disease progression without the need for invasive kidney biopsies. OBJECTIVES/GOALS: Primary membranous glomerulopathy is caused by the formation of autoantibody immune complexes which deposit in the glomerulus and obstruct kidney function. Causative antigens remain to be identified in roughly 20% of cases. Our goal is to identify the antigen in these cohorts, so that non-invasive assays can be developed for disease monitoring. METHODS/STUDY POPULATION: Renal biopsy tissue from known antigen cases (PLA2R, THSD7A), and unknown cases were included in the analysis. Renal biopsy tissue from formalin fixed paraffin embedded tissue was cut at a thickness of 10 µm onto Leica PET-membrane frame slides. These slides were then stained with hematoxylin. The glomeruli were microdissected into microcentrifuge tubes using a Leica DM6000B microscope. The microdissected glomeruli were lysed in 2% SDS and 0.1M DTT at 99 degrees Celsius for 1 hour and processed by filter assisted sample preparation (FASP). Digested peptides were analyzed by liquid chromatography-mass spectrometry using an Orbitrap Fusion Lumos using data-dependent acquisition. RESULTS/ANTICIPATED RESULTS: Mass spectrometry data collected from the laser captured glomeruli was searched against the human proteome fasta database from Uniprot using MaxQuant. IBAQ values were used for quantitation and statistical analysis. Null hypothesis significance testing was performed for each protein by comparing each sample group to the rest of the samples in the data set. In the control groups, the causative antigens PLA2R and THSD7A were detected and quantified with the largest magnitude fold change in their respective category, validating the experimental design. Using this approach, the proteins SAP, NELL1, and NCAM1 were identified and subsequently validated as causative antigens in distinct patient cohorts. DISCUSSION/SIGNIFICANCE OF FINDINGS: Here, we share the results of our efforts to comprehensively identify the spectrum of causative antigens in membranous glomerulopathy. In this context, antigen discovery is an essential first step for the development of non-invasive assays to inform prognosis, monitor response to treatment, and better understand disease etiology.
Modern videography provides an ever-widening window into subsea echinoderm life with vast potential for new knowledge. Supported by video evidence throughout, this Element begins with time-lapse video made in 1983 on film, using an off-the-shelf camera, flash, and underwater housings. Although quality has now been significantly improved by digital imagery, films from over thirty years ago captured crinoid feeding behavior previously unknown and demonstrated a great potential to learn about many other aspects of their biology. This sequence is followed by several examples of recent digital videography from submersibles of deep-sea crinoids and remotely operated vehicles (ROVs) (stalked and unstalked), as well as close-up video of crinoids in aquaria. These recent studies enabled a new classification of crinoid arm postures, provided detailed views of food particle capture, and revealed a wide range of behaviors in taxa never before seen in life.
Public preferences for wildlife protection can dictate the success or failure of conservation interventions. However, little research has focused on wildlife preferences among youth or how youth prioritize species-based conservation. We conducted a study of youth between 7 and 20 years old (n = 128) at five local schools situated near critical hawksbill turtle (Eretmochelys imbricata) nesting beaches in El Salvador to determine their wildlife preferences and how they prioritize species for conservation based on five attributes: endemism; use for hunting and fishing; rapid decline in population size; presence around their home; and ecological significance. These Salvadoran youth showed preferences for native over non-native species and tended to rank rapid population decline as the most important attribute for prioritizing wildlife for protection, followed by use for hunting and fishing. Participants in local environmental education activities placed greater importance on species in rapid decline than non-participants, who considered endemism as most important. Overall, these findings reveal how environmental education may successfully promote increased prioritization of imperilled species among youth. Economic payments for conserving hawksbill turtles may link the two top reasons that Salvadoran youth provided for protecting species by compensating for the reduced hunting required to facilitate population stabilization.
Advance Clinical and Translational Research (Advance-CTR) serves as a central hub to support and educate clinical and translational researchers in Rhode Island. Understanding barriers to clinical research in the state is the key to setting project aims and priorities.
We implemented a Group Concept Mapping exercise to characterize the views of researchers and administrators regarding how to increase the quality and quantity of clinical and translational research in their settings. Participants generated ideas in response to this prompt and rated each unique idea in terms of how important it was and feasible it seemed to them.
Participants generated 78 unique ideas, from which 9 key themes emerged (e.g., Building connections between researchers). Items rated highest in perceived importance and feasibility included providing seed grants for pilot projects, connecting researchers with common interests and networking opportunities. Implications of results are discussed.
The Group Concept Mapping exercise enabled our project leadership to better understand stakeholder-perceived priorities and to act on ideas and aims most relevant to researchers in the state. This method is well suited to translational research enterprises beyond Rhode Island when a participatory evaluation stance is desired.
The phenomenon of acute behavioural disturbance (ABD) (also known as acute behavioural disorder or excited delirium) is an underrecognised and potentially life-threatening syndrome, and an emergency in psychiatric settings. Causes are discussed and the pathophysiology explained. The challenges faced by practitioners are highlighted, including how ‘standard’ control and restraint can exacerbate symptoms. Initial treatment strategies are suggested.
Post-tonsillectomy bleeding is the most frequent complication of tonsillectomy. Inherited platelet function disorders have an estimated prevalence of 1 per cent. Any association between post-tonsillectomy bleeds and undiagnosed inherited platelet function disorders has not been investigated before.
To assess the prevalence of inherited platelet function disorders in a cohort of post-tonsillectomy bleed patients.
An observational cohort study was conducted using hospital digital records. Platelet function analyser 100 (‘PFA-100’) closure time was tested on post-tonsillectomy bleed patients who presented to hospital.
Between 2013 and 2017, 9 of 91 post-tonsillectomy bleed patients who underwent platelet function analyser 100 testing (9.89 per cent) had positive results. Five patients (5.49 per cent) had undiagnosed inherited platelet function disorders. Four patients had false positive results secondary to a non-steroidal anti-inflammatory drug effect (specificity of 95.3 per cent) proven by repeat testing six weeks later, off medication. The false negative rate was 0 per cent.
The prevalence of inherited platelet function disorders in our post-tonsillectomy bleed cohort is five-fold higher than in the general population. Platelet function analyser 100 testing when patients present with a post-tonsillectomy bleed allows management of their inherited platelet function disorder.
One form of communication deficiency leading to patient harm is failure to keep colleagues informed and to share appropriate levels of clinical information. The production of discharge letters is a clinical and professional requirement, deficiencies of which contribute to clinical risks, while failure to observe standards may be a focus of medico-legal enquiry.
To examine the adequacy of clinical discharge letters from the OAMH inpatient wards in one Scottish Health region (Fife, population 370,000) against the 14-day discharge policy, with focus on medication advice and follow-up arrangements.
All discharge notifications from the five OAMH wards were examined retrospectively against the electronic records and case-files for the 7-month period ending 31st January 2020.
169 discharge notifications inclusive of 14 deaths were reduced to 123 after excluding brief inter-ward transfers. Female:male ratio of 1.05:1; average age 77 (range 60 -99) years, average inpatient duration 120 (range 2-934) days. There was no identified discharge letter in 20.3%. Direct admissions from Care Homes died more often (30%) than those admitted directly from home (2%), presumably a reflection of greater frailty. 29% patients were discharged to (19% admitted from) Care Homes. 59% patients had dementia, 20% an affective disorder, 7% a psychotic disorder, with 20% having multiple diagnoses. Antidepressants were the commonest (49%) regularly prescribed psychotropic medication on discharge both for those with (47%) or without (52%) dementia. 32% of all patients (25% in dementia) were discharged on antipsychotics, often without advice on monitoring, prescribing restrictions or risks. The 98 verified letters took 27 (range 0-168) days to verify, 67% failing the production-time standard. 53% discharges had multiple follow-up arrangements. Variabilities were noted in letter production according to the discharge ward (range 53-100%) and between consultant teams (verification rates 50-100%) where delays ranged 6-109 days and ability to produce letters within the standard ranged from 0-92% (average 33%).
There appear significant failings in the timely transfer of clinical details between OAMH inpatient services and primary care services in this region that require intervention to minimise clinical risk and maximise patient safety. There were identified factors that are amenable to quality improvement.
Background: There is published evidence of the benefits and limitations, including potential harm, of psychotropic medication and benefits of non-pharmacological interventions for the management of challenging behaviours associated with dementia (BPSD).
Objectives: To examine the usage of such interventions in the management of BPSD within three National Health Service (NHS) ‘specialist’ dementia inpatient wards (56 beds) in a Scottish health region (Fife, population 370,000) and to identify targets for service improvements.
Methods: Patient demographic data, mental and physical health diagnoses, current and recent (within 3 months) psychotropic prescriptions, multidisciplinary team input, and evidence of individualised non-pharmacological interventions for BPSD were collected in February 2020 from patient notes, care plans and medication charts.
Results: 42 older patients (mean age 80 years, range 59-99) with dementia had spent on average 18.7 months within hospital, some categorised as ‘delayed discharges’ awaiting care home placements All lacked capacity to consent to their general care and medical treatments, most having multiple (average 5) medical co-morbidities. 36% were detained in hospital under Mental Health legislation, 29% prescribed medications so authorised, and 40% had medications administered covertly. 76% were prescribed an antipsychotic (Risperidone in 24%), 40% a cognitive enhancer (Memantine and/or a cholinesterase inhibitor), 48% an antidepressant (Trazodone in 19%), 26% a regular benzodiazepine. There was limited regular multi-professional team working in the wards (under 18% had any non-nursing input within the previous 3 months). Of non-pharmacological therapeutic interventions, 26% were receiving multisensory inputs, 19% soft toy, 12% massage, 7% music playlist and 7% cognitive stimulation therapy.
Conclusions: For this population with BPSD there were high rates of off -licence drug prescribing with limited investment in evidence-based non-pharmacological therapeutic alternatives. During ongoing review of staffing on these wards, it would appear appropriate to examine the expectation that wards serve multiple functions, such as transitional care and specialist continuing care. We suggest reviews contextualise prescribing within an increased availability of multi-disciplinary therapeutic interventions, to ensure this patient population is cared for in an evidence-based therapeutic environment. The Scottish Government’s publication3 (2018) “Transforming Specialist Dementia Hospital Care” should help raise the profile of this “overlooked” inpatient population.
Background: Antimicrobial resistance (AMR) is an increasingly critical global public health challenge. An initial step in prevention is the understanding of resistance patterns with accurate surveillance. To improve accurate surveillance and good clinical care, we developed training materials to improve the appropriate collection of clinical culture samples in Ethiopia. Methods: Specimen-collection training materials were initially developed by a team of infectious diseases physicians, a clinical microbiologist, and a monitoring and evaluation specialist using a training of trainers (ToT) platform. Revisions after each training session were provided by Ethiopian attendees including the addition of regional and culturally relevant material. The training format involved didactic presentations, interactive practice sessions with participants providing feedback and training to each other and the entire group as well as assessments of all training activities. Results: Overall, 4 rounds of training were conducted from August 2017 to September 2019. The first 2 rounds of training were conducted by The Ohio State University (OSU) staff, and Ethiopian trainers conducted the last 2 rounds. Initial training was primarily in lecture format outlining use of microbiology laboratory findings in clinical practice and steps for collecting specimens correctly. Appropriate specimen collection was demonstrated and practiced. Essential feedback from this early audience provided input for the final development of the training manual and visual aids. The ToT for master trainers took place in July 2018 and was conducted by OSU staff. In sessions held in February and August 2019, these master trainers provided training to facility trainers, who provide training to personnel directly responsible for specimen collection. In total, 144 healthcare personnel (including physicians, nurses, and laboratory staff), from 12 representative Ethiopian public and academic hospitals participated in the trainings. Participants were satisfied with the quality of the training (typically ranked >4.5 of 5.0) and strongly agreed that the objectives were clearly defined and that the information was relevant to their work. Posttraining scores increased by 23%. Conclusions: Training materials for clinical specimen collection have been developed for use in low- and middle-resource settings and with initial pilot testing and adoption in Ethiopia. The trainings were well accepted, and Ethiopian personnel were able to successfully lead the trainings and improve their knowledge and skills regarding specimen collection. The materials are being finalized in an online format for easier open access dissemination. Further studies are planned to determine the effectiveness of the trainings in improving the quality of clinical specimen submissions to the microbiology laboratory.