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OBJECTIVES/GOALS: Team science competencies are not well-defined for nonfaculty staff of Clinical Research Professionals (CRPs) who conduct research. Using an existing framework, our work has determined skills associated with team science competencies as related to CRPs. Our team also outlined examples of those skills on a fundamental, skilled, and advanced level. METHODS/STUDY POPULATION: The team consists of both CRPs and those working in the Team Science space. This team used a modified Delphi approach to determine the skills and leveling examples of each team science competency. The team broke into four groups and was assigned 3-4 competencies each. Each group determined skills needed to support (exhibit, promote) each competency and then described an example of this skill at the fundamental, skilled, and advanced levels. Once each group was finished with their assigned competencies, they were re-assigned to a different group for review and changes. Finally, team science and CRP experts reviewed the skills and levels. RESULTS/ANTICIPATED RESULTS: Our results are a rubric that defines 3-5 practical skills per described competency. These skills are needed to support and promote each competency as a CRP. An additional outcome from this work includes examples of each skill at the fundamental, skilled, and advanced levels in a CRP’s career. Each leveled example is described in a concise, actionable way using Bloom’s taxonomy. This rubric is meant to be easily understood, very useable and able to be used in conjunction with existing CRP competency frameworks. By using Bloom’s taxonomy, we set the stage for future educational programming in Team Science skill-building for clinical research professionals. DISCUSSION/SIGNIFICANCE: Team science concepts and competencies have been increasingly integrated into translational science teams. However, team science competencies related to CRPs have remained largely undefined. Our work helps to define these competencies for CRPs in a practical way. Our rubric fills gaps in, and builds on, existing CRP competency frameworks.
There have been a number of federal policies and guidance’s impacting diversity, equity, inclusion, and accessibility (DEI) in clinical research. While these are needed, they have not diminished the gaps related to clinical trial recruitment, research professional’s capacity for cultural competence, and clinical research professional role development. Mentoring and co-mentoring circles have traditionally been used in Medicine, but until now had not been used for workforce development of clinical research professionals (CRPs).
We designed a six-session, monthly co-mentoring circle to take place at two academic medical centers to pilot an interinstitutional co-mentoring circle centered on storytelling videos of Black Voices in Clinical Research. This provided a DEI framework for discussions on role experiences, cultural competence, and role progression.
Seven CRPs completed the DRC pilot. The participants positively evaluated the experience and made recommendations for future iterations. Discussion: Co-mentoring circles can be useful tools to connect CRPs across complex research medical centers and provide support that may have a positive impact on role satisfaction and retention.
This framework for developing co-mentoring circles can serve as a toolkit for future CRP co-mentoring circles within and across institutions for workforce development. The Black Voices in Clinical Research storytelling videos provide a rich foundation for future discussion on DEI issues for CRPs and collaborating with participants.
Infants with critical CHD have abnormal neurobehavior assessed by the Neonatal ICU Network Neurobehavioral Scales. This retrospective cohort study hypothesized associations between abnormal infant neurobehavior in the first month of life and later neurodevelopmental outcomes at 1−2 years of age. Associations between abnormal infant attention (orienting to and tracking stimuli) on the Neonatal ICU Network Neurobehavioral Scales and later motor, cognitive, and language neurodevelopmental outcomes on the Bayley Scales of Infant Development-III at follow-up were examined with descriptive statistics and univariable and multivariable regression. Multiple imputation was used to account for missing outcome data. 189 infants with critical CHD were included, and 69% had abnormal neurobehavioral attention scores. 58 (31%) returned as toddlers for neurodevelopmental follow-up, of which 23% had motor delay. Abnormal infant attention had high sensitivity (92%, 95% CI 60−100%) but low specificity (36%, 95% CI 23−52%) for later motor delay. Higher infant attention scores were associated with higher later motor scores in univariable analysis (coefficient 3.49, 95% CI 0.52,6.46, p = 0.025), but not in multivariable analyses. Neither cognitive nor language scores were associated with infant attention scores. Lower birth weight and male sex were significantly associated with lower motor scores in multivariable analysis (p = 0.048, 0.007). Although impaired infant attention is interdependent with other clinical and demographic risk factors, it may be a sensitive clinical marker of risk for later motor delay. In children with critical CHD, impaired infant attention may be capturing early signs of abnormal visual-motor neurodevelopment.
Identification of evidence-based factors related to status of the clinical research professional (CRP) workforce at academic medical centers (AMCs) will provide context for National Center for Advancing Translational Science (NCATS) policy considerations and guidance. The objective of this study is to explore barriers and opportunities related to the recruitment and retention of the CRP workforce.
Materials and Methods:
Qualitative data from a series of Un-Meeting breakout sessions and open-text survey questions were analyzed to explore barriers and recommendations for improving AMC CRP recruitment, retention and diversity.
While certain institutions have established competency-based frameworks for job descriptions, standardization remains generally lacking across CTSAs. AMCs report substantial increases in unfilled CRP positions leading to operational instability. Data confirmed an urgent need for closing gaps in CRP workforce at AMCs, especially for attracting, training, retaining, and diversifying qualified personnel. Improved collaboration with human resource departments, engagement with principal investigators, and overcoming both organizational and resource challenges were suggested strategies, as well as development of outreach to universities, community colleges, and high schools raising awareness of CRP career pathways.
Based on input from 130 CRP leaders at 35 CTSAs, four National Institute of General Medical Sciences’ Institutional Development Award (IDeA) program sites, along with industry and government representatives, we identified several barriers to successful recruitment and retention of a highly trained and diverse CRP workforce. Results, including securing institutional support, champions, standardizing and adopting proven national models, improving local institutional policies to facilitate CRP hiring and job progression point to potential solutions.
Defining key barriers to the development of a well-trained clinical research professional (CRP) workforce is an essential first step in identifying solutions for successful CRP onboarding, training, and competency development, which will enhance quality across the clinical and translational research enterprise. This study aimed to summarize barriers and best practices at academic medical centers related to effective CRP onboarding, training, professional development, identify challenges with the assessment of and mentoring for CRP competency growth, and describe opportunities to improve training and professionalization for the CRP career pathway.
Qualitative data from a series of Un-Meeting breakout sessions and open-text survey questions were analyzed to explore the complex issues involved when developing high-quality onboarding and continuing education opportunities for CRPs at academic medical centers.
Results suggest there are several barriers to training the CRP workforce, including balancing foundational onboarding with role-based training, managing logistical challenges and institutional contexts, identifying/enlisting institutional champions, assessing competency, and providing high-quality mentorship. Several of these themes are interrelated. Two universal threads present throughout all themes are the need for effective communication and the need to improve professionalization of the CRP career pathway.
Few institutions have solved all the issues related to training a competent and adaptable CRP workforce, although some have addressed one or more. We applied a socio-technical lens to illustrate our findings and the need for NCATS-funded academic medical centers to work collaboratively within and across institutions to overcome training barriers and support a vital, well-qualified workforce and present several exemplars from the field to help attain this goal.
Between 21 November and 22 December 2020, a SARS-CoV-2 community testing pilot took place in the South Wales Valleys. We conducted a case-control study in adults taking part in the pilot using an anonymous online questionnaire. Social, demographic and behavioural factors were compared in people with a positive lateral flow test (cases) and a sample of negatives (controls). A total of 199 cases and 2621 controls completed a questionnaire (response rates: 27.1 and 37.6% respectively). Following adjustment, cases were more likely to work in the hospitality sector (aOR 3.39, 95% CI 1.43–8.03), social care (aOR 2.63, 1.22–5.67) or healthcare (aOR 2.31, 1.29–4.13), live with someone self-isolating due to contact with a case (aOR 3.07, 2.03–4.62), visit a pub (aOR 2.87, 1.11–7.37) and smoke or vape (aOR 1.54, 1.02–2.32). In this community, and at this point in the epidemic, reducing transmission from a household contact who is self-isolating would have the biggest public health impact (population-attributable fraction: 0.2). As restrictions on social mixing are relaxed, hospitality venues will become of greater public health importance, and those working in this sector should be adequately protected. Smoking or vaping may be an important modifiable risk factor.
OBJECTIVES/GOALS: a. Summarize barriers and best practices related to effective CRP onboarding, training and professional development b. Identify challenges with the assessment of and mentoring for CRP competency growth. c. Describe opportunities to improve the training and professionalization of the CRP career pathway. METHODS/STUDY POPULATION: Qualitative data from a series of UnMeeting breakout sessions and open-text survey questions were analyzed to explore the complex issues at play when developing high-quality onboarding and continuing education opportunities for CRPs at academic health centers. RESULTS/ANTICIPATED RESULTS: Results suggest there are several barriers to providing training to the CRP workforce, including: balancing foundational onboarding with role-based training, managing logistical challenges and institutional contexts, the need for institutional champions, assessing competency, and providing high-quality mentorship. Several of these themes are interrelated. One common thread present throughout all of these themes is the challenge of effective communication and team science training. DISCUSSION/SIGNIFICANCE: Few institutions have solved all of the issues related to training a competent and adaptable CRP workforce, although some have addressed one or more. This study illustrates the need to work collaboratively within and across institutions to overcome training barriers and support a vital and well-qualified workforce.
OBJECTIVES/GOALS: a) Explore topics related to AMC CRP job titles, descriptions, and pre-requisites for hire b) Describe impact of COVID-19 on the AMC CRP workforce c) Discuss opportunities for improving diversity in the CRP workforce d) Discuss opportunities to enhance institutional staffing culture to retain CRP workforce METHODS/STUDY POPULATION: Qualitative data from a series of workshop breakout sessions and open-text survey materials focusing on AMC CRP recruitment, retention and diversity were analyzed to inform content and recommendations for clinical research job titles and descriptions, pre-requisites, diversity, and current needs. RESULTS/ANTICIPATED RESULTS: While certain institutions have established competency-based frameworks for job descriptions and career ladders, standardization remains generally lacking across CTSA hubs. Significant hiring needs have reached exponential proportions across hubs, unable to meet current and projected clinical research goals. Data confirmed an urgent need for closing gaps in clinical research workforce at AMCs, especially for improving diversity and equity of personnel. Improved collaboration with human resource departments, engagement with principal investigators, and overcoming both organizational and resource challenges were suggested strategies, as well as pipeline development via outreach to universities, community colleges, and high schools to raise awareness of the professional pathways for CRPs. DISCUSSION/SIGNIFICANCE: Based on input from 130 CRP leaders at 38 CTSA hubs and 4 IDeA sites evaluating data from 23 breakout transcripts and ~92 surveys from the Collaborative Conversations Unmeeting, new opportunities emerged during the analysis. The findings will be summarized in a 2022 Synergy manuscript including best practice benchmarking recommendations.
Many conservation initiatives call for ‘transformative change’ to counter biodiversity loss, climate change, and injustice. The term connotes fundamental, broad, and durable changes to human relationships with nature. However, if oversimplified or overcomplicated, or not focused enough on power and the political action necessary for change, associated initiatives can perpetuate or exacerbate existing crises. This article aims to help practitioners deliberately catalyze and steer transformation processes. It provides a theoretically and practically grounded definition of ‘transformative conservation’, along with six strategic, interlocking recommendations. These cover systems pedagogy, political mobilization, inner transformation, as well as planning, action, and continual adjustment.
Calls for ‘transformative change’ point to the fundamental reorganization necessary for global conservation initiatives to stem ecological catastrophe. However, the concept risks being oversimplified or overcomplicated, and focusing too little on power and the political action necessary for change. Accordingly, its intersection with contemporary biodiversity and climate change mitigation initiatives needs explicit deliberation and clarification. This article advances the praxis of ‘transformative conservation’ as both (1) a desired process that rethinks the relationships between individuals, society, and nature, and restructures systems accordingly, and (2) a desired outcome that conserves biodiversity while justly transitioning to net zero emission economies and securing the sustainable and regenerative use of natural resources. It first reviews criticisms of area-based conservation targets, natural climate solutions, and nature-based solutions that are framed as transformative, including issues of ecological integrity, livelihoods, gender, equity, growth, power, participation, knowledge, and governance. It then substantiates six strategic recommendations designed to help practitioners deliberately steer transformation processes. These include taking a systems approach; partnering with political movements to achieve equitable and just transformation; linking societal with personal (‘inner’) transformation; updating how we plan; facilitating shifts from diagnosis and planning to action; and improving our ability to adjust to transformation as it occurs.
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To explore the lived experience of delivering or receiving news about an unborn or newborn child having a condition associated with a learning disability in order to inform the development of a training intervention for healthcare professionals. We refer to this news as different news.
How healthcare professionals deliver different news to parents affects the way they adjust to the situation, the wellbeing of their child and their ongoing engagement with services. This is the first study that examined the lived experience of delivering and receiving different news, in order to inform the development of training for healthcare professionals using the Theoretical Domains Framework version 2.
We conducted qualitative interviews with a purposive sample of 9 different parents with the lived experience of receiving different news and 12 healthcare professionals who delivered different news. It was through these descriptions of the lived experience that barriers and facilitators to effectively delivering different news were identified to inform the training programme. Data analysis was guided by Theoretical Domains Framework version 2 to identify these barriers and facilitators as well as the content of a training intervention.
Receiving different news had a significant impact on parents’ emotional and mental wellbeing. They remembered how professionals described their child, the quality of care and emotional support they received. The process had a significant impact on the parent–child relationship and the relationship between the family and healthcare professionals.
Delivering different news was challenging for some healthcare professionals due to lack of training. Future training informed by parents’ experiences should equip professionals to demonstrate empathy, compassion, provide a balanced description of conditions and make referrals for further care and support. This can minimise the negative psychological impact of the news, maximise psychological wellbeing of families and reduce the burden on primary care services.
The COVID-19 pandemic has had a major impact on clinical practice. Safe standards of practice are essential to protect health care workers while still allowing them to provide good care. The Canadian Society of Clinical Neurophysiologists, the Canadian Association of Electroneurophysiology Technologists, the Association of Electromyography Technologists of Canada, the Board of Registration of Electromyography Technologists of Canada, and the Canadian Board of Registration of Electroencephalograph Technologists have combined to review current published literature about safe practices for neurophysiology laboratories. Herein, we present the results of our review and provide our expert opinion regarding the safe practice of neurophysiology during the COVID-19 pandemic in Canada.
Approximately 18% of adults with intellectual disabilities living in the community display behaviours that challenge. Intensive support teams (ISTs) have been recommended to provide high-quality responsive care aimed at avoiding unnecessary admissions and reducing lengthy in-patient stays.
To identify and describe the geographical distribution and characteristics of ISTs, and to develop a typology of IST service models in England.
We undertook a national cross-sectional survey of 73 ISTs. A hierarchical cluster analysis was performed based on six prespecified grouping factors (mode of referrals, size of case-load, use of outcome measures, staff composition, hours of operation and setting of service). A simplified form of thematic analysis was used to explore free-text responses.
Cluster analysis identified two models of IST provision: (a) independent and (b) enhanced provision based around a community intellectual disability service. ISTs aspire to adopt person-centred care, mostly use the framework of positive behaviour support for behaviour that challenges, and report concerns about organisational and wider context issues.
This is the first study to examine the delivery of intensive support to people with intellectual disability and behaviour that challenges. A two-cluster model of ISTs was found to have statistical validity and clinical utility. The clinical heterogeneity indicates that further evaluation of these service models is needed to establish their clinical and cost-effectiveness.
Asking questions is a powerful learning tool that children take full advantage of, as they are well-known to be prolific and determined question-askers. But do children ask good questions? In this chapter, we review and discuss qualitative and quantitative studies to trace the developmental trajectory of children’s question–asking strategies, focusing on their effectiveness and adaptiveness. Previous research has so far established three milestones: children’s question–asking abilities evolve from being able to identify effective questions, but not being able to spontaneously generate them at the age of five, to beginning to generate effective questions from scratch at age seven, to implementing efficient and adaptive question–asking strategies by the age of ten, echoing adult–level patterns of performance. We discuss how the cognitive and environmental factors driving these developmental changes still remain unclear, and how taking a multidisciplinary approach might be necessary to fill these gaps. We argue that the results from research on question-asking have the potential to inform educational policies, and to help design targeted training interventions and educational curricula that exploit the early emergence of these skills and support their further development, providing children with a toolbox of strategies and concepts they can use to effectively navigate the world.
We explored how positive and negative life experiences of caregivers are associated with household food insecurity.
The Midlands Family Study (MFS) was a cross-sectional study with three levels of household food security: food secure, food insecure without child hunger and food insecure with child hunger. Ordinal logistic regression analysis was used for analyses of negative and positive life experiences (number, impact, type) associated with food insecurity.
An eight-county region in South Carolina, USA, in 2012–2013.
Caregivers (n 511) in households with children.
Caregivers who reported greater numbers of negative life experiences and greater perceived impact had increased odds of household food insecurity and reporting their children experienced hunger. Each additional negative life experience count of the caregiver was associated with a 16 % greater odds of food insecurity without child hunger and a 28 % greater odds of child hunger. Each one-unit increase in the negative impact score (e.g. a worsening) was associated with 8 % higher odds of food insecurity without child hunger and 12 % higher odds of child hunger. Negative work experiences or financial instability had the strongest association (OR = 1·8; 95 % CI 1·5, 2·2) with child hunger. Positive life experiences were generally not associated with food security status, with one exception: for each unit increase in the number of positive experiences involving family and other relationships, the odds of child hunger decreased by 22 %.
More research is needed to understand approaches to build resilience against negative life experiences and strengthen positive familial, community and social relationships.
Synthetic ferrihydrites with Si added at mass ratios of Si/Fe = 0, 10, 20, 40, 80, and 160 × 10−3 have been studied to examine the effect of Si on the properties of ferrihydrite. The Si proportionally reduces the point of zero charge but influences surface area, loss of weight to 800°C and solubility in acid oxalate solution to varying degrees. At a critical concentration of Si (when Si/Fe = 20 × 10−3) these measured properties indicate a greater particle size and a more ordered structure. The relationship between synthetic ferrihydrite and the surface of kaolinite has been studied by a combination of surface area and charge determinations and TEM. An attraction predicted at pH 3 between ferrihydrite particles and the basal surface of kaolinite has been confirmed, and resulted in a stable coating. However, at pH 6 any attraction between the minerals appears to be too weak to produce a coating of the kaolinite surfaces.
Selected-area electron diffraction has been used to examine ferrihydrite coatings on kaolinite crystals and is shown to provide a sensitive means of detection. It also gives better diffraction patterns of ferrihydrite than does XRD and the patterns sometimes give additional indications of the crystal size. It is suggested that the technique may be useful in examining other coatings on soils and clays.
Two chlorites, sheridanite and clinochlore, have been examined to determine their surface charge characteristics. In order to increase their surface area and to produce a measurable surface charge, the chlorites were treated with 10−3m, 10−2m, and 10−1m HCl in 10−2m MgCl2 solutions. These treatments are shown not to alter the crystallinity of the chlorites and to produce a small pH-dependent negative charge which is not directly related to the total surface area. The clinochlore, (Si6.13Al1.84)(Al1.53FeIII0.53FeII0.18Mg9.52)O20(OH)16, is more readily attacked by the acids than the sheridanite, (Si5.43Al2.55)(Al2.90FeII0.05Mg8.86)O20(OH)16, and also produces material with greater surface area and pH-dependent, negative, surface charge. It is concluded that: (i) isomorphous substitutions in the lattice are not reflected in a permanent surface charge; (ii) the observed surface charge arises not only at the edges of the particles but also at points where the chlorite is predisposed to attack by acids; (iii) in the chlorite-acid system used, anions—probably mainly silicate—block positively charged sites.
The form and thickness of the ferrihydrite coating on kaolinite basal surfaces was studied in mixes containing 1–10% ferrihydrite through a combination of TEM, shadowed replicas, selected area electron diffraction, and determinations of surface area and distribution of charge on the surfaces. At pH3 the ferrihydrite was found to attach initially as single particles to certain sites on the kaolinite. These particles grew laterally and vertically until with 4% ferrihydrite they were aggregates of from 8 to 25 layers of particles. With more ferrihydrite the aggregates coalesced. Despite the irregular cover on the kaolinite satisfactory electron diffraction patterns were obtained and as little as 2% ferrihydrite was detected in a mixture at pH3.