Challenges and Potential Solutions for Recruitment and Retention of Hematopoietic Cell Transplantation Physicians: The National Marrow Donor Program’s System Capacity Initiative Physician Workforce Group Report

Hematopoietic cell transplantation (HCT) remains the only known curative therapy for many patients with hematologic, metabolic, and immunologic disorders. Furthermore, the use of HCT has increased with the emergence of HCT as a viable therapeutic option for older patients, those with significant comorbidities, and, with the demonstrated clinical effectiveness of alternative allogeneic donor sources, for those patients without a suitable sibling donor. The National Marrow Donor Program (NMDP) estimates that by 2020, it will facilitate 10,000 transplantations per year, double the number in 2010. To understand the needs of the HCT infrastructure to facilitate this number of transplantations, the NMDP organized the System Capacity Initiative 2020, centered on 6 working groups representing a diverse group of stakeholders. The Physician Workforce Group was tasked with addressing issues relating to recruitment and retention of transplantation physicians. We report here the results of our efforts and future initiatives.     

Retention in medication-assisted treatment programs in Ukraine—Identifying factors contributing to a continuing HIV epidemic

BackgroundOpioid agonist treatments (OAT) are widely-used, evidence-based strategies for treating opioid dependence and reducing HIV transmission. The positive benefits of OAT are strongly correlated with time spent in treatment, making retention a key indicator for program quality. This study assessed patient retention and associated factors in Ukraine, where OAT was first introduced in 2004.MethodsData from clinical records of 2916 patients enrolled in OAT at thirteen sites from 2005 to 2012 were entered into an electronic monitoring system. Survival analysis methods were used to determine the probability of retention and its correlates.ResultsTwelve-month retention was 65.8%, improving from 27.7% in 2005, to 70.9% in 2011. In multivariable analyses, the correlates of retention were receiving medium and high doses of medication (compared to low doses, dropout aHR = 0.57 for both medium and high doses), having not been tested for HIV and tuberculosis (compared to not being tested, dropout aHR = 4.44 and 3.34, respectively), and among those who were tested—a negative TB test result (compared to receiving a positive test result, dropout aHR = 0.67).ConclusionRetention in Ukrainian OAT programs, especially in recent years, is comparable to other countries. The results confirm the importance of adequate OAT dosing (≥60 mg of methadone, ≥8 mg of buprenorphine). Higher dosing, however, will require interventions that address negative attitudes toward OAT by patients and providers. Interruption of OAT, in the case developing tuberculosis, should incorporate continuity of OAT for TB patients through integrated care delivery systems.     

光固化氢氧化钙制剂作为临时冠粘结剂的临床应用

目的 探讨光固化氢氧化钙制剂作为临时冠粘结剂的可行性.方法 纳入242例需行临时冠的患者,根据每月就诊周数顺序随机分为3组,每组患牙制作临时冠并分别采用TempoCemNE(n=78)、Provicol(n=80)、Calcimol LC(n=84)行临时冠粘结,1周后复诊,观察固位效果、牙龈状况以及牙髓状况,比较其临床效果.结果 1周后复诊,3组间总体的固位效果、牙龈状况以及牙髓状况比较,差异无统计学意义(c12=5.553,P1=0.062>0.05;c22=4.783,P2=0.091>0.05;c32=3.290,P3=0.193>0.05).结论 光固化氢氧化钙制剂Calcimol LC和临时冠粘结剂TempoCemNE、Provicol具有相似的粘结效果,牙龈和牙髓保护作用良好,操作简单,可作为一种新型临时冠粘结剂进行临床应用.     

The experiences and perceptions of newly qualified nurses in the UK: An integrative literature review

AimThis integrative review aimed to develop an understanding of the experiences and perceptions of newly qualified nurses in the United Kingdom (UK).BackgroundIn the transitional period following registration, newly qualified nurses may feel socially isolated and overwhelmed by increases in accountability, workplace pressures and the psychological demands of the role. Despite this, the experiences and perceptions of newly qualified nurses remains an under-researched area in the UK, with much of the existing research having been conducted internationally.MethodAn integrative framework methodology was used as a basis for the literature review. The methodology comprised of five stages: problem identification, literature search, data evaluation, data analysis and presentation of the findings. 20 papers were assessed for quality and analysed thematically.ResultsData were synthesised under four themes: Preparation for real-world practice, the transition experience, growing into the role and preceptorship and support from the wider team.ConclusionThe review suggests that newly qualified nurses require on-going support post qualification. Workplace culture appears to have a significant impact on the transition experience. The review provides further evidence in relation to the experiences of newly qualified nurses in the UK context. The review may help to inform the development of strategies to support and retain newly qualified nurses in an ever-changing health care environment.     

三联疗法在月经周期治疗慢性盆腔炎的临床研究

目的观察三联疗法在月经周期治疗慢性盆腔炎的疗效。方法将70例慢性盆腔炎患者随机分为治疗组与对照组各35例。对照组采用单纯药物治疗，炎症急性发作期或月经期静脉滴注头孢噻肟钠4．0g＋替硝唑0．8g，每日1次，7d为1个疗程，连续3个月经周期后进行疗效评定。治疗组在的对照组基础上，于月经干净3d后给予中药口服、中药保留灌肠，同时给予超短波物理治疗。两组均连续治疗3个疗程，治疗结束后进行疗效比较。结果治疗前后两组患者疼痛程度均有改善，差异有统计学意义（P〈0．01），且治疗组明显优于对照组（P〈0．05）；两组治疗后临床症状体征均改善明显，各组内差异均有统计学意义（P〈0．05），两组治疗前后临床症状体征表现例及消失例的比较，治疗组优于对照组（P〈0．01）；治疗组临床治愈率和总有效率明显优于对照组（P〈0．05）。结论三联疗法在月绎周期治疗愕件翁眸炎是一种佰得临床推广的治疗方案．     

Research with youth of color in low-income communities: Strategies for recruiting and retaining participants

BackgroundYouth of color from low-income urban communities are crucial participants in research, as their involvement can shape effective, culturally responsive interventions and policy to promote youth health and well-being. These young people, however, are an often-neglected research population, due in part to perceived challenges associated with their inclusion as well as marginalized communities’ justifiable mistrust of research.ObjectivesBased on our experience conducting a school-based randomized intervention trial in Baltimore, Maryland, we present strategies for conducting research with low-income, urban youth of color. We discuss strategies in three domains: university-community partnership development, participant recruitment, and participant retention.MethodsWe reviewed partnership building and recruitment strategies employed by our team across four years of trial implementation and evaluated success of participant retention at our final survey timepoint.ResultsPartnership building was facilitated by selection of a study design that maximized benefits for all participants, promotion of capacity building at partner institutions, and attention to research staff hiring and training practices. Effective study recruitment strategies included personal contact with parents and close cooperation between school personnel and study staff. Providing incentives and collecting multiple types of participant contact information contributed to increased retention rates. On average, those who participated in the final survey timepoint were less likely to be male and Latinx and exhibited more favorable baseline mental health than those who did not, suggesting differential attrition based on youth characteristics.ConclusionsLessons learned from this school-based trial can be applied more broadly to research with low-income urban youth of color. Researchers should strive to maximize scientific rigor, minimize harm to vulnerable adolescents and their communities, promote positive research experiences for young people, and provide concrete benefits to those who participate.     

Monitoring the Retention of a Protein Antigen in Complete Freund's Adjuvant,Alum, and Pluronic F-127 Gel Formulations by X-ray Fluorescence

Adjuvants function by protecting antigens from rapid degradation or dispersal. The effectiveness of experimental adjuvants can be assessed by measuring antibody titers to the antigen of interest or, less frequently, by evaluating the retention and distribution of antigen at the application site. In this study, we used X-ray fluorescence (XRF) to monitor the release of an iodinated protein (I-bovine serum albumin) from several adjuvant formulations after its subcutaneous injection in rats. The interaction of the tagged antigen with an external Am-241 source leads to the emission of iodine X-rays from the application site; the number of these X-rays is proportional to the concentration of the protein remaining at the injection site. The disappearance of the iodine X-rays, and hence the antigen, from the injection site followed first-order kinetics for all adjuvant formulations tested; mean half-life values were as follows: in 50% Freund's adjuvant, 17.1 ± 1.1 h; in 4-hour-old 25% Alum, 11.78 ± 0.08 h; in 4-h-old 50% Alum, 13.2 ± 2 h; in 3-day-old 50% Alum, 15.8 ± 1.5 h; and in 240 mg/mL Pluronic F-127, 7.9 ± 0.7 h. We conclude that XRF is an easy, reliable, noninvasive method to monitor the retention of antigens in these adjuvant solutions.     

Validation of the self-confidence scale of nursing care in urinary retention

Objective:

to validate an instrument to measure self-confidence of nursing care in urinary retention.

Methods:

methodological research study, carried out after ethical approval. A Likert-like scale of 32 items related to nursing care in urinary retention was applied to students of the graduate nursing course. For instrument validation, analysis of the sample adequacy and main components, Varimax orthogonal rotation and internal consistency analyses were developed.

Results:

in a sample of 305 students, there was high correlation of all items with the total scale and Cronbach''s alpha of 0.949. The scale items were divided into five factors with internal consistency: Factor 1 (0.890), Factor 2 (0.874), Factor 3 (0.868), Factor 4 (0.814) and Factor 5 (0.773), respectively.

Conclusion:

the scale meets the validity requirements, demonstrating potential for use in evaluation and research.