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Evaluation of an Innovative Medical-Legal Partnership in Camden, NJ: Implications for Practice and Research
Get PDFThe challenge: This study evaluated a Medical-Legal Partnership (MLP) coordinated between the Camden Coalition and the Cooper Center for Healing in Camden, NJ. The MLP integrates legal services into addiction medicine to address the intertwined legal, social, and health challenges faced by individuals with substance use disorders (SUDs).
Potential consequences: Addressing the legal needs of individuals with SUDs through MLPs can mitigate barriers to recovery, improve health outcomes, and enhance quality of life.
Description/ analysis/methods: Researchers used a mixed-methods design to evaluate the Camden Coalition MLP. Data were collected through interviews with 39 MLP participants and 13 staff members and a survey of 70 MLP participants. Analyses explored legal needs, service delivery, and participant outcomes.
Rationale/reflection/replication: Findings highlighted the MLP\u27s comprehensive approach, which included direct legal representation in criminal and civil matters, the co-location of services, and interdisciplinary collaboration between providing partners. Participants reported high satisfaction, positive recovery-related outcomes, and confidence in addressing future legal issues. This model offers a replicable framework for integrating legal and medical care to address social determinants of health and foster recovery. Key lessons include the importance of multidisciplinary collaboration and sustained funding mechanisms.
 
Equitable Access to For-Credit and Paid Internships
Get PDFThis article shares a working group’s self-study and report on equitable access to for-credit and paid internships at a large public university. Academic internships or other forms of field experience are high-impact practices that offer many potential benefits for students, including real-life applications of theoretical knowledge, pre-professional training and socialization, career exploration, and, in some cases, career opportunities after graduation. The opportunities for academic internships, however, may not be distributed equally particularly for Black, Latinx, and other minoritized students. In this report, we apply an equity-minded framework to examine available campus data on the state of internships and other paid employment across our university and the potential barriers to access and participation. Based on the evidence presented in this report, we offer several recommendations for our campus that also may inform similar student success initiatives at other institutions
Building Community-Engaged Learning Through Interprofessional Mentorship
Get PDFMentoring is an essential concept for facilitating learning across many disciplines to support the professional development of students into the workforce. Typically, these mentorships are initiated between individuals in a similar field or expertise for the purpose of meeting learning objectives driven by profession-specific standards. This paper describes the importance of expanding traditional mentorship opportunities to encompass interdisciplinary mentoring relationships which can foster interprofessional learning, promote increased diverse experiences in underrepresented communities, and create pathways for community-engagement between academic institutions and partnering organizations to improve client services. This study included an innovative approach which used evidenced-based resources to support mentors in their willingness to mentor students outside of their own profession. The findings of this program acknowledge that with intentional educational resources framed within interprofessional learning, mentors of diverse backgrounds can grow in their perception of confidence and competence leading to improved understanding of the importance of communication strategies and the various ways mentors and mentees can communicate with one another. In addition, mentors can develop greater confidence of their ability to mentor and serve as a role model by nurturing trust in the relationship which can lead to positive self-efficacy of the student in the community-engaged partnership.
 
Predicting NCAA Division I Football Conference Winning Percentage: An Applied Resource Allocation Perspective
Get PDFApplied strategies to improve conference wins for NCAA Division I FBS football teams could have implications for increased resource acquisition, bowl berths, or inclusion in the lucrative college football playoffs. Unfortunately, aggregated research is lacking that identifies how administrators might prioritize such efforts, so that they may allocate their scarce resources to the most impactful areas. Thus, the purpose of this study was to investigate variables likely to impact conference winning percentage to provide practical insight for leaders embracing their role within managerial capitalism. Pearson correlations and multilinear OLS were applied to determine which descriptive, financial, and performance variables predict conference winning percentage. Football expenditures as well as coach success, recruit quality, and power conference membership were significantly predictive. Application of these results suggest conference winning percentage would likely increase as a result of targeted financial development leading to investments in recruiting and football expenditures, particularly in the power conferences
Factors Associated with Anemia in Infants with and without HIV Exposure in Western Kenya
Get PDFBackground: Anemia is a major global health problem impacting morbidity and mortality, especially in children under 5 years of age. Children living with HIV are more likely to develop anemia, but little is known about children who are HIV exposed but uninfected (HEU). The objective of this study is to evaluate rates of anemia and factors associated with anemia in a population of 6-month-old infants who are HEU and HIV-unexposed and uninfected (HUU) in western Kenya.
Methods: This study included a cross-sectional analysis of a large prospective cohort study. The study was conducted as part of the Academic Model Providing Access to Healthcare (AMPATH) and took place at Moi Teaching and Referral Hospital (MRTH) in Eldoret, Kenya. Only those participants with lab values were included in this analysis. Anemia was defined as hemoglobin level ≤10.5 g/dL. Data were analyzed from prenatal and birth records, questionnaires, anthropometric measurements, and blood samples. Two sample t-tests, chi-square, Fisher’s exact tests, and logistic regression were used for analyses.
Results: Of the 586 infants with lab values, 95 had anemia (16.2%), with 38 (6.5%) meeting the threshold for moderate-to-severe anemia (≤ 9.4 g/dL). Infant anemia was associated with male sex (p=0.02) and stunting (low height-for-age) status (p=0.04). Furthermore, infants with HIV exposure (OR=2.63, 95%Cl: 1.29, 4.54), preterm birth (OR=3.92, 95%CI: 2.29, 6.70), high maternal blood pressure (OR=2.31, 95%CI: 1.05, 4.90), and interruption of breastfeeding before 6 months of age (OR=2.77, 95%CI: 1.29, 5.88) had increased odds of anemia, even after adjusting for covariates.
Conclusions: Infants who are HEU, born prematurely, exposed to maternal hypertension, and with interruption of breastfeeding were more likely to develop anemia, even when accounting for other factors. Health systems should monitor these risk factors to identify children at high risk for having anemia and ensure early referral for treatment.
Kidney Function and Mortality Following Two-Stage Revision Total Joint Arthroplasty for Periprosthetic Joint Infection
Get PDFBackground and Hypothesis: Periprosthetic joint infection (PJI) after total hip and knee arthroplasty (THA, TKA) is reported in up to 2% of cases yet remains a serious complication. The current gold standard of treatment consists of a two-stage surgery involving intravenous antibiotic therapy between stages of implant resection and reimplantation. In addition, studies on the effects of these antibiotics on kidney function after two-stage treatment for PJI are limited. This study evaluated kidney function and mortality before, during, and after two-stage revision for PJI. The hypothesis of the study was that the antibiotics part of the treatment course would not lead to an increased risk of kidney injury.
Project Methods: Clinical data on 160 THAs and TKAs undergoing two-stage treatment for PJI were retrospectively reviewed. Standardized protocols were used for all cases consisting of robust medical optimization by a dedicated perioperative medicine specialist and 6-weeks of intravenous antibiotics prior to reimplantation. Kidney function metrics of serum creatinine (Cr), estimated glomerular filtration rate (eGFR), and blood urea nitrogen (BUN) were collected from routine labs in the electronic medical record along with mortality data. A P-value of 0.05 was considered statistically significant.
Results: No significant differences were observed in mean serum Cr (1.10, 1.12, 1.13 mg/dL), eGFR (78.6, 77.7, 74.8 mL/min/1.73m2), or BUN levels (19.8, 18.9, 19.0 mg/dL) between pre-resection, the inter-stage period, or post-reimplant, respectively (P ≥ 0.432; Power ≥ 85.3%). Mortality was 0% within 90-days of resection and 1.4% (2/138) within 1-year of resection (both cardiac events unrelated to kidney function). Kaplan-Meier survivorship estimates were 98% at 2-years and 86% at 5-years post-resection.
Potential Impact: Kidney function was not adversely impacted by the antibiotics associated with the two-stage revision procedure for PJI. With proper medical management, the two-stage revision for PJI remains the preeminent treatment for PJI following TJA. 
Right-Sizing Inflaction in Anti-Kickback Law Rhetoric: Avoiding Unnecessary Market Distortion in Commissions on Medical Device Sales
No full textFor three decades, the federal agency charged with administrative oversightof the Federal Health Care Programs Anti-kickback statute, the Office of theInspector General of the Department of Health and Human Services, has advisedthat paying for marketing and advertising of covered health care items andservices should be treated as “at most a technical violation” of the law. OIG hasnoted that enforcement should be limited to cases where certain “suspectcharacteristics” are present and has issued several advisory opinions decliningenforcement in the case of commission-type payments to independent salesagents. In contrast, in the last twenty years, obiter dicta in a number of judicialdecisions upholding criminal convictions have described such commissions asa per se violation of the law. Left unchallenged, this rhetorical inflation presentsunjustified risks of enforcement to medical device makers for nothing morenefarious than selling their products in accordance with widespread industrynorms that do not implicate any of the purposes underlying the Anti-kickbackstatute. More important, these decisions have the potential to distort the healthcare economy through economically disadvantageous allocations of resources:the wastefulness of unwarranted enforcement on the one hand, and on the other,discouraging innovation by imposing additional costs on medical productmakers, especially the often small, entrepreneurial, one-product companies thatdominate the medical device industry, and do not have the resources to use afully-employed sales force. This article attempts to remedy these risks byshowing that, dicta in the opinions notwithstanding, the facts in those cases trackthe agency’s guidance, upholding convictions only when suspectcharacteristics—chiefly that the sales personnel are not truly independent salesrepresentatives but are in a position to exercise undue influence over referraldecisions—have been present. Presenting an independent but parallel argument,the article also examines a recent Supreme Court case narrowing the meaningof the term “induce” in an analogous criminal statute, and shows how this newauthority also (perhaps even more strongly) supports the conclusion that theAnti-kickback law may not be used to prosecute ordinary commissions. In thehope that it also will influence courts and lead to a more fair, accurate andpragmatic Anti-kickback law jurisprudence, the article concludes with anAppendix containing recommendations for joint OIG/Department of Justiceguidance that aligns the rules for enforcement discretion with this reality,instructing the bringing, or joining, of enforcement cases only when thepresence of suspect characteristics creates a genuine risk of the fraud and abuse evils that the statute was designed to prohibit
A Cross-Disciplinary Team Approach to Offering Institution-Wide Structural Racism Educational Programming: Three-Year Reflections
Get PDFIntroduction
Diversity, equity, and inclusion (DEI) initiatives are at the forefront of institutional conversations, strategies, and goals. Librarians have a natural role in contributing to greater institutional DEI activities, including educational programming and training. However, it can often be challenging for librarians to dedicate time and staff and to be seen as a partner in DEI activities on campus. This Voices of Experience article reflects on the educational advocacy work of a cross-disciplinary committee at a small graduate school of psychology whose goal was to educate the campus community about the embedded historic and ongoing structural racist practices that impact the community.
Experience
Over three academic years, 2021- 2024, the Structural Racism Programming Committee (SRPC) planned and offered 21 programs to our entire community of students, faculty, and staff. Each event centered on a theme, such as voting, housing, education, and the environment. A variety of event types were offered, including presentations, panels, film screenings, exhibits, and tours. An end-of-year program evaluation survey was developed and distributed each year to aid in continuously improving and planning future programs.
Discussion
Overall, the programming was valued by the community, but attendance remained low due to several consistent barriers including scheduling conflicts, lack of time, and competing priorities. Additionally, a small number of students reported that they did not participate because they failed to see the relevance of the subject matter to their clinical psychology studies and field work. Varying the event formats seemed to increase interest and participation. Based on the committee’s observations and the program evaluation results, programming was adjusted each year.
Takeaways
For other librarians seeking to contribute similarly to DEI educational initiatives at their institutions, recommendations include proactively expressing interest and offering expertise, seeking partners outside the library, determining activity scope, and remaining flexible.