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When you prepare for a global audience as a facilitator or designer for your virtual classroom training, you need to think globally about every aspect of the training from the learner perspective, and make adjustments geared to those perspectives. Following are five key areas to consider: 1. logistics, 2. content, 3. learning styles, 4. rehearsal, and 5. facilitation. Follow these tips to ensure you hit a home run with your global virtual classroom, or rather, that you are successful in the global virtual classroom. By accounting for the participants' perspectives and making adjustments based on them, you will make participants feel included, maximize learning transfer, regardless of their location or cultural background, and make them eager for more.

If your organization is dedicated to environmental sustainability, you should consider making a business case for virtual classroom training by connecting it to the organization's carbon footprint reduction. For many organizations, bringing trainers and participants to a central hub can require long flights or car travel-significant sources of carbon emissions. Using free online tools, you can calculate the carbon emissions savings that would be realized by replacing traditional classroom training with virtual training, along with savings on travel costs. To emphasize this benefit to stakeholders, present a slide at the beginning of each virtual class that shows the amount of carbon emissions avoided by delivering training virtually. Participants will gain an appreciation for how environmentally friendly and sustainable virtual training can be.

Beginning in the 1930s, Black Chicago experienced a cultural renaissance that lasted into the 1950s and rivaled the cultural outpouring in the Harlem Renaissance of the 1920s. The contributors to this volume analyze this prolific period of African American creativity in music, performance art, social science scholarship, and visual and literary artistic expression. Unlike Harlem, Chicago was an urban industrial center that gave a unique working class and internationalist perspective to the cultural work being done in Chicago. This collection's various essays discuss the forces that distinguished the Black Chicago Renaissance from the Harlem Renaissance and placed the development of black culture in a national and international context. Among the topics discussed in this volume are Chicago writers Gwendolyn Brooks and Richard Wright,The Chicago Defenderand Tivoli Theater, African American music and visual arts, and the American Negro Exposition of 1940. Contributors are Hilary Mac Austin, David T. Bailey, Murry N. DePillars, Samuel A. Floyd Jr., Erik S. Gellman, Jeffrey Helgeson, Darlene Clark Hine, John McCluskey Jr., Christopher Robert Reed, Elizabeth Schlabach, and Clovis E. Semmes.

Background Surveillance is a core component of an effective system to support malaria elimination. Poor surveillance data will prevent countries from monitoring progress towards elimination and targeting interventions to the last remaining at-risk places. An evaluation of the performance of surveillance systems in 16 countries was conducted to identify key gaps which could be addressed to build effective systems for malaria elimination. Methods A standardized surveillance system landscaping was conducted between 2015 and 2017 in collaboration with governmental malaria programmes. Malaria surveillance guidelines from the World Health Organization and other technical bodies were used to identify the characteristics of an optimal surveillance system, against which systems of study countries were compared. Data collection was conducted through review of existing material and datasets, and interviews with key stakeholders, and the outcomes were summarized descriptively. Additionally, the cumulative fraction of incident infections reported through surveillance systems was estimated using surveillance data, government records, survey data, and other scientific sources. Results The landscaping identified common gaps across countries related to the lack of surveillance coverage in remote communities or in the private sector, the lack of adequate health information architecture to capture high quality case-based data, poor integration of data from other sources such as intervention information, poor visualization of generated information, and its lack of availability for making programmatic decisions. The median percentage of symptomatic cases captured by the surveillance systems in the 16 countries was estimated to be 37%, mostly driven by the lack of treatment-seeking in the public health sector (64%) or, in countries with large private sectors, the lack of integration of this sector within the surveillance system. Conclusions The landscaping analysis undertaken provides a clear framework through which to identify multiple gaps in current malaria surveillance systems. While perfect systems are not required to eliminate malaria, closing the gaps identified will allow countries to deploy resources more efficiently, track progress, and accelerate towards malaria elimination. Since the landscaping undertaken here, several countries have addressed some of the identified gaps by improving coverage of surveillance, integrating case data with other information, and strengthening visualization and use of data.

Large language models (LLMs) have shown promise in medical question answering, with Med-PaLM being the first to exceed a ‘passing’ score in United States Medical Licensing Examination style questions. However, challenges remain in long-form medical question answering and handling real-world workflows. Here, we present Med-PaLM 2, which bridges these gaps with a combination of base LLM improvements, medical domain fine-tuning and new strategies for improving reasoning and grounding through ensemble refinement and chain of retrieval. Med-PaLM 2 scores up to 86.5% on the MedQA dataset, improving upon Med-PaLM by over 19%, and demonstrates dramatic performance increases across MedMCQA, PubMedQA and MMLU clinical topics datasets. Our detailed human evaluations framework shows that physicians prefer Med-PaLM 2 answers to those from other physicians on eight of nine clinical axes. Med-PaLM 2 also demonstrates significant improvements over its predecessor across all evaluation metrics, particularly on new adversarial datasets designed to probe LLM limitations ( P  < 0.001). In a pilot study using real-world medical questions, specialists preferred Med-PaLM 2 answers to generalist physician answers 65% of the time. While specialist answers were still preferred overall, both specialists and generalists rated Med-PaLM 2 to be as safe as physician answers, demonstrating its growing potential in real-world medical applications. With an improved framework for model development and evaluation, a large language model is shown to provide answers to medical questions that are comparable or preferred with respect to those provided by human physicians.

Persons Living with Dementia (PLWD), diagnosed or undiagnosed, have high Emergency Department (ED) use. Identification of such patients poses significant challenges for emergency clinicians with considerable downstream implications on patients, care partners, and healthcare systems. With the advent of Geriatric Emergency Departments (GEDs) there is an opportunity to understand and improve care of PLWDs in EDs with effective allocation of resources and the development of novel techniques to better support detecting those at risk, communicating findings, and coordinating care for such patients. Advances have been made leveraging Electronic Health Record (EHR) data to risk stratify patients for dementia in the hope that those at high-risk may benefit from further evaluation. The promise of multiple blood-base biomarkers (BBM) as a future modality to improve detection of those at risk of dementias, will also have the potential to advance the delivery of care of PLWD and their care partners in EDs. HIGHLIGHTS: EDs have an integral role in delivering care for Person Living with Dementia and their care partners. High acuity and fast paced ED environment and other barriers makes it difficult to identify Person Living with Dementia. EHR-based risk stratification algorithms can identify patients at risk for Dementia in ED and outpatient settings. Use of Blood-Based Biomarkers in the ED setting is novel and considerations of its use and implications need to be studied. EHR based risk stratification algorithm and Blood Based Biomarkers when used judiciously have the potential to overcome some of the known barriers to identify and improve care for Person Living with Dementia as they transition through EDs.

Background Benzodiazepines (BZD) misuse is a serious public health problem, especially among opiate-dependent patients with anxiety enrolled in methadone program because it puts patients at higher risk of life-threatening multiple drug overdoses. Both elevated anxiety and BZD misuse increase the risk for ex-addicts to relapse. However, there is no recent study to assess how serious the problem is and what factors are associated with BZD misuse. This study estimates the prevalence of BZD misuse in a methadone program, and provides information on the characteristics of BZD users compared to non-users. Methods An anonymous survey was carried out at a methadone program in Baltimore, MD, and all patients were invited to participate through group meetings and fliers around the clinic on a voluntary basis. Of the 205 returned questionnaires, 194 were complete and entered into final data analysis. Those who completed the questionnaire were offered a $5 gift card as an appreciation. Results 47% of the respondents had a history of BZD use, and 39.8% used BZD without a prescription. Half of the BZD users (54%) started using BZD after entering the methadone program, and 61% of previous BZD users reported increased or resumed use after entering methadone program. Compared to the non-users, BZD users were more likely to be White, have prescribed medication for mental problems, have preexistent anxiety problems before opiate use, and had anxiety problems before entering methadone program. They reported more mental health problems in the past month, and had higher scores in anxiety state, depression and perceived stress (p < .05). Conclusions Important information on epidemiology of BZD misuse among methadone-maintenance patients suggests that most methadone programs do not address co-occurring anxiety problems, and methadone treatment may trigger onset or worsening of BZD misuse. Further study is needed to explore how to curb misuse and abuse of BZD in the addiction population, and provide effective treatments targeting simultaneously addiction symptoms, anxiety disorders and BZD misuse.