dRecently, tomatoes have been implicated as a primary vehicle in food-borne outbreaks of Salmonella enterica serovar Newport and other Salmonella serovars. Long-term intervention measures to reduce Salmonella prevalence on tomatoes remain elusive for growing and postharvest environments. A naturally occurring bacterium identified by 16S rRNA gene sequencing as Paenibacillus alvei was isolated epiphytically from plants native to the Virginia Eastern Shore tomato-growing region. After initial antimicrobial activity screening against Salmonella and 10 other bacterial pathogens associated with the human food supply, strain TS-15 was further used to challenge an attenuated strain of S. Newport on inoculated fruits, leaves, and blossoms of tomato plants in an insect-screened high tunnel with a split-plot design. Survival of Salmonella after inoculation was measured for groups with and those without the antagonist at days 0, 1, 2, and 3 and either day 5 for blossoms or day 6 for fruits and leaves. Strain TS-15 exhibited broad-range antimicrobial activity against both major food-borne pathogens and major bacterial phytopathogens of tomato. After P. alvei strain TS-15 was applied onto the fruits, leaves, and blossoms of tomato plants, the concentration of S. Newport declined significantly (P < 0.05) compared with controls. Astonishingly, >90% of the plants had no detectable levels of Salmonella by day 5 for blossoms. The naturally occurring antagonist strain TS-15 is highly effective in reducing the carriage of Salmonella Newport on whole tomato plants. The application of P. alvei strain TS-15 is a promising approach for reducing the risk of Salmonella contamination during tomato production.
In the US, health care professionals are trained predominantly in uniprofessional settings independent of interprofessional education and collaboration. Yet, these professionals are tasked to work collaboratively as part of an interprofessional team in the practice environment to provide comprehensive care to complex patient populations. Although many advantages of interprofessional education have been cited in the literature, interprofessional education and collaboration present unique barriers that have challenged educators and practitioners for years. In spite of these impediments, one student-led organization has successfully implemented interprofessional education and cross-disciplinary collaboration. The purpose of this paper is to provide a conceptual framework for successful implementation of interprofessional education and collaboration for other student organizations, as well as for faculty and administrators. Each member of the interprofessional team brings discipline-specific expertise, allowing for a diverse team to attend to the multidimensional health needs of individual patients. The interprofessional team must organize around a common goal and work collaboratively to optimize patient outcomes. Successful interdisciplinary endeavors must address issues related to role clarity and skills regarding teamwork, communication, and conflict resolution. This conceptual framework can serve as a guide for student and health care organizations, in addition to academic institutions to produce health care professionals equipped with interdisciplinary teamwork skills to meet the changing health care demands of the 21st century.
Health-care educators share the social responsibility to teach medical students about social determinants of health and health-care disparities and subsequently to encourage medical students to pursue residencies in primary care and medical practice in underserved communities. Free clinics provide care to underserved communities, yet collaborative partnerships with such organizations remain largely untapped by medical schools. Free clinics and medical schools in 10 US states demonstrate that such partnerships are geographically feasible and have the potential to mutually benefit both organizational types. As supported by prior research, students exposed to underserved populations may be more likely to pursue primary care fields and practice in underserved communities, improving health-care infrastructure.
Limited-English-proficient (LEP) patients in the United States experience a variety of health care disparities associated with language barriers, including reduced clinical encounter time and substandard medical treatment compared with their English-speaking counterparts. In most current U.S. health care settings, interpretation services are provided by personnel ranging from employed professional interpreters to untrained, ad hoc interpreters such as friends, family, or medical staff. Studies have demonstrated that untrained individuals commit many interpretation errors that may critically compromise patient safety and ultimately prove to be life-threatening. Despite documented risks, the U.S. health care system lacks a required standardized certification for medical interpreters. The authors propose that the standardization of medical interpreter training and certification would substantially reduce the barriers to equitable care experienced by LEP patients in the U.S. health care system, including the occurrence of preventable clinical errors. Recent efforts of the U.S. federal court system are cited as a successful and realistic example of how these goals may be achieved. As guided by the evolution of the federal court interpreting certification program, subsequent research will be required to demonstrate the improvements and challenges that would result from national certification standards and policy for medical interpreters. Research should examine cost-effectiveness and ensure that certified interpreting services are appropriately used by health care practitioners. Ongoing commitment is required from lawmakers, health care providers, and researchers to remove barriers to care and to demand that equity remain a consistent goal of our health care system.
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