Objectives The purpose of this study was to elucidate changes in attitudes, experiences, readiness, and confidence levels of medical residents to perform screening, brief intervention, and referral to treatment (SBIRT) and factors that moderate these changes. Methods A cohort of 121 medical residents received an educational intervention. Self-reported experience, readiness, attitude, and confidence toward SBIRT-related skills were measured at baseline and at follow-up. Analyses were conducted to evaluate the effects of medical specialization. Results The intervention significantly increased experience (P < .001), attitude (P < .05), readiness (P < .001), and confidence (P < .001). Residents were more likely to report that their involvement influenced patients’ substance use. However, experience applying SBIRT skills varied by country of birth, specialty, and baseline scores. Conclusions This study suggested that SBIRT training was an effective educational tool that increased residents’ sense of responsibility. However, application of skills might differ by specialization and other variables. Future studies are needed to explore and evaluate SBIRT knowledge obtained, within the context of cultural awareness and clinical skills.

Purpose The purpose of this paper is to investigate the effect of ethical leadership on the burnout process among resident physicians, and the mediating roles of general self-efficacy and perceived supervisor support (PSS) in the relationship between ethical leadership behavior and various aspects of burnout. Design/methodology/approach A total of 203 residents of three teaching hospitals in the South Atlantic Division of the USA completed the Maslach Burnout Inventory-Human Services Survey, the General Self-Efficacy Scale, and Survey of Perceived Supervisor Support and rated the ethical leadership of their supervising attending physicians on the Ethical Leadership Scale. Confirmatory factor analysis and path analysis were conducted to test the measurement and hypothesized structural models. Findings The results showed that ethical leadership had a negative indirect effect on emotional exhaustion through PSS and a positive indirect effect on personal accomplishment through general self-efficacy. However, PSS and general self-efficacy did not mediate the relationship between ethical leadership and depersonalization. Originality/value This study adds to the body of knowledge on the impact of ethical leadership on three aspects of burnout syndrome, i.e., emotional exhaustion, depersonalization and personal accomplishment. Moreover, this is the first study to consider PSS and general self-efficacy as intervening variables to the ethical leadership-burnout relationship.

Iron chelators inhibit the growth of the malaria parasite, Plasmodium falciparum, in culture and in animal and human studies. We previously reported the anti-plasmodial activity of the chelators, 2-hydroxy-1-naphthylaldehyde isonicotinoyl hydrazone (311), 2-hydroxy-1-naphthylaldehyde 4-methyl-3-thiosemicarbazone (N4mT), and 2-hydroxy-1-naphthylaldehyde 4-phenyl-3-thiosemicarbazone (N4pT). In fact, these ligands showed greater growth inhibition of chloroquine-sensitive (3D7) and chloroquine-resistant (7G8) strains of P. falciparum in culture compared to desferrioxamine (DFO). The present study examined the effects of 311, N4mT and N4pT on erythrocyte membrane integrity and asexual parasite development. While the characteristic biconcave disk shape of the erythrocytes was unaffected, the chelators caused very slight hemolysis at IC50 values that inhibited parasite growth. The chelators 311, N4mT and N4pT affected all stages of the intra-erythrocytic development cycle (IDC) of P. falciparum in culture. However, while these ligands primarily affected the ring-stage, DFO inhibited primarily trophozoite and schizont-stages. Ring, trophozoite and schizont-stages of the IDC were inhibited by significantly lower concentrations of 311, N4mT, and N4pT (IC50 = 4.45 ± 1.70, 10.30 ± 4.40, and 3.64 ± 2.00 μM, respectively) than DFO (IC50 = 23.43 ± 3.40 μM). Complexation of 311, N4mT and N4pT with iron reduced their anti-plasmodial activity. Estimation of the intracellular labile iron pool (LIP) in erythrocytes showed that the chelation efficacy of 311, N4mT and N4pT corresponded to their anti-plasmodial activity, suggesting that the LIP may be a potential source of non-heme iron for parasite metabolism within the erythrocyte. This study has implications for malaria chemotherapy that specifically disrupts parasite iron utilization.

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BackgroundHistorically, studies suggested that immigrants acquire the risk of colorectal cancer (CRC) as US-born persons within the same generation. CRC risk of immigrants is largely unknown in this era of cancer screening and widespread immigration. We investigated the association of place of birth and cancer beliefs with uptake of CRC screening.MethodsThe 2007 Health Information National Trends Survey was used and 4,299 respondents (weighted population size=81,896,392) who were 50 years and older (3,960 US-born and 339 foreign-born) were identified. We defined being current with CRC screening guidelines as the use of fecal occult blood test within 1 year, sigmoidoscopy within 5 years, or colonoscopy within 10 years. We compared being up-to-date with CRC screening among foreign-born versus US-born respondents. Logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (CI).ResultsOverall, 2,594 (63.3%) US-born and 208 (52.8%) foreign-born respondents were current with CRC screening. Foreign-born respondents were less current in unadjusted model (OR 0.65; 95% CI: 0.50-0.85) but became non-statistically significant after adjustment (OR 0.79; 95% CI: 0.51-1.24). Respondents who believed that screening finds cancer when it is easy to treat (OR 2.85; 95% CI: 1.44-3.61), those who believed that cancer can be cured when detected early (OR 1.56; 95% CI: 1.20-2.00), and those who worry about getting cancer (OR 1.34; 95% CI: 1.10-1.61) were likely to be current with CRC screening. However, respondents with fatalistic beliefs were borderline less likely to be current (OR 0.82; 95% CI: 0.65-1.04).ConclusionThere is a need to improve education on CRC screening, particularly among foreign-born adults.