Saturday, September 05, 2026

 

National call-to-action needed to strengthen primary care pipeline in medical education: HMSOM Educators



No single ‘fix’ for this kind of systemic problem, but well-thought-out strategies can nudge the trend in a positive direction




Hackensack Meridian Health

Tovah Tripp, M.D., of the Hackensack Meridian School of Medicine 

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A new paper led by a faculty member at the Hackensack Meridian School of Medicine (HMSOM) points to why there is a shortage of primary-care doctors - and outlines strategies to boost recruitment, starting in undergraduate medical education.

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Credit: Hackensack Meridian Health





A primary-care physician is hard to find. The thousands needed nationwide are even tougher to discover. A new paper led by a faculty member at the Hackensack Meridian School of Medicine (HMSOM) points to why - and outlines strategies to boost recruitment, starting in undergraduate medical education.

The perspective piece in the Journal of General Internal Medicine identifies what they call a critical gap in “med ed”: while graduate medical education mandates ambulatory training, neither the Liaison Committee on Medical Education (LCME) nor the Association of American Medical Colleges (AAMC) requires specific outpatient exposure during medical school.

This is a missed opportunity, according to the experts. 

The paper is authored by medical education experts on behalf of the Society of General Internal Medicine (SGIM) and Association of Chiefs and Leaders of General Internal Medicine (ACLGIM) Hess Initiative Work Group, and the writers were led by Tovah Tripp, M.D., associate professor of Internal Medicine at HMSOM, also the school’s Internal Medicine clerkship director and a practicing primary-care doctor at Hackensack Meridian Health. 

“Investing in (undergraduate medical education) experiences is essential to rebuild the primary care pipeline and create a generation of physicians who understand the value and role of primary care within the healthcare system regardless of their ultimate specialty,” write the authors.

The paper synthesizes existing literature into interrelated pathways on how to boost primary care’s importance to doctors-in-training. First, stimulating the “ecosystem” of primary care through mitigation of administrative burdens and debt, while leveraging artificial intelligence and team models of learning, will boost the value of the clinical role to learners. Faculty can also be developed through incentives, including educational relative value units (RVUs) or tax credits, as well as protected time and flexible schedules, among other give-backs. Finally, enriching the student’s experience of primary career during clerkships and mentorships would heighten the value of primary care, they write. 

Specialty choices are often solidified long before residency, making early interventions absolutely critical, the authors inveigh. Medical schools and accrediting bodies should mandate minimum ambulatory rotation requirements to ensure primary care choices when the time comes, the authors add.

“There is not a single ‘fix’ for this kind of systemic problem, but well-thought-out strategies can nudge the trend in a positive direction,” said Tripp. 

 

 

Five ways K–12 leaders can strengthen teacher recognition beyond appreciation weeks, according to new University of Phoenix white paper



Author Dr. Contessa T. Walker-Jackson distinguishes professional recognition from general appreciation and offers practical approaches for school leaders seeking to support teacher morale and engagement



University of Phoenix





University of Phoenix College of Doctoral Studies has published a new white paper, “Beyond Appreciation Weeks: Building Teacher Recognition Into the Everyday Work of K–12 Leadership,” by Contessa Walker-Jackson, Ed.D., alumni fellow with the University’s Center for Educational and Instructional Technology Research (CEITR). In the paper, Walker-Jackson examines how K–12 school leaders can move beyond episodic teacher-appreciation activities by making substantive teacher recognition part of everyday leadership practice.

Walker-Jackson distinguishes between appreciation — general expressions of gratitude directed toward teachers as a group — and recognition, which acknowledges a specific professional contribution by an individual teacher. The paper argues that both have a place in school culture, but that recognition is most meaningful when it is specific, consistent and connected to teachers’ actual work.

“Teacher appreciation plays an important role in school culture, but recognition highlights the specific work that a teacher has accomplished,” said Walker-Jackson. “A principal who notices well is a gem to the school. A principal who departs without incorporating a system of recognition into the school's operations creates a potential failure within the institution, as the elements that contributed to teachers feeling acknowledged and valued will leave with them.”

Why is teacher recognition different from teacher appreciation?

Walker-Jackson argues that appreciation activities such as staff celebrations, thank-you notes and appreciation weeks can help schools express collective gratitude and create opportunities for connection. However, the paper distinguishes those activities from substantive recognition, which is tied to something a leader has directly observed a teacher accomplish.

Drawing on established motivation theory, recent research on teacher engagement and narrative interviews with current and former teachers, the paper suggests that recognition becomes more meaningful when it reinforces professional competence, belonging and contribution rather than functioning primarily as a scheduled or generic gesture.

The distinction is particularly important for school leaders, Walker-Jackson writes, because recognition practices that depend primarily on the preferences of an individual principal may disappear when leadership changes. Building recognition into school routines and expectations can make the practice more consistent over time.

What did teachers say makes recognition meaningful?

For the paper, Walker-Jackson conducted semi-structured narrative interviews with 10 current and former teachers at a faith-based private school in the southeastern United States. The analysis identified six themes:

  • Consistency matters. Teachers described recognition as less meaningful when it was unpredictable or dependent on the preferences of an individual leader.
  • Culture shapes recognition. Participants emphasized that recognition should reflect the values and norms of the school community, with some preferring private or quieter acknowledgment.
  • Leadership plays a central role. Teachers reported that the presence and quality of recognition could change significantly with a change in principal.
  • Specific recognition can affect morale. Participants described small, targeted gestures as meaningful when they acknowledged something the teacher had actually done.
  • Tangible recognition can have lasting value. Some participants valued recognition that created a visible or enduring acknowledgment of their contribution.
  • Structure supports continuity. Teachers with experience across different settings described recognition as more reliable when supported by established practices rather than individual goodwill.

Across the interviews, Walker-Jackson found that teachers tended to describe recognition as meaningful when it was specific and tied to a real professional contribution, while generic, inconsistent or leader-dependent recognition was more likely to be viewed as insufficient.

How can K–12 leaders make teacher recognition part of everyday practice?

The white paper identifies five practices school and district leaders can consider:

  1. Replace generic praise with named-action feedback. Give teachers timely feedback that identifies a specific instructional action or professional contribution and its observed effect.
  2. Use post-observation conversations as recognition opportunities. Treat the conversation following a classroom observation as an opportunity to acknowledge professional strengths, not solely as an evaluation or compliance step.
  3. Protect planning time as a form of recognition. Recognize the importance of teachers’ professional preparation by protecting planning periods from unnecessary disruption when possible.
  4. Build recognition practices that survive leadership changes. Establish consistent expectations, review cycles and leadership responsibilities so recognition does not depend entirely on one principal’s personal habits.
  5. Train principals in specific recognition. Treat effective recognition as a leadership skill that can be developed through coaching and incorporated into leadership expectations.

Together, the recommendations position recognition not as a once-a-year event, but as a leadership discipline that can be practiced, reinforced and evaluated as part of everyday school operations.

The paper notes important limitations to the findings. The narrative interviews involved 10 current and former teachers from one faith-based private school in the southeastern United States, and Walker-Jackson recommends further research in public schools, additional geographic regions and other educational settings. As the five recommended leadership practices have not yet been tested together as a single intervention, the paper presents them as evidence-informed leadership practices for further consideration and study.

About the author

Dr. Walker-Jackson is an Alumni Fellow with the University of Phoenix Center for Educational and Instructional Technology Research (CEITR) and founding president of the University of Phoenix Alabama Alumni Chapter. An educator, educational consultant, and K-12 school founder with more than two decades in education, she advises schools, districts, and homeschool programs on curriculum design, differentiated instruction, and teacher development. She is a National Certified Trainer in Differentiated Instruction, holds teaching certification in Alabama and Arizona, and founded Teacher's PETS Inc., a 501(c)(3) organization serving underserved students since 2007. Walker-Jackson earned her Doctorate in Educational Leadership with a concentration in Curriculum and Instruction from University of Phoenix, and a bachelor's in elementary education from Oakwood University. She can be reached through her LinkedIn profile.

The full white paper is available on the University of Phoenix Research Hub or as a direct link here.

About University of Phoenix 

University of Phoenix is Built for Real Life. 50 Years Strong. The University innovates to help working adults enhance their careers and develop skills in a rapidly changing world through flexible online learning, relevant courses, academic AI pillars, and skills-mapped curriculum for associate, bachelor’s and master’s degree programs. Active students and alumni have access to Career Services for Life® resources including career guidance and tools. For more information, visit phoenix.edu.

About the College of Doctoral Studies

University of Phoenix’s College of Doctoral Studies focuses on today’s challenging business and organizational needs, from addressing critical social issues to developing solutions to accelerate community building and industry growth. The College’s research program is built around the Scholar, Practitioner, Leader Model which puts students in the center of the Doctoral Education Ecosystem® with experts, resources and tools to help prepare them to be a leader in their organization, industry and community. Through this program, students and researchers work with organizations to conduct research that can be applied in the workplace in real time.

 

Microplastics may act as pollutant shuttles, carrying chemicals, pathogens and antibiotic resistance genes



New review reveals how microplastics transport multiple pollutants across ecosystems and proposes a framework for identifying when these vector effects become serious ecological threats



Shenyang Agricultural University Collaborative Journals

Microplastics as pollutant shuttles: unraveling the drivers of chemical and biological vector effects 

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Microplastics as pollutant shuttles: unraveling the drivers of chemical and biological vector effects

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Credit: Zhengyingzi He, Xinping Zhu, Rui Pei, Jingliang Shi, & Qinghua Zhang





Microplastics are often viewed as pollutants in their own right, but their environmental impact may extend far beyond the plastic particles themselves. A new review shows that microplastics can act as mobile "pollutant shuttles," carrying toxic chemicals, microorganisms and antibiotic resistance genes through water, soil, food webs and even across environmental boundaries.

Published in Energy & Environment Nexus, the review by researchers from Jiangxi Agricultural University provides a comprehensive analysis of the dual role of microplastics as vectors for both chemical and biological contaminants. The authors also introduce a three-tiered framework for understanding the physical, chemical and biological factors that determine when these transport effects may become major ecological risks.

"Microplastics should not be considered isolated particles in the environment," said corresponding author Jingliang Shi. "They can interact with chemicals and microorganisms, transport them between environmental compartments and, under certain conditions, amplify their ecological effects. Understanding when these processes become dominant is essential for realistic risk assessment."

One major concern is the "Trojan horse effect." Microplastics can adsorb persistent organic pollutants, heavy metals and other contaminants on their surfaces. After being ingested by organisms, these pollutants may be released in the digestive system, increasing their bioavailability. The review highlights an important size dependence: conventional microplastics generally deliver contaminants through the gastrointestinal tract, while nanoplastics smaller than about 1 micrometer may cross biological membranes and distribute associated pollutants to internal organs.

The biological dimension may be equally important. Microplastic surfaces can develop microbial communities known as the plastisphere, which can provide protected habitats for pathogens and antibiotic resistance genes. Within these biofilms, close contact between microorganisms may promote horizontal gene transfer, potentially accelerating the spread of antimicrobial resistance.

The review further shows that chemical and biological effects may reinforce each other. Pollutants attached to microplastics can create selective pressure on microbial communities, while biofilms can alter plastic surface properties and increase subsequent pollutant adsorption. This bidirectional positive feedback may intensify both contaminant accumulation and the transfer of antibiotic resistance genes.

To move beyond simple descriptions of microplastic pollution, the authors propose a three-tiered regulatory framework involving physical, chemical and biological drivers. Particle size, shape and aging influence transport and surface reactivity. Polymer chemistry and environmental conditions control adsorption and desorption. Biological processes, including biofilm formation, ingestion and food-web transfer, determine how contaminants ultimately reach organisms.

The researchers also identify conditions under which combined chemical and biological vector effects may become particularly important. These include strong microbial selective pressure at relatively low contaminant concentrations, high extracellular polymeric substance content in biofilms, highly aged microplastics with oxygen-rich surface groups, and prolonged exposure exceeding 30 days.

The authors emphasize that future research should shift toward quantitative, environmentally realistic studies that can define ecological risk thresholds. Current toxicity experiments often rely on short-term, high-concentration exposures that poorly represent chronic environmental conditions. The review calls for long-term observations, improved exposure models, targeted removal of high-risk aged microplastics and more unified approaches to global microplastic governance.

Ultimately, the study reframes microplastics not simply as contaminants, but as dynamic platforms capable of connecting chemical pollution, microbial ecology and antimicrobial resistance across ecosystems.

 

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Journal reference: He Z, Zhu X, Pei R, Shi J, Zhang Q. 2026. Microplastics as pollutant shuttles: unraveling the drivers of chemical and biological vector effects. Energy & Environment Nexus 2: e023 doi: 10.48130/een-0026-0017   

https://www.maxapress.com/article/doi/10.48130/een-0026-0017  

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About Energy & Environment Nexus:
Energy & Environment Nexus (e-ISSN 3070-0582) is an open-access journal publishing high-quality research on the interplay between energy systems and environmental sustainability, including renewable energy, carbon mitigation, and green technologies.

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Origins of COPD may lie in how some children’s lungs develop, but only when they are exposed to polluted air





European Respiratory Society

Dr Carla da Silva Sena 

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Dr Carla da Silva Sena

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Credit: Carla da Silva Sena / European Respiratory Society





Chronic obstructive pulmonary disease (COPD) is a serious, incurable lung disease that is common in older people. However, researchers are learning that the origins of the disease may lie decades earlier in how children’s lungs grow and develop.

 

New research, presented at the European Respiratory Society (ERS) Congress in Barcelona, Spain [1], suggests that babies born with higher genetic risk for COPD showed reduced lung function growth between birth and six years, which could place them on a path to developing the disease. However, researchers only saw this pattern in children who were exposed to higher levels of air pollution.

 

The research was presented by Dr Carla da Silva Sena from University Children's Hospital Basel UKBB, University of Basel, and Bern University Hospital, Switzerland. She said: “COPD develops through a combination of genetic factors and environmental exposures across the lifespan, leading to an accelerated decline in lung function. While COPD is often associated with smoking, growing evidence suggests that genetic and environmental factors in early life may also contribute to the foundations of the disease, particularly during lung development in infancy and childhood.

 

“We believe that COPD can result from lung function ‘trajectories’ established early in life. For example, COPD can develop because the lungs do not reach their full growth potential during childhood or because lung function declines faster than expected later on. Studying these trajectories from the earliest stages of life is key to understanding how COPD develops.”

 

The research included 484 children who were taking part in the Basel-Bern Infant Lung Development (BILD) study. This is an ongoing Swiss birth cohort study that follows children born between 1999 and 2020.

 

Children’s lung function was assessed in the first month of life using the infant tidal breathing test, which records a baby's natural breathing while they sleep. At age six, children took part in a spirometry test, where lung function is assessed by taking a deep breath and blowing out as hard as possible. Researchers estimated each child’s exposure to outdoor air pollution, including fine particles (PM2.5) and nitrogen dioxide (NO2), from birth until age six.

 

Researchers also collected genetic information from children’s blood samples. COPD is not caused by a single gene, but the risk of developing COPD has been linked to many small genetic differences that can be combined into a measure known as a ‘polygenic risk score’. The researchers examined whether this polygenic risk score, which has been established by studying adult COPD patients, shows an effect on how lung function develops in healthy newborns, even before they display any symptoms.

 

The researchers found that this genetic risk for developing COPD was aligned with a lower lung function growth in children between birth and six years old, but only in the children who grew up in areas with the highest PM2.5 air pollution (average 15.3 μg/m³). In children from areas with lower air pollution, this effect was much weaker. Researchers found a similar pattern between lung function growth and higher levels of nitrogen dioxide (average 28.3 μg/m³).

 

Dr da Silva Sena said: “These findings suggest that some babies may be born with a higher genetic risk for COPD, and this risk may already begin to show up as differences in lung function growth in early childhood, but only in those who grow up in areas with higher air pollution.

 

“This study adds to the evidence that early-life environment matters for lung health, and not just for children who already have breathing problems, but potentially for how lungs develop over time in seemingly healthy children. It reinforces that protecting air quality in early life may benefit children’s long-term health.”

 

Researchers plan to follow the children into adolescence and adulthood to see whether the differences they see in the children’s lung function persist or grow over time.

 

A limitation of the study is that it is not possible to use the same lung function test in babies and school-age children. To overcome this problem, the researchers used statistical techniques to make the results comparable between the different tests. The study also relied on a genetic risk score that was developed based on populations of European ancestry. This means the findings may not directly apply to children from other backgrounds.

 

Professor Barbara Hoffmann, Chair of the European Respiratory Society’s Advocacy Council, based at the University of Düsseldorf, Germany, who was not involved in the research said: “This study reveals a genetic risk pathway for COPD that only became apparent when researchers looked at the effects of air pollution in seemingly healthy children. This shows how genes and environment in the early years can combine to set children on a path to lung disease much later in life.

 

“These findings fit with a broader shift in how COPD is understood, reflected in a 2022 Lancet Commission, which argued that COPD is shaped by risk pathways across life, not just by adult smoking. It may help explain why COPD can also occur in non-smokers.

 

“Given the potential long-term benefits for children's lung development, this research strengthens the case for clean air policies. Air pollution, unlike genetic risk, is something that can be addressed through the right policy and regulation.”