Modality and terminology changes for behavioral health service delivery during the COVID-19 pandemic: a systematic review

Introduction: The COVID-19 pandemic prompted healthcare professionals to implement service delivery adaptations to remain in compliance with safety regulations. Though many adaptations in service delivery were reported throughout the literature, a wide variety of terminology and definitions were used. Methods: To address this, we conducted a PRISMA review to identify service delivery adaptations across behavioral healthcare services in the United States from March 2020 to May 2022 and to identify variations in terminology used to describe these adaptations. We identified 445 initial articles for our review across eight databases using predetermined keywords. Using a two-round screening process, authors used a team approach to identify the most appropriate articles for this review. Results: Our results suggested that a total of 14 different terms were used to describe service modality changes, with the most frequent term being telehealth (63%). Each term found in our review and the frequency of use across identified articles is described in detail. Discussion: Implications of this review such as understanding modality changes during the COVID-19 pandemic and beyond are discussed. Our findings illustrate the importance of standardizing terminology to enhance communication and understanding among professionals

DNP Final Report: PROMOTING PHYSICAL ACTIVITY IN NURSE STUDENTS

Undergraduate nursing students experience educational rigor and challenging clinical experiences that potentially affect stress levels and increase the risk for adverse mental and physical health outcomes. Prolonged stress is associated with emotional exhaustion, unhealthy coping mechanisms, unhealthy behaviors, and impaired functioning. This evidence-based practice project aimed to decrease undergraduate nursing students\u27 perceived stress levels by promoting physical activity. The PICOT question that led this project was in undergraduate nursing students (P), how does the promotion of physical activity (I) compare to no promotion of physical activity (C) affect perceived stress (O) across one semester (T)? The evidence supports physical activity as a non-pharmacological therapy that can reduce stress and positively impact academic performance and resilience. During the implementation process, students self-enrolled in an online course, completed the Qualtrics Perceived Stress Scale, and reported their weekly minutes of physical activity before and after the intervention. It included evidence-based strategies to increase physical activity, the Move Your Way® campaign resources, and weekly synchronous online belly dance classes. The outcomes and evaluation confirmed that various kinds of moderate-intensity activity decrease stress. Following eight weeks, participant’s stress levels reduced significantly, as in the body of evidence. Three ten-minute physical activity study breaks sessions a day can help the students attain the minimum physical activity guidelines for Americans of 150 minutes per week of moderate physical activity

Neither Meek nor Docile: An Analysis of Margaret Hale and Jane Eyre in Elizabeth Gaskell’s North and South and Charlotte Brontë’s Jane Eyre

The Victorian period was an era of societal change in Great Britain. Viewing gender in hetero- and CIS- normative terms, the “woman question” – what to do with unmarried women – became a topic that was widely debated. Activists such as Barbara Leigh Smith, Francis Power Cobbe and Josephine Butler advocated for better education and employment opportunities for women emphasizing the need for women to find dignity and fulfilment outside of the private sphere to which they were relegated. Jane Eyre by Charlotte Brontë and North and South by Elizabeth Gaskell reflect the issues facing middle-class women during this period, including the desire to find fulfilment and dignity in their lives. My paper examines the protagonists of these two novels, Jane Eyre and Margaret Hale, as examples of women who were beginning to question their role in society. Using the works of scholars such as Elaine Showalter, Ellen Moers, Barbara Leah Harman, Patricia Ingham and Nicola Thompson, it examines how these two characters both subvert Victorian expectations for women and conform to them. It posits that while historically Brontë has been viewed as a radically feminist writer, Gaskell is more successful in subverting Victorian notions of gender roles, for she successfully offers her audience a more admirably free and dignified yet still respectable female protagonist, one who is not only about to be happily married but who is also a land owner and sponsor of a “master of industry.

Experimental and Theoretical Analysis of Nonlinear Triboelectric Energy Harvester for Frequency Up-Conversion Applications

With the development of micro-sensors and wireless applications, energy harvesting has become an effective method for self-powering. However, ambient energy is only limited to below 100Hz, which restricts the energy harvester designs to this range resulting inan impractical bulky and large-scale harvester. Therefore, in this thesis, we investigatedfrequency Up and Down conversion energy harvesters to benefit from the high-frequency oscillations and transferred them to the ambient vibration ranges. Toward this, the triboelectric transduction mechanism has been utilized for a frequency-up conversion for energy harvesting applications, while the piezoelectric transduction mechanism is used for frequency-downconversion for mass sensing applications. The performance of Vibro-impact triboelectric energy harvesting from low frequency using frequency up-conversion has been investigated theoretically and experimentally validated. The structure consists of two cantilever beams, one with a low natural frequency (Low-Frequency Beam (LFB)) and the other with a high natural frequency (High-Frequency Beam(LFB)). The two beams are coupled through repulsive magnetic force between two magnets attached as tip masses of the beams and facing each other at the same polarity. The HFB tip magnet acts as an upper electrode of a triboelectric energy harvester, while a PDMS insulator is attached to a lower electrode. When the structure is subjected to base excitation,the triboelectric layers generate an electrical signal via contact-separation impact motion between the triboelectric’s layers. The magnetic coupling converts low-frequency vibrations to high-frequency self-oscillations, and an electrical signal is generated at the LFB resonance. By controlling the distance between the two magnets, the structure will vibrate in eithermono or bistable oscillations. A lumped parameter model of a two-degree of freedom system is proposed to simulate the dynamic behavior and the generated electrical signal. The static and dynamic behaviors are investigated at different separation distances selected to cover the monostable, transition, and bistable regions. In addition, a parametric numerical analysisfor enhancing the electrical output and optimizing the harvester functionality. This study shows the feasibility of utilizing Vibro-impact triboelectric energy harvesting for frequency up-converting applications from ambient vibrations. Since the ambient vibrations are below 100 Hz while most machines and equipment operaterelatively at high frequencies (more than 70 Hz), we also propose a theoretical study to harvest energy from high frequencies using a frequency-down bistable piezoelectric energy harvester mechanism. We investigate the energy harvesting benefit in the down-conversion of a high-frequency signal to a low-frequency signal utilizing magnetic coupling. A high-frequency driving beam triggers a low-frequency generating beam. We use a spring-mass-damper equivalent model to understand the operation mechanism of the proposed piezoelectric vibration energy harvester. Based on the theoretical model, the static and dynamic effect of magnetic nonlinearity on the performance of the proposed piezoelectric vibration energy harvester is numerically analyzed. The targeted applications are the down-conversion and the filtering of high frequencies and mass sensing, particularly the harvester’s behavior for mass sensing applications

A Mixed Methods Feasibility Study Comparing Rural and Nonrural Critical Illness Survivors

This dissertation is an exploration of mental health (MH) and behavioral concepts related to the experience of critical illness survivors (CISs). Physical issues of survivorship after critical illness have long been studied and treated; however, less is known about the mental health of CISs, what influences them to seek MH treatment, and if there are differences in these phenomena in rural and nonrural CISs. The first manuscript is a concept analysis of “powerlessness” as it relates to the intensive care unit (ICU) patient experience. The second manuscript explores the MH outcomes of sepsis patients, the most common diagnosis in ICUs, and how ICU nurses can support the MH of sepsis patients. The third manuscript represents the primary research study. Using an adapted Social Cognitive Theory model as a guide, a convergent mixed methods feasibility study examined Post-Traumatic Stress Disorder symptoms, self-efficacy, powerlessness, seeking MH treatment, health-related goals, and perceived barriers and facilitators to seeking MH treatment in rural and nonrural CISs. In completing this dissertation, the researcher was able to lay the foundation for future research involving rural and nonrural CISs. Implications for future research and practice are considered and discussed

IMPACT OF RESPONSE TO INTERVENTION ON ACHIEVEMENT

The Improvement Science Dissertation in Practice focused on an initial comprehensive assessment of the Response to Intervention (RtI) framework, implemented in a district in East Texas, and its impact of student achievement. Following the evaluation, a subsequent improvement iteration concentrated on the impact of RtI, with the use of job-embedded professional learning, on student achievement. Both iterations utilized a mixed-methods case study using an embedded experimental model with a one-phase approach. The findings highlighted that student achievement did improve with statistically significant results except for in the second iteration where there was not statistically significant results in fifth and sixth grade reading from winter to spring and eighth grade reading overall. Additionally, the data showcased the need for targeted professional development on Tier Two and Tier Three instructional strategies as well as a documented RtI framework guide

GENERATION OF CHIMERIC RHINOVIRUSES PRESENTING SARS-COV-2 BROADLY NEUTRALIZING EPITOPES AND THEIR ANTIGENICITY CHARACTERIZATION

The global COVID pandemic is not yet fully under control as there were over 21 million new cases of SARS-CoV-2 infections and over 50,000 deaths globally as of January of 2022. A heavily mutated variant of concern, Omicron is responsible for most of these cases which demands an urgency for a new vaccine. NIH reports over 180 vaccine candidates that use various strategies currently in development. However, a recurring concern with these vaccines is that the continuous viral mutations decrease the efficacy of vaccines. Therefore, we proposed to construct a human rhinovirus (HRV) based chimeric virus containing highly conserved, broadly neutralizing antibody epitopes of SARS-CoV-2 as a universal vaccine candidate. The HRV: SARS-CoV-2 chimeric virus was constructed using recombinant DNA technology, where DNA sequence encoding conserved epitopes of SARS-CoV-2 were inserted into HRV plasmid, transcribed into mRNA, and transfected into HeLa cells. With the research ongoing, we have inserted the epitopes of interest into HRV, however, we found the chimeric virus mutates itself to remove portions of the insert after being passaged a few times. Thus, we were unsuccessful in making the chimeric virus. Although this thesis research is focused on the construction and characterization of a chimeric virus as a vaccine candidate, the goal of the study is to develop an effective universal vaccine against different strains of SARS-CoV-2

(Semi)automated approaches to data extraction for systematic reviews and meta-analyses in social sciences: A living review protocol

Background: An abundance of rapidly accumulating scientific evidence presents novel opportunities for researchers and practitioners alike, yet such advantages are often overshadowed by resource demands associated with finding and aggregating a continually expanding body of scientific information. Across social science disciplines, the use of automation technologies for timely and accurate knowledge synthesis can enhance research translation value, better inform key policy development, and expand the current understanding of human interactions, organizations, and systems. Ongoing developments surrounding automation are highly concentrated in research for evidence-based medicine with limited evidence surrounding tools and techniques applied outside of the clinical research community. Our objective is to conduct a living systematic review of automated data extraction techniques supporting systematic reviews and meta-analyses in the social sciences. The aim of this study is to extend the automation knowledge base by synthesizing current trends in the application of extraction technologies of key data elements of interest for social scientists. Methods: The proposed study is a living systematic review employing a partial replication framework based on extant literature surrounding automation of data extraction for systematic reviews and meta-analyses. Protocol development, base review, and updates follow PRISMA standards for reporting systematic reviews. This protocol is preregistered in OSF: (Semi)Automated Approaches to Data Extraction for Systematic Reviews and Meta-Analyses in Social Sciences: A Living Review Protocol on August 14, 2022. Conclusions: Anticipated outcomes of this study include: (a) generate insights supporting advancement in transferring existing reliable methods to social science research; (b) provide a foundation for protocol development leading to enhancement of comparability and benchmarking standards across disciplines; and (c) uncover exigencies that spur continued value-adding innovation and interdisciplinary collaboration for the benefit of the collective systematic review community

Unsung heroes in health education and promotion: How Community Health Workers contribute to hypertension management

Rural communities are noted as having poor health outcomes. Rural areas experience barriers to care primarily due to a lack of resources, including education, health insurance, transportation, and social support. Additionally, poor health outcomes are a consequence of poor health literacy skills. Community Health Workers (CHWs) are utilized as a resource to combat these issues. This study focused on a CHW led Self-Management Blood Pressure (SMBP) program offered through the University of Texas at Tyler Health Science Center. The goal of the program was to improve management of hypertension through awareness, education, navigation, advocacy, and resource assistance. The SMBP program included structured workshops and regular follow-up with participants including connections to community resources and social support. CHWs worked closely with physicians providing bi-directional feedback on referrals and engagement of communities through outreach events. Furthermore, CHWs aided to bridge cultural or linguistic gaps between service providers and community members. Data is provided indicating this CHW-led intervention played a significant role in improving hypertension through education of how to make lifestyle changes that impact overall health and quality of life. Participants gained knowledge encouraging them to create lifelong healthy habits, coping skills, stress management, self-care, and accountability. Through this innovative approach, participants thrived in the supportive and encouraging environment led by CHWs as well as improved their blood pressure management

Occupational Health and Safety Policy Compliance among Community Health Workers in Western Kenya

Background: Compliance with occupational health and safety policies, monitoring, and evaluation are critical components of a safe workplace. Occupational hazards among community health workers have rarely been studied. This study aimed to assess compliance with occupational health and safety among community health workers in Western Kenya. Methods: This cross-sectional study used a quantitative data-collection method. A sample of 309 community health workers and community health extension workers was selected using purposive and simple random sampling from 47 counties in Kenya and community health units, respectively. All community health workers in the sampled community units in the administrative locations were included as study participants. A structured questionnaire was used to collect data from the participants. Results: Approximately one-third of the participants were females, 211(75.9%). Participants’ ages ranged from 18 to 68 years, with a mean of 36.8 years and a peak of 41-50 years, 113 (40.6%). The mean compliance to occupational level was 15.5, with a standard deviation of 6.7. Nearly three-quarters (76.6%) of the participants had low compliance with occupational health policy. A relatively high compliance score was in the 20-30 age group, with a mean score of 2.86±1.07 SD. Conclusion: This study provides evidence for the implementation of an occupational health policy to improve the care and safety of community health workers in Kenya