6,676 research outputs found

    UMSL Bulletin 2023-2024

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    The 2023-2024 Bulletin and Course Catalog for the University of Missouri St. Louis.https://irl.umsl.edu/bulletin/1088/thumbnail.jp

    A Phenomenological Study Exploring the Factors That Contribute to Persistence in Online Doctoral Programs for Students With Learning Disabilities or ADHD

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    The purpose of this transcendental phenomenological study was to discover the factors that contributed to persistence in online doctoral programs for students with learning disabilities (LD) and attention deficit hyperactivity disorder (ADHD). The theory guiding this study was Tinto’s theory of student persistence, as it suggested the more students were academically and socially integrated into their institution, the more likely they were to persist in their studies. The Central research question of this study is, “What are the factors that contribute to persistence in online doctoral programs for students with LD and ADHD?” Participants in this study consisted of seven individuals with learning disabilities or ADHD who had completed all of their required coursework in their current online doctoral program and had started the dissertation phase of their program, and four who had graduated from their online doctoral programs within the last two years. Candidates were selected using purposive sampling. Perspectives of students with LD and ADHD as they related to their academic persistence were shared. The lived experiences of online doctoral students with LD and ADHD were studied using online discussion board prompts, individual interviews, and focus groups. The data were collected and analyzed using Moustakas’ transcendental phenomenology approach and generated six themes and commonalities among the participants in this study. The themes were Overcoming Challenges and Barriers, Adaptation and Coping Strategies, Motivation, Self-Efficacy, Support Systems, and Personal Determination and Perseverance. The data analysis revealed empirical, practical, and theoretical implications along with recommendations for future research

    A tailored psychological intervention for anxiety and depression management in people with chronic obstructive pulmonary disease: TANDEM RCT and process evaluation

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    Background: People with chronic obstructive pulmonary disease have high levels of anxiety and depression, which is associated with increased morbidity and poor uptake of effective treatments, such as pulmonary rehabilitation. Cognitive-behavioural therapy improves mental health of people with long-term conditions and could potentially increase uptake of pulmonary rehabilitation, enabling synergies that could enhance the mental health of people with chronic obstructive pulmonary disease. Aim: Our aim was to develop and evaluate the clinical effectiveness and cost effectiveness of a tailored cognitive-behavioural approach intervention, which links into, and optimises the benefits of, routine pulmonary rehabilitation. Design: We carried out a pragmatic multicentre randomised controlled trial using a 1.25 : 1 ratio (intervention : control) with a parallel process evaluation, including assessment of fidelity. Setting: Twelve NHS trusts and five Clinical Commissioning Groups in England were recruited into the study. The intervention was delivered in participant\u27s own home or at a local NHS facility, and by telephone. Participants: Between July 2017 and March 2020 we recruited adults with moderate/very severe chronic obstructive pulmonary disease and mild/moderate anxiety and/or depression, meeting eligibility criteria for assessment for pulmonary rehabilitation. Carers of participants were invited to participate. Intervention: The cognitive-behavioural approach intervention (i.e. six to eight 40- to 60-minute sessions plus telephone support throughout pulmonary rehabilitation) was delivered by 31 trained respiratory healthcare professionals to participants prior to commencing pulmonary rehabilitation. Usual care included routine pulmonary rehabilitation referral. Main outcome measures: Co-primary outcomes were Hospital Anxiety and Depression Scale - anxiety and Hospital Anxiety and Depression Scale - depression at 6 months post randomisation. Secondary outcomes at 6 and 12 months included health-related quality of life, smoking status, uptake of pulmonary rehabilitation and healthcare use. Results: We analysed results from 423 randomised participants (intervention, n = 242; control, n = 181). Forty-three carers participated. Follow-up at 6 and 12 months was 93% and 82%, respectively. Despite good fidelity for intervention delivery, mean between-group differences in Hospital Anxiety and Depression Scale at 6 months ruled out clinically important effects (Hospital Anxiety and Depression Scale - anxiety mean difference -0.60, 95% confidence interval -1.40 to 0.21; Hospital Anxiety and Depression Scale - depression mean difference -0.66, 95% confidence interval -1.39 to 0.07), with similar results at 12 months. There were no between-group differences in any of the secondary outcomes. Sensitivity analyses did not alter these conclusions. More adverse events were reported for intervention participants than for control participants, but none related to the trial. The intervention did not generate quality-of-life improvements to justify the additional cost (adjusted mean difference \ua3770.24, 95% confidence interval -\ua327.91 to \ua31568.39) to the NHS. The intervention was well received and many participants described positive affects on their quality of life. Facilitators highlighted the complexity of participants\u27 lives and considered the intervention to be of potential valuable; however, the intervention would be difficult to integrate within routine clinical services. Our well-powered trial delivered a theoretically designed intervention with good fidelity. The respiratory-experienced facilitators were trained to deliver a low-intensity cognitive-behavioural approach intervention, but high-intensity cognitive-behavioural therapy might have been more effective. Our broad inclusion criteria specified objectively assessed anxiety and/or depression, but participants were likely to favour talking therapies. Randomisation was concealed and blinding of outcome assessment was breached in only 15 participants. Conclusions: The tailored cognitive-behavioural approach intervention delivered with fidelity by trained respiratory healthcare professionals to people with chronic obstructive pulmonary disease was neither clinically effective nor cost-effective. Alternative approaches that are integrated with routine long-term condition care are needed to address the unmet, complex clinical and psychosocial needs of this group of patients. Trial registration: This trial is registered as ISRCTN59537391. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 13/146/02) and is published in full in Health Technology Assessment; Vol. 28, No. 1. See the NIHR Funding and Awards website for further award information.People with long-standing lung problems, such as chronic obstructive pulmonary disease, often also have anxiety and depression, which further reduces their quality of life. Two existing treatments could help. Pulmonary rehabilitation (a programme of exercise and education) improves both the physical and mental health of people with chronic obstructive pulmonary disease. Cognitive–behavioural therapy (a talking therapy) may reduce anxiety and depression. The TANDEM [Tailored intervention for Anxiety and Depression Management in chronic obstructive pulmonary disease (COPD)] intervention linked these two treatments by providing talking therapy based on cognitive–behavioural therapy during the waiting time following referral for pulmonary rehabilitation. The TANDEM treatment was delivered by respiratory healthcare professionals (e.g. nurses or physiotherapists) trained to deliver the talking therapy in six to eight weekly sessions. The sessions were conducted in the participant’s home (or another convenient location), with brief telephone support during the pulmonary rehabilitation. Of 423 participants recruited to the study, 242 participants received TANDEM talking therapy and 181 participants received usual care (including a referral to pulmonary rehabilitation). We measured mental health, quality of life, social life, attendance at pulmonary rehabilitation and healthcare use in both groups at 6 and 12 months. Forty-three carers joined the study and we assessed their mental well-being. We interviewed patients, carers and health professionals to find out their views and experience of the TANDEM treatment. We also examined whether or not the TANDEM treatment was good value for money. The TANDEM treatment did not improve the mental or the physical health of people with chronic obstructive pulmonary disease. In addition, the TANDEM treatment cost the NHS an extra \ua3770 per patient, which was not good value for money. The TANDEM treatment was well received, and many participants told us how it had helped them. Heath-care professionals noted how participants did not just have chronic obstructive pulmonary disease, but were coping with many physical, mental and social problems. The TANDEM intervention was not effective and, therefore, other strategies will be needed to help people with chronic obstructive pulmonary disease and mental health problems live with their condition

    Examining systemic and dispositional factors impacting historically disenfranchised schools across North Carolina

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    This mixed method sequential explanatory study provided analysis of North Carolina (NC) school leaders’ dispositions in eliminating opportunity gaps, outlined in NC’s strategic plan. The study’s quantitative phase used descriptive and correlation analysis of eight Likert subscales around four tenets of transformative leadership (Shields, 2011) and aspects of critical race theory (Bell, 1992; Ladson-Billings, 1998; Ladson-Billings & Tate, 2006) to understand systemic inequities and leadership attitudes. The qualitative phase comprised three analyses of education leadership dispositions and systemic factors in NC schools. The first analysis of State Board of Education meeting minutes from 2018–2023 quantified and analyzed utterances of racism and critical race, outlined the sociopolitical context of such utterances, and identified systemic patterns and state leader dispositions. The second analysis of five interviews of K–12 graduates identified persistent and systemic factors influencing NC education 3 decades after Brown v. Board of Education (1954) and within the context of Leandro v. State of NC (1997), where the NC Supreme Court recognized the state constitutional right for every student to access a “sound basic education.” The final qualitative analysis consisted of five interviews of current NC public school system leaders, for personal narratives of the state of NC schools compared to patterns from lived experiences of NC K–12 graduates. The study’s findings suggested NC school and state education leaders experience a racialized dichotomy between willingness for change (equity intentions) and execution of transformative action (practice). Although leaders at the board and school levels recognize the need for inclusivity and equity, a struggle to transcend systemic challenges, especially rooted in racial biases and power dynamics is evident. This study may identify leadership qualities needed for change in NC to address systemic inequities for improving educational access and inform policy to uphold all students’ constitutional right to a sound, basic education

    Commercial provider staff experiences of the NHS low calorie diet programme pilot: a qualitative exploration of key barriers and facilitators

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    Background The National Health Service Type 2 Diabetes Path to Remission programme in England (known as the NHS Low Calorie Diet programme when piloted) was established to support people living with excess weight and Type 2 Diabetes to lose weight and improve their glycaemic control. A mixed method evaluation was commissioned to provide an enhanced understanding of the long-term cost effectiveness of the pilot programme, its implementation, equity and transferability across broad and diverse populations. This study provided key insights on implementation and equity from the service providers’ perspective. Methods Thirteen focus groups were conducted with commercial providers of the programme, during the initial pilot rollout. Participants were purposively sampled across all provider organisations and staff roles involved in implementing and delivering the programme. Normalisation Process Theory (NPT) was used to design the topic schedule, with the addition of topics on equity and person-centredness. Data were thematically analysed using NPT constructs with additional inductively created codes. Codes were summarised, and analytical themes generated. Results The programme was found to fulfil the requirements for normalisation from the providers’ perspective. However, barriers were identified in engaging GP practices and receiving sufficient referrals, as well as supporting service users through challenges to remain compliant. There was variation in communication and training between provider sites. Areas for learning and improvement included adapting systems and processes and closing the gap where needs of service users are not fully met. Conclusions The evaluation of the pilot programme demonstrated that it was workable when supported by effective primary care engagement, comprehensive training, and effective internal and external communication. However, limitations were identified in relation to programme specifications e.g. eligibility criteria, service specification and local commissioning decisions e.g. pattern of roll out, incentivisation of general practice. A person-centred approach to care is fundamental and should include cultural adaptation(s), and the assessment and signposting to additional support and services where required

    Safe passage for attachment systems:Can attachment security at international schools be measured, and is it at risk?

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    Relocations challenge attachment networks. Regardless of whether a person moves or is moved away from, relocation produces separation and loss. When such losses are repeatedly experienced without being adequately processed, a defensive shutting down of the attachment system could result, particularly when such experiences occur during or across the developmental years. At schools with substantial turnover, this possibility could be shaping youth in ways that compromise attachment security and young people’s willingness or ability to develop and maintain deep long-term relationships. Given the well-documented associations between attachment security, social support, and long-term physical and mental health, the hypothesis that mobility could erode attachment and relational health warrants exploration. International schools are logical settings to test such a hypothesis, given their frequently high turnover without confounding factors (e.g. war trauma or refugee experiences). In addition, repeated experiences of separation and loss in international school settings would seem likely to create mental associations for the young people involved regarding how they and others tend to respond to such situations in such settings, raising the possibility that people at such schools, or even the school itself, could collectively be represented as an attachment figure. Questions like these have received scant attention in the literature. They warrant consideration because of their potential to shape young people’s most general convictions regarding attachment, which could, in turn, have implications for young people’s ability to experience meaning in their lives

    Beam scanning by liquid-crystal biasing in a modified SIW structure

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    A fixed-frequency beam-scanning 1D antenna based on Liquid Crystals (LCs) is designed for application in 2D scanning with lateral alignment. The 2D array environment imposes full decoupling of adjacent 1D antennas, which often conflicts with the LC requirement of DC biasing: the proposed design accommodates both. The LC medium is placed inside a Substrate Integrated Waveguide (SIW) modified to work as a Groove Gap Waveguide, with radiating slots etched on the upper broad wall, that radiates as a Leaky-Wave Antenna (LWA). This allows effective application of the DC bias voltage needed for tuning the LCs. At the same time, the RF field remains laterally confined, enabling the possibility to lay several antennas in parallel and achieve 2D beam scanning. The design is validated by simulation employing the actual properties of a commercial LC medium

    An American Knightmare: Joker, Fandom, and Malicious Movie Meaning-Making

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    This monograph concerns the long-standing communication problem of how individuals can identify and resist the influence of unethical public speakers. Scholarship on the issue of what Socrates & Plato called the “Evil Lover” – i.e., the ill-intended rhetor – began with the Greek philosophers, but has carried into [post]Modern anxieties. For instance, the study of Nazi propaganda machines, and the rhetoric of Hitler himself, rejuvenated interest in the study of speech and communication in the U.S. and Europe. Whereas unscrupulous sophists used lectures and legal forums, and Hitler used a microphone, contemporary Evil Lovers primarily draw on new, internet-related tools to share their malicious influence. These new tools of influence are both more far-reaching and more subtle than the traditional practices of listening to a designated speaker appearing at an overtly political event. Rhetorician Ashley Hinck has recently noted the ways that popular culture – communication about texts which are commonly accessible and shared – are now significant sites through which citizens learn moral and political values. Accordingly, the talk of internet influencers who interpret popular texts for other fans has the potential to constitute strong persuasive power regarding ethics and civic responsibility. The present work identifies and responds to a particular case example of popular culture text that has been recently, and frequently, leveraged in moral and civic discourses: Todd Phillips’ Joker. Specifically, this study takes a hermeneutic approach to understanding responses, especially those explicitly invoking political ideology, to Joker as a method of examining civic meaning-making. A special emphasis is placed on the online film criticisms of Joker from white nationalist movie fans, who clearly exemplify ways that media responses can be leveraged by unethical speakers (i.e., Evil Lovers) and subtly diffused. The study conveys that these racist movie fans can embed values related to “trolling,” incelism, and xenophobia into otherwise seemingly innocuous talk about film. While the sharing of such speech does not immediately mean its positive reception, this kind of communication yet constitutes a new and understudied attack on democratic values such as justice and equity. The case of white nationalist movie fan film criticism therefore reflects a particular brand of communicative strategy for contemporary Evil Lovers in communicating unethical messages under the covert guise of mundane movie talk

    Understanding the Potential of Sport for Promoting Physical Activity and Psychological Well-Being in Middle-Aged and Older Adults

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    Insufficient physical activity is considered a global public health challenge. This thesis highlights that, for middle-aged and older adults, sport participation is associated with a wide range of psychosocial benefits. Then, the thesis offers insight into the potential of walking sport programmes to promote health-enhancing physical activity in middle-aged and older adults. Recommendations are provided to promote the appeal, feasibility, and sustainability of walking sport programmes in community-based settings
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