Building Resilience Through Strengths-Based Learning During Graduate Study Abroad: An Exploratory Study

Resilience has been identified as an essential skill for leaders (Basso, Gruendel, Key, MacBlaine, & Reynolds, 2015) and as crucial for navigating both school and life challenges (Yeager & Dweck, 2012). Research indicates that there are a variety of ways to build resilience, including in educational settings (Yeager & Dweck, 2012). Higher education institutions utilize pedagogical practices to maximize student learning and growth opportunities (Rennick, 2015). One pedagogical frame often employed is experiential education. College and university faculty have embedded experiential learning pedagogy in the curriculum to facilitate learning outside the classroom (Liang, Caton, & Hill, 2015; Jordan, Gagnon, Anderson, & Pilcher, 2018; Towers & Loyness, 2018). Additionally, experiential education principles have been integrated with study abroad curriculum to support student learning (Harper, 2018; Pipitone and Raghaven, 2017; Pipitone, 2018). Educators are interested in learning more about the potential effect of strengths-based initiatives in higher education (Soria & Stubblefield, 2015a). While scholars have reported on the benefits of utilizing a strengths-based curriculum for personal development (Passerilli, Hall, & Anderson, 2010), much work is still needed to explore the potential outcomes of strengths-based education on resilience development. This research sought to address the gap in the literature using a short-term graduate study abroad program embedded with experiential education practices to examine how the pedagogy design contributed to students’ perceived growth in resilience. The strengths-based curricular design included approximately sixty hours of strengths-based instruction prior to the trip and fourteen days of applying the common strengths language to enhance learning experiences and mitigate challenges

Employment status and work-related problems of gastrointestinal cancer patients at diagnosis: a cross-sectional study

Objective To assess the employment status of patients with gastrointestinal cancer at diagnosis and to examine work-related problems of employed patients. Design New, consecutive patients were included at the Gastrointestinal Oncology Center Amsterdam, a one-stop, rapid access diagnostic assessment centre. Patients were interviewed on their employment status by a nurse. If (self-) employed, patients were asked to self-report on work-related problems, perceived distress (0-10), cancer-related problems, fatigue (MFI-20, range 4-20) and work ability (three WAI questions, range 0-10). Results Of all 333 included new consecutive patients (age range 32-89 years), 95 patients (28%) were (self-) employed at time of diagnosis, 179 (54%) were pensioners, and 59 were not working (18%). For the assessment of work-related problems, 45 (47%) of these 95 employed patients with cancer participated. Their mean age was 56 years, and patients had oesophageal/stomach (49%), colorectal (18%) or hepatic/pancreatic/biliary cancer (33%). Half of the employed patients (49%) were still at work, while 51% were on sick leave. The main reasons for sick leave were stress (35%), (scheduled) operation (26%), fatigue (17%) and pain (13%). Most patients on sick leave (70%) had no contact with their own occupational physician, although the majority (67%) would like to continue to work. Work-related problems were experienced by 73% of working patients. The mean work ability was 5.4, the mean general fatigue score was 11.5, and the mean distress score was 4.7. Employed patients on sick leave reported a lower work ability, more fatigue and higher distress but no more cancer-related problems compared with those still working. Conclusion A quarter of all patients with gastrointestinal cancer seen at an oncological centre are employed at time of diagnosis, and of these employed patients, 73% experience work-related problems. During diagnosis and treatment, information and support on work-related issues should be offered to patients with cancer as an essential part of high-quality oncological car

Usefulness and feasibility of comprehensive and less comprehensive vocational rehabilitation for patients with chronic musculoskeletal pain:perspectives from patients, professionals, and managers

Purpose: To explore the usefulness and feasibility of a comprehensive vocational rehabilitation (C-VR) program and less comprehensive (LC-VR) program for workers on sick leave due to chronic musculoskeletal pain, from the perspective of patients, professionals, and managers.Materials and methods: Semi-structured interviews were held with patients, professionals, and managers. Using topic lists, participants were questioned about barriers to and facilitators of the usefulness and feasibility of C-VR and LC-VR. Thirty interviews were conducted with thirteen patients (n = 6 C-VR, n = 7 LC-VR), eight professionals, and nine managers. All interviews were transcribed verbatim. Data were analyzed by systematic text condensation using inductive thematic analysis.Results: Three themes emerged for usefulness ("patient factors," "content," "dosage") and six themes emerged for feasibility ("satisfaction," "intention to continue use," "perceived appropriateness," "positive/negative effects on target participants," "factors affecting implementation ease or difficulty," "adaptations"). The patients reported that both programs were feasible and generally useful. The professionals preferred working with the C-VR, although they disliked the fixed and uniform character of the program. They also mentioned that this program is too extensive for some patients, and that the latter would probably benefit from the LC-VR program. Despite their positive intentions, the managers stated that due to the Dutch healthcare system, implementation of the LC-VR program would be financially unfeasible.Conclusions: The main conclusion of this study is that it is not useful to have one VR program for all patients with CMP and reduced work participation, and that flexible and tailored-based VR are warranted.Implications for rehabilitationBoth comprehensive and less comprehensive vocational rehabilitation are deemed useful for patients with chronic musculoskeletal pain and reduced work participation. Particular patient factors, for instance information uptake, discipline, willingness to change, duration of complaints, movement anxiety, obstructing thoughts, and willingness to return to work might guide the right program for the right patient.Both comprehensive and less comprehensive vocational rehabilitation are deemed feasible in practice. However, factors such as center logistic (schemes, rooms, professionals available) and country-specific healthcare insurance and sickness compensation systems should foster the implementation of less comprehensive programs

Hamlet and the fall of the Berlin wall : the myth of interventionist Shakespeare performance

The critical reception of Heiner Müller’s 1990 Hamlet/Maschine at the Deutsches Theater in East Berlin epitomizes a trend of crediting GDR Shakespeare performance with political influence. Drawing on rehearsal notes and reviews, Oliver challenges the interventionist Shakespeare myth, contrasting the Deutsches Theater’s political involvement with the impact of its Hamlet production on events surrounding the fall of the Berlin Wall. Shakespeare’s capacity for political intervention at this point was limited by theater practitioners’ reliance on public funding, their close relationships with governmental authority, and an underlying distrust of the masses. Ultimately, GDR artists proved useful to the 1989 protest movement because they occupied a unique position at the interface of dissidence and power

Barriers and facilitators for the use of a medical mobile app to prevent work-related risks in pregnancy: a qualitative analysis

Background: The number of women participating in the labor market in Europe has increased over the last several decades. At the same time, there is growing evidence that certain conditions of employment during pregnancy may have a negative influence on pregnancy outcomes. In order to better inform pregnant women, we aim to develop an app to help assess the health risk as a result of personal and work-related factors and provide personal advice for these women and their health care providers. Objective: The aim of this study was to compose a thematic overview of the perceived facilitators and barriers according to pregnant women, medical professionals, and employers for the use of a mobile app in obstetrical care to prevent occupational-related pregnancy complications. Methods: Two multidisciplinary focus group meetings with in total 14 participants were conducted with pregnant women, occupational physicians, general practitioners, midwives, obstetricians, and representatives of trade unions and employer organizations. Transcripts were analyzed by qualitatively coding procedures and constant comparative methods. Results: We identified 24 potential facilitators and 12 potential barriers for the use of the app in 4 categories: content of the app, the app as a mean to provide information, ease of use, and external factors. The 3 main facilitators identified were the need for a good interaction between the app and the user, apps were viewed as a more practical source of information, and the information should be understandable, according to the existing guidelines, and well-dosed. The 2 main barriers for use were extensive battery and memory use of the smartphone and sending frequent push notifications. Conclusions: The results of this study are important considerations in the developing process of a medical app implementing a guideline or evidence-based information in practice.Adeline V Velu, Monique DM van Beukering, Frederieke G Schaafsma, Monique HW Frings-Dresen, Ben WJ Mol, Joris AM van der Post, Marjolein Ko

Universal Quake Statistics: From Compressed Nanocrystals to Earthquakes

Slowly-compressed single crystals, bulk metallic glasses (BMGs), rocks, granular materials, and the earth all deform via intermittent slips or “quakes”. We find that although these systems span 12 decades in length scale, they all show the same scaling behavior for their slip size distributions and other statistical properties. Remarkably, the size distributions follow the same power law multiplied with the same exponential cutoff. The cutoff grows with applied force for materials spanning length scales from nanometers to kilometers. The tuneability of the cutoff with stress reflects “tuned critical” behavior, rather than self-organized criticality (SOC), which would imply stress-independence. A simple mean field model for avalanches of slipping weak spots explains the agreement across scales. It predicts the observed slip-size distributions and the observed stress-dependent cutoff function. The results enable extrapolations from one scale to another, and from one force to another, across different materials and structures, from nanocrystals to earthquakes

Value of MRI and diffusion-weighted MRI for the diagnosis of locally recurrent rectal cancer

OBJECTIVES: To evaluate the accuracy of standard MRI, diffusion-weighted MRI (DWI) and fusion images for the diagnosis of locally recurrent rectal cancer in patients with a clinical suspicion of recurrence. METHODS: Forty-two patients with a clinical suspicion of recurrence underwent 1.5-T MRI consisting of standard T2-weighted FSE (3 planes) and an axial DWI (b0,500,1000). Two readers (R1,R2) independently scored the likelihood of recurrence; [1] on standard MRI, [2] on standard MRI+DWI, and [3] on T2-weighted+DWI fusion images. RESULTS: 19/42 patients had a local recurrence. R1 achieved an area under the ROC-curve (AUC) of 0.99, sensitivity 100% and specificity 83% on standard MRI versus 0.98, 100% and 91% after addition of DWI (p = 0.78). For R2 these figures were 0.87, 84% and 74% on standard MRI and 0.91, 89% and 83% with DWI (p = 0.09). Fusion images did not significantly improve the performance. Interobserver agreement was kappa0.69 for standard MRI, kappa0.82 for standard MRI+DWI and kappa0.84 for the fusion images. CONCLUSIONS: MRI is accurate for the diagnosis of locally recurrent rectal cancer in patients with a clinical suspicion of recurrence. Addition of DWI does not significantly improve its performance. However, with DWI specificity and interobserver agreement increase. Fusion images do not improve accuracy