WELLNESS WEDNESDAY: MONITORING LIFESTYLE CHANGES VIA SELF-DETERMINATION THEORY

Physical activity has been shown to improve cognition, functional and overall health indicators across the lifespan. Older adults are less likely to participate in physical activity due to barriers and risk related factors. Additionally, lower income, underserved populations experience added barriers as well. Interventions addressing negative health behaviors in these populations have rarely been implemented. PURPOSE: Using the Self-Determination Theory (SDT) behavior change theory, the purpose of this study was to determine if five, monthly educational and exercise classes targeting these populations will improve motivation levels and result in facilitating increases in physical activity levels. METHODS: Two validated SDT surveys were completed upon the first month’s visit. Through the following months, group exercises and educational materials were prepared according to a monthly theme. Three different locations received the two hour interventions each month for four months. During the last month’s meeting, the same surveys were completed and used to compare the pre and post measurements of the participants. RESULTS: The results of the study suggested that the Wellness Wednesday program is effective for individuals in increasing motivation levels. Paired sample t-tests revealed a non-significant change in amotivation levels (p=0.06) and a significant increase in intrinsic motivation levels (p=0.04) for the BREQ-2 survey. Paired sample t-tests revealed a significant decrease in amotivation levels (p=0.01) and a non-significant increase in intrinsic motivation levels (p=0.13) according to the SIMS survey. CONCLUSION: Results of this study will be used to re-evaluate the Wellness Wednesday program and adjust strategies to enable continued participant engagement and adherence to recommended physical activity guidelines

Nutritional Intake and Weight Gain in Infants with Neonatal Abstinence Syndrome: A Literature Review

Neonatal abstinence syndrome (NAS) in infants presents unique challenges in feeding and weight gain. The unpredictable clinical manifestations associated with the newborns withdrawal from exposure to drugs in utero can lead to costly delays in transition of the infant out of the Neonatal Intensive Care Unit (NICU).The purpose of this review of literature was to explore feeding positions and nutritional intake with the greatest impact on weight gain in infants with neonatal abstinence syndrome (NAS) following delivery. The secondary purpose was to compare the clinical manifestations of infants with NAS that influence nutritional intake and their relationship to length of time and cost of stay in the NICU. A review of literature was performed using multiple databases. Articles focusing on feeding position and nutrition intake were identified for interventions to effectively promote weight gain, while reducing clinical manifestations common in infants with NAS. Articles exploring improved feeding and weight gain in infants with NAS and reduced length of stay in the NICU were also synthesized for cost reductions to the facility. Results from 12 studies comparing various feeding positions that optimized nutrition, and reduced negative clinical manifestations in infants with NAS were synthesized for content relevant to the research questions. Results suggest a relationship between placing infants in the c-position, and side-lying position to reduce sensory stimulation, with reducing clinical manifestations for infants actively experiencing withdrawal symptoms from NAS. Providing chin and cheek support as needed, decreasing eye contact during feeding periods, and providing darker quiet environments all play an important role in allowing infants with NAS to optimize their weight gain. As previously stated, to manage nutritional intake and optimize weight gain, reduction of clinical manifestations through pharmacological and non-pharmacological interventions must be actively incorporated into the infants\u27 plan of care

Solving the Problem of Puppy Mills: Why the Animal Welfare Movement\u27s Bark is Stronger than its Bite

The relationship between man and dog is one characterized by companionship, service, and love; but dogs serve a variety of functions beyond just man‘s best friend. These companion animals provide valuable assistance to people with disabilities, in military and police service, in therapeutic contexts, and in numerous other areas of life. With approximately 78.2 million pet dogs in the United States, and approximately 39 percent of U.S. households owning at least one dog, it is no surprise that so many animal welfare activists and organizations possess a deep passion for protecting and improving the lives of these animals. The prevalence of dogs in American culture makes the opposition to protecting them perplexing. At the root of this opposition is a fundamental disconnect between the message presented by animal welfare activists and the message received by individuals in the agriculture industry, who view animal regulations as a threat to their livelihood. On one side, activists, seeking regulations and protections for dogs, frame the issue as one of animal welfare and morality. On the other side, the agriculture industry, motivated largely by economic factors, opposes outside oversight likely to reduce profits. This Note examines these differing perspectives and explains how members of the animal welfare movement can mitigate opposition to animal welfare reforms. Using Missouri ballot initiative Proposition B ( Prop B ) as a lens, this Note analyzes the animal welfare movement‘s political efforts to eradicate puppy mills. First, it discusses the history of puppy mills. Second, it explains the political role of animal welfare organizations. Third, it identifies opponents of these welfare reforms. And finally, this Note argues that animal welfare activists can more effectively achieve their policy goals by implementing a number of common-sense strategies. By producing a mainstream message, connecting with more human-focused interest groups, increasing public awareness, and building local relationships, the animal welfare movement can work to achieve greater political influence and success

Multigenerational legacy projects

Multigenerational legacy projects and activities facilitate meaning making and instill hope for further generations. Hospice and palliative care entities can use legacy projects to help terminally ill clients share how they want to be remembered. Legacy projects come in many forms including but not limited to scrapbooks, holiday rituals, and storytelling. In this perspective piece, examples of legacy projects will be explored as ways to process loss. Keywords: Legacy projects, bonds, hospice/palliative care, meaning construction, bereavement

Development and Validation of Implicit Measures for Organizational Climate

Organizational climate is the shared perceptions and valuations people hold about their experiences in the workplace. Organizational climate research has relied upon self-report measures, which can be influenced by impression management and inaccurate self-knowledge artifacts. This research used IAT procedures to develop measures of selected aspects of organizational climate and examined the relationships of the implicit measures with theoretically related explicit measures according to a multitrait-multimethod design. Confirmatory factor analyses of alternative latent trait models provided evidence of convergent and discriminant validity. Future research might focus upon developing measures with better psychometric properties and exploring the potential for incremental predictive validity

The Use of Family Engagement Principles by Childcare Providers From Various Childcare Settings: A Qualitative Study

Family engagement in childcare is important to ensure the optimal growth, development, and safety of children. Previous research has explored family engagement practices, but limited research is available on the application of theory to explain the uptake of family engagement principles. The purpose of this study was to explore the use and perceptions of the National Association of the Education for Young Children’s six principles of effective family engagement among childcare providers from various childcare settings following the Innovation-Decision Process of the Diffusion of Innovation Theory. A semi-structured interview with a card-sorting task was used to explore providers’ knowledge, adoption, and perceived difficulty of implementation as well as their perceived outcomes, reasoning for use or non-use, and advice on use of the family engagement principles. Notable findings suggest variance in childcare providers’ knowledge, adoption, and perceived difficulty of all six family engagement principles. Childcare providers mentioned various perceived outcomes and reasoning for use of principles, such as improved relationship with parents and enhanced child learning. Lack of time and perceived disinterest of parents were commonly reported difficulties for the use of family engagement principles. Future studies should expand upon the exploration of family engagement practices and comparison between different childcare settings and philosophies. Further efforts are needed to investigate effective integration and use of technology for communication

A qualitative comparison of parent and childcare provider perceptions of communication and family engagement in children\u27s healthy eating and physical activity

Background Parents and childcare providers play a substantial role in the development of health behaviours among the children they care for. In order to ensure the optimal growth and development of children, communication and family engagement in childcare is critical. Previous studies examining parent or provider perceptions about healthy eating or physical activity have explored these concepts individually and/or have only included only parents or providers. Therefore, the purpose of this study was to compare childcare provider and parent perceptions of communication regarding healthy eating and physical activity as well as use of best practice strategies on family engagement for these topics. Methods Childcare providers (n = 12) in childcare centres or a family childcare home and a parent (n = 12) of a child they provide care for participated in a semi-structured interview guided by the Social Ecological Model. Interviews were transcribed verbatim and uploaded to NVivo for data analysis. Data were analysed using a directed content analysis. Three trained qualitative researchers developed a codebook and then compared responses between parents and providers. Results Similarities in provider and parent responses included agreement on healthy eating; influences on child development; parents being the most influential on children\u27s healthy eating; how they identified physical activity opportunities; and the use of family engagement principles. Differences that arose included parents\u27 roles in promoting children\u27s physical activity; challenges for parents in promoting healthy eating and physical activity; and providers\u27 encouragement of physical activity. Importantly, few parents mentioned providers were top influences on their child\u27s healthy eating or physical activity. Providers also mentioned having difficult conversations with parents was challenging. Conclusions Future efforts are needed to (1) help parents understand the providers\u27 role in the development of their child\u27s health behaviours and (2) strengthen efforts to engage families in healthy behaviours outside of childcare facilities

Parents’ Perspectives on Variants of Uncertain Significance from Chromosome Microarray Analysis

Chromosomal microarray analysis (CMA) for unexplained anomalies and developmental delay has improved diagnosis rates, but results classified as variants of uncertain significance (VUS) may challenge both clinicians and families. We explored the impact of such results on families, including parental knowledge, understanding and interpretation. Semi‐structured telephone interviews were conducted with parents (N = 14) who received genetic counseling for a VUS in their child. Transcripts were analyzed through an iterative coding process. Participants demonstrated a range of recall and personal interpretation regarding whether test results provided a causal explanation for their children’s health issues. Participants maintained contradictory interpretations, describing results as answers while maintaining that little clarification of their child’s condition had been provided. Reported benefits included obtaining medical services and personal validation. Parents described adaptation/coping processes similar to those occurring after positive test results. Recall of terminology, including “VUS” and precise CMA abnormalities, was poor. However, most demonstrated conceptual understanding of scientific uncertainty. All participants expressed intentions to return for recommended genetics follow‐up but had misconceptions about how this would occur. These results provide insight into the patient‐and‐family experience when receiving uncertain genomic findings, emphasize the importance of exploring uncertainty during the communication process, and highlight areas for potential attention or improvement in the clinical encounter.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146918/1/jgc40101.pd

Toward the Development of a Monitoring and Feedback System for Predicting Poor Adjustment to Grief

Losing a loved one is a fundamental and ubiquitous life experience that is often characterized by a certain period of grief and emotional distress. Although the majority of the bereaved can cope with grief resiliently, around 1 of 10 individuals could experience an unusually protracted and intense response referred to as prolonged grief disorder (PGD) following death of a loved one. PGD is associated with work and social impairment and heightened risk of severe medical and psychological conditions. Current means of diagnosis requires a minimum of 6 months to confirm and identify PGD and is discrepant with the fact that the bereaved may need psychotherapeutic intervention in a more timely manner. Contemporary studies have outlined prospective risk factors that could cause poor bereavement outcome, which can potentially contribute to early identification and prevention of problematic response to grief. Self-monitoring applications have been developed and broadly implemented in a vast spectrum of mental and health-related interventions and self-managing processes. This study presents the conceptualization and development of an Internet-based screening method designed by the researchers and psychotherapists that aims to provide meaningful and quantitative feedback in the early phase of the grief and to support decision making in the bereavement process through monitoring the susceptibility to problematic grief outcome