Organ Donation Decision Making Among Non-Catholic Christians: An Expansion of the Theory of Planned Behavior

According to the United Network for Organ Sharing (2012), 112,264 people are on the waiting list for an organ transplant in the United States. The gap between patients and donors continues to expand. There is a need for research and intervention aimed at closing this gap. Religion is both a barrier to and facilitator of organ donation; this paradoxical relationship was investigated in a sample non-Catholic Christian university students (N = 176). The Theory of Planned Behavior was used to predict intentions to donate. A model including moral norm, religious attitudes toward organ donation, and affective attitudes was proposed to address domain and population specific predictors of intentions. Participants reported positive intentions (M = 6.06 on a 7-point scale). Controlling for past behaviors, the TPB significantly predicted intentions (R2=.30, F(3, 144) =5.56, p.35), suggesting its importance in donation behaviors and supporting its inclusion in future research on intentions. The final model included attitudes, subjective norms, and moral norms accounting for 47% (R2 = .05) of the variance in participant’s intentions

"Veneer"

The choreographer found the relationship between music and dance to be a significant and necessary area of study for the creation of her thesis dance entitled VENEER. Her appreciation of music was expanded by listening to various types of music in order to find an appropriate selection for the dance. Through this process the choreographer's interest in what experienced artists had to say about this unique relationship was awakened. How a choreographer chooses to combine music and dance for the final product varies according to personal preference. There are three common ways to obtain music for a dance; (1) have music created for a completed dance (2) have both music and dance created simultaneously (3) have the dance set to a musical selection already composed. In the case of this choreographer's dance the third alternative was chosen. The music did at times serve as inspiration for the movement but the choreographer chose the three selections for very specific reasons. The three sections varied widely in mood, character and costuming. The passages of the first musical selection had an airy, surrealistic character which was reflected in the choreography; the second in contrast incorporated humor; the third combined selected movements from Sections I and II with large locomotor patterns

Attributions : relations to attachment and caregiving representations

"The purpose of this study was to examine associations among maternal attributions for infant behavior, maternal attachment, and representations of the self as caregiver, as well as to examine the stability of maternal attributions from the prenatal to the postpartum period. Eighty-one primiparous mothers completed measures of attachment and attributions for imagined infant behavior in their third trimester of pregnancy and completed measures of attributions for actual infant behavior and caregiving representations at 6 months postpartum. Correlational analyses and multiple regressions were performed. Consistent with predictions, attributions were moderately stable from the prenatal to the postpartum period. Contrary to predictions, mothers with a dismissing attachment classification predominantly accounted for the change in maternal attributions over time. Also consistent with predictions, the attachment-based positive view of the self was associated with maternal investment in the parenting role. However, contrary to predictions, the attachment-based positive view of the self, rather than the positive view of the other, was also associated with prenatal maternal attributions. There were no associations with overall representations of the self as a caregiver or with postpartum maternal attributions. The current study highlights the relationship between attributions and attachment styles and demonstrates the need for further research in this area."--Abstract from author supplied metadata

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty

A systematic review of the psychometric properties of self-report research utilization measures used in healthcare

<p>Abstract</p> <p>Background</p> <p>In healthcare, a gap exists between what is known from research and what is practiced. Understanding this gap depends upon our ability to robustly measure research utilization.</p> <p>Objectives</p> <p>The objectives of this systematic review were: to identify self-report measures of research utilization used in healthcare, and to assess the psychometric properties (acceptability, reliability, and validity) of these measures.</p> <p>Methods</p> <p>We conducted a systematic review of literature reporting use or development of self-report research utilization measures. Our search included: multiple databases, ancestry searches, and a hand search. Acceptability was assessed by examining time to complete the measure and missing data rates. Our approach to reliability and validity assessment followed that outlined in the <it>Standards for Educational and Psychological Testing</it>.</p> <p>Results</p> <p>Of 42,770 titles screened, 97 original studies (108 articles) were included in this review. The 97 studies reported on the use or development of 60 unique self-report research utilization measures. Seven of the measures were assessed in more than one study. Study samples consisted of healthcare providers (92 studies) and healthcare decision makers (5 studies). No studies reported data on acceptability of the measures. Reliability was reported in 32 (33%) of the studies, representing 13 of the 60 measures. Internal consistency (Cronbach's Alpha) reliability was reported in 31 studies; values exceeded 0.70 in 29 studies. Test-retest reliability was reported in 3 studies with Pearson's <it>r </it>coefficients > 0.80. No validity information was reported for 12 of the 60 measures. The remaining 48 measures were classified into a three-level validity hierarchy according to the number of validity sources reported in 50% or more of the studies using the measure. Level one measures (n = 6) reported evidence from any three (out of four possible) <it>Standards </it>validity sources (which, in the case of single item measures, was all applicable validity sources). Level two measures (n = 16) had evidence from any two validity sources, and level three measures (n = 26) from only one validity source.</p> <p>Conclusions</p> <p>This review reveals significant underdevelopment in the measurement of research utilization. Substantial methodological advances with respect to construct clarity, use of research utilization and related theory, use of measurement theory, and psychometric assessment are required. Also needed are improved reporting practices and the adoption of a more contemporary view of validity (<it>i.e.</it>, the <it>Standards</it>) in future research utilization measurement studies.</p

Population‐based cohort study of outcomes following cholecystectomy for benign gallbladder diseases

Background The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all‐cause 30‐day readmissions and complications in a prospective population‐based cohort. Methods Data were collected on consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing all‐cause 30‐day readmissions and complications were analysed by means of multilevel, multivariable logistic regression modelling using a two‐level hierarchical structure with patients (level 1) nested within hospitals (level 2). Results Data were collected on 8909 patients undergoing cholecystectomy from 167 hospitals. Some 1451 cholecystectomies (16·3 per cent) were performed as an emergency, 4165 (46·8 per cent) as elective operations, and 3293 patients (37·0 per cent) had had at least one previous emergency admission, but had surgery on a delayed basis. The readmission and complication rates at 30 days were 7·1 per cent (633 of 8909) and 10·8 per cent (962 of 8909) respectively. Both readmissions and complications were independently associated with increasing ASA fitness grade, duration of surgery, and increasing numbers of emergency admissions with gallbladder disease before cholecystectomy. No identifiable hospital characteristics were linked to readmissions and complications. Conclusion Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics

Neurological Effects Of A Single Low Level Blast Overpressure Exposure : Behavior And Micro RNA Mechanisms Of Mild Traumatic Brain Injury In A Rodent Model

The increased use of explosive devices within warfare and acts of terrorism has allowed blast overpressure exposure (BOE) to become a significant concern. The most common wound sustained by BOE is blast-induced mild traumatic brain injury (mTBI). These injuries involve no gross physical damage to the brain and evolve over time. The late manifestation of neuropsychiatric symptoms combined with no observable physical damage allows these injuries to largely remain undiagnosed or misdiagnosed for other mental disorders. This study aims to understand the effects of blast-induced neurotrauma and possibly improve diagnostics for these injuries. Anesthetized subjects were exposed to a single low-level blast overpressure of 10-12 psi. Behavioral assessments were performed at various time points to assess the evolution of blast-induced mTBIs. Micro RNAs (miRNAs) were extracted from whole blood and assessed for any changes in gene expression at 24 hours, one week, one month, and two months after BOE. Morris water maze testing at 1 and 2 months after BOE was used to examine behavioral changes associated with BOE. Blasted subjects exhibited increased depression and impairments to learning and memory at one month but these changes were absent by two months after injury. Molecular assessments revealed five miRNAs commonly dysregulated across time points, miR- 27a, 30a, 34c, 449a and let-7c. The functional impact of these miRNAs was determined through pathway analysis using DAVID and GOrilla. Aberrant miRNA expression was found to regulate increased neurogenesis, synaptogesis, synaptic plasticity, long-term potentiation and apoptosis. The miRNA mediated gene network regulation may be an attributing factor to neuropsychiatric symptoms and behavioral changes observed in blasted subjects. Temporal changes in miRNA expression and behavior provide a better understanding of blast-induced mTBI sequelae. Identified miRNAs induced by blast exposure have the potential to improve diagnostic and therapeutic strategies

Assessment of work-based learning

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