A website supporting sensitive religious and cultural advance care planning (ACPTalk): Formative and summative evaluation

Background: Advance care planning (ACP) promotes conversations about future health care needs, enacted if a person is incapable of making decisions at end-of-life that may be communicated through written documentation such as advance care directives. To meet the needs of multicultural and multifaith populations in Australia, an advance care planning website, ACPTalk, was funded to support health professionals in conducting conversations within diverse religious and cultural populations. ACPTalk aimed to provide religion-specific advance care planning content and complement existing resources. Objective: The purpose of this paper was to utilize the context, input, process, and product (CIPP) framework to conduct a formative and summative evaluation of ACPTalk. Methods: The CIPP framework was used, which revolves around 4 aspects of evaluation: context, input, process, and product. Context: health professionals’ solutions for the website were determined through thematic analysis of exploratory key stakeholder interviews. Included religions were determined through an environmental scan, Australian population statistics, and documentary analysis of project steering committee meeting minutes. Input: Project implementation and challenges were examined through documentary analysis of project protocols and meeting minutes. Process: To ensure religion-specific content was accurate and appropriate, a website prototype was built with content review and functionality testing by representatives from religious and cultural organizations and other interested health care organizations who completed a Web-based survey. Product: Website analytics were used to report utilization, and stakeholder perceptions were captured through interviews and a website survey. Results: Context: A total of 16 key stakeholder health professional (7 general practitioners, 2 primary health nurses, and 7 palliative care nurses) interviews were analyzed. Website solutions included religious and cultural information, communication ideas, legal information, downloadable content, and Web-based accessibility. Christian and non-Christian faiths were to be included in the religion-specific content. Input: Difficulties gaining consensus on religion-specific content were overcome by further state and national religious organizations providing feedback. Process: A total of 37 content reviewers included representatives of religious and cultural organizations (n=29), health care (n=5), and community organizations (n=3). The majority strongly agree or agree that the content used appropriate language and tone (92%, 34/37), would support health professionals (89%, 33/37), and was accurate (83%, 24/29). Product: Resource usage within the first 9 months was 12,957 page views in 4260 sessions; majority were (83.45%, 3555/4260) from Australia. A total of 107 Australian-based users completed the website survey; most felt information was accurate (77.6%, 83/107), easy to understand (82.2%, 88/107), useful (86.0%, 92/107), and appropriate (86.0%, 92/107). A total of 20 nurses (general practice n=10, palliative care n=8, and both disciplines n=2) participated in stakeholder interviews. Qualitative findings indicated overall positivity in relation to accessibility, functionality, usefulness, design, and increased knowledge of advance care planning. Recommended improvements included shortened content, a comparable website for patients and families, and multilingual translations. Conclusions: The CIPP framework was effectively applied to evaluate the development and end product of an advance care planning website. Although overall findings were positive, further advance care planning website development should consider the recommendations derived from this study

The Social Arena of Mental Health Act Apprehensions: An Examination of Partnership between Police and Hospital Services

Improvement in the collaboration between police and emergency hospital services in responding to citizens in mental health (MH) crisis has been identified as vital by researchers and service organizations alike (Human Services and Justice Coordinating Committee, 2013). Research suggests that collaboration between these two services is inhibited by a lack of clear communication, protection of patient privacy, insufficient training, siloing of services, and safety concerns for patients and staff (Cotton & Coleman, 2010). Consequences of inadequate cooperation between police and hospital services has resulted in lengthy emergency room (ER) wait times for those apprehended by police officers under the Mental Health Act (MHA), poor patient follow-up, and frustration between services (Cotton, 2004). Recently, some police services have begun to implement formal agreements with local hospitals to enhance collaboration in Memorandums of Understanding (MOUs) in caring for those in MH crisis. The purpose of this study was to investigate these emerging agreements to gain insight into how they collectively framed their partnerships and responsibilities, identified their common objectives, and emphasized significant concerns in the context of MHA apprehensions. A Social Arena (Star & Griesemer, 1989) theoretical framework was used to argue that MOUs act as “boundary objects” (p.393). The boundary object comes into play when the diverse worlds, values and ideologies of the police service and the ER service come together to shape their collaboration, negotiate identities and roles, and bridge gaps in cooperating. Implications of such boundary objects are discussed

An Examination of Goal Orientation between Genders – An Exploratory Study

Goal orientation is defined as the perceptual-cognitive frameworks that determine how an individual approaches, interprets, and responds to achievement situations (Janssen & Van Yperen, 2004). Goal orientation refers to the reasons an individual engages in an activity and the goals he or she sets to define success (D’Lima et al., 2014). Research has shown that there are gender differences when examining goal orientation. However, little research has been found that has examined this within the millennial generation. The purpose of this exploratory study is to examine the differences between male and female millennial college students on goal orientation. The design of this study was a quantitative, quasi-experimental, cross-sectional descriptive study. A 31-item researcher design questionnaire was administered to current university students (n=1724) to measure physical activity, course satisfaction, and sport orientation (Competitiveness, Win Orientation, and Goal Orientation.) Data was gathered from students at a midsized southeastern university who are enrolled in physical activity classes. The survey contained demographic questions as well as the Sport Orientation Questionnaire, both of which have been found to be psychometrically reliable and valid. In order to increase participation, students were verbally recruited by their instructors with a bonus grade incentive. T-tests were used to determine if significant differences in the demographic independent variables existed between groups, while Pearson’s correlation was used to examine relationships. Results revealed significantly higher goal orientation in females than males

Immigrants and their grandchildren who marry people born in their destination country are more likely to be politically active

Immigration has once again become a controversial issue on both sides of the Atlantic, with many concerned about how immigrants integrate into the countries they have moved to. Immigration has once again become a controversial issue on both sides of the Atlantic, with many concerned about how immigrants integrate into the countries they have moved to. In new research, Monica Boyd and Amanda Couture-Carron examine how the political participation of immigrants in Canada is influenced by their marriage or cohabitation with someone who is native born. They find that foreign born residents with Canadian partners are more political than their counterparts who are married to those who are foreign born, as are their grandchildren. They write that the native born may provide more insight into Canada’s politics and institutions, thus making political participation easier for their partners

Activation of PKR by Bunyamwera virus is independent of the viral interferon antagonist NSs

Double-stranded RNA (dsRNA) is a by-product of viral RNA polymerase activity, and its recognition is one mechanism by which the innate immune system is activated. Cellular responses to dsRNA include induction of alpha/beta interferon (IFN) synthesis and activation of the enzyme PKR, which exerts its antiviral effect by phosphorylating the eukaryotic initiation factor eIF-2 alpha, thereby inhibiting translation. We have recently identified the nonstructural protein NSs of Bunyamwera virus (BUNV), the prototype of the family Bunyaviridae, as a virulence factor that blocks the induction of IFN by dsRNA. Here, we investigated the potential of NSs to inhibit PKR. We show that wild-type (wt) BUNV that expresses NSs triggered PKR-dependent phosphorylation of eIF-2 alpha to levels similar to those of a recombinant virus that does not express NSs (BUNdelNSs virus). Furthermore, the sensitivity of viruses in cell culture to IFN was independent of PKR and was not determined by NSs. PKR knockout mice, however, succumbed to infection approximately 1 day earlier than wt mice or mice deficient in expression of RNase L, another dsRNA-activated antiviral enzyme. Our data indicate that (i) bunyaviruses activate PKR, but are only marginally sensitive to its antiviral effect, and (ii) NSs is different from other IFN antagonists, since it inhibits dsRNA-dependent IFN induction but has no effect on the dsRNA-activated PKR and RNase L systems

Health Practitioners’ Perspective On Caring For Older Adults In Rural Maine – A Pilot Study

Research poster stemming from IPEC mini-grant funded student project Health Practioners’ Perspective on Caring for Older Adults in Rural Maine. This pilot study was designed to identify challenges and determine potential solutions for Maine practitioners delivering health care to rural Maine’s aging population. UNE students from several healthcare professions partnered to interview physicians, physician assistants, nurse practitioners, social workers, occupational therapists, and physical therapists caring for community-dwelling older adults in Rural Maine. The student researchers then analyzed the interviews and identified themes.https://dune.une.edu/minigrant_hppoa/1001/thumbnail.jp

Effect Of Exercise Training On Endothelium-Dependent Vasodilation In Cerebral Arteries

Endothelial function and expression of endothlelial nitric oxide synthase (eNOS) have been shown to increase with exercise training in the peripheral vasculature. However, the effect of exercise training on endothelial function in the cerebral vasculature is poorly understood. PURPOSE: The purpose of this study was to determine the effect of exercise training on endothelium-dependent vasodilation of large cerebral arteries. METHODS: Three-month-old male Fischer 344 rats were assigned to either a sedentary (SED, n=4) or exercise-trained (ET, n=4) group. ET rats ran on a motorized rodent treadmill 60 min/day at 15 m/min (15 incline), 5 d/wk for 10 wk. Posterior communicating arteries (PCoA) were isolated from the brain of both SED and ET rats. The isolated arteries were cannulated and pressurized to 90 cm H2O via hydrostatic reservoirs. Luminal diameter changes were determined in response to the endothelium-dependent vasodilator, Bradykinin (BK) (10-13 – 10-7 M) and the direct vascular smooth muscle dilator, sodium nitroprusside (SNP, 10-10 – 10-4 M). RESULTS: Responsiveness to the endothelium-dependent vasodilator BK was enhanced in PCoA of ET rats compared to SED rats, whereas responsiveness to the endothelium-independent vasodilator SNP was not different between PCoA of SED and ET rats. CONCLUSION: These data demonstrate that exercise training is associated with enhanced endothelium-mediated vasodilation in PCoA of young rats, whereas vascular smooth muscle responsiveness of PCoA is unaffected by exercise training