Implementation of an Evidence-Based, Electronic Clinical Algorithm to Improve Screening, Evaluation, and Referral of College Students for Depressive Symptoms and an Evaluation of Differences Based on Sexual Orientation and Gender Identity Data

The purpose of this project was to improve the screening, evaluation, and referral of college students (LGBTQ+/Heterosexual) for depressive symptoms through the implementation of an evidence-based, electronic clinical algorithm. There is evidence in the literature indicating that there are increased mental health disparities among college students and the LGBTQ+ population. The prevalence of depressive symptoms among university students is higher than the general population, requiring university student health centers to implement enhanced screenings for depressive symptoms and identification of depression predictors. Prior to implementation of this project, a student health clinic in the Southeastern part of the United States used a paper/pencil Patient Health Questionnaire 2 (PHQ-2) scale, followed by a paper/pencil Patient Health Questionnaire 9 (PHQ-9), when appropriate, to screen for depressive symptoms. The specific aims of this project were to: (1) assess the effectiveness of an evidence-based electronic clinical algorithm to improve the evaluation of depressive symptoms among college students; (2) identify university students who self-report as Lesbian, Gay, Bisexual, Transgender, Queer/Questioning + (LGBTQ+); and (3) assess knowledge and attitudes of healthcare providers toward the LGBTQ+ community. An evidence-based electronic clinical algorithm was created to improve screening of depressive symptoms for students seeking campus health services, a self-report question related to Sexual Orientation and Gender Identity (SOGI) was added to the electronic intake form, and pre-post provider surveys of knowledge and attitudes toward the LGBTQ+ community were administered. The project was evaluated by assessing self-reported SOGI data; quantifying compliance with PHQ-2 and subsequent PHQ-9 screenings, when appropriate; and measuring knowledge and attitudes of healthcare providers pre and post-completion of a learning module. Data was collected for February through April, 2018 visits (pre-implementation) and February through April, 2019 visits (post-intervention). The pre-implementation of the electronic data form revealed that PHQ-2 screenings were offered to clinic students 44.3% of the time, with no follow-up of PHQ-9, when appropriate (0.0%); no SOGI data was requested; and no estimate was available for the prevalence of students who belonged to the LGBTQ+ community. Post implementation of the electronic data form, 93.2% of the students meeting inclusion criteria, received the PHQ-2 screening; all students scoring a positive score on the PHQ-2 were given the PHQ-9. The difference in PHQ-2 scores for heterosexual students and those self-reporting as members of the LGBTQ community, was insignificant. Students who self-reported as LGBTQ+ was 15.6%, compared to an estimated 4.5% of adults nationwide. A third assessment of provider knowledge and attitude toward the LGBTQ+ community showed no significant difference in scores pre and post completion of an LGBTQ+ teaching module

Synthesis and characterisation of size-selective nanoporous polymeric adsorbents for blood purification

This thesis is concerned with the development and characterisation of polymeric nanoporous adsorbents to be used for blood purification. Current treatment methods for suffers of chronic renal failure are limited to haemodialysis, peritoneal dialysis and organ transplant. Organ transplant is the most efficient option however lack of donor organs mean that the majority of suffers rely on dialysis. Unfortunately both dialysis treatments are lacking when it comes to the removal of middle molecular weight molecules (MMs) (500 - 60000 Da) and the accumulation of these molecules has been attributed to a number of additional ailments suffered by those on long term dialysis. Sorbent augmented dialysis has been identified as a potential avenue to remove these MMs, an additional column would be introduced to the haemodialysis loop this would contain adsorbent particles to remove these unwanted molecules. Styrene-divinylbenzne copolymers have been identified as suitable for this task as they will non-specifically adsorb a wide range of molecules. One major concern with the introduction of a polymeric adsorbent is the potential removal of human serum albumin HSA from the patient’s blood, this essential blood protein is present in very high concentrations typically 40g/l and this will potentially swamp the surface of any adsorbent. Fortunately HSA is a large blood protein (69kDa) and as such the method to combat this limitation as explored in this thesis is to tailor the pore structure of the polymeric adsorbent to size exclude albumin while retaining sufficient adsorption capacity to remove the MMs. To achieve these goals a number of polymeric adsorbents were generated using different porogens and degrees of crosslinking to control the porous structure. These adsorbents were analysed using a number of characterisation methods to assess their dry and swollen state porosities and molecular weight cut offs. Once a suitable material had been developed protein adsorption studies were carried out to confirm the size exclusion of HSA and the uptake of MMs

Start with the learner

This item has been published in the journal Update [©CILIP]Teaching information literacy is about empowering users, not following a sterile curriculum. To be effective, we need to provide a mixture of teaching and learning activities to accommodate diversity

Transcript of Interview With Jim Webb

An interview with Jim Webb by Chris Green discussing the early days of the Southern Appalachian Writers Cooperative

John Webb interview, Former University Archivist, University Libraries, Wright State University

Chris Wydman interviewed John Webb on October 12, 2007 about the founding of Wright State University and the development of the library and special collections and archives. In the interview Mr. Webb discusses his career and his decision to come to Wright State as a founding staff member

A review of the research literature relating to ICT and attainment

Summary of the main report, which examined current research and evidence for the impact of ICT on pupil attainment and learning in school settings and the strengths and limitations of the methodologies used in the research literature

Nebraska Department of Social Services\u27 Child Support Enforcement Unit Demonstration Project: Final Evaluation Report

In July 1987, the Nebraska Department of Social Services successfully applied to the U.S. Family Support Administration\u27s Office of Child Support Enforcement for funds to conduct a Demonstration Project. This Demonstration Project, The Nebraska IV-D/IV-A Intake and Phone Collection Project, was designed to increase telephone activities and improve intake practice as part of the ongoing child support collection activities. It was expected that such improvements would result in an increased level of absent parent location and an increased level of child support payment

The empty throne

The Empty Throne is a specially commisisoned 'featurette' . A high definition film that was conceived as a living painting, a window into the characters and events leading up to the sealing of Magna Carta by King John in 1215. I was engaged to create the sound design and mix the soundtrack for the piece. This was an unusual brief as the piece was 48 minutes long and contains sections of distinct action and speech along with sections which were characterised by atmospheric soundscapes, a storm brewing, castle echoes etc etc The film was directed by Philip Stevens, lecturer in the School of Film and Media. Stressing the power of the individual and is a call to arms for young artists to make their voices heard. The Empty Throne was shown as part of the multi-­‐faceted 1215.today launch event at Lincoln Castle, where the film was simultaneously projected onto multiple walls inside the castle. Viewers could catch a glimpse of the film as they passed by, perhaps coming across one of the tableaus. A series of dramas unfold. The production was also distinctive as it developed as a collaboration between staff, students and graduates of the School of Film & Media at the University of Lincoln, working together on a professional shoot to produce a film the University is incredibly proud of. As a key partner of the 1215.today project, who commissioned the film to form a key part of the launch event, the School of Film & Media is delighted and grateful that the project has provided our students with this invaluable opportunity to extend their skills and expertise – and the intended audience will gain valuable knowledg

A randomised control trial and cost-consequence analysis to examine the effects of a print-based intervention supported by internet tools on the physical activity of UK cancer survivors

Objective: The objective of this study was to evaluate the effectiveness of a print-based intervention supported by Internet tools at improving physical activity in cancer survivors compared with a standard letter recommendation. Prediagnosis physical activity and self-efficacy were hypothesised to predict physical activity improvement. Study design: Waiting list randomised control trial and cost-consequence analysis. Methods: Adult cancer survivors who could become physically active without prior medical approval were randomised to receive either a print-based intervention supported by Internet tools (intervention, n - 104) or a standard letter recommendation (control, n - 103). Physical activity was assessed at 12 weeks with maintenance assessed at 24 weeks in the intervention arm. The number needed to treat was calculated, and a cost-consequence analysis completed. Results: Participants in receipt of a print-based intervention supported by Internet tools improved their physical activity by 36.9% over 12 weeks compared with 9.1% in the control arm. Physical activity was maintained at 24 weeks in the intervention arm. A total of 6.29 cancer survivors needed to receive the intervention for one cancer survivor to improve their physical activity over a standard letter recommendation. Intervention delivery cost £8.19 per person. Prediagnosis physical activity and self-efficacy did not predict physical activity improvement. Conclusion: A print-based intervention supported by Internet tools offers a promising low-cost means to intervene to improve physical activity in cancer survivors