HE 190: Health Education Course Redesign

Poster summarizing course redesign activities for HE 190: Health Education.https://scholarworks.sjsu.edu/davinci_itcr2014/1012/thumbnail.jp

“Get the Mexican”: Attending to the Moral Work of Teaching in Fraught Times

This article details a four-faceted approach we developed to help structure discourse about topics in partisan arenas, many of which intersect with issues of equity and social justice. The article’s narrative centers on challenging and emotionally charged discussions that unfolded in a classroom management class in our teacher preparation program on November 9, 2016, the day following the election of Donald Trump. We offer the approach, which centers on addressing cognitive biases common in partisan discourse, as a robust, straightforward, and nontechnocratic way to help teachers (both teacher preparation instructors and teachers of children) mediate partisan discussions among their students and to help them situate their personal beliefs within a professional context. When practiced well, the approach invites discussants to engage fully and authentically with ideas even when discourse threatens to become fractious and can help students who may disagree actually hear one another, consider one another’s ideas, and make decisions not as bitterly divided partisans but as members of complex, multifaceted, multicultural communities

Recovered Memories of Alleged Sexual Abuse: An Analysis of the Theory of Repressed Memories Under the Washington Rules of Evidence

This Comment explores whether testimony regarding repressed memories is admissible under Washington rules of evidence. This Comment concludes that the process of repression and accurate recall of memories has not been proven to be a sufficiently reliable and trustworthy phenomenon to justify admission of evidence that abuse occurred

Countering Deficit Thinking About Neurodiversity Among General Education Teacher Candidates: A Case Discussion Approach

We have observed that many of the multiple-subjects teacher credential candidates in our program often reveal deficit views of autistic children. This report provides an example of how we help credential candidates learn to reframe deficit thinking about neurodiversity via the examination, discussion, and dramatization of a collection of dilemma-based case stories designed to help our students unearth preconceptions and engage in shared inquiry. One strength of this approach is that it asks candidates to develop specific and realistic plans of action, to adopt a care ethic requiring them to think and act from the perspective of the child, to think about the limits of their ability to differentiate, and to recognize that even with mainstreamed autistic children, as non-specialists our candidates may frequently find themselves out of their depth and in need of the expertise of more knowledgeable colleagues

Prediction-based classification for longitudinal biomarkers

Assessment of circulating CD4 count change over time in HIV-infected subjects on antiretroviral therapy (ART) is a central component of disease monitoring. The increasing number of HIV-infected subjects starting therapy and the limited capacity to support CD4 count testing within resource-limited settings have fueled interest in identifying correlates of CD4 count change such as total lymphocyte count, among others. The application of modeling techniques will be essential to this endeavor due to the typically nonlinear CD4 trajectory over time and the multiple input variables necessary for capturing CD4 variability. We propose a prediction-based classification approach that involves first stage modeling and subsequent classification based on clinically meaningful thresholds. This approach draws on existing analytical methods described in the receiver operating characteristic curve literature while presenting an extension for handling a continuous outcome. Application of this method to an independent test sample results in greater than 98% positive predictive value for CD4 count change. The prediction algorithm is derived based on a cohort of $n=270$ HIV-1 infected individuals from the Royal Free Hospital, London who were followed for up to three years from initiation of ART. A test sample comprised of $n=72$ individuals from Philadelphia and followed for a similar length of time is used for validation. Results suggest that this approach may be a useful tool for prioritizing limited laboratory resources for CD4 testing after subjects start antiretroviral therapy.Comment: Published in at http://dx.doi.org/10.1214/10-AOAS326 the Annals of Applied Statistics (http://www.imstat.org/aoas/) by the Institute of Mathematical Statistics (http://www.imstat.org

Falling treatment uptake in the hepatitis C care cascade is a growing threat to achieving elimination

Most high-income countries are not on track to achieve the World Health Organization hepatitis C elimination targets. As elimination programmes assess growing proportions of patients in community-based pathways, rates of treatment uptake may fall. We aimed to identify factors associated with DAA treatment uptake and measure changes in their prevalence over time. We performed a time-to-treatment analysis on 2728 patients approved for hepatitis C Direct-Acting Antiviral treatment in the North Central London region between January 2016 and October 2019. We investigated the association between treatment uptake and factors including assessment/treatment setting (hospital, drug service or prison), patient age, gender, injection drug use, harmful alcohol use, cirrhosis status and previous treatment. The likelihood of treatment uptake was reduced by three independent risk factors. These included assessment setting: prison-based or drug-service pathways (aHR 0.29 or 0.81 vs. hospital outpatient pathway, 95% CI 0.21-0.40 and 0.70-0.94 respectively, p<0.001); being UK-born (aHR 0.89 vs. non-UK born, 0.82-0.98, p=0.01); and history of harmful alcohol use (aHR 0.84 vs. no history, 0.72-0.99, p=0.04). The average number of these risk factors for not starting treatment per patient increased over time (R2 =0.66 p<0.001). Independent of these, there was an additional 5% reduction in rate of treatment initiation in each successive year of the programme (aHR 0.95, 0.91-0.99, p=0.02). In conclusion, d isengagement from care before treatment uptake was found to be a growing threat to elimination. Despite provision of community-based test-to-cure pathways, there are persistent barriers to treatment uptake and these are increasing over time

Reflections of South African nurses migrating to the Kingdom of Saudi Arabia a framework for support

The last decade has seen an exodus of South African nurses migrating to "greener pastures". As a result of this migration, the South African Healthcare Service has been drained of one of its most essential resources – nurses. Subsequently, the crippling flight of nurses has thrown the nursing profession into a state of crisis. The Kingdom of Saudi Arabia is one of the more popular destinations for South African nurses, the main reason being the attractive financial rewards. One agency reports that they send an average of thirty nurses a month to various hospitals within the Kingdom of Saudi Arabia. Saudi Arabia is an Islamic country. Due to the uniqueness of the enforcement of the Islamic faith and the Saudi culture, many restrictions are imposed, particularly on women. The challenges and problems facing the South African nurses were, therefore, unique compared to elsewhere in the world. This research study had a primary and a secondary objective: The primary objective of this study was to explore and describe the lived experiences of South African nurses related to living and working in Saudi Arabia; The secondary objective of this study was to develop orientation guidelines to support South African nurses working and living in Saudi Arabia. The researcher utilized a qualitative, explorative, descriptive and contextual design based on a phenomenological approach to inquiry, in an attempt to answer the question: "What are the professional and personal experiences of the South African registered nurses working and living in Saudi Arabia?" Eleven registered nurses were selected to participate by means of purposive sampling. These nurses had been living in Saudi Arabia between three and six months. Consent was obtained from participants and the ethics committee of both the Nelson Mandela Metropolitan University and King Faisal Specialist Hospital and Research Centre. The central theme emanating from the study was recognized as being 'Cultural Diversity'. The sub-themes identified related to the registered nurses’: - Religious/spiritual adaptation - Environmental adaptation - Emotional/psychological adaptation - Professional adaptation Based on the identified themes, guidelines were formulated to assist South African registered nurses when migrating to Saudi Arabia. Utilization of these should assist the South African registered nurse in assimilating into both the cultural and working environment. However, in reality, the outcome showed that no one can be prepared fully for what awaits them in Saudi Arabia