748 research outputs found
Affirming Strengths-Based Models of Practice
Affirming and strengths- based practice with lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals and communities started to become more mainstream in the 1970s and 1980s and continues today. Whereas stigmatization of LGBTQ individuals and communities was once the accepted norm, most mainstream professional organizations in social work and allied helping professions today treat LGBTQ identity as part of the normal spectrum of human experience and support affirming and strengths- based models of practice with LGBTQ communities (American Counseling Association, 2013; American Psychological Association [APA], 2008; Council on Social Work Education [CSWE], 2015; National Association of Social Workers, 2005). In this chapter, we describe affirming and strengths- based practice with LGBTQ individuals and communities and consider the context in which these practice models emerged. Additionally, we explore the various theoretical and practice models that are the foundation of affirming and strengths- based practice with LGBTQ communities and consider the efficacy of these service approaches
Feeding Behaviors of Laying Hens with or without Beak Trimming
This study quantifies feeding behavior of the W-36 White Leghorn laying hen (77-80 weeks old) as influenced by the management practice of beak trimming. The feeding behavior is characterized by a newly developed measurement system and computational algorithm. Non-trimmed (NT) and beak trimmed (BT) birds showed similar meal size. BT birds spent longer time at the feeder, which is compatible to their slower ingestion rate of 0.9 g/min vs. 1.3 g/min of the NT type. Compared with NT bird, the BT bird had smaller time intervals between meals, 200 vs. 450 s. By scientifically characterizing the feeding behavior of laying hens, baseline information will result that may help better quantify the welfare of birds
Pharmacist-Administered Influenza Vaccination in Children and Corresponding Regulations
In our retrospective cohort study, we evaluated trends in pharmacist-administered pediatric influenza vaccination rates in the United States and corresponding state-level pharmacist pediatric vaccination authorization models, including minimum age requirements, vaccination protocols, and/or prescription requirements. An administrative health claims database was used to capture influenza vaccinations in children less than 18 years old with 1 year of continuous enrollment and joinpoint regression was used to assess trends. Of the 3,937,376 pediatric influenza vaccinations identified over the study period, only 3.2% were pharmacist-administered (87.7% pediatrician offices, 2.3% convenience care clinics, 0.8% emergency care, and 6.0% other locations). Pharmacist-administered pediatric influenza vaccination was more commonly observed in older children (mean age 12.65 ± 3.26 years) and increased significantly by 19.2% annually over the study period (95% confidence interval 9.2%-30.2%, p \u3c 0.05). The Northeast, with more restrictive authorization models, represented only 2.2% (n = 2816) of all pharmacist-administered pediatric influenza vaccinations. Utilization of pharmacist-administered pediatric influenza vaccination remains low. Providing children with greater access to vaccination with less restrictions may increase overall vaccination rates. Due to the COVID-19 pandemic and the Public Readiness and Emergency Preparedness Act, pharmacists will play a major role in vaccinating children
Strengths-based Behavioral Telehealth with Sexual and Gender Diverse Clients at Center on Halsted
The COVID-19 pandemic necessitated an immediate response and rapid transition from traditional face-to-face behavioral health services to behavioral telehealth at an organization serving sexual and gender diverse (SGD) individuals in Chicago. In this practice innovations article, we explore the unfolding public health crisis and the impact on service delivery for SGD individuals. Using a large multi-service organization as a case study, this paper describes how key members of the staff and leadership team shifted services online as a means of responding to isolation, loneliness, and disparities in access to healthcare for Chicago SGD communities. Lessons learned and practice recommendations are presented
Physical activity and osteoarthritis: a consensus study to harmonise self-reporting methods of physical activity across international cohorts
Physical activity (PA) is increasingly recognised as an important factor within studies of osteoarthritis (OA). However, subjective methods used to assess PA are highly variable and have not been developed for use within studies of OA, which creates difficulties when comparing and interpreting PA data in OA research. The aim of this study was, therefore, to gain expert agreement on the appropriate methods to harmonise PA data among existing population cohorts to enable the investigation of the association of PA and OA. The definition of PA in an OA context and methods of harmonization were established via an international expert consensus meeting and modified Delphi exercise using a geographically diverse committee selected on the basis of individual expertise in physical activity, exercise medicine, and OA. Agreement was met for all aims of study: (1) The use of Metabolic Equivalent of Task (MET) minutes per week (MET-min/week) as a method for harmonising PA variables among cohorts; (2) The determination of methods for treating missing components of MET-min/week calculation; a value will be produced from comparable activities within a representative cohort; (3) Exclusion of the domain of occupation from total MET-min/week; (4) The need for a specific measure of joint loading of an activity in addition to intensity and time, in studies of diseases, such as OA. This study has developed a systematic method to classify and harmonise PA in existing OA cohorts. It also provides minimum requirements for future studies intending to include subjective PA measures
Adult Wilmsâ Tumor: A Rare Case Report
Wilmsâ tumor is one of the most common intraabdominal malignancies among children and treatment protocols have been well studied in this population. The clinical presentation differs between the pediatric and adult populations with adults presenting similar to patients with renal cell carcinoma. Diagnosis is usually made by surgical pathology as imaging cannot differentiate between Wilmsâ tumor and other kidney pathologies. In addition to surgical excision, treatment includes systemic chemotherapy and/or radiation. In this case report, we present a patient who underwent successful surgical resection of a 29x24x25 cm right-sided Wilmsâ tumor with subsequent chemotherapy and radiation
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Womenâs responses to changes in U.S. preventive task forceâs mammography screening guidelines: results of focus groups with ethnically diverse women
Background: The 2009 U.S. Preventive Services Task Force (USPSTF) changed mammography guidelines to recommend routine biennial screening starting at age 50. This study describes womenâs awareness of, attitudes toward, and intention to comply with these new guidelines. Methods: Women ages 40â50 years old were recruited from the Boston area to participate in focus groups (k = 8; n = 77). Groups were segmented by race/ethnicity (Caucasian = 39%; African American = 35%; Latina = 26%), audio-taped, and transcribed. Thematic content analysis was used. Results: Participants were largely unaware of the revised guidelines and suspicious that it was a cost-savings measure by insurers and/or providers. Most did not intend to comply with the change, viewing screening as obligatory. Few felt prepared to participate in shared decision-making or advocate for their preferences with respect to screening. Conclusions: Communication about the rationale for mammography guideline changes has left many women unconvinced about potential disadvantages or limitations of screening. Since further guideline changes are likely to occur with advances in technology and science, it is important to help women become informed consumers of health information and active participants in shared decision-making with providers. Additional research is needed to determine the impact of the USPSTF change on womenâs screening behaviors and on breast cancer outcomes
The cost-effectiveness of a mechanical compression device in out of hospital cardiac arrest
AIM:
To assess the cost-effectiveness of LUCAS-2, a mechanical device for cardiopulmonary resuscitation (CPR) as compared to manual chest compressions in adults with non-traumatic, out-of-hospital cardiac arrest.
METHODS:
We analysed patient-level data from a large, pragmatic, multi-centre trial linked to administrative secondary care data from the Hospital Episode Statistics (HES) to measure healthcare resource use, costs and outcomes in both arms. A within-trial analysis using quality adjusted life years derived from the EQ-5D-3L was conducted at 12-month follow-up and results were extrapolated to the lifetime horizon using a decision-analytic model.
RESULTS:
4471 patients were enrolled in the trial (1652 assigned to the LUCAS-2 group, 2819 assigned to the control group). At 12 months, 89 (5%) patients survived in the LUCAS-2 group and 175 (6%) survived in the manual CPR group. In the vast majority of analyses conducted, both within-trial and by extrapolation of the results over a lifetime horizon, manual CPR dominates LUCAS-2. In other words, patients in the LUCAS-2 group had poorer health outcomes (i.e. lower QALYs) and incurred higher health and social care costs.
CONCLUSION:
Our study demonstrates that the use of the mechanical chest compression device LUCAS-2 represents poor value for money when compared to standard manual chest compression in out-of-hospital cardiac arrest
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