The Effect of Implementing an Evidence-Based Family History Screening Tool in the Primary Care Setting to Increase the Identification of Patients at Risk for Hereditary Breast and Ovarian Cancer Syndrome A Quality Improvement Project

Improvement of identification and education of Hereditary Breast and Ovarian Cancer Syndrome (HBOC) among primary care providers was the focus of this quality improvement project. The development of a pre-implementation and post-implementation survey along with the distribution of a family history screening tool and the Evidence-Based Practice Guidelines provided by the Centers for Disease Control was introduced for the intervention. The anonymous surveys were distributed to primary care providers at the University of Miami in Miami-Dade County locations. Participants recruited for this quality improvement project included Doctors (MD, DO), Nurse practitioners, and Physician assistants currently practicing in primary care. The quality improvement project included two surveys using clinical scenarios to assess primary care providers\u27 knowledge in identifying patients at an increased risk for HBOC. The providers willing to participate began by taking a pre-implantation survey to assess their baseline knowledge. The providers then received the Evidence-based Practice Guidelines Supporting Genetic Susceptibility Testing for Hereditary Breast and Ovarian Cancer Syndrome and the seven-question family history screening tool. They were then asked to review and implement these tools into their practice for 6 weeks. After the completion of the 6 weeks, the providers were then asked to complete a second survey using the provided family history screening tool to answer clinical scenario questions. Family history and screening tools were designed to identify at-risk patients for HBOC. On average, the post-implementation clinical scenario questions while utilizing the family history screening tool showed an increase in the identification of patients at risk for HBOC in comparison to the pre-implantation clinical scenario questions where no family history screening tool was used. While this project cannot make final conclusions due to its sample size, it can open opportunities for further validation of this theory and bring further evidence to translate research into changing clinical practice to better serve the community

Cascading effects of BPT for child internalizing problems and caregiver depression

Behavioral Parent Training (BPT) is the standard of care for early onset (3 to 8 years old) disruptive behavior disorders (DBDs). Preliminary evidence suggests that BPT may also produce cascading treatment effects for comorbid and interrelated symptomatology in children, primarily internalizing problems, as well as symptomatology in multiple systems of the family, including caregiver depressive symptomatology. What is less well understood, however, is why and how BPT functions to impact these multiple symptom clusters within and between family members. Accordingly, this manuscript aims to serve as a conceptual and theoretical consideration of the mechanisms through which BPT may produce generalized treatment effects among children with early onset DBDs and internalizing problems, as well as the psychosocial difficulties among their caregivers. It is our intention that the hypothesized mechanisms highlighted in this review may guide advances in clinical research, as well as assessment and practice

Teachers Who Left the Teaching Profession: A Qualitative Understanding

In this study, the researchers investigated public school teacher attrition in the State of Texas. The study examined the problem by focusing on the predominant reasons teachers give for leaving the profession after working only one year as a teacher. Eight persons who had left the teaching profession after one year teaching were contacted and interviewed concerning their reasons for leaving. The three most influential factors found were lack of administrative support, difficulties with student discipline, and low salary levels. Study findings and implications for policy are discussed

The Cascading Effects of Behavioral Parent Training on Caregiver Depressive Symptoms: An Examination of Generalized Treatment Effects and Potential Modulating Mechanisms of Change in Low-Income Families

Preliminary evidence suggests that Behavioral Parent Training (BPT) for early onset disruptive behavior disorders (DBDs) may also alleviate caregiver depressive symptoms; however, less is known about the interrelationship of depressive symptoms and BPT skill use throughout the course of treatment. Accordingly, this study replicated and extended the literature by preliminarily examining caregiver depressive symptoms among low-income families (N = 13) of children with early onset DBDs who participated in either a standard course or technology-enhanced version of BPT. Findings suggested that BPT holds promise in reducing caregiver depressive symptoms. Specifically, data trends revealed reductions in depressive symptoms among caregivers who completed BPT. Although baseline caregiver depressive symptoms were not correlated with baseline use of BPT skills as predicted, evidenced emerged suggesting possible relationships between relationship enhancing skills (BPT skills learned in Phase I) and child compliance (BPT skills learned in Phase II) and caregiver depressive symptoms. Preliminary findings also provide support for caregiver-child relationship quality, caregiver warmth, and child defiance as potential mechanisms of change accounting for the cascading effect of BPT on caregiver depressive symptoms. Findings have important implications for guiding clinical judgment and treatment planning for families with this common constellation of symptoms.Doctor of Philosoph

An Ecological Model of SES and Youth Hopelessness: The Intervening Roles of Neighborhood Context and Family Processes

Although prior work demonstrates a link between low socioeconomic status (SES) and youth hopelessness, less is known about the mechanisms by which hopelessness is transmitted. This study examined an ecological model of SES and youth hopelessness via a series of intervening processes at both the neighborhood (i.e., crime and sense of community) and family levels (i.e., maternal hopelessness and compromised positive parenting) in a sample of 193 African American single mother-youth (11-16 year old) dyads. Path analyses revealed that families from lower SES backgrounds were more likely to live in neighborhoods with more crime and less sense of community. Lower levels of sense of community, in particular, were associated with higher levels of maternal hopelessness, which in turn, was associated with compromised positive parenting. Lastly, mothers who engaged in less positive parenting practices had adolescents who reported higher levels of hopelessness. Clinical implications and directions for future research are discussed.Master of Art

Test results of a 60 volt bipolar nickel-hydrogen battery

In July, l986, a high-voltage nickel-hydrogen battery was assembled at the NASA Lewis Research Center. This battery incorporated bipolar construction techniques to build a 50-cell stack with approximately 1.0 A-hr capacity (C) and an open-circuit voltage of 65 V. The battery was characterized at both low and high current rates prior to pulsed and nonpulsed discharges. Pulse discharges at 5 and 10 C were performed before placing the battery on over 1400, 40% depth-of-discharge, low-earth-orbit cycles. The successful demonstration of a high-voltage bipolar battery in one containment vessel has advanced the technology to where nickel-hydrogen high-voltage systems can be constructed of several modules instead of hundreds of individual cells

Component variations and their effects on bipolar nickel-hydrogen cell performance

A 50 cell bipolar nickel-hydrogen battery was assembled to demonstrate the feasibility of constructing a high voltage stack of cells. Various component combinations were tested in this battery. The battery had approximately 1 ampere-hour of capacity and was constructed from components with an active area of 2" X 2". The components were parametrically varied to give a comparison of nickel electrodes, hydrogen electrodes, separators, fill procedures and electrolyte reservoir plate thicknesses. Groups of five cells were constructed using the same components; ten combinations were tested in all. The battery was thoroughly characterized at various change and discharge rates as well as with various pulse patterns and rates. Over a period of 1400 40% DOD LEO cycles some of the groups began to exhibit performance differences. In general, only separator variations had a significant effect on cell performance. It also appears that shunt currents may have been operating within the stack, resulting in electrolyte transfer from one cell to another, thus contributing to cell performance variations

Oral History Transcript - Eloy Z. Gonzalez

https://scholarworks.utrgv.edu/chapsoralhistories/1033/thumbnail.jp

Perceived Burdensomeness and Thwarted Belongingness Influence the Childhood Polyvictimization and Suicide Ideation Association among Hispanic Undergraduates

The present study examined the mediating effect of perceived burdensomeness (PB) and thwarted belongingness (TB) in the association between childhood polyvictimization and suicide ideation (past week) among 528 Hispanic college students. Nearly 10% reported polyvictimization, 19.8% had suicide ideation, and polyvictimization was a risk factor of suicide ideation through PB and TB. The indirect effect through PB was stronger than the indirect effect through TB. Interventions should focus on PB and TB to alleviate suicide ideation among Hispanic undergraduate students

Abundance of Crabs and Predation on Hemigrapsis oregonensis in Tiscornia Marsh, San Francisco Bay

With a carapace width ranging up to 35 mm for adult males and 29 mm for adult females, Hemigrapsis oregonensis is a native shore crab typically found in the rocky intertidal zone along the Northern Pacific coast. Although this habitat provides protection against desiccation as well as changes in temperature, it may also expose H. oregonensis to predators who prefer the same habitat. The goal of this research was to investigate both the predation on H. oregonensis and the abundance of various crabs of Tiscornia Marsh in San Francisco Bay. We hypothesize that the largest predation will occur in the mud with no vegetation habitat, followed by the mud with Spartina foliosa habitat, then the rock with no vegetation habitat and rock with Spartina foliosa habitat will have equal rates of predation. In regards to the abundance of crabs, we hypothesize that the rock with no vegetation and rock with Spartina foliosa habitats will have an equal abundance of crabs, followed by the mud with Spartina foliosa, and finally the mud with no vegetation having the least amount of crabs. At each of these four different habitat types, 20 tethers were set out to monitor predation rates over a 24 hour period. Then, 10 traps were used at each habitat to record the abundance of crabs every 24 hours spanning three days, for a total of 30 traps. Results supported the hypothesis that the largest amount of crabs would be found in the rocks with no vegetation, however, the results did not support the hypothesis that the largest predation rate would occur in the mud habitat. Instead, the most predation on H. oregonensis was found in the rock with Spartina foliosa habitat. Based on these results, more research needs to be conducted to determine if the distribution throughout the different habitats of H. oregonensis is due to the presence of Spartina Foliosa, predators, or another factor