Resensies/Reviews

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How Expressive Arts Therapy is being used to treat children with developmental trauma and its implications for treating community and systemic causes of developmental trauma.

Adverse Childhood Experiences, or ACEs, are circumstances that occur in a child’s life which are either long-lasting or have long-lasting effects due to their traumatic nature. Developmental trauma is a composite name for the effects of adverse childhood experiences on children. It has been found that, across racial groups, in locations with high poverty, children are more at-risk for scoring high (four or more) on the ACE questionnaire (Choi, Wang, & Jackson, 2019, p. 1). Treatment for developmental trauma begins with establishing a sense of safety in the child, but also within the family and the community. It is also important to build personal, familial, and community resilience in order to combat, or even override the effects of adverse experiences. Expressive Arts Therapy provides easy access to parts of the brain that store emotion, memory, and sensation, all necessary for treating developmental trauma effectively. Expressive Arts Therapy is uniquely situated to provide individual, family, and community connectivity and relational healing within a systems approach because most art forms are scalable. The efforts that currently exist to provide community-level care to families at-risk for developmental trauma must begin to incorporate Expressive Arts Therapy in order to be more fully effective. Expressive Arts Therapists should get involved at the systemic level and develop programs that wrap around the whole family and the whole community toward reducing instances of developmental trauma in children

SPERT PROJECT. Quarterly Technical Report for April, May, June 1959

SPERT I: The characteristics of the boiling process and its relatin to moderator expulsion in Spert I were investigated in a series of capsule type experiments. A fuel-bearing oapsule, instrumented to provide pressure, volume, and temperature data during transient power excursions, was placed in a high flux region of the Spert I P core. Five step-induced transients initiated from boiling indicate that the kinetic behavior of the stainless steel clad P-18/19 core is dependent on initial temperature in a manner similar to that of previously tested aluminum clad spert cores. Reactivity oscillator techniques were used in the P-18/19 core to determine the phase and magnitude of the reactivity-to-power transfer function from 0.01 to 18.4 cps at low power and at temperatures below boiling. Criticality data on relatively simple lattices, both rod-free and containing a single poison rod, were obtained from a series of clean critical experiments performed on a number of light water-moderated and - reflected slab configurations of Spert III fuel elements. Changes in water height during the critical water height experiment were measured to plus or minus 0.0013 inches by means of a simple remoteindicating system designed and built for this purpose. SPERT III: The operational loading was determined to be 44 fuel assemblies and 8 control rods. Experiments revealed that this loading provides about .50 excess at 2500 psi ard 650 deg C and a total rod worth above ambient critical of about .50. Measurements were made of the pressure and temperature coefficients of reactivity and the temperature defect. Apparatus for non-nuclear engineering tests was installed and the tests were initiated to obtain data on core hydraulics, system energy balance, and general plant equipment. A primary coolant sampling station has been added. Experimental apparatus for void experiments was designed and fabrication started. DATA REDUCTION AND INTERPRETATION: A review of previous investigations of boiling and its relation to shutdown effects was made in pursuance of a photographic investigation of shutdown mechanisms. A photographic technique was developed for conducting tests in a fuel-bearing, water-filled test cell in Spert I. A machine program using computed reactivity as input data was used to obtain power solutions tc the kinetics equations. Comparison of the computed and experimental power burst shapes showed the reactivity data and power data to be consistent and in this way has essentially verified the independent program for reactivity calculations. ENGINEERING: Corrosion and galling tendencies were investigated in materials of construction for threaded components used in high temperature demineralized water service. The Spert II primary piping system was completed. Calibrations, check-out, and final tests are in preparation. Work continued on control system wiring, wiring schedules, and schematic drawings. The initial core was accepted. (For preceding period see IDO-16539.) (auth

Good, better or best: A study of standards of prevention and care in HIV prevention trials

Introduction This study examines the negotiation of benefits to participants in efficacy trials of biomedical HIV prevention technologies (HPT). It was conducted from 2009-2012, during which time there were positive efficacy results from six large, randomised controlled trials of HPT. Debates about obligations to trial participants are reconsidered in the light of abovementioned results. Methods Empirical • Survey of principal investigators of HPT • 14 in-depth interviews with principal investigators • Additional data from document analysis and personal communications. Normative Key normative issues examined are: • Ethical justification for antiretroviral (ARV)-based prevention • Impact of partial efficacy results on HIV prevention research • Implications of incorporating newly validated technologies into standard of prevention (SOP). Results • There is no consensus on whether or when new interventions should be added to SOP. • Access to ARV for seroconverters has become a norm. • Ancillary care provision is also a norm. • Post-trial access differs in both the duration and the timeliness of provision. Conclusion Partially effective interventions raise questions about standards in both research and implementation contexts. While ongoing research into HPT is crucial, reducing HIV incidence in trial populations remains a legitimate goal. Adding an active comparator in HIV prevention trials could balance protection of participants with research imperatives

Developing priorities to achieve health equity through diabetes translation research: A concept mapping study

Introduction: The goal of diabetes translation research is to advance research into practice and ensure equitable benefit from scientific evidence. This study uses concept mapping to inform and refine future directions of diabetes translation research with the goal of achieving health equity in diabetes prevention and control. Research design and methods: This study used concept mapping and input from a national network of diabetes researchers and public health practitioners. Concept mapping is a mixed-method, participant-based process. First, participants generated statements by responding to a focus prompt ( Results: Ten clusters were identified containing between 6 and 12 statements from 95 total generated statements. The ranges of average importance and feasibility ratings for clusters were fairly high and narrow (3.62-4.09; 3.10-3.93, respectively). Clusters with the most statements in the go-zone quadrant (above average importance/feasibility) were Conclusions: This study created a framework of 10 priority areas to guide current and future efforts in diabetes translation research to achieve health equity. Themes rated as highly important and feasible provide the basis to evaluate current research support. Future efforts should explore how to best support innovative-targets, those rated highly important but less feasible

Alleviating Discharge Confusion for Older Patients Using the Teach-Back Method

Discharge instructions and medication directions can be overwhelming for older adults, which can lead to potential medication errors, noncompliance, readmissions, and patient safety concerns. At a specialty lung clinic, the goal is to improve patient safety and to decrease the chance of errors by standardizing the discharge process via a Teach-Back education policy and protocol. Without consistency, there is a potential for mistakes and misunderstandings. The Agency for Healthcare Research and Quality (AHRQ) and the Institute for Healthcare Improvement (IHI) considers the Teach-Back discharge method as best practice and should be considered universal practice among health care workers. Using the Always Use Teach-Back Toolkit for education and evaluation provided strategies and resources for the project. Five nurse practitioners and a physician assistant, who are responsible for discharge instructions, participated in the study by viewing an online teaching module and completing written surveys. The Conviction and Confidence Tool revealed 100% of the clinicians agreed that Teach-Back education was \u2710-Very Important\u27 and were \u2710-Very Confident\u27 in their abilities to apply the Teach-Back methods using a 1-10 Likert scale. Likewise, the practitioners showed significant improvements when comparing the pre-implementation and one-month, post-policy implementation, as indicated in the paired t test of the second part of the Conviction and Confidence Teach-Back Tool. Nursing plays a pivotal role in positive social change by using an evidence-based education method, which improves patient care through medication compliance and decreased readmission rates, thus showing significant transformation in chronic health management

I Am Woman: The Complicated Relationship between Fairy Mistresses, Virgin Martyrs, and the Medieval Patriarchy

While modern scholars cannot expect medieval authors to live up to our expectations of feminism, we can still reflect upon the ways in which they both circumvented and upheld the typical patriarchal discursive structure which dominated the Middle Ages. A cross-genre examination of virgin martyred saints and fairy mistresses will illuminate significant overlap in the treatment of magic and divine intervention and the typical female portrayal in these circumstances. Saint’s Lives and Medieval Romances occupy significantly distinct spaces in the popular literary consciousness of the High and Late Middle Ages; however, both genres offer moral instruction for the women who encounter these stories allowing for a meaningful comparison of the female tropes in each genre. Using Sandy Bardsley’s distinction between power and authority from Women’s Roles in the Middle Ages, in which “Power suggests the ability to effect a change…[and] Authority is defined as ‘recognized and legitimized power,’” this project examines the extent to which virgin martyred saints and fairy mistresses are allowed power and authority in their respective texts (Bardsley 193). Through an examination of the Katherine Group virgin martyr saints’ lives and the fairy mistresses of Sir Launfal, Lanval, and Tomas off Ersseldoune, this paper demonstrates that while Saints’ Lives and Romances can depict powerful women, there is still a tendency to undermine women’s authority; even when a woman has legitimized authority over her own power, an inexplicable source such as magic is used to justify that authority. I hope this paper will challenge traditional notions of women’s power and authority in the well-trod tropes of virgin martyred saints and fairy mistresses

Do Weight Status and the Level of Dietary Restraint Moderate the Relationship between Package Unit Size and Food Intake?

Background: Package unit size may influence consumption. Single-serving (SS) packages, as compared to larger, standard (ST) packages, may increase awareness of what a standard serving is and assist in reducing consumption. Individuals who may be concerned about the amount they consume, such as overweight (OW) and dietary restrained individuals, may be more influenced by SS packages. Thus, the purpose of this study was to examine if weight and dietary restraint status moderate the influence of package size on consumption. It was hypothesized that SS packages would help to reduce intake in OW and/or restrained individuals as compared to normal weight (NW) and/or unrestrained individuals. Methods: Using a 2x2x2 (unrestrained/restrained x NW/OW x SS package/ST package) between-subjects factorial design, the effects of weight and restraint status on the relationship between package unit size and food intake were examined in 64 participants in a natural environment. NW and OW, unrestrained and restrained participants (23.7+3.3 years; 81.3% white; 96.9% non-Hispanic) were randomly assigned to receive either 20 ounces of pretzels packaged in SS packages or ST packages to eat ad libitum for 4 days. Total grams of pretzels consumed was determined by subtracting pre- and post-consumption weight of packages provided. Results: Using a 2x2x2 analysis of variance, for total grams of pretzels consumed, there was a significant interaction between package unit size and weight status (F(1,56)=7.1, p=0.01). Pairwise comparisons showed that OW participants in the ST size condition ate (p\u3c0.05) more grams of pretzels (204.4+144.9 g) compared to OW participants in the SS condition (107.0+101.9 g). Pairwise comparisons also revealed that for participants in the ST size condition, OW participants ate (p\u3c0.05) more grams of pretzels (204.4+144.9 g) than NW participants (112.7+58.9 g). No significant difference was found between OW and NW participants in the SS condition for grams of pretzels consumed (107.0+101.9 g vs. 158.1+104.4 g, respectively). Conclusion: Results from this study suggest that for OW individuals, ST packages increased consumption as compared to SS packages, which did not occur for NW individuals. While SS packages may not influence OW individuals to eat less in comparison to NW individuals, replacing ST packages with SS packages may assist with reducing overconsumption