Evaluation of Internet education to increase dietary calcium intake in youth

In recent years, dietary calcium intake among children and adolescents has fallen sharply. This trend is alarming because childhood and adolescence are the primary ages for building bone mass. Therefore, an interactive website, Clueless in the Mall (http://calcium.tamu.edu) was developed targeting youth to increase knowledge, improve attitudes, and equip them to incorporate calcium-rich foods into their diets. This website was created with the help of adolescents at every stage of development and has been pilot tested with adolescents at home and in school, showing improvements in knowledge and attitudes. However, the website has not been tested for effectiveness in changing behaviors, specifically for increasing calcium intake. The present study was conducted to measure the effectiveness of the website for changing knowledge, attitudes, and behaviors. The hypothesis of this investigation was that the website intervention would significantly improve attitudes and knowledge about calcium and increase dietary calcium intake among adolescents and pre-adolescents who took part in the study. After the group-administered Food Frequency Questionnaire (FFQ) was validated among a local church youth group, a total of 126 middle school and high school students were recruited from 12 local public school classes to participate. Each student took three questionnaires during class time to measure baseline knowledge, attitudes, and behaviors (including calcium intake using the FFQ). Then each student took one class period to view the calcium website. Four to six weeks later, the investigators returned to administer the same three tests to each student. Demographic information was collected, and data were analyzed using paired samples t-tests and analyses of variance (ANOVA). Results demonstrated that the website alone was sufficient to improve knowledge scores; however, it was not enough to change attitudes and behaviors significantly. In conclusion, the website should be used to promote and reinforce health behaviors, but should not be expected to stand alone as an intervention

Employer Perceptions of Addiction Recovery and Hiring Decisions

Abstract Addiction to drugs and alcohol is a widespread, and ever-growing problem in American society today. Individuals who undergo treatment for their addiction often find it difficult to gain employment due to employers\u27 negative perceptions of addiction. Previous research has found that many employers have a stigma of those in addiction recovery. However, little research has been done to determine if these stigmas affect hiring decisions. Drug and alcohol misuse are prominent in the Appalachian area, which presents an issue for employers in the area who maintain a drug-free work place or who have a stigma of those in addiction recovery. The proposed study will assess employers’ attitudes towards applicants who have a history of substance misuse and/or are in treatment for substance misuse, with specific focus on self-reported likelihood of hiring an applicant who is in recovery. We hypothesize that employers will report a decreased likelihood of hiring individuals who are in recovery for substance misuse. Participants who are at least eighteen years of age and English-speaking will complete a survey on the REDCap web platform that includes a subset of questions from the Addiction Attitudes and Beliefs Scale (AABS). Items that will be used to assess employers’ attitudes were adapted from the Substance Use Stigma Mechanisms Scale (SU-SMS) and the Perceived Stigma Addiction Scale (PSAS). The proposed study is part of a larger study that is assessing attitudes and beliefs toward addiction among employers and within faith communities, as well as perceived stigmas experienced by those who are living with addiction or have a history of substance misuse, with particular emphasis on attitudes within the Appalachian Highlands community. Possible limitations of this proposed study include the lack of generalizability since employers in the Appalachian area may not be representative of the overall population. Another possible limitation is the use of self-report measures. Participants may not be willing to report accurately due to the sensitivity of the topic. If results of the proposed study support our hypothesis, further research should look at ways to reduce stigma and support employers in hiring those in addiction recovery. Existing research suggests that employment is vital for addiction treatment success and is associated with a decreased likelihood of relapse, making the need for the amelioration of this stigma imperative in dealing with the addiction crisis

Employer Perceptions about Addiction Recovery and Hiring Decisions

Drug and alcohol addiction is a nationwide epidemic with an increasing number of Americans being affected. Individuals who seek treatment for their addiction often face barriers, such as costs, waiting time, and available support, and those who are able to receive treatment are likely to experience or anticipate stigma from others. Existing literature has found that many employers have negative perceptions of individuals in addiction recovery. However, there is limited research that has analyzed whether these negative perceptions affect hiring decisions. We predicted that employers would have negative perceptions of those in recovery, would be less likely to hire individuals in recovery, and that those with previous substance misuse would perceive stigma from employers. A survey was completed by 53 employers using the REDCap web platform. There were 23 respondents who had a history of substance misuse. The survey contained items from the Addiction Attitudes and Beliefs Scale (AABS) and the Tobacco, Alcohol, Prescription medication, and other Substance use Tool (TAPS). The AABS contained modified items from the Substance Use Stigma Mechanisms Scale (SU-SMS) and the Perceived Stigma Addiction Scale (PSAS). Results indicated that the majority of employers had negative perceptions of people in addiction recovery, but employers were willing to hire those individuals. Results suggested that those with a history of addiction perceived stigma from their employers. Limitations of this study include lack of generalizability due to the small sample size and limited geographic area. Participants may have reported in a way that would make them appear socially desirable

Participant-reported effect of an Indigenous health continuing professional development initiative for specialists

Background: Health outcomes of Indigenous patients are impacted by culturally unsafe specialty care environments. The ‘Educating for Equity (E4E)’ program is a continuing professional development (CPD) intervention which incorporates skill-based teaching to improve Indigenous patient experiences and outcomes in healthcare interactions. Methods: The E4E program was delivered to rheumatologists in two phases, each delivered as experiential learning workshops where participants engaged with and applied course content within an interactive format focusing on real-time feedback. The phase 1 workshop focused on skill development of E4E Framework concepts and principles. Phase 2 concentrated on building capacity for teaching of E4E content. Evaluation of the program’s effectiveness was through longitudinal responses to the Social Cultural Confidence in Care Survey (SCCCS), self-reported strategies employed to address social issues and improve therapeutic relationships, engagement with teaching others, and satisfaction with the program. Results: Two cohorts of participants have participated in the program (n = 24 Phase 1, n = 10 Phase 2). For participants completing both phases of training, statistically significant improvements were observed in exploring social factors with patients, gaining knowledge and skills related to cultural aspects of care, improved communication and relationship building, and reflections on held stereotypes. Strategies to address social issues and build therapeutic relationships remained consistent throughout participation, while the training enhanced exploration and confidence to ask about cultural and traditional practices, and stronger communication strategies for exploring beliefs, expectations, social barriers, and residential school impacts on health. Participants reported feeling prepared to teach Indigenous health concepts to others and subsequently lead teaching with residents, fellows, and allied health professionals. Satisfaction with the delivery and content of the workshops was high, and participants valued interactions with peers in learning. Conclusions: This CPD intervention had a beneficial impact on self-reported confidence and enhanced practice strategies to engage with Indigenous patients

Open Research Indicators: sector priorities. UKRN Working Paper 02

Pilot projects are planned in 14 institutions that are members of the UK Reproducibility Network (UKRN), to explore the potential and value of indicators of open research to inform how those institutions plan, implement and evaluate their support for open research. The views of both institutions and individuals in the UK academic research sector were sought, to establish which aspects of open research should be priorities for monitoring in those pilots. A total of 29 responses were received, which identified 83 discrete priorities. The results of that exercise were that the following aspects of open research were prioritised: • Sharing research data • Sharing research software • FAIR research • Open Access to publications • Open research beyond publications • The use of persistent identifiers • Metadata and technical standards • Links across the scholarly record • Pre-registration • Reward and recognition • Training and awareness • Equality, diversity and inclusion Some of the priorities are on technical infrastructure, which may also enable the other priorities, and there are existing principles and initiatives informing open infrastructure. The pilot institutions reviewed this list and selected a sample of the priorities as likely to be the focus of those pilots. These were around research data sharing, pre-registration and recognition and reward

RELATIONAL ASPECTS OF FAMILY FUNCTIONING AND FAMILY SATISFACTION WITH A SAMPLE OF FAMILIES IN THE WESTERN CAPE

Family functioning may affect how satisfied family members are within the family. This study assessed the relational aspects between family functioning and family satisfaction with a conveniently sampled group of families. This study applied a quantitative methodology with a cross-sectional correlational design. The sample consisted of 204 participants (57% females, 50% Black Africans and 39% speaking isiXhosa). The average age was 31 years (SD=11.07). The results suggest that families could be at risk in terms of family functioning and this predicted being satisfied with the family. Implications for social work practice are provided

Attitudes toward the employment of mothers of preschoolers: Implications for child care

With increasing numbers of mothers entering the work force, including mothers of preschool age children, the policies that guide child care have yet to provide adequate services for large numbers of families. In this article, we investigate several possibilities for this delay in services by focusing on current attitudes toward maternal employment and certain factors that may influence these attitudes. We look at whether mothers and fathers differ on this issue and what, if any, demographic, situational, and values characteristics, may be influencing these attitudes. The implications for policy changes affecting child care services are discussed within this context.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44271/1/10566_2004_Article_BF00868989.pd

Comparing alternating pressure mattresses and high-specification foam mattresses to prevent pressure ulcers in high-risk patients: the PRESSURE 2 RCT

Background: Pressure ulcers (PUs) are a burden to patients, carers and health-care providers. Specialist mattresses minimise the intensity and duration of pressure on vulnerable skin sites in at-risk patients. Primary objective: Time to developing a new PU of category ≥ 2 in patients using an alternating pressure mattress (APM) compared with a high-specification foam mattress (HSFM). Design: A multicentre, Phase III, open, prospective, planned as an adaptive double-triangular group sequential, parallel-group, randomised controlled trial with an a priori sample size of 2954 participants. Randomisation used minimisation (incorporating a random element). Setting: The trial was set in 42 secondary and community inpatient facilities in the UK. Participants: Adult inpatients with evidence of acute illness and at a high risk of PU development. Interventions and follow-up: APM or HSFM – the treatment phase lasted a maximum of 60 days; the final 30 days were post-treatment follow-up. Main outcome measures: Time to event. Results: From August 2013 to November 2016, 2029 participants were randomised to receive either APM (n = 1016) or HSFM (n = 1013). Primary end point – 30-day final follow-up: of the 2029 participants in the intention-to-treat population, 160 (7.9%) developed a new PU of category ≥ 2. There was insufficient evidence of a difference between groups for time to new PU of category ≥ 2 [Fine and Gray model HR 0.76, 95% confidence interval (CI) 0.56 to 1.04; exact p-value of 0.0890 and 2% absolute difference]. Treatment phase sensitivity analysis: 132 (6.5%) participants developed a new PU of category ≥ 2 between randomisation and end of treatment phase. There was a statistically significant difference in the treatment phase time-to-event sensitivity analysis (Fine and Gray model HR 0.66, 95% CI 0.46 to 0.93; p = 0.0176 and 2.6% absolute difference). Secondary end points – 30-day final follow-up: new PUs of category ≥ 1 developed in 350 (17.2%) participants, with no evidence of a difference between mattress groups in time to PU development, (Fine and Gray model HR 0.83, 95% CI 0.67 to 1.02; p-value = 0.0733 and absolute difference 3.1%). New PUs of category ≥ 3 developed in 32 (1.6%) participants with insufficient evidence of a difference between mattress groups in time to PU development (Fine and Gray model HR 0.81, 95% CI 0.40 to 1.62; p = 0.5530 and absolute difference 0.4%). Of the 145 pre-existing PUs of category 2, 89 (61.4%) healed – there was insufficient evidence of a difference in time to healing (Fine and Gray model HR 1.12, 95% CI 0.74 to 1.68; p = 0.6122 and absolute difference 2.9%). Health economics – the within-trial and long-term analysis showed APM to be cost-effective compared with HSFM; however, the difference in costs models are small and the quality-adjusted life-year gains are very small. There were no safety concerns. Blinded photography substudy – the reliability of central blinded review compared with clinical assessment for PUs of category ≥ 2 was ‘very good’ (kappa statistic 0.82, prevalence- and bias-adjusted kappa 0.82). Quality-of-life substudy – the Pressure Ulcer Quality of Life – Prevention (PU-QoL-P) instrument meets the established criteria for reliability, construct validity and responsiveness. Limitations: A lower than anticipated event rate. Conclusions: In acutely ill inpatients who are bedfast/chairfast and/or have a category 1 PU and/or localised skin pain, APMs confer a small treatment phase benefit that is diminished over time. Overall, the APM patient compliance, very low PU incidence rate observed and small differences between mattresses indicate the need for improved indicators for targeting of APMs and individualised decision-making. Decisions should take into account skin status, patient preferences (movement ability and rehabilitation needs) and the presence of factors that may be potentially modifiable through APM allocation, including being completely immobile, having nutritional deficits, lacking capacity and/or having altered skin/category 1 PU. Future work: Explore the relationship between mental capacity, levels of independent movement, repositioning and PU development. Explore ‘what works for whom and in what circumstances’. Trial registration: Current Controlled Trials ISRCTN01151335. Funding: This project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 52. See the NIHR Journals Library website for further project information