Mixed methods evaluation of an educational intervention to change mental health nurses' attitudes to people diagnosed with borderline personality disorder

Aims and objectives: To evaluate and explore mental health nurses’ responses to and experience of an educational intervention to improve attitudes towards people with a diagnosis of Borderline Personality Disorder. Report findings are concordant with relevant EQUATOR guidelines (STROBE and COREQ).Background: Attitudes towards people with a diagnosis of Borderline Personality Disorder are poorer than for people with other diagnoses. There is limited evidence about what might improve this situation. One intervention with reportedly good effect uses an underlying biosocial model of borderline personality disorder. No previous intervention has been co-produced with an expert-by-experience. We developed and delivered a 1-day intervention comprising these elements.Design: A mixed-methods design was used comprising prospective uncontrolled cohort intervention and qualitative elements. Participants were mental health nursing staff working in inpatient and community settings in one NHS Board in Scotland, UK.Methods: Measurement of cognitive and emotional attitudes to people with a borderline personality diagnosis at pre- and post- intervention (N =28) and at 4-month follow-up. Focus groups were used to explore participants’ experiences of the intervention (N =11).Results: Quantitative evaluation revealed some sustained changes consistent with expected attitudinal gains in relation to the perceived treatment characteristics of this group, the perception of their suicidal tendencies, and negative attitudes in general. Qualitative findings revealed some hostility towards the underpinning biosocial model and positive appreciation for the involvement of an expert-by-experience. Conclusions: Sustained benefits of an educational intervention for people working with people diagnosed with BPD in some but not all areas. Participants provided contrasting messages about what they think will be useful.Relevance to clinical practice: The study provides further evidence for incorporation of a biosocial model into staff training as well as the benefits of expert-by-experience co-production. Mental health nurses, however, believe that more well-resourced services are the key to improving care. <br/

Internationalizing Illinois: English language policy at UIUC

This dissertation examines the experiences and perceptions of multilingual international undergraduate students with English language policy at the University of Illinois at Urbana-Champaign (UIUC) in order to better understand the larger issue of language ideology and language practices amid the context of the internationalization of higher education in a hyper-globalized and neoliberal age. This qualitative study uses participant observations, interviews, and document analysis to analyze the language ideologies, language management, and language practices (Spolsky, 2004) that make up the language policy from above and language policy from below (Mortensen, 2014; Preisler 1999) that affect students taking a mandatory English as a Second Language writing course. The study aims to answer the questions: What are the English language policies at this university, and what are the implications of those policies for multilingual international undergraduate students? The main findings of the research are: 1) English language policies at UIUC are complex, multi-faceted, ad hoc, and often contradictory, leaving students with varying experiences and perceptions; 2) Institutional language ideology at UIUC has language-as-problem orientation and a monoglossic bias that perpetuates English hegemony; 3) Student participants’ navigation of language policy at UIUC is heavily influenced by their own language ideologies and previous language policy experiences prior to university life; 4) English-only language policy in official university spaces can be harmful to multilingual international undergraduate students . The findings of this dissertation lead to the conclusion that in order to protect the linguistic human rights of multilingual international undergraduate students, UIUC should work towards a shift in language ideology, both in English language policy from above and from below, that rejects the hegemony of English and reflects language-as-right and language-as-resource orientations towards language

Expressions 2000

https://openspace.dmacc.edu/expressions/1019/thumbnail.jp

Minimal intervention delivered by 2-1-1 information and referral specialists promotes smoke-free homes among 2-1-1 callers: a Texas generalisation trial

Replication of intervention research is reported infrequently, limiting what we know about external validity and generalisability. The Smoke Free Homes Program, a minimal intervention, increased home smoking bans by United Way 2-1-1 callers in randomised controlled trials in Atlanta, Georgia and North Carolina

Expressions 1998-1999

https://openspace.dmacc.edu/expressions/1018/thumbnail.jp

Evaluation of the zucker diabetic fatty (ZDF) rat as a model for human disease based on urinary peptidomic profiles

Representative animal models for diabetes-associated vascular complications are extremely relevant in assessing potential therapeutic drugs. While several rodent models for type 2 diabetes (T2D) are available, their relevance in recapitulating renal and cardiovascular features of diabetes in man is not entirely clear. Here we evaluate at the molecular level the similarity between Zucker diabetic fatty (ZDF) rats, as a model of T2D-associated vascular complications, and human disease by urinary proteome analysis. Urine analysis of ZDF rats at early and late stages of disease compared to age- matched LEAN rats identified 180 peptides as potentially associated with diabetes complications. Overlaps with human chronic kidney disease (CKD) and cardiovascular disease (CVD) biomarkers were observed, corresponding to proteins marking kidney damage (eg albumin, alpha-1 antitrypsin) or related to disease development (collagen). Concordance in regulation of these peptides in rats versus humans was more pronounced in the CVD compared to the CKD panels. In addition, disease-associated predicted protease activities in ZDF rats showed higher similarities to the predicted activities in human CVD. Based on urinary peptidomic analysis, the ZDF rat model displays similarity to human CVD but might not be the most appropriate model to display human CKD on a molecular level

A Familial Case of Wiskott-Aldrich Syndrome with a Hotspot Mutation in Exon 2 of the WAS Gene

The Wiskott-Aldrich syndrome (WAS) is a severe X-linked disorder characterized classically by thrombocytopenia, immunodeficiency, and eczema. The phenotype observed in this syndrome is caused by mutation in the WAS gene. Peripheral blood DNAs were isolated from an 18-month-old boy with WAS and his mother, maternal uncle, and maternal grandmother. Genetic analysis for the detection of a mutation of WAS gene was performed by polymerase chain reaction-single strand conformational polymorphism analysis (PCR-SSCP) and direct sequencing of the PCR product. In PCR-SSCP, the patient and his maternal uncle had an abnormal shift band, which was not found in normal controls, and his mother and maternal grandmother showed heterozygous bands. In direct sequencing analysis, the patient with WAS had CGC→CAC point mutation in exon 2 that resulted in an amino acid change in codon 86 (Arg86His). The present study identified a gene mutation responsible for WAS at a mutation hotspot of the WAS gene in a Korean family

Expressions 1997

https://openspace.dmacc.edu/expressions/1017/thumbnail.jp

The effectiveness of interventions to change six health behaviours: a review of reviews

Background: Several World Health Organisation reports over recent years have highlighted the high incidence of chronic diseases such as diabetes, coronary heart disease and cancer. Contributory factors include unhealthy diets, alcohol and tobacco use and sedentary lifestyles. This paper reports the findings of a review of reviews of behavioural change interventions to reduce unhealthy behaviours or promote healthy behaviours. We included six different health-related behaviours in the review: healthy eating, physical exercise, smoking, alcohol misuse, sexual risk taking (in young people) and illicit drug use. We excluded reviews which focussed on pharmacological treatments or those which required intensive treatments (e. g. for drug or alcohol dependency). Methods: The Cochrane Library, Database of Abstracts of Reviews of Effectiveness (DARE) and several Ovid databases were searched for systematic reviews of interventions for the six behaviours (updated search 2008). Two reviewers applied the inclusion criteria, extracted data and assessed the quality of the reviews. The results were discussed in a narrative synthesis. Results: We included 103 reviews published between 1995 and 2008. The focus of interventions varied, but those targeting specific individuals were generally designed to change an existing behaviour (e. g. cigarette smoking, alcohol misuse), whilst those aimed at the general population or groups such as school children were designed to promote positive behaviours (e. g. healthy eating). Almost 50% (n = 48) of the reviews focussed on smoking (either prevention or cessation). Interventions that were most effective across a range of health behaviours included physician advice or individual counselling, and workplace- and school-based activities. Mass media campaigns and legislative interventions also showed small to moderate effects in changing health behaviours. Generally, the evidence related to short-term effects rather than sustained/longer-term impact and there was a relative lack of evidence on how best to address inequalities. Conclusions: Despite limitations of the review of reviews approach, it is encouraging that there are interventions that are effective in achieving behavioural change. Further emphasis in both primary studies and secondary analysis (e.g. systematic reviews) should be placed on assessing the differential effectiveness of interventions across different population subgroups to ensure that health inequalities are addressed.</p