Reflections on Study Abroad: Insights from Registered Nurses

Globalization has resulted in the increased internationalization of higher education with most universities hosting international students and sending domestic students on international learning experiences. As part of this trend, many undergraduate nursing programs offer study abroad clinical placements to promote cultural sensitivity and global citizenship. While there is an abundance of research evaluating student perceptions of specific international study abroad experiences soon upon their return, there is little research exploring longer-term perspectives of participants across a range of diverse international placement sites. To provide guidance for their study abroad program, a nursing school in western Canada gathered the perspectives of participants from the previous one to eight years. These currently practicing registered nurses had clinical placements in one of six countries across four continents between 2008 and 2015 as part of their undergraduate nursing education. In total 35 participants completed an online survey with 13 agreeing to an individual, semi-structured follow-up interview to elicit more detailed responses. The study was guided by Thorne’s interpretive description qualitative approach. The key beneficial features of their experience identified by the participants included cross-cultural learning, relationship building, and exposure to diverse health contexts. Narratives also captured challenges including cultural adjustment, financial burden, meeting placement and academic expectations, and issues of social injustice/inequality. The participants provided advice for the planning and delivery of international nursing clinical placements and recommended close curricular alignment between the course and placement site, faculty presence, and thorough student pre-departure preparation as essential components of study abroad nursing programs. The narratives highlighted the importance of faculty guidance to help participants move toward critical global citizenship by assessing their own beliefs and assumptions while considering the historical, sociocultural, economic, and political factors as well as other perspectives evident in the host placement context. Such transformational learning should be reinforced by the integration of social responsibility and global citizenship within undergraduate nursing curricula to ensure all nursing graduates are exposed to these critical worldviews. The findings provide guidance for the delivery of future international placements at this school of nursing and may help inform the design and implementation of similar programs. These registered nurses reinforced the value of study abroad as rich experiential learning opportunities that facilitate long-term cultural competence and a critical global nursing perspective. Résumé La mondialisation a entraîné une internationalisation accrue de l’enseignement supérieur, la plupart des universités accueillant des étudiants internationaux et soutenant la mobilité de ses propres étudiants pour une partie de leur formation à l’international. Suivant cette tendance, de nombreux programmes de premier cycle en sciences infirmières offrent des stages cliniques à l’international pour soutenir le développement de leur sensibilité culturelle et citoyenneté mondiale. Bien que plusieurs recherches portent sur les perceptions d’étudiantes peu après leur retour d’expériences spécifiques d’études à l’international, peu de recherches ont examiné la perspective à plus long terme des participantes à des stages dans divers contextes internationaux. Afin d’orienter son programme de stages à l’international, une école de sciences infirmières de l’Ouest canadien a recueilli le point de vue de participantes des dernières huit années. Celles-ci, désormais infirmières en exercice, avaient fait un stage clinique dans un de six pays répartis sur quatre continents, au cours de leurs études de premier cycle en sciences infirmières, entre 2008 et 2015. Au total, 35 participantes ont répondu à un sondage en ligne et 13 d’entre elles ont accepté de prendre part à un entretien individuel subséquent semi-dirigé afin d’approfondir leurs réponses. La recherche était guidée par l’approche qualitative de description interprétative proposée par Thorne. Parmi les plus grands avantages de l’expérience, identifiés par les participantes, notons l’apprentissage interculturel, la création de relations et l’exposition à divers contextes de santé. Les récits décrivaient aussi certains défis, dont l’adaptation culturelle, le fardeau financier, le respect des exigences à la fois du milieu de stage et du milieu de formation, ainsi que les questions d’injustice/ inégalité sociale. Les participantes ont formulé des recommandations pour la planification et la réalisation de stages cliniques internationaux en sciences infirmières, et ont jugé essentiels ces éléments pour tout programme de mobilité : un lien pédagogique étroit entre le cours et le milieu de stage, la présence d’un membre du corps professoral et la préparation minutieuse des étudiantes avant leur départ. Les récits soulignaient l’importance de l’encadrement professoral pour soutenir le développement des participantes vers une citoyenneté mondiale critique en analysant leurs propres croyances et idées préconçues, tout en tenant compte des facteurs historiques, socioculturels, économiques et politiques, ainsi que d’autres perspectives observées dans le milieu d’accueil du stage. Une telle expérience d’apprentissage transformationnelle devrait être consolidée par l’intégration des notions de responsabilité sociale et de citoyenneté mondiale dans le programme d’études de premier cycle en sciences infirmières, de sorte que toutes les diplômées soient exposées à ces visions du monde essentielles. Les résultats ont servi à orienter le format des prochains stages internationaux dans cette école de sciences infirmières et pourraient contribuer à la conception et à la mise en œuvre de programmes similaires. Ces infirmières en exercice ont réaffirmé l’importance des études à l’international comme étant de riches occasions d’apprentissage expérientiel, qui favorisent une intégration durable de la compétence culturelle et une perspective globale critique en sciences infirmières

Real-time automated failure identification in the Control Center Complex (CCC)

A system which will provide real-time failure management support to the Space Station Freedom program is described. The system's use of a simplified form of model based reasoning qualifies it as an advanced automation system. However, it differs from most such systems in that it was designed from the outset to meet two sets of requirements. First, it must provide a useful increment to the fault management capabilities of the Johnson Space Center (JSC) Control Center Complex (CCC) Fault Detection Management system. Second, it must satisfy CCC operational environment constraints such as cost, computer resource requirements, verification, and validation, etc. The need to meet both requirement sets presents a much greater design challenge than would have been the case had functionality been the sole design consideration. The choice of technology, discussing aspects of that choice and the process for migrating it into the control center is overviewed

Differences in trauma history and psychopathology between PTSD patients with and without co-occurring dissociative disorders

Wabnitz P, Gast U, Catani C. Differences in trauma history and psychopathology between PTSD patients with and without co-occurring dissociative disorders. European Journal of Psychotraumatology. 2013;2013(4): 21452.Background: The interplay between different types of potentially traumatizing events, posttraumatic symptoms, and the pathogenesis of PTSD or major dissociative disorders (DD) has been extensively studied during the last decade. However, the phenomenology and nosological classification of posttraumatic disorders is currently under debate. The current study was conducted to investigate differences between PTSD patients with and without co-occurring major DD with regard to general psychopathology, trauma history, and trauma-specific symptoms. Methods: Twenty-four inpatients were administered the Clinician-Administered PTSD Scale for DSM-IV (CAPS) and the Mini-Structured Clinical Interview for DSM-IV Dissociative Disorders (MINI-SKID-D) to assess DD and PTSD. Additionally, participants completed questionnaires to assess general psychopathology and health status. Results: Symptom profiles and axis I comorbidity were similar in all patients. Traumatic experiences did not differ between the two groups, with both reporting high levels of childhood trauma. Only trauma-specific avoidance behavior and dissociative symptoms differed between groups. Conclusion: Results support the view that PTSD and DD are affiliated disorders that could be classified within the same diagnostic category. Our results accord with a typological model of dissociation in which profound forms of dissociation are specific to DD and are accompanied with higher levels of trauma-specific avoidance in DD patients

The Effect of Bank Competition on the Bank's Incentive to Collateralize

It has been argued that competing banks make inefficiently frequent use of collateralization in situations where they are better able to evaluate a project's risk than entrepreneurs. We study the bank's choice between screening and collateralization in a model where banks do not have this superior screening skill. In particular, we study the effect of bank competition on this choice. We find that competing banks use collateral less often than a monopolistic bank because competition will intensify if both banks collateralize. Moreover, bank competition is welfare improving if collateralization is rather costly

Predictive processing and the varieties of psychological trauma

A recently popular framework in the cognitive sciences takes the human nervous system to be a hierarchically arranged Bayesian prediction machine. In this paper, we examine psychological trauma through the lens of this framework. We suggest that this can help us to understand the nature of trauma, and the different effects that different kinds of trauma can have. We end by exploring synergies between our approach and current theories of PTSD, and gesture toward future directions

Framework for sustained climate assessment in the United States

Author Posting. © American Meteorological Society, 2019. This article is posted here by permission of American Meteorological Society for personal use, not for redistribution. The definitive version was published in Bulletin of the American Meteorological Society, 100(5), (2019): 897-908, doi:10.1175/BAMS-D-19-0130.1.As states, cities, tribes, and private interests cope with climate damages and seek to increase preparedness and resilience, they will need to navigate myriad choices and options available to them. Making these choices in ways that identify pathways for climate action that support their development objectives will require constructive public dialogue, community participation, and flexible and ongoing access to science- and experience-based knowledge. In 2016, a Federal Advisory Committee (FAC) was convened to recommend how to conduct a sustained National Climate Assessment (NCA) to increase the relevance and usability of assessments for informing action. The FAC was disbanded in 2017, but members and additional experts reconvened to complete the report that is presented here. A key recommendation is establishing a new nonfederal “climate assessment consortium” to increase the role of state/local/tribal government and civil society in assessments. The expanded process would 1) focus on applied problems faced by practitioners, 2) organize sustained partnerships for collaborative learning across similar projects and case studies to identify effective tested practices, and 3) assess and improve knowledge-based methods for project implementation. Specific recommendations include evaluating climate models and data using user-defined metrics; improving benefit–cost assessment and supporting decision-making under uncertainty; and accelerating application of tools and methods such as citizen science, artificial intelligence, indicators, and geospatial analysis. The recommendations are the result of broad consultation and present an ambitious agenda for federal agencies, state/local/tribal jurisdictions, universities and the research sector, professional associations, nongovernmental and community-based organizations, and private-sector firms.This report would not have been possible without the support and participation of numerous organizations and individuals. We thank New York State Governor Andrew M. Cuomo for announcing in his 2018 State of the State agenda that the IAC would be reconvened. The New York State Energy Research and Development Authority (Contract ID 123416), Columbia University’s Earth Institute, and the American Meteorological Society provided essential financial support and much more, including sage advice and moral support from John O’Leary, Shara Mohtadi, Steve Cohen, Alex Halliday, Peter deMenocal, Keith Seitter, Paul Higgins, and Bill Hooke. We thank the attendees of a workshop, generously funded by the Kresge Foundation in November of 2017, that laid a foundation for the idea to establish a civil-society-based assessment consortium. During the course of preparing the report, IAC members consulted with individuals too numerous to list here—state, local, and tribal officials; researchers; experts in nongovernmental and community-based organizations; and professionals in engineering, architecture, public health, adaptation, and other areas. We are so grateful for their time and expertise. We thank the members and staff of the National Academy of Sciences, Engineering, and Medicine’s Committee to Advise the U.S. Global Change Research Program for providing individual comments on preliminary recommendations during several discussions in open sessions of their meetings. The following individuals provided detailed comments on an earlier version of this report, which greatly sharpened our thinking and recommendations: John Balbus, Tom Dietz, Phil Duffy, Baruch Fischhoff, Brenda Hoppe, Melissa Kenney, Linda Mearns, Claudia Nierenberg, Kathleen Segerson, Soroosh Sorooshian, Chris Weaver, and Brian Zuckerman. Mary Black provided insightful copy editing of several versions of the report. We also thank four anonymous reviewers for their effort and care in critiquing and improving the report. It is the dedication, thoughtful feedback, expertise, care, and commitment of all these people and more that not only made this report possible, but allow us all to continue to support smart and insightful actions in a changing climate. We are grateful as authors and as global citizens. Author contributions: RM, SA, KB, MB, AC, JD, PF, KJ, AJ, KK, JK, ML, JM, RP, TR, LS, JS, JW, and DZ were members of the IAC and shared in researching, discussing, drafting, and approving the report. BA, JF, AG, LJ, SJ, PK, RK, AM, RM, JN, WS, JS, PT, GY, and RZ contributed to specific sections of the report

Evaluating knowledge to support climate action: A framework for sustained assessment. report of an independent advisory committee on applied climate assessment.

Author Posting. © American Meteorological Society, 2019. This article is posted here by permission of American Meteorological Society for personal use, not for redistribution. The definitive version was published in Weather Climate and Society 11(3), (2019):465-487, doi: 10.1175/WCAS-D-18-0134.1.As states, cities, tribes, and private interests cope with climate damages and seek to increase preparedness and resilience, they will need to navigate myriad choices and options available to them. Making these choices in ways that identify pathways for climate action that support their development objectives will require constructive public dialogue, community participation, and flexible and ongoing access to science- and experience-based knowledge. In 2016, a Federal Advisory Committee (FAC) was convened to recommend how to conduct a sustained National Climate Assessment (NCA) to increase the relevance and usability of assessments for informing action. The FAC was disbanded in 2017, but members and additional experts reconvened to complete the report that is presented here. A key recommendation is establishing a new nonfederal “climate assessment consortium” to increase the role of state/local/tribal government and civil society in assessments. The expanded process would 1) focus on applied problems faced by practitioners, 2) organize sustained partnerships for collaborative learning across similar projects and case studies to identify effective tested practices, and 3) assess and improve knowledge-based methods for project implementation. Specific recommendations include evaluating climate models and data using user-defined metrics; improving benefit–cost assessment and supporting decision-making under uncertainty; and accelerating application of tools and methods such as citizen science, artificial intelligence, indicators, and geospatial analysis. The recommendations are the result of broad consultation and present an ambitious agenda for federal agencies, state/local/tribal jurisdictions, universities and the research sector, professional associations, nongovernmental and community-based organizations, and private-sector firms.This report would not have been possible without the support and participation of numerous organizations and individuals. We thank New York State Governor Andrew M. Cuomo for announcing in his 2018 State of the State agenda that the IAC would be reconvened. The New York State Energy Research and Development Authority (Contract ID 123416), Columbia University’s Earth Institute, and the American Meteorological Society provided essential financial support and much more, including sage advice and moral support from John O’Leary, Shara Mohtadi, Steve Cohen, Alex Halliday, Peter deMenocal, Keith Seitter, Paul Higgins, and Bill Hooke. We thank the attendees of a workshop, generously funded by the Kresge Foundation in November of 2017, that laid a foundation for the idea to establish a civil-society-based assessment consortium. During the course of preparing the report, IAC members consulted with individuals too numerous to list here—state, local, and tribal officials; researchers; experts in nongovernmental and community-based organizations; and professionals in engineering, architecture, public health, adaptation, and other areas. We are so grateful for their time and expertise. We thank the members and staff of the National Academy of Sciences, Engineering, and Medicine’s Committee to Advise the U.S. Global Change Research Program for providing individual comments on preliminary recommendations during several discussions in open sessions of their meetings. The following individuals provided detailed comments on an earlier version of this report, which greatly sharpened our thinking and recommendations: John Balbus, Tom Dietz, Phil Duffy, Baruch Fischhoff, Brenda Hoppe, Melissa Kenney, Linda Mearns, Claudia Nierenberg, Kathleen Segerson, Soroosh Sorooshian, Chris Weaver, and Brian Zuckerman. Mary Black provided insightful copy editing of several versions of the report. We also thank four anonymous reviewers for their effort and care in critiquing and improving the report. It is the dedication, thoughtful feedback, expertise, care, and commitment of all these people and more that not only made this report possible, but allow us all to continue to support smart and insightful actions in a changing climate. We are grateful as authors and as global citizens. Author contributions: RM, SA, KB, MB, AC, JD, PF, KJ, AJ, KK, JK, ML, JM, RP, TR, LS, JS, JW, and DZ were members of the IAC and shared in researching, discussing, drafting, and approving the report. BA, JF, AG, LJ, SJ, PK, RK, AM, RM, JN, WS, JS, PT, GY, and RZ contributed to specific sections of the report.2020-05-2

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Childhood in Sociology and Society: The US Perspective

The field of childhood studies in the US is comprised of cross-disciplinary researchers who theorize and conduct research on both children and youth. US sociologists who study childhood largely draw on the childhood literature published in English. This article focuses on American sociological contributions, but notes relevant contributions from non-American scholars published in English that have shaped and fueled American research. This article also profiles the institutional support of childhood research in the US, specifically outlining the activities of the ‘Children and Youth’ Section of the American Sociological Association (ASA), and assesses the contributions of this area of study for sociology as well as the implications for an interdisciplinary field.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline