African American Women\u27s Perceptions of and Experiences with Mandated Substance Abuse Treatment: Implications for Counselors

African American women, in particular those who are economically marginalized, are disproportionately subject to surveillance by social service and criminal justice agencies (James et al., 2003) and are vulnerable to race- and gender-biased policy implementation (Chibnall et al., 2003; Zerai, 2002). They also experience population-specific personal (Ehrmin, 2001, 2002), social (Riehman, Iguchi, Zeller, & Morral, 2003; MacMaster, 2005), and economic barriers (Tighe & Saxe, 2006) to accessing and entering substance abuse treatment services. These factors contribute to lower rates of treatment entry follow-through (Siqueland et al., 2002) and higher drop-out rates (Scott-Lennox, Rose, Bohlig, & Lennox, 2000) than women from other racial and ethnic groups. This qualitative study explored African American women’s perceptions of mandated referral to substance abuse treatment and the impact of those perceptions on their treatment entry. The sample included 17 women age 18 years and over who were currently enrolled at three gender-specific treatment programs (one intensive outpatient and two residential) in a major southeastern urban area. This naturalistic inquiry (Lincoln and Guba, 1987) was informed by Black feminist epistemology (Collins, 2000) in accordance with recommendations for culturally sensitive research with women of color (Landrine, Klonoff, & Brown-Collins, 1995). Participants completed one-time, in-depth (one to two hour) interviews in which they were invited to explore their experiences with mandated substance abuse treatment referrals from state agencies (child protective services and the criminal justice system). Results indicate that participants generally perceived the treatment mandate as helpful. However, they also indicated that their willingness and ability to follow-through with treatment entry were influenced by multidimensional (Marlowe, Merikle, Kirby, Festinger, & McLellan, 2001) and interacting factors. Participants identified influence factors that included intra- and interpersonal concerns, the quality of interactions with state agencies, and treatment-specific issues. Results are presented along with suggestions for counselors and future research

Information Seeking in Context: Teachers' Content Selection during Lesson Planning Using the Shoah Foundation's Visual History Archive of Holocaust Survivor Testimony

This study explored the information seeking task of content selection. An integrative conceptual framework used existing models to examine the context and process of information seeking, evaluation, and selection. The conceptual framework incorporated three main elements of the information seeking process: * The information need context, * The information search process, * Relevance criteria. Among teachers' many duties are the creation, implementation, and revision of lesson plans. A subtask of lesson planning is content selection, which occurs when teachers seek outside content, such as readings or audio recordings, to incorporate into lesson plans. Content selection is seen here as a work-task-embedded information seeking process. A qualitative study was implemented within the setting of a week-long professional development workshop, during which eight teachers used a custom software product that combined a lesson-planning module with an information retrieval (IR) system. The IR system provided access to a subset of the Shoah Foundation's Visual History Archive. Data types included interviews, fly-on-the-wall transcripts, transaction logs, relevance judgments, and lesson plans. Analysis combined inductive and deductive techniques, including start codes, constant comparison, emergent themes, and matrix analysis. Findings depict associations among each component of the framework. 1. The information need context consists of five layers (Environment, Role, Person, Task, Information Source), each of which influences information search and relevance. 2. The ISP includes two cognitive-behavioral facets: Conceptualizing and Actualizing. 3. Relevance criteria are the situationally-driven embodiment of contextual elements that apply to information seeking. These findings have theoretical and practical implications for information studies and education. For information studies, this study contributes to understanding of the ISP as contextual, cognitive, and interactive. Information need, while unobservable in its native form, can be depicted in enough detail to supply meaningful requirements for the design of information systems and processes. Content selection is a form of exploratory search, and this study's implications suggest that the "traditional" reference interview should be used as an interaction model during exploratory search. For education, this study extends the discourse about consequences of standards-based education for teacher practice and contributes to models of teacher planning as an iterative, cognitive process

Introducing the Interdisciplinary Nature of Health Care Through Case Study Models

Interprofessional education (IPE) is a critical area needed to improve the quality of healthcare. Stereotypes of other disciplines persist by healthcare workers, limiting the ability to work as a team. Knowledge of roles of healthcare professions is a key competency of IPE. An online, 12-week course was developed to introduce students to the interdisciplinary nature of healthcare through case study models. Through built-in links, students explore medical terminology, diagnostic testing, pathophysiology, treatment, and health professionals who work as a team to diagnose and treat the patient. A 24-question survey was administered to a convenience sample of 582 high school students. Results of paired-samples t-tests showed significant increases pre-training to post-training in: 1) knowledge of the different roles of health professionals, (n = 338, M = .71, SEM = .01) to post-training (M = .82, SEM = .01), t(337) = 11.08, p<.001, pη2 = .203, 2) and self-reported knowledge of roles of different health professions, pre-training (n = 338, M = 2.73, SEM = .30) to post-training (M = 3.60, SEM = .039), t(337) = 20.02, p < .001, pη2 = .543. Interestingly, students’ likelihood in a career in healthcare professions decreased significantly pre-training (n = 338, M = 4.30, SEM = .043) to post-training (M = 4.20, SEM = .06), t(337) = 2.21, p = .028, pη2 = .016. Introducing knowledge of health professions to this population may be critical in avoiding stereotypes before a student enters a chosen career path, increasing the likelihood of participation in interdisciplinary teams

Survival and haematological recovery of children with severe malaria transfused in accordance to WHO guidelines in Kilifi, Kenya

Background: Severe anaemia requiring emergency blood transfusion is a common complication of malaria in children. To ensure access for urgent blood transfusion, the World Health Organization has developed clear guidelines with haemoglobin thresholds prevent unwarranted transfusion,. Few studies have reported outcome and haematological recovery of children with severe malaria where transfusion practice complies with WHO recommendations. Methods: A prospective observational study of survivors of severe and complicated malaria transfused in accordance with WHO guidelines. Children were invited for review at one month post-discharge. Non-attendees were traced in the community to ascertain survival. Results: Outcome was assessed in 213 survivors. Those transfused were younger, had a higher base deficit, mean lactate levels and a higher prevalence of respiratory distress. As expected mean admission haemoglobin (Hb) was significantly lower amongst transfused [5.0 g/dL SD: 1.9] compared to non-transfused children [8.3 g/dL SD: 1.7] (p < 0.001). At discharge mean Hb was similar 6.4 g/dL [SD: 1.5] and 6.8 g/dL [SD: 1.6] respectively (p = 0.08), most children remained moderately to severely anaemic. At one month follow up 166 children (78%) returned, in whom we found no differences in mean Hb between the transfused (10.2 g/dL [SD: 1.7]) and non-transfused (10.0 g/dL [SD: 1.3]) survivors ( p = 0.25). The major factors affecting haematological recovery were young age (< 24 months) and concomitant malaria parasitaemia; Hb being 8.8 g/dL [SD: 1.5] in parasitaemic individuals compared with 10.5 g/dL [SD: 1.3] in those without (p < 0.001). Conclusion: This data supports the policy of rational use of blood transfusion, as proposed in the WHO guidelines, for children with anaemia in areas where access to emergency transfusion is not guaranteed. We have provided empirical data indicating that transfusion does not influence superior recovery in haemoglobin concentrations and therefore cannot be justified on this basis alone. This may help resolve the disparity between international policy and current clinical practice. Effective anti- malarial treatment at discharge may prevent reoccurrence of anaemia

Do anti-malarials in Africa meet quality standards? The market penetration of non quality-assured artemisinin combination therapy in eight African countries.

BACKGROUND: Quality of artemisinin-based combination therapy (ACT) is important for ensuring malaria parasite clearance and protecting the efficacy of artemisinin-based therapies. The extent to which non quality-assured ACT (non-QAACT), or those not granted global regulatory approval, are available and used to treat malaria in endemic countries is poorly documented. This paper uses national and sub-national medicine outlet surveys conducted in eight study countries (Benin, Kinshasa and Kantanga [Democratic Republic of the Congo, DRC], Kenya, Madagascar, Nigeria, Tanzania, Uganda and Zambia) between 2009 and 2015 to describe the non-QAACT market and to document trends in availability and distribution of non-QAACT in the public and private sector. RESULTS: In 2014/15, non-QAACT were most commonly available in Kinshasa (83%), followed by Katanga (53%), Nigeria (48%), Kenya (42%), and Uganda (33%). Non-QAACT accounted for 20% of the market share in the private sector in Kenya, followed by Benin and Uganda (19%), Nigeria (12%) and Zambia (8%); this figure was 27% in Katanga and 40% in Kinshasa. Public sector non-QAACT availability and distribution was much lower, with the exception of Zambia (availability, 85%; market share, 32%). Diverse generics and formulations were available, but non-QAACT were most commonly artemether-lumefantrine (AL) or dihydroartemisinin-piperaquine (DHA PPQ), in tablet formulation, imported, and distributed in urban areas at either pharmacies or drug stores. The number of unique manufacturers supplying non-QAACT to each country ranged from 9 in Uganda to 92 in Nigeria. CONCLUSIONS: Addressing the availability and distribution of non-QAACT will require effective private sector engagement and evidence-based strategies to address provider and consumer demand for these products. Given the variation in non-QAACT markets observed across the eight study countries, active efforts to limit registration, importation and distribution of non-QAACT must be tailored to the country context, and will involve addressing complex and challenging aspects of medicine registration, private sector pharmaceutical regulation, local manufacturing and drug importation. These efforts may be critical not only to patient health and safety, but also to effective malaria control and protection of artemisinin drug efficacy in the face of spreading resistance

Intended Mathematics Curriculum as Represented in State-Level Curriculum Standards: Consensus or Confusion?

Full Report published by: Information Age Publishers. http://www.infoagepub.comThis report represents the first detailed analysis of the grade placement of particular learning goals across all state-level curriculum documents published and current as of May 2005. The report documents the current situation regarding grade-level mathematics curriculum specification in the U.S. and highlights a general lack of consensus across states. As states continue to work to improve learning opportunities for all students, we hope this report will serve as a useful summary to inform future curriculum decisions.This report is based on the work of the Center for the Study of Mathematics Curriculum, supported by the National Science Foundation under Grant No. ESI-0333879. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the National Science Foundation

Clinically Actionable Hypercholesterolemia and Hypertriglyceridemia in Children with Nonalcoholic Fatty Liver Disease

OBJECTIVE: To determine the percentage of children with nonalcoholic fatty liver disease (NAFLD) in whom intervention for low-density lipoprotein cholesterol or triglycerides was indicated based on National Heart, Lung, and Blood Institute guidelines. STUDY DESIGN: This multicenter, longitudinal cohort study included children with NAFLD enrolled in the National Institute of Diabetes and Digestive and Kidney Diseases Nonalcoholic Steatohepatitis Clinical Research Network. Fasting lipid profiles were obtained at diagnosis. Standardized dietary recommendations were provided. After 1 year, lipid profiles were repeated and interpreted according to National Heart, Lung, and Blood Institute Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction. Main outcomes were meeting criteria for clinically actionable dyslipidemia at baseline, and either achieving lipid goal at follow-up or meeting criteria for ongoing intervention. RESULTS: There were 585 participants, with a mean age of 12.8 years. The prevalence of children warranting intervention for low-density lipoprotein cholesterol at baseline was 14%. After 1 year of recommended dietary changes, 51% achieved goal low-density lipoprotein cholesterol, 27% qualified for enhanced dietary and lifestyle modifications, and 22% met criteria for pharmacologic intervention. Elevated triglycerides were more prevalent, with 51% meeting criteria for intervention. At 1 year, 25% achieved goal triglycerides with diet and lifestyle changes, 38% met criteria for advanced dietary modifications, and 37% qualified for antihyperlipidemic medications. CONCLUSIONS: More than one-half of children with NAFLD met intervention thresholds for dyslipidemia. Based on the burden of clinically relevant dyslipidemia, lipid screening in children with NAFLD is warranted. Clinicians caring for children with NAFLD should be familiar with lipid management