Developing Civic Identity Amongst Middle School Students in Northern Chicago

Civic engagement programs allow students to develop confidence, passion, and a sense of responsibility toward their community. In a program like Summer Civics Academy at Loyola University Chicago, students are provided with a space for dialogue about the social problems they see in their community and given the resources to try and work towards a solution. Students provided with this type of engaged learning experience are thus encouraged to be a part of our democratic system in the future. Our focus on critical civic engagement attempted to build student skills in identity building, intercultural learning and collective social action. More importantly, students learn to look at policy not as a passive bystander, but as an active participant who has the ability to create change. Summer Civics Academy and programs like it hold substantial benefits for middle school students in urban contexts, where issues of race, nationality, and identity development are often brought to the forefront

Patient participation in nursing bedside handover: a systematic mixed-methods review

Background: Numerous reviews of nursing handover have been undertaken, but none have focused on the patients’ role. Objectives: To explore how patient participation in nursing shift-to-shift bedside handover can be enacted. Design: Systematic mixed-methods review. Data sources: Three search strategies were undertaken in July-August 2016: database searching, backwards citation searching and forward citation searching. To be included, papers had to either be research or quality improvement (QI) projects focusing on the patient role. Fifty-four articles were retrieved, including 21 studies and 25 QI projects. Review methods: Screening, data extraction and quality appraisal was undertaken systematically by two reviewers. Research studies and QI projects were synthesised separately using thematic synthesis, then the results of this synthesis were combined using a mixed-method synthesis table. Results: Segregated synthesis of research of patients’ perceptions revealed two contrasting categories; (1) patient-centred handover and (2) nurse-centred handover. Segregated synthesis of research of nurses’ perceptions included three categories: (1) viewing the patient as an information resource; (2) dealing with confidential and sensitive information; and (3) enabling patient participation. The segregated synthesis of QI projects included two categories: (1) nurse barrier to enacting patient participation in bedside handover; and (2) involving patients in beside handover. Once segregated findings were configured, we discovered that the patients’ role in bedside handover involves contributing clinical information related to their care or progress, which may affect patient safety. Barriers relate to nurses’ concerns for the consequences of encouraging patient participation, worries for sharing confidential and sensitive information and feeling hesitant in changing their handover methods. The way nurses approach patients, and how patient-centred they are, constitute further potential barriers. Strategies to improve patient participation in handover include training nurses, making handovers predictable for patients and involving both patients and nurses throughout the change process. Conclusions: Using research and QI projects allowed diverse findings to expand each other and identify gaps between research and heuristic knowledge. Our review showed the tension between standardising handovers and making them predictable for patient participation, while promoting tailored and flexible handovers. Further investigation of this issue is required, to understand how to train nurses and ensure patients’ viewpoint is captured. Many barriers and strategies identified QI projects were from the nurse perspective, thus caution interpreting results is required. We recommend steps be taken in the future to ensure improved quality of QI projects

HER2-enriched subtype and novel molecular subgroups drive aromatase inhibitor resistance and an increased risk of relapse in early ER+/HER2+ breast cancer

BACKGROUND: Oestrogen receptor positive/ human epidermal growth factor receptor positive (ER+/HER2+) breast cancers (BCs) are less responsive to endocrine therapy than ER+/HER2- tumours. Mechanisms underpinning the differential behaviour of ER+HER2+ tumours are poorly characterised. Our aim was to identify biomarkers of response to 2 weeks’ presurgical AI treatment in ER+/HER2+ BCs. METHODS: All available ER+/HER2+ BC baseline tumours (n=342) in the POETIC trial were gene expression profiled using BC360™ (NanoString) covering intrinsic subtypes and 46 key biological signatures. Early response to AI was assessed by changes in Ki67 expression and residual Ki67 at 2 weeks (Ki672wk). Time-To-Recurrence (TTR) was estimated using Kaplan-Meier methods and Cox models adjusted for standard clinicopathological variables. New molecular subgroups (MS) were identified using consensus clustering. FINDINGS: HER2-enriched (HER2-E) subtype BCs (44.7% of the total) showed poorer Ki67 response and higher Ki672wk (p<0.0001) than non-HER2-E BCs. High expression of ERBB2 expression, homologous recombination deficiency (HRD) and TP53 mutational score were associated with poor response and immune-related signatures with High Ki672wk. Five new MS that were associated with differential response to AI were identified. HER2-E had significantly poorer TTR compared to Luminal BCs (HR 2.55, 95% CI 1.14–5.69; p=0.0222). The new MS were independent predictors of TTR, adding significant value beyond intrinsic subtypes. INTERPRETATION: Our results show HER2-E as a standardised biomarker associated with poor response to AI and worse outcome in ER+/HER2+. HRD, TP53 mutational score and immune-tumour tolerance are predictive biomarkers for poor response to AI. Lastly, novel MS identify additional non-HER2-E tumours not responding to AI with an increased risk of relapse

Modeling Dyadic Attunement: Physiological Concordance in Newly Married Couples and Alliance Similarity in Patient-Therapist Dyads

Mutual influence within relationships is theorized as central to human development and functioning across the lifespan. Multiple theories posit a process of progressive bidirectional influence that results in greater similarity between dyad members over time, termed attunement. Yet attunement processes, from dyadic synchrony in healthy child development to partner influence within romantic relationships, are difficult to measure and model. One difficulty is that capturing information from both members of a relationship pair, or dyad, requires statistical modeling that appropriately accounts for the interdependence between them. The present study addressed this issue by putting forward a framework for modeling attunement processes between relationship members over time, and applied this framework to two distinct studies. The studies both tested whether attunement occurred in two large-scale dyadic samples, the first in a sample of newly-married couples, the second in a sample of psychotherapy dyads. Attunement was modeled both as an outcome (in Study 1) and a predictor (in Study 2), providing interested researchers with an analytic framework for using measures of dyadic attunement as either an independent or a dependent variable. Findings from Study 1 showed significant attunement in the stress hormone cortisol over the early years of marriage in newlywed couples. This finding is suggestive of bidirectional spousal influence over a longer term than previously tested, as other studies have only inferred attunement processes by finding covariation in spousal cortisol over a matter of days. This study also disaggregated cortisol fluctuations into discrete parts, allowing for tests of spousal attunement not only in cortisol level, but also in physiological response to a stressor. Findings from Study 2 also found significant attunement processes within patient-therapist dyads. Specifically, patient-therapist alliance attunement over time was predictive of better outcome for patients receiving psychotherapy for chronic depression. A major contribution of these studies was that they modeled theorized relationship processes at the level of the dyad, rather than emphasizing individual outcomes. This dyadic-level modeling of bidirectional influence in turn related to outcomes relevant to psychological health, which may have been obscured or undetectable with other modeling techniques

The Longitudinal Relation Between Academic/Cognitive Skills and Externalizing Behavior Problems in Preschool Children

Objective—Existing research suggests that there is a relation between academic/cognitive deficits and externalizing behavior in young children, but the direction of this relation is unclear. The present study tested competing models of the relation between academic/cognitive functioning and behavior problems during early childhood Method—Participants were 221 children (120 boys, 101 girls) who participated in a longitudinal study from age 3 to 6 Results—A reciprocal relation (Model 3) was observed only between inattention and academic achievement; this relation remained controlling for SES and family stress. The relation between inattention and cognitive ability was consistent with Model 1 (cognitive skills predicting later inattention) with controls. For hyperactivity and aggression, there was some support for Model 2 (early behavior predicting later academic/cognitive ability), but this model was no longer supported when controlling for family functioning. Conclusion—These results suggest that the relation between academic achievement/cognitive ability and externalizing problems may be driven primarily by inattention. These results also suggest that this relation is evident early in development, highlighting the need for early assessment and intervention