Influence of Motivation on the Efficacy of Natural Family Planning

Purpose: Mutual motivation is recognized as essential for effective behavioral methods of family planning. Few studies have studied this factor in family planning efficacy. The purpose of this study was to determine the influence of mutual motivation on unintended pregnancy rates of couples who used natural family planning (NFP) methods to avoid pregnancy. Study Design and Methods: Using an online taught NFP method, 358women and ( their male partners) indicated “how much” and “how hard” they wished to avoid pregnancy on a scale of 0-10 before each menstrual cycle charted over 12 month of use. This motivation scale is used in the National Survey of Family Growth as a measure of motivation. All pregnancies were verified with an online pregnancy evaluation and urine based pregnancy test. A combined motivation score was used in analysis. Results: There were 28 pregnancies among the low motivation participants (N=60) and 16 among the high motivation participants (N=298). At 12 months of use, there were 75 pregnancies per 100 users for the low motivation group and only 8 for the high motivation group. There was an 80% greater likelihood of a pregnancy with the low motivation group (χ2 = 25.5, p \u3c .001) OR = 1.80; 95% CI = 1.61-1.90). Clinical Implications: High motivation to avoid pregnancy by both the female user of a behavioral method of family planning and her male partner is required for high efficacy. Assessing motivation of both the woman and her male partner before prescribing NFP methods is recommended

Fostering Transformative Learning, Self-reflexivity and Medical Citizenship Through Guided Tours of Disadvantaged Neighborhoods

Background and objectives: Medical school curricula increasingly seek to promote medical students’ commitment to redressing health disparities, but traditional pedagogical approaches have fallen short of this goal. The objective of this work was to assess the value of using community-based guided tours of disadvantaged neighborhoods to fill this gap. Methods: A total of 50 second-year medical students participated in a guided tour of disadvantaged public housing neighborhoods in Richmond, Virginia. Students completed self-reflexive writing exercises during a post-tour debriefing session. Student writings were analyzed to assess the tour’s effect on their awareness of poverty’s impact on vulnerable populations’ health and wellbeing, and their personal reactions to the tour. Results: Student writings indicated that the activity fostered transformative learning experiences around the issue of poverty and its effects on health and stimulated a personal commitment to working with underserved populations. Themes from qualitative analysis included: increased awareness of the extent of poverty, enhanced self-reflexive attitude towards personal feelings, biases and misperceptions concerning the poor, increased intentional awareness of the effects of poverty on patient health and well-being, and, encouragement to pursue careers of medical service. Conclusions: This pilot demonstrated that incorporating self-reflexive learning exercises into a brief community-based guided tour can enhance the social consciousness of medical students by deepening understandings of health disparities and promoting transformative learning experiences

Sixty original plays for primary grades

Thesis (Ed.M.)--Boston Universit

Using Action Research To Improve Teaching And Learning

This paper outlines the components of an action research project developed in a Master of Arts in Teaching and Leadership program designed to improve teaching and learning

Bezlotoxumab for prevention of recurrent Clostridium difficile infection in patients at increased risk for recurrence

Background: Bezlotoxumab is a human monoclonal antibody against Clostridium difficile toxin B indicated to prevent C. difficile infection (CDI) recurrence (rCDI) in adults at high risk for rCDI. This post hoc analysis of pooled monocolonal antibodies for C.difficile therapy (MODIFY) I/II data assessed bezlotoxumab efficacy in participants with characteristics associated with increased risk for rCDI. Methods: The analysis population was the modified intent-to-treat population who received bezlotoxumab or placebo (n = 1554) by risk factors for rCDI that were prespecified in the statistical analysis plan: age ≥65 years, history of CDI, compromised immunity, severe CDI, and ribotype 027/078/244. The proportion of participants with rCDI in 12 weeks, fecal microbiota transplant procedures, 30-day all cause and CDI-associated hospital readmissions, and mortality at 30 and 90 days after randomization were presented. Results: The majority of enrolled participants (75.6%) had ≥1 risk factor; these participants were older and a higher proportion had comorbidities compared with participants with no risk factors. The proportion of placebo participants who experienced rCDI exceeded 30% for each risk factor compared with 20.9% among those without a risk factor, and the rCDI rate increased with the number of risk factors (1 risk factor: 31.3%; ≥3 risk factors: 46.1%). Bezlotoxumab reduced rCDI, fecal microbiota transplants, and CDI-associated 30-day readmissions in participants with risk factors for rCDI. Conclusions: The risk factors prespecified in the MODIFY statistical analysis plan are appropriate to identify patients at high risk for rCDI. While participants with ≥3 risk factors had the greatest reduction of rCDI with bezlotoxumab, those with 1 or 2 risk factors may also benefit. Clinical Trials Registration: NCT01241552 (MODIFY I) and NCT01513239 (MODIFY II)

System, Apparatus and Method for Pedal Control

An apparatus, method, and system for controlling motion in six degrees of freedom is described. The apparatus includes a support structure, a first pedal and a second pedal. A first set of three independent articulating mechanisms is operatively connected to the support structure and the first pedal. The first set of three independent articulating mechanisms, in combination, enable motion of the first pedal in three control axes corresponding to three discrete degrees of freedom. A second set of three independent articulating mechanisms, operatively connected to the second pedal, enable motion, in combination, in three control axes corresponding to a discrete second set of three degrees of freedom. The apparatus may also include first and second sensors configured to detect the motion of the first and second pedals

The Effects of Visual Cues, Prompting, and Feedback within Activity Schedules on Increasing Cooperation Between Pairs of Children with Autism Spectrum Disorder

Activity schedules are visual support strategies that use visual cues, such as photographs and/or written words, to teach a learner to engage in a sequence of tasks or activities independently. Until recently, research on activity schedules has involved one schedule being followed by one individual. In order to facilitate cooperation between two individuals to complete one task, and to increase engagement between peers, cooperative activity schedules are being introduced as interventions in educating students with autism. A multiple baseline design across three activities was used to assess the effects of including an instructional package consisting of visual cues, prompting, and feedback to increase cooperation within an activity schedule between two students with autism spectrum disorder (ASD). This design was replicated across two pairs of participants. Baseline data indicated a lack of cooperation across both of the pairs. Following intervention, an increase in cooperation amongst both of the pairs was demonstrated. All prompting and reinforcement systems were effectively faded out for both pairs, and 2-week and 1-month follow up probes indicated cooperation maintained in the presence of the visual cue

The Relationship of a Systemic Student Support Intervention to Academic Achievement in Urban Catholic Schools

Much of the achievement gap between rich and poor students can be attributed to out-of-school factors, yet few schools have a comprehensive, coordinated system for addressing students’ nonacademic needs. Within a group of Catholic schools located in one city, this study examines academic achievement on the Stanford Achievement Test battery in mathematics, reading, and language among 2nd through 8th grade students participating in such an intervention, and compares the results with those of similar nonparticipating students in nearby cities. Using hierarchical longitudinal growth modeling and adjusting for demographic characteristics, this study found that students in intervention schools outperformed the comparison group on average in 6th grade mathematics. Intervention students also experienced significantly higher rates of growth in achievement than the comparison group in all three subjects. The results suggest that systemic service provision models have the potential to help urban Catholic schools meet their mission of educating the whole child and serving the poorest families. Keywords Catholic education, longitudinal growth analysis, achievement gap Le lien entre une intervention systémique de soutien aux élèves et la réussite scolaire dans les écoles catholiques en milieu urbain. Une bonne partie de l\u27écart entre les résultats obtenus par les élèves riches et les pauvres peut être attribuée à des facteurs extérieurs à l\u27école, pourtant peu d\u27écoles disposent d\u27un système complet et coordonné pour résoudre les besoins extrascolaires des élèves. Cette étude, qui porte sur un groupe d\u27écoles catholiques situées dans une seule ville, examine la réussite scolaire sut la batterie de tests de réussite de Stanford en mathématiques, lecture et langage parmi des élèves de la 11eà la 3eparticipant à cette intervention et compare les résultats avec ceux d\u27élèves similaires, dans des villes voisines qui n\u27y participaient pas. À l\u27aide d\u27une modélisation longitudinale de croissance, avec un ajustement pour les caractéristiques démographiques, cette étude a trouvé que les élèves des écoles où avait lieu l\u27intervention avaient de meilleurs résultats en moyenne que le groupe de comparaison en mathématiques de classe de 6e. Les élèves bénéficiant de l\u27intervention ont aussi eu des taux de croissance plus élevés que le groupe de comparaison dans les trois matières. Ce résultat indique que des modèles de service systémique fourni aux élèves peuvent potentiellement aider les écoles catholiques urbaines à remplir leur mission d\u27éducation intégrale de l\u27enfant et rendre service aux familles pauvres. Mots-clés : éducation catholique, analyse longitudinale de croissance, écart de réussite Relación entre una intervención sistémica de apoyo al estudiante y los logros académicos en escuelas católicas urbanas La mayor parte de la brecha en los logros entre estudiantes ricos y pobres puede atribuirse a factores extraescolares, sin embargo, pocas escuelas disponen de un sistema comprensivo coordinado que aborde las necesidades no académicas de los estudiantes. Tomando un grupo de escuelas católicas ubicadas en una misma ciudad, este estudio examina los logros académicos en las pruebas de aptitud de Stanford (SAT) en matemáticas, lectura y lengua de estudiantes entre segundo y octavo curso que participan en tales intervenciones; y compara los resultados a los de estudiantes no participantes, con perfiles similares, en ciudades cercanas. Al emplear modelos de crecimiento longitudinal jerárquico y al ajustarlos a las características demográficas, el presente estudio encontró que los estudiantes de escuelas con intervención superaron la media de los resultados del grupo de comparación en 6º curso de matemáticas. Los estudiantes con intervención también experimentaron significativamente mayores tasas de crecimiento que los del grupo de comparación en las tres materias. Los resultados sugieren que los modelos que proveen servicios sistémicos disponen del potencial para ayudar a que las escuelas católicas urbanas cumplan su misión de educar al niño en su totalidad y de servir a las familias pobres. Palabras clave educación católica, análisis de crecimiento longitudinal, brecha de logro