Towards the development of a resource center for individuals with anorexia nervosa and/or bulimia a needs/resource assessment, professional networking, and program planning process

An assessment of service needs and resource availability for clients with the eating disorders anorexia nervosa and bulimia was conducted in the Waterloo region, located in southwestern Ontario, in order to ascertain the number of individuals in the region who currently suffer from the disorders but for various reasons have not sought treatment. In addition, the assessment examined the availability of specialized services for this client population, the sufficiency of extant services in relation to estimated service needs, and the degree of inter-agency networking in treating eating disorders. A variety of needs/resource assessment techniques were utilized including the social indicators approach, key informant interviews, a mail survey of community professionals, and a telephone survey of individuals afflicted with the disorders. In order to facilitate utilization of the results of the assessment a networking/health education conference was arranged at which the preliminary results of the assessment were presented and delegates were invited to become part of the task force which would utilize the results of the assessment to improve services for clients with eating disorders in the region. The results of the needs/resource assessment suggested that there were a large number of individuals in the region who currently suffer from an eating disorder but have not sought treatment. In addition, several specialized services for the treatment of these disorders were found to be absent and the extant services insufficient in relation to estimated service needs. Finally, the assessment indicated a lack of professional and agency networking in treating these disorders. Apart from facilitating the utilization of the results of the assessment through the development of a task force, the networking/health education conference also facilitated the education of community professionals and encouraged networking of services. Presently the task force consists of twelve committed individuals, including professionals from a wide range of disciplines and two recovered bulimics. The groups is currently in the process of applying for funding and seeking sponsorship for an eating disorders resource center in the region which would encourage those afflicted with the disorders to seek treatment, provide referrals to professionals who are capable of treating the disorders, provide self help groups for sufferers, facilitate networking of services and the education of community professionals, and employ preventative/educational interventions in the region

Merging human becoming theory and health coaching principles into the role of the family nurse practitioner

Family Nurse Practitioners have limited time with patients to address their health care concerns. Practitioners need to make the most of this limited time in order to promote positive patient outcomes. Health coaching is a proven method to assist others in identifying obstacles, prioritize what is important to them, leverage strengths, and in making healthy behavior changes. Drawing on evidenced-based practice in health coaching assists the Family Nurse Practitioner with making deeper connections with patients and guides in co-creating a plan that is truly patient-centered. The health coaching process is in parallel with the Human Becoming Theory by the use of presence, suspending judgement, bearing witness to patients\u27 stories, and originating results. Health coaching and Human Becoming Theoty lift up the lived experience of the patient, placing them in control, elevating their sense of agency. Blending Human Becoming Theory with hearth coaching principles serves as a foundation to create a new model of practice and a paradigm shift with how Family Nurse Practitioners interact with patients to achieve optimal patient outcomes

RELATIONSHIPS BETWEEN ABUNDANCE OF PHYSICALLY COMPLEX HABITAT AND BENTHIC MACROINVERTEBRATE COMMUNITY PARAMETERS IN THE JAMES RIVER, NELSON COUNTY, VA

This study shows the importance of structurally complex habitat on abundance and diversity of organisms in a benthic macroinvertebrate community in the James River, Nelson County, Virginia. Structural complexity was manipulated by attaching stones to five concrete blocks (12.8 ± 0.97% coverage; mean ± SE) and comparing organism abundance on these blocks and blocks lacking stones (0% coverage). Concrete blocks were randomly placed at a site in the James River on November 14, 1999 and collected on December 12, 1999. Macroinvertebrates and particulate organic and inorganic matter on the blocks were collected. Total invertebrate abundance, abundance of eight individual taxa, taxonomic richness, and particulate organic and inorganic matter mass were greater in the low-coverage treatment then the control treatment. The increase in the particulate organic and inorganic matter in the low-coverage treatment likely provided the major resources for the invertebrates that positively responded. The slight increase in physical structure in the low-coverage treatment provided the organisms with refuge from predators and natural disturbances, as well as increased habitat variety . Physical structural complexity is an important habitat quality that is able to regulate organism distribution, abundance, and diversity. This study could be an effective model to predict habitat changes and promote efficient management of a variety of natural resources in many ecosystems

Development and Evaluation of an Internet-Based Airway Evaluation Tutorial

Airway evaluation and basic management are essential skills for all physicians. Identifying patients for whom mask ventilation or endotracheal intubation will be difficult to impossible is vital for patient safety. Despite this, training in airway evaluation is minimal in the curricula of most medical schools. To ensure a thorough understanding of airway anatomy and evaluation, as well as exposure to various abnormal findings, we developed an Internet-based module including interactive components, graphics, animation, video, and a self-assessment tool. The site received more than 1800 visits in its first nine months of operation, with uniformly laudatory comments. Eighty subjects over a six-month period completed a pre- and post-test quiz structured to evaluate the utility of the site. Of those completing the on-line survey, more than 76% rated the site very useful. Most felt their knowledge of airway examination improved after completion of the site (p<0.00004). The median amount of time spent on the site was 29.5 minutes. Judging from the overwhelming response to this site from around the world and across disciplines, such interactive training tools that exploit the technological capabilities of the Internet provide useful adjuncts to traditional teaching methods

AMBIVALENCE OVER EMOTIONAL EXPRESSION AND PAIN SENSITIVITY: A CROSS-CULTURAL COMPARISON

Pain is universally understood and frequently experienced. It is a complex phenomenon with multidimensional aspects, making it a highly subjective experience. Its prevalence and impact on socio-ecological levels are likely to continue increasing. Yet, most of what we comprehend about pain comes from a biomedical standpoint, leaving gaps in the full understanding of pain from a broader biopsychosocial perspective. Thus, it is imperative to expand the scope of knowledge of pain and its underlying mechanisms. With more insight into the range of experiences of pain, the hope is for better prevention and treatment of painful conditions – that are better personalized and culturally relevant – in the future. The objectives of this study were to gather a better understanding of the associations of the pain experience from a psycho-socio-emotional perspective. More specifically, with a focus on the variables of pain sensitivity (PS) and ambivalence over emotional expression (AEE), embedded within the context of culturally distinct self-identified values (VS), and the extent to which these associations differ cross-culturally. Responses were obtained from participants via a series of questionnaires online in Singapore (Sample 1) and the United States (Sample 2), forming two culturally separate samples. The measures used per the variables of interest were scores from the Asian Values Scale-Revised, Ambivalence over Emotional Expression, and Pain Sensitivity Questionnaire. The responses were analyzed and compared using SPSS with univariate analysis of variance and linear regression. Results showed mixed findings and patterns of observation. Levels of AEE were significantly higher in Sample 1, F(1, 67) = 2.98, p = .09, to a medium effect size, and Sample 1 consistently scored higher on levels of PS. The samples endorsed opposite directions of associations for VS and PS, while endorsing similar directions in associations for VS and AEE. Patterns of associations between AEE and PS varied depending on the samples. The overall relations among variables may be more complex than originally conceptualized. Several factors and limitations that might have influenced the outcome were discussed, along with considerations for refinement of future research directions

A combination of a physiotherapy and cognitive behavioural therapy in the treatment of non-specific chronic lower back pain: A systematic review

Magister Scientiae (Physiotherapy) - MSc(Physio)Evidence indicates that the current physiotherapy management of patients with chronic non-specific LBP only offers moderate benefit. Combined treatment programmes, addressing body as well as the mind, shows promising results in developed countries with adequate resources but low evidence in poorly-resourced countries and contexts. This is another gap in the existing knowledge. The study aimed to evaluate the effectiveness of a combined physiotherapy and cognitive-behavioral therapy treatment, compared to physiotherapy alone, in reducing pain, disability, mental health and fear-avoidance behavior, in adults with non-specific low back pain. The systematic review included articles published, in English only, between 1985-2018 (July) in the following databases available at the University of The Western Cape: EbscoHost, BioMedCentral, Cambridge Journals Online, CINAHL, Cochrane Library, Medline (EbscoHost), Medline (Pubmed), Sabinet Reference, SAGE Journals Online, ScienceDirect,SciFinder Scholar, SCOPUS, Wiley Online Library, Springerlink and PubMed.Two reviewers independently evaluated the methodological quality of full text articles, using a critical appraisal tool. Fourteen (14) articles were included based on methodological rigour. Five (5) articles were included in the narrative synthesis and nine (9) articles were included in the meta-analyses. Statistically significant improvements in pain, disability and mental health, in favour of combination therapy for patients with chronic lower back pain were found. A small but statistically significant cumulative effect size for mental health (g = -0.26, Z = -4.49, p <.01) , physical disability (g = -0.27, Z = -5.09, p <.01) and pain (g = -.27, Z = -5.05, p <.01) , in favour of a combination of cognitive behavioural therapy and physiotherapy in patients with chronic lower back pain was found. In addition, a medium but statistically significant cumulative effect size (g = -0.50, Z = -6.95, p <.01), in terms of fear avoidance, was found in favour of the combination therapy. In conclusion, physiotherapy in combination with cognitivebehavioral therapy was more effective than physiotherapy alone, in reducing pain, disability, mental health and fear-avoidance behaviour, in adults with non-specific low back pain. Ethics: Permission for the study was obtained from the university’s Biomedical Research Ethics Committee

Predicting Certification Success for the Family Nurse Practitioner

High-stakes licensure or certification examinations are required for many health professions disciplines to ensure safe entry-level practice. Accrediting agencies set a benchmark for graduates\u27 first-time licensure or certification success as a measure of program effectiveness. Failures of graduates on licensure or certification examinations may directly affect the school\u27s recruitment and retention of qualified students and faculty, as well as institutional financial viability. A health science university has added Health Education System, Inc. (HESI) standardized examinations using computer adaptive testing into the family nurse practitioner (FNP) master\u27s program to support certification success, although research on these advanced practice examinations as related to certification outcomes was lacking. Guided by classical test theory, this study was an investigation of whether a relationship existed between students\u27 performance on 4 HESI standardized examinations (Advanced Pathophysiology, Advanced Pharmacotherapeutics, Advanced Health Assessment, and the APRN/FNP Exit exam) and first-time FNP certification success. Binary logistic regression analysis of data from 117 students who graduated between 2013-2016 indicated that none of the 4 standardized HESI examinations significantly predicted FNP certification success, perhaps due to the examinations not carrying any evaluative weight within the program. The results of this project study may be used to promote positive social change by providing a means to improve first-time certification success and increasing the availability of primary care providers in the role of FNP

Link Between Monitoring Behavior and Adolescent Adjustment: Examination of Mediation Effects

The purpose of this cross-sectional study was to examine the link between monitoring behavior (parental solicitation, child disclosure, parental involvement,) and adolescent adjustment (antisocial behavior, substance use, academic achievement) and whether this link was mediated by parent-child relationship quality and parental knowledge. The sample consisted of 206 families with adolescent who participated in the Family and Youth Development Project. The results indicate that high levels of child disclose and parental involvement were associated with low levels of antisocial behavior and high levels of academic achievement. In addition, following the criteria of Baron and Kenny (1986), parental knowledge and parent-child relationship quality were found to fully mediate the link between monitoring behavior and adolescent adjustmentDepartment of Psycholog

Depression among health care students in the time of COVID-19: The mediating role of resilience in the hopelessness–depression relationship

COVID-19 spread rapidly across the world, and by March 2020, the first case of COVID-19 was identified in South Africa. Lockdown-related measures such as restricted movement and isolation were implemented to contain the virus. Combined with these measures, factors such as economic decline, job losses, and food shortages can cause numerous mental health sequelae such as depression. Feelings of hopelessness and helplessness as well as cases of suicide have been reported around the world due to the pandemic and the associated feelings of anxiety and depression. The aims of this study were to investigate levels of hopelessness and depression in a sample of health care students. A random sample of students (N=174) enrolled in a health sciences programme at the University of the Western Cape completed the Beck Hopelessness Scale, the Center for Epidemiological Studies Depression Scale, and a three-item Resilience Scale. The results revealed high levels of hopelessness and depression compared to previously reported normative data for these scales. In addition, the indirect effects of hopelessness on depression were significant, demonstrating the mediating role of resilience in the hopelessness–depression relationship