Selective Screening of Type 2 Diabetes for Washoe County’s Hispanic Population

Hispanic Americans with unrecognized, asymptomatic diabetes are more likely to experience poor quality of life and diabetic complications such as heart, eye and kidney disease than non-Hispanic whites of similar age. Multiple factors, such as cultural beliefs, lack of knowledge and limited access to health care, contribute to the fact that one-third of total diabetes among Hispanic Americans is undiagnosed. For Washoe County, Nevada, the actual percentage of adult Hispanics with diabetes may be almost 12%. In 2003, the Defeat Diabetes Screening Project provided three screenings targeting the Hispanic population in Reno and Sparks. Seventy-one percent of 348 screened were Hispanic. The purpose of the screenings was to identify and provide persons at high risk for diabetes with early diagnosis and health care. Defeat Diabetes identified 11 new cases of diabetes, a 32% yield that is within the historical range of 5 to 40% for selective screening

Awesome God : connecting through multisensory study and Lectio Divina of spiritual narratives

https://place.asburyseminary.edu/ecommonsatsdissertations/1765/thumbnail.jp

A Descriptive Study: The Views Of Touch As Related To Childrearing Practices Correlated With Certain Demographic Factors

This descriptive study was designed to correlate the views of touch as related to childrearing practices with certain demographic factors. The researcher hypothesized that there would be no significant difference when parent­ ing skills and abusive behavior were correlated with identified demographic variables based on the scores of the researcher-designed questionnaire. A researcher-designed survey was administered to 10 mothers who were participating in a Parents Anonymous group. Nine of the subjects had abused their child/children, while one subject stated she felt she could abuse. All subjects were natural mothers who had received prenatal care while pregnant. Seven subjects had experienced unplanned pregnancies. All stated they had a special child/children, either stubborn, spoiled, premature, or subject to illness. To test each of the null hypotheses regarding parenting skills and abusive behavior as related to age, income, race, education, employment, and marital status, the Pearson’s R and the Biserial Correlation were used. Age was the only demographic variable found to be significant at the .05 level. Because this variable was significant, the theoretical hypothesis was rejected

Benefits to Qualitative Data Quality with Multiple Coders: Two Case Studies in Multi-coder Data Analysis

Qualitative research methods contend with debates surrounding subjectivity and bias. Researchers use a variety of techniques to help ensure data trustworthiness. One such technique is to involve multiple coders in data analysis. The deliberative nature of codebook development among multiple coders produces rich data analysis that may not otherwise be achieved with a single (or even two) researcher(s). In this manuscript, we make a plea for researchers and journals to include data analysis procedures and descriptions in published literature. In addition, we illustrate minimal reporting of qualitative data analysis processes through a synthesis of 21 years of agricultural best management practice adoption literature. We present two rural agricultural case studies on multi-coder team codebook development and intercoder reliability processes specific to interviews, focus groups, and content analysis. Overall, we argue that multi-coder teams can improve data quality, and reporting data analysis procedures can mitigate implications of subjectivity in qualitative methods

Managing Careers for Ambidexterity and Organizational Alignment: Why It Matters Today to HR Practice

Today’s competitive environment increasingly calls for organizations and their employees to align competencies and individual capabilities for ambidexterity. Ambidexterity is defined as the need to exploit competencies while allowing for innovative potential. The role of human capital development, and specifically understanding how existing human resources (HR) practices may limit ambidexterity, is central to career management. While career management spans both individual and organizational interests, we approach this issue from the question of how firms can manage careers to build organizational ambidexterity. We also explore what HR professionals can do to address this issue. As part of our approach, we focus on three central and interrelated issues: (a) the role of legacy effects in HR practices, which may over- or underestimate the respective competencies and capabilities needed for exploitation and exploration; we relate this issue to “goal displacement” and the “Peter Principle”; (b) the management of psychological contracts, and how implied expectations may compromise or facilitate ambidexterity; and finally, (c) the role of social networks. Our conceptual article reviews these challenges with recommendations for HR professionals and academics

Patient empowerment: The need to consider it as a measurable patient-reported outcome for chronic conditions

Background: Health policy in the UK and elsewhere is prioritising patient empowerment and patient evaluations of healthcare. Patient reported outcome measures now take centre-stage in implementing strategies to increase patient empowerment. This article argues for consideration of patient empowerment itself as a directly measurable patient reported outcome for chronic conditions, highlights some issues in adopting this approach, and outlines a research agenda to enable healthcare evaluation on the basis of patient empowerment. Discussion: Patient empowerment is not a well-defined construct. A range of condition-specific and generic patient empowerment questionnaires have been developed; each captures a different construct e.g. personal control, self-efficacy/self-mastery, and each is informed by a different implicit or explicit theoretical framework. This makes it currently problematic to conduct comparative evaluations of healthcare services on the basis of patient empowerment. A case study (clinical genetics) is used to (1) illustrate that patient empowerment can be a valued healthcare outcome, even if patients do not obtain health status benefits, (2) provide a rationale for conducting work necessary to tighten up the patient empowerment construct (3) provide an exemplar to inform design of interventions to increase patient empowerment in chronic disease. Such initiatives could be evaluated on the basis of measurable changes in patient empowerment, if the construct were properly operationalised as a patient reported outcome measure. To facilitate this, research is needed to develop an appropriate and widely applicable generic theoretical framework of patient empowerment to inform (re)development of a generic measure. This research should include developing consensus between patients, clinicians and policymakers about the content and boundaries of the construct before operationalisation. This article also considers a number of issues for society and for healthcare providers raised by adopting the patient empowerment paradigm. Summary: Healthcare policy is driving the need to consider patient empowerment as a measurable patient outcome from healthcare services. Research is needed to (1) tighten up the construct (2) develop consensus about what is important to include (3) (re)develop a generic measure of patient empowerment for use in evaluating healthcare (4) understand if/how people make trade-offs between empowerment and gain in health status

Increased expression of programmed death ligand 1 (PD-L1) in human pituitary tumors

PURPOSE: Subsets of pituitary tumors exhibit an aggressive clinical courses and recur despite surgery, radiation, and chemotherapy. Because modulation of the immune response through inhibition of T-cell checkpoints has led to durable clinical responses in multiple malignancies, we explored whether pituitary adenomas express immune-related biomarkers that could suggest suitability for immunotherapy. Specifically, programmed death ligand 1 (PD-L1) has emerged as a potential biomarker whose expression may portend more favorable responses to immune checkpoint blockade therapies. We thus investigated the expression of PD-L1 in pituitary adenomas. METHODS: PD-L1 RNA and protein expression were evaluated in 48 pituitary tumors, including functioning and non-functioning adenomas as well as atypical and recurrent tumors. Tumor infiltrating lymphocyte populations were also assessed by immunohistochemistry. RESULTS: Pituitary tumors express variable levels of PD-L1 transcript and protein. PD-L1 RNA and protein expression were significantly increased in functioning (growth hormone and prolactin-expressing) pituitary adenomas compared to non-functioning (null cell and silent gonadotroph) adenomas. Moreover, primary pituitary adenomas harbored higher levels of PD-L1 mRNA compared to recurrent tumors. Tumor infiltrating lymphocytes were observed in all pituitary tumors and were positively correlated with increased PD-L1 expression, particularly in the functional subtypes. CONCLUSIONS: Human pituitary adenomas harbor PD-L1 across subtypes, with significantly higher expression in functioning adenomas compared to non-functioning adenomas. This expression is accompanied by the presence of tumor infiltrating lymphocytes. These findings suggest the existence of an immune response to pituitary tumors and raise the possibility of considering checkpoint blockade immunotherapy in cases refractory to conventional management

Patellar Tendonopathy in Collegiate Volleyball Athletes

Purpose: The first purpose was to identify the prevalence of patellar tendon abnormality in female collegiate volleyball players. The second purpose was to identify a potential association between kinetic measures during the drop vertical jump between those with tendon abnormality and those without in female collegiate volleyball athlete