What is the prognostic value of stress echocardiography for patients with atypical chest pain?

Patients with atypical chest pain and no history of cardiovascular events (coronary artery disease, unstable angina, or history of percutaneous transthoracic coronary angioplasty [PTCA]) and a negative stress echocardiography test are unlikely to experience a cardiovascular event in the next 1 to 4 years. However, the positive predictive value of the test in this population is low, indicating that a positive stress echocardiography is less useful for prognostic purposes (strength of recommendation: B, based on multiple cohort studies)

Developing a Service-Learning Student Facilitator Program: Lessons Learned

The Service-Learning Student Facilitator Program originated from the first author who was engaged in service learning and sought to transform her ideas into a sustainable project that could be reproduced annually. The purpose of this program was to train and certify students as facilitators so that they could assist faculty members in implementing service-learning experiences in their courses in various disciplines across the campus. Student participants became effective leaders of service-learning projects, developed great respect for the methods of service-learning, and expressed a desire for a deeper understanding of its theoretical basis. Their feedback, along with lessons learned, helped shape training in subsequent semesters. These lessons, which are shared, are valuable to those planning to develop similar programs in their universities

Informing Policy on Volunteer Service Through Agency-Based Evaluations

This working paper describes the evidence-based policy making process. We focus on what information is needed to inform policy development and decision-making on volunteer service and then how this information can be most effectively disseminated to policy makers, outlining a range of specific strategies. Existing volunteer service research is used as illustration. Implications are drawn for the capacity of agency staff to implement the research methods and strategies that are discussed

Enhancing Preservice Teachers' Self-Efficacy for Teaching Diverse Learners: Capturing Young Students' Attention through a Read-a-loud and Music

Abstract: The sense of efficaciousness for engaging diverse learners was examined with twenty-four pre-service teachers concurrently enrolled in a junior-level Creative Arts methods course and a field experience course with placements in K-2 general education classrooms. The pre-service teachers participated in music and literacy activities in their university class, then planned and implemented standards-based music activities in literacy lessons with their young students. In this case study, both quantitative and qualitative data were collected, including a teacher self-efficacy scale, an attitude survey, written reflections, interviews, open-ended responses, and lesson plans. Results demonstrated a significant increase in the pre-service teachers’ self-efficacy in pre-post ratings analysis and indicated that this project contributed to their efficacy for engaging and meeting needs of diverse learners in the elementary classrooms.  The pre-service teachers demonstrated proactive classroom management and reflected upon their students’ increased focus in class. The pre-service teachers indicated that their success with these types of projects encouraged them to plan for similar implementation with their future diverse learners; therefore, providing potential to positively impact their future performance. Additionally, this project emanated Scholarship of Teaching and Learning by encouraging self-reflection; examining and applying effective teaching strategies; and advancing the field of teacher education. Keywords: self-efficacy, preservice teachers, creative arts, diverse learners, Scholarship of Teaching and Learning

Variations in the California Emergency Medical Services Response to Opioid Use Disorder

Introduction: Opioids contributed to over 300,000 deaths in the United States in the past 10 years. Most research on drug use occurs in clinics or hospitals; few studies have evaluated the impact of opioid use on emergency medical services (EMS) or the EMS response to opioid use disorder (OUD). This study describes the perceived burden of disease, data collection, and interventions in California local EMS agencies (LEMSA). Methods: We surveyed medical directors of all 33 California LEMSAs with 25 multiple-choice and free-answer questions. Results were collected in RedCap and downloaded into Excel (Microsoft Corporation, Redmond WA). This study was exempt from review by the Alameda Health System - Highland Hospital Institutional Review Board. Results: Of the 33 California LEMSAs, 100% responded, all indicating that OUD significantly affects their patients. Most (91%) had specific protocols directing care of those patients and repeat naloxone dosing. After naloxone administration, none permitted release to law enforcement custody, 6% permitted patient refusal of care, and 45% directed base hospital contact for refusal of care. Few protocols directed screening or treatment of OUD or withdrawal symptoms. Regular data collection occurred in 76% of LEMSAs, with only 48% linking EMS data with hospital or coroner outcomes. In only 30% did the medical director oversee regular quality improvement meetings. Of respondents, 64% were aware of public health agency-based outreach programs and 42% were aware of emergency department BRIDGE programs (Medication Assisted Treatment and immediate referral). Only 9% oversaw naloxone kit distribution (all under the medical director), and 6% had EMS-based outreach programs. In almost all (94%), law enforcement officers carried naloxone and administered it anywhere from a few times a year to greater than 200 in one LEMSA. Conclusion: This study represents an important description of EMS medical directors' approaches to the impact of OUD as well as trends in protocols and interventions to treat and prevent overdoses. Through this study, we can better understand the variable response to patients with OUD across California

Experience Corps: Pathway to New Engagement

Experience Corps: Pathway to New Engagemen

A Case for Stipends in Volunteer Service

Long-term, intensive volunteer roles in civic service programs are often stipended, meaning volunteers receive monetary support for their time commitment that is considerably below market wages. The effect of stipends on role uptake, performance, and perceived benefits is not known. In this study, we seek to understand the role of stipends as an institutional facilitator. Using data from a longitudinal study of older adults serving in the national service program Experience Corps (N=263), we assess stipend status relative to volunteer socio-demographic characteristics, characteristics of the service experience, and volunteers’ perceived benefits. Overall, we find that stipends may promote participant diversity. Stipended older adult volunteers also serve for longer periods of time than non-stipended volunteers and their motivations for serving are as altruistic as non-stipended volunteers. Finally, stipended volunteers report higher perceived benefits of participation than non-stipended volunteers. These results suggest that stipends may promote program inclusion, efficiency, and effectiveness

Discrimination of Mild Cognitive Impairment and Alzheimer\u27s Disease Using Transfer Entropy Measures of Scalp EEG

Mild cognitive impairment (MCI) is a neurological condition related to early stages of dementia including Alzheimer\u27s disease (AD). This study investigates the potential of measures of transfer entropy in scalp EEG for effectively discriminating between normal aging, MCI, and AD participants. Resting EEG records from 48 age-matched participants (mean age 75.7 years)-15 normal controls, 16 MCI, and 17 early AD-are examined. The mean temporal delays corresponding to peaks in inter-regional transfer entropy are computed and used as features to discriminate between the three groups of participants. Three-way classification schemes based on binary support vector machine models demonstrate overall discrimination accuracies of 91.7- 93.8%, depending on the protocol condition. These results demonstrate the potential for EEG transfer entropy measures as biomarkers in identifying early MCI and AD. Moreover, the analyses based on short data segments (two minutes) render the method practical for a primary care setting