Racial/Ethnic Disparities in Infectious Disease Hospitalizations in Arizona

Infectious disease (ID) hospitalizations in Arizona, a diverse population with nearly complete race/ethnicity data, were analyzed using the State Inpatient Database for 2005-2008. ID hospitalizations rates were calculated and compared by ID group, race/ethnicity, age, and sex. During 2005-2008, there were 383,597 ID hospitalizations reported in Arizona, resulting in an age-adjusted rate of 1498.1 per 100,000 persons. A range of racial/ethnic disparities in ID hospitalization rates were noted. Persons of Native American and black race/ethnicity had overall ID hospitalization rates higher than the rate for persons of white race/ethnicity; persons of Asian or Pacific Islander race/ethnicity had a lower rate. The lower respiratory tract infection (LRTI) hospitalization rate was the highest rate of all ID groups, followed by cellulitis and septicemia. Persons of black and Native American race had higher LRTI hospitalization rates than persons of white race. Racial/ethnic disparities persist for ID hospitalizations in Arizona. Persons of Native American and black race/ethnicity experience high age-adjusted rates of ID hospitalization. Prevention efforts should focus on high risk race/ethnicity groups and disease groups

Semester at Sea Global Studies Program

Increasing intercultural competence in students is becoming extremely important to institutions around the United States. With the current trends in higher education, study abroad programs need to address intercultural competence as a necessity for the global age (Fantini, 1995). There is no clear consensus on how intercultural competence should be defined. Despite the varied definitions, the need for preparing students for an interconnected world could not be more important. There has been a recent push for assessing intercultural competence in study abroad programs. Many institutions and organizations claim that their programs are developing global citizens and intercultural competence, but they do not describe how they are developing these competencies. Intercultural competence, for most, does not “just happen.” It must be intentionally addressed in higher education programs, experiences, and courses. The Semester at Sea (SAS) Global Studies Program (GSP) has been remodeled to support students in understanding the importance of intercultural competence on the ship and in a port. Intentionally addressing intercultural competence in co-curricular activities can provide a more comprehensive and integrated approach, while aiding students on their intercultural discovery. Successful intercultural interactions are at the heart of study abroad; therefore, it is worth investigating the criteria by which SAS in-country programs help students become more culturally sensitive and less ethnocentric. SAS believes in providing students with a hands-on field experience in-country. Thus, it is necessary to discover what kind of GSP curriculum would mirror the students’ learning outside the classroom. This expanded program will support SAS participants in further engaging in global initiatives while in-country

Can video interaction guidance improve children's participation in group work lessons?

Video Interaction Guidance (VIG) is an intervention that aims to improve communication and relationships. It is a video-based approach that involves a trained VIG professional filming, editing and reviewing film clips with a client, of their interactions with a significant other person. This thesis explores whether VIG can be used to improve pupils' participation in group work lessons, following a novel application of VIG in natural classroom settings. Study 1 aimed to determine whether there were improvements in video samples of observable classroom behaviour following VIG and to investigate participant experiences of the intervention. Participant evaluation of VIG, via focus groups, interviews and questionnaires, was positive. However, while Percentage of Data Points Exceeding the Mean (PEM) calculations of video data using a multiple baseline across participant small-N experimental design showed some degree of post-intervention changes, these were not statistically significant (p>.05) as indicated by Dugard and Todman's bootstrapped exact probability test (2011). Study 2 investigated whether the improvements reported by participants from Study 1 could be objectively observed by experienced professionals. A sample of 4 educational psychologists blind rated a random sample of pre- and post-intervention videos and identified post-intervention videos as evidencing significantly more effective examples of group work (p=.003). The criteria used in their clinical decision-making were used to inform a new video coding schedule. Re-coded observations from the sample of videos used in Study 1 were then analysed. Target pupils were found to be significantly more attentive and attuned to their peers after VIG (p=.05). While PEM scores of video data again indicated other post-intervention improvements, these were not statistically significant (p>.05). This study is unique in reporting objective, observable pupil behaviour change over the relatively short period of VIG intervention, with high levels of client satisfaction and acceptability. Methodological limitations and recommendations for future research are discussed together with key implications for practicing EPs.Video Interaction Guidance (VIG) is an intervention that aims to improve communication and relationships. It is a video-based approach that involves a trained VIG professional filming, editing and reviewing film clips with a client, of their interactions with a significant other person. This thesis explores whether VIG can be used to improve pupils' participation in group work lessons, following a novel application of VIG in natural classroom settings. Study 1 aimed to determine whether there were improvements in video samples of observable classroom behaviour following VIG and to investigate participant experiences of the intervention. Participant evaluation of VIG, via focus groups, interviews and questionnaires, was positive. However, while Percentage of Data Points Exceeding the Mean (PEM) calculations of video data using a multiple baseline across participant small-N experimental design showed some degree of post-intervention changes, these were not statistically significant (p>.05) as indicated by Dugard and Todman's bootstrapped exact probability test (2011). Study 2 investigated whether the improvements reported by participants from Study 1 could be objectively observed by experienced professionals. A sample of 4 educational psychologists blind rated a random sample of pre- and post-intervention videos and identified post-intervention videos as evidencing significantly more effective examples of group work (p=.003). The criteria used in their clinical decision-making were used to inform a new video coding schedule. Re-coded observations from the sample of videos used in Study 1 were then analysed. Target pupils were found to be significantly more attentive and attuned to their peers after VIG (p=.05). While PEM scores of video data again indicated other post-intervention improvements, these were not statistically significant (p>.05). This study is unique in reporting objective, observable pupil behaviour change over the relatively short period of VIG intervention, with high levels of client satisfaction and acceptability. Methodological limitations and recommendations for future research are discussed together with key implications for practicing EPs

The Effect of Acceptance Training on Psychological and Physical Health Outcomes in Elders with Chronic Conditions

This pilot trial investigated the short and long-term effects of Acceptance Training (ACT) intervention on acceptance, perceived health, functional status, anxiety, and depression in elders with chronic conditions living in retirement communities (RCs). The ACT intervention combined Rational Emotive Behavior Therapy with music, relaxation, and guided imagery during six weekly 2-hour sessions. Face-to-face interviews were conducted with 16 African-American and 46 White elders across four data collection points in six randomly selected RCs using well-established measures of perceived health, functional status, anxiety, and depression, and a measure of acceptance of chronic conditions adapted from a previous measure of acceptance of diabetes. While changes were found in perceived health, functional status, anxiety, and depression, the most significant changes occurred in the elders\u27 acceptance of chronic conditions immediately after the intervention (t = -2.62, P \u3c .02), and these changes persisted for 6 and 12 weeks (t\u27s = -2.74, -3.32, p\u27s \u3c .01), respectively. Although a 40% attrition rate reduced the sample size from 62 (N = 62) to 37 (N = 37), the significant increases in acceptance over time provide initial evidence for the fidelity of the ACT intervention

Health Literacy and Health Outcomes of Adults in the United States: Implications for Providers

The purpose of this paper is to explore health literacy of adults in the United States and review health outcomes as well as provider implications. Limited health literacy is a serious problem in the United States. Approximately 80 million adults in the United States have limited health literacy, which can adversely affect the quality of their health care. Poor health outcomes are associated with being health illiterate. Evidence shows that limited health literacy is associated with more hospitalizations; greater use of emergency care; lower receipt of mammography screening and influenza vaccine; poorer ability to demonstrate taking medications properly; poorer ability to interpret drug labels and health messages; and, among elderly persons, poorer overall health status and higher mortality rates. Health literacy is essential for patients to be able to take control and manage their own health. The benefits of being health literate include greater patient safety, less hospitalizations, a greater ability to care for oneself, and a greater cost savings to the healthcare system. This paper emphasizes “best practices” recommended by the World Health Organization (WHO),1 The American Medical Association (AMA),2 the Institute of Medicine (IOM),3 the Center for Disease Control (CDC),4 and the Joint Commission (JCAHO) 5 When patients, providers and communities work together to understand and improve health literacy a greater quality of life will result. Today’s health care providers are in a position to make an impact on the health illiteracy epidemic and improve the patient’s understanding about their health and outcomes

Monitoring and access management of resource roads with instrumentation

Forest transportation operations are facing challenges such as having larger road networks to manage because of dispersed harvest patterns, climate changes forcing more hauling to take place under wet road conditions, shortages of gravel, more worn-out roads without a budget to rebuild, and the use of larger heavier trucks. This provides an opportunity for the use of instrumentation with sensors and data acquisition systems to allow real-time monitoring of road conditions that, when tied to threshold values, can be used to manage access and control road operating costs. This research study will describe the link between road material and road performance as well as different types of instrumentation (how and why they are used). It will discuss a case study performed by FPInnovations that used instrumentation to test if the installation of insulation within the road structure of a weak and wet section of the road will improve road strength and performance in the spring by preventing the road from freezing and thawing. Other uses of instrumentation on resource roads will also be discussed as well as the use of instrumentation in defining start and end dates for spring thaw load restrictions (SLRs) on low-volume highways and resource roads across Canada

Prevalence of antibiotic resistance genes in the oral cavity and mobile genetic elements that disseminate antimicrobial resistance: A systematic review

The objective of this review was to assess the prevalence of antibiotic resistance genes in the oral cavity and identify mobile genetic elements (MGEs) important in disseminating them. Additionally, to assess if age, geographic location, oral site, bacterial strains and oral disease influence the prevalence of these genes. Three electronic databases (Medline, Embase and the Cochrane Library) were used to search the literature. Journals and the grey literature were also hand searched. English language studies from January 2000 to November 2020 were selected. Primary screening was performed on the titles and abstracts of 1509 articles generated. One hundred and forty-seven full texts were obtained to conduct the second screening with strict inclusion and exclusion criteria. Forty-four final articles agreed with the inclusion criteria. Half of the studies were classed as low quality. tet(M) was the most prevalent gene overall and the conjugative transposon Tn916 the most common MGE associated with antibiotic resistance genes in the oral cavity. In babies delivered vaginally, tet(M) was more prevalent, whilst tet(Q) was more prevalent in those delivered by C-section. Generally, countries with higher consumption of antibiotics had higher numbers of antibiotic resistance genes. Agricultural as well as medical use of antibiotics in a country should always be considered. Between healthy, periodontitis and peri-implantitis subjects, there was no difference in the prevalence of tet(M); however, erm(B), tet(M) and tet(O) were higher in carious active children than the non-carious group. Subjects with poor oral hygiene have more pathogenic bacteria that carry resistance genes compared to those with good oral hygiene. Enterococcus faecalis isolates demonstrated significant tetracycline resistance (tet(M) up to 60% prevalence in samples) and erythromycin resistance (erm(B) up to 61.9% prevalence in samples), periodontal pathogens showed significant beta-lactam resistance with blaZ and cfxA present in up to 90%–97% of samples and the normal oral flora had a high level of erythromycin resistance with mef(A/E) present in 65% of Streptococcus salivarius isolates. The most common resistance gene was tet(M) in root canals, cfxA in subgingival plaque, erm(B) in supragingival plaque and tet(W) in 100% of whole saliva samples. The review highlights that although many studies in this area have been performed, 50% were classed as low quality. We advise the following recommendations to allow firm conclusions to be drawn from future work: the use of large sample sizes, investigate a broad range of antibiotic resistance genes, improved methodologies and reporting to improve the quality of genetic testing in microbiology and randomisation of subject selection