Schreier groups and symmetric neighborhoods with a finite number of open components

The purpose of this investigation is to consider the group structure of Schreier groups for both general topological groups and euclidean space in particular where U is taken to have a finite number of components. Theorem 1 exibits a homomorphism from the Schreier group into the direct product of the underlying topological group and a specified finitely presented group with the components of U as generators. Theorem 2 shows that in euclidean space the given homomorphism is an isomorphism. Examples are given which illustrate the process laid out in Theorem 1

A Comparison of the Deck Group and the Fundamental Group on Uniform Spaces Obtained by Gluing

We de…ne a uniformity on a glued space under uniformly continuous attachment maps. If the component spaces are uniform coverable then the resulting glued space is uniform coverable. We consider examples including the glued uniformity on a …nite dimensional CW complex which is shown to be uniformly coverable. For one dimensional CWcomplexes, the resulting deck group is equivalent to the fundamental group. Other properties of the deck group are explored

Reproductive Health Needs Among Women in Treatment for Substance Use Disorder

Integrated care models for substance use disorder (SUD) and reproductive health care have been proposed as a strategy to increase access to reproductive health care for women in treatment for SUD. This cross-sectional, survey-based study measured how women of childbearing age in residential treatment report their demand for and access to reproductive health care, their pregnancy intention, contraceptive utilization and preference for integrating reproductive health care with their current SUD treatment milieu. Eighty-five percent of the women interviewed (N=108) expressed a desire to prevent pregnancy in the next year, although only one-third (33.6%) were using a form of contraception at the time of the study. The majority of women (69%) reported their preference for the integration of contraceptive care and treatment for SUD. If cost was not an issue, 28.7% of women would prefer a long acting reversible contraceptive (LARC) and 40.7% would prefer either injectables, oral contraceptive pills or patches. Improving access to reproductive health for women in treatment for SUD by integrating these services may increase uptake of all methods of contraception and would be well received by most women. Eliciting the preferences of women related to family planning and pregnancy prevention and then responding to those preferences with affordable or no cost access to contraception is a public health imperative. These practice changes stand to improve the myriad health outcomes for women and children associated with unintended pregnancy in the context of SUD

Increasing Colorectal Cancer Screening Uptake Among Hispanic/Latino Patients: A Quality Improvement Initiative

Background: In 2021, cancer (CRC) screening rates for Latino men (42%) and women (47.5%) remain well below the Health People 2020 target (70.5%). Extensive documentation of barriers for screening include language, insurance status, and other sociocultural barriers which contribute to delays in diagnosis and/or diagnosis at advanced stages of the disease, and worse health outcomes. Latinos need culturally and linguistically appropriate health promotion interventions aimed to increase CRC screening rates with any modality (FIT, Cologuard, or Colonoscopy). Methods: The Donabedian Structure-Process-Outcome (S-P-O) Model for quality improvement was used to develop and target a provider-driven, language-concordant communication interventions for Hispanic patients who were eligible for CRC screening according to the USPS Task Force Guidelines in a primary care practice in Nashville, TN. Results: Out of the 458 Latino patients who were eligible for screening between August 2021-November 2022, only 124 were seen for an annual preventative visit in which screening was ordered. Out of the 124 patients who had orders for CRC screening and received the targeted communication intervention, 85 (68.5%) completed the screening and 39 (31.5%) did not complete the screening. Of those who completed the screening, 47 were insured (55.3%) and 38 were uninsured (44.7%). Conclusion: This study shows that with targeted, linguistically appropriate provider recommendation, Latino patients agree to recommended screening at rates that approach the national benchmark. However most eligible Latino patients are not receiving the recommended screening because they underutilize annual wellness visits during which this counseling/awareness typically takes place. This highlights the need for providers to provide counseling and recommendation for routine cancer screening during any follow-up visits to increase screening uptake in this population. Keywords: Hispanic/Latinos, insured/uninsured, self-pay, colorectal cancer screening, quality improvement, provider-driven interventions, language and cultural barriers

Shared Decision Making and Decisional Conflict in Women with Postpartum Depression

Despite well documented adverse outcomes related to untreated postpartum depression, many women face difficulty accessing care. A woman’s experience of conflict related to appraising treatment options that align with both her needs and her values can contribute to delays or barriers to seeking and accessing effective treatment. Shared decision making is the cornerstone of a collaborative patient-provider relationship and has been shown to decrease patient’s experience of decisional conflict. This cross-sectional web-based survey examined the relationship between shared decision making and decisional conflict for postpartum women experiencing depressive symptoms at an urban counseling center in Nashville, TN. Data were collected between October and December 2019. Decisional conflict was measured using the Decisional Conflict Scale. Perception of shared decision making was measured using the Shared Decision-Making Questionnaire (SDMQ-9). A total of 169 women completed the online survey. Of the 121 women who reported symptoms of postpartum depression, less than half were currently engaged in care for PPD, Of the 48 women who were engaged in care, there was a significant negative correlation between shared decision making and decisional conflict, p\u3c.05, Pearson’s r = -.287. Results of this study confirm finding of existing research that many women who are experiencing symptoms of PPD are not engaging in care. However, when women engage in care that reflects the principles of shared decision-making, they experience less decisional conflict. Providers who practice shared decision making in their care of women with postpartum depression may improve treatment engagement as well as myriad health outcomes for women and children. Keywords: Postpartum Depression, Women, Decisional Conflict, Shared Decision Makin

Recommendations for Academic Programs to Best Support Occupational Therapy Students: Student Perspectives

Declining occupational therapy student mental health and well-being is well described in the literature. However, there is a lack of literature describing recommendations from the student perspective that could help academic programs as they develop and implement support programming. Involving students in the process can be beneficial as they are experts in their experiences. The purpose of this qualitative descriptive study was to describe recommendations current occupational therapy students had for their academic programs to best support them during their educational experience. The study sample consisted of 628 entry-level masters and doctoral occupational therapy students from 31 states. Participant responses to one open-ended question compromised the raw data. Data was analyzed line by line using a multi-tiered coding process. Five themes emerged from the data related to faculty/student interactions, in-classroom learning, out of classroom support, programmatic recommendations, and no recommendations. Many of the participants’ recommendations were consistent with the general recommendations found in the literature. However, occupational therapy academic programs could incorporate the participants’ recommendations into their local level programming while also highlighting occupational therapy’s distinct values. To promote student well-being, consider all contexts and factors that impact their students’ occupational performance and incorporating meaningful, occupation-based activities inside and outside of the classroom. As occupational therapy programs are successful in supporting their students, they could contribute to their university systems’ wider campus efforts highlighting the profession’s unique role in promoting health and well-being

Learn, Reflect, Practice, Discuss: A Professional Development Pilot for Clinical Nurse Educators

Abstract AIM: The aim of this project was to assess the effect of a professional development pilot on the self-efficacy among clinical nurse educators toward evaluation and assessment of students in the clinical setting. BACKGROUND: Nursing schools employ clinical nurse faculty with varied levels of experience and formal education in teaching. Positive student outcomes are dependent on the competency of their nursing faculty, yet best practices to train and support the professional growth of clinical faculty have not yet been identified. METHOD: A multi-modal professional development pilot including online-learning modules, self-reflection, practice-learning, and peer-mentoring components was designed and implemented with a small group of clinical nursing faculty (n=9). Participants were provided a survey on self-efficacy toward teaching prior to and following this professional development pilot. RESULTS: Mean scores in total self-efficacy toward teaching were somewhat increased following participation in this pilot (r = 0.246, Z = - 0.676, p = 0.499) with a pre-post survey percent change of 3.98 percent (n = 7). More notably the percent change in self-efficacy in the subscale of exam and evaluation increased by 10.98 percent (n = 7). CONCLUSION: Results suggest that this professional development pilot was successful in increasing self-efficacy toward evaluation and assessment of students in the clinical setting among clinical nurse educators

Attitudes Towards End-of-life Care: An Educational Intervention in Long-term Care

Background: Nursing assistants provide the most consistent care to dying patients in long-term care facilities; however, they receive little training to do so. Nursing assistants are significant, yet under recognized members of the health care team. Purpose: To provide a brief educational intervention to nursing assistants in long-term care facilities with a goal of increasing comfort and improving attitudes towards caring for palliative care patients. Review of Evidence: Symptom management, stress related to the role as a provider, goals of care, time limitations, and fear, are the most significant challenges nursing assistants experience. Few studies have examined education, age, and years of experience as contributing factors that may influence a nursing assistant’s attitudes towards end-of-life care. Project Design: A pre- and post-test design was used to evaluate the impact of an educational session on the attitudes of nursing assistants towards end-of-life care. Methods: A paper survey and brief educational session was provided to a convenience sample of nursing assistants in four long-term care facilities in the Southeastern United States (N=42). Results: Nursing assistants had more positive attitudes after the educational intervention (p \u3c.001, d= 0.5678). There was a potential relationship between age and attitudes (p = .105, η2= .124), however, years of experience was not a statistically significant variable (p = .642, η2= .050). Conclusion: Additional education is warranted to improve attitudes and knowledge for nursing assistants to influence overall quality of care provided to residents at end-of-life

Perceptions of Preparedness Among New Graduate Nurses: Traditional Curriculum Versus Concept-Based Curriculum

Concept-based curriculum (CBC) is a newer trend in nursing education curriculum aimed at preparing new graduates to enter the workforce as generalist nurses better suited to care for a more medically complex population. Using CBC, students are introduced to concepts in order to build conceptual understandings as they engage in knowledge and skill learning, as opposed to a traditional nursing curriculum that is taught in sections grouped by patient population and medical complexity. At a nursing school housed within a private university in the southeast, the traditional nursing curriculum was replaced with CBC in 2016. To better understand the preparedness of new graduate nurses, students graduating from both traditional curriculum and CBC curricular designs were asked about their perception of preparedness in five specific areas during their first three months of clinical practice. The results of the explanatory mixed-methods survey, which consisted of Likert scale responses and qualitative data, showed no statistically significant difference in perception of preparedness between the two groups. The outcomes of each individual curricula were not dramatically different, but the actionable data reinforces the importance of clinical learning

Knowledge and Attitudes Toward Renal Transplantation in Individuals Undergoing Transplant Evaluation

Background: The underutilization of kidney transplant as the preferred treatment for end-stage renal disease is influenced by a lack of knowledge, poor attitudes toward transplantation, and various socio-demographic characteristics amongst the patient population. Negative attitudes toward renal transplant disengages the patient from the evaluation process and often hinders their likelihood of receiving a transplant. Purpose: The purpose of this scholarly project was to determine if patients undergoing transplant evaluation had more positive attitudes and greater levels of knowledge about renal transplantation after attending a standardized educational session. Project Design: This project was a cross-sectional study that utilized a pre-test/post-test design to assess attitudes and knowledge toward renal transplant before and after an educational session. Methods: The pre- and post-surveys were distributed to a convenience sample of 341 and 115 patients, respectively, between the months of September and December 2019. Results: Exposure to kidney transplant education resulted in greater levels of knowledge (p = .019, d = 0.334). The following socio-demographic characteristics were significantly associated with more negative baseline attitude scores: end-stage renal disease duration less than one year (p = .011, R2 = 0.943) and no college education (p = .048, d = 0.382). Conclusion: More longitudinal research should be utilized to explore how level of knowledge, attitudes toward transplant, and certain socio-demographic characteristics impact a patient’s intention to pursue kidney transplant. Uncovering reasons as to why certain populations of individuals have more negative baseline attitudes toward kidney transplant may also provide clinicians with valuable information on how pre-transplant education can be tailored to meet the needs of specific populations