An online narrative archive of service user experiences to support the education of undergraduate physiotherapy and social work students in North East England: An evaluation study.

Background: Patient narratives are a viable process for patients to contribute to the education of future health professionals and social workers. Narratives can facilitate a deeper understanding of the self and others through self-reflection and encourage transformative learning among students. Increasingly, accounts of health and care are available online but their use in health and social work education requires evaluation. This study explored the experiences of stakeholders who contributed to, developed and used an online narrative archive, which was developed in collaboration with five universities and healthcare providers in the North East of England (CETL4HealthNE). Methods: Realistic evaluation principles were used to underpin data collection, which consisted of semi-structured interviews, a focus group and observations of educators using narrative resources in teaching sessions with different professional groups in two universities. Participants included educators, storytellers, narrative interviewers, students and a transcriber. Data were analysed thematically by two researchers and verified by a third researcher. Findings: Stakeholders reported that listening to patient narratives was challenging. The process of contributing the story was a positive cathartic experience for patients, and the powerful storyteller voice often evoked empathy. Students commented on the ability of the online audio-visual narratives to enable them to see the patient holistically, and educators reported that narratives provided a means to introduce sensitive topics. Conclusions: The use of a locally generated online narrative archive is beneficial for storytellers, students and educators, providing an opportunity to influence healthcare professional training. Care needs to be taken when exposing individuals to potentially sensitive narratives

The Effects of Fatigue on Balance in Individuals with Parkinson\u27s Disease: Influence of Medication and Brain-Derived Neurotrophic Factor Genotype

Background and Purpose: The purpose was to investigate the effects of fatigue on balance in individuals with Parkinson’s disease (PD). Because falls in this population can have deleterious consequences, it is important to understand the influence of fatigue and PD medications on balance. Additionally, since brain-derived neurotrophic factor (BDNF) has been shown to be related to motor performance, we explored its role in balance fatigue. Participants: 27 individuals (age= 65.4±8.1; males= 14, females= 13) with neurologist-diagnosed PD. Of the 27, 13 were genotyped for BDNF as Val/Val, 11 as Val/Met, 2 as Met/Met, and one refused genotyping. Methods: Participants were tested twice, first on medication and second off medication, one week apart. On both days, participants completed the following tests before and after a fatiguing condition: mini-Balance Evaluation Systems Test (mini-BESTest), computerized dynamic posturography (sensory orientation and motor control), functional reach, and gait spatial-temporal parameters at preferred gait speed across an instrumented walking mat. To address the primary aim of the study, a 2 (condition: pre and post) X 2 (medication: on and off) factorial ANOVA was performed for each outcome variable in each of the following domains: 1. anticipatory postural response; 2. adaptive postural responses; 3. Dynamic balance; 4. sensory orientation; and, 5. gait characteristics. For the exploratory aim, independent t-tests were conducted to compare both pre- and post-fatigue states, and on and of medication states for all of the aforementioned balance domains. Results: There were no statistically significant interactions between time (pre and post) and medication (on and off) for anticipatory postural responses, adaptive postural responses, dynamic balance, sensory orientation, or gait characteristics (ps≥.187). Participants with BDNF Met alleles were not significantly different from Val/Val participants in balance or gait (ps≥.111) and response to a fatiguing condition (ps≥.070). Discussion: The results of this study suggest that fatigue does not have a detrimental effect on balance and gait in individuals with PD. Likewise, our results were also in line with other studies that suggest that PD medications are not effective for decreasing risk of falls due to postural instability. Lastly, these results also indicate that individuals with a BDNF Met allele are not at an increased fall risk after a fatiguing condition compared to those with the Val/Val genotype

Learning Modality: Another Pebble in the Pond

Approaches for teaching reading, as found in the plethora of reading materials now available, have become increasingly diversified. Audio materials have been added to several major reading programs. Kinesthetic materials are now provided for some programs. Many authors of reading programs are now reluctant to rely on visual only cues for teaching the numerous reading skills

Federal Home Loan Bank advances and commercial bank portfolio composition

This paper considers the role of Federal Home Loan Bank (FHLB) advances in stabilizing their commercial bank members' residential mortgage lending activities. Our theoretical model shows that using mortgage-related membership criteria or requiring mortgage-related collateral does not ensure that FHLB advances will be put to use for stabilizing members' financing of housing. Using panel vector autoregression (VAR) techniques, we estimate recent dynamic responses of U.S. bank portfolios to FHLB advance shocks, bank lending shocks, and macroeconomic shocks. Our empirical findings suggest that FHLB advances are just as likely to fund other types of bank credit as to fund single-family mortgages.

Integrating Reading And Writing Lessons

In American schools reading and Writing are usually taught as separate subjects in the curriculum. This has been a convenient way to organize instruction even though for more than a century educators have advocated their integration. Research and pedagogy on integrating reading and writing (Chomsky, 1970; Loban, 1976; Smith, 1982) suggest the facilitating effects of reading practice upon writing practice, and of writing practice upon reading skills (Applebee, 1977; p. 536). Such proclamations have let to renewed interest and quests on the part of curriculum developers to design instructional programs that highlight relationships between expressive and receptive language skills

Negative emotional reactivity as a marker of vulnerability in the development of borderline personality disorder symptoms

Negative emotionality is a distinguishing feature of borderline personality disorder (BPD). However, this person-level characteristic has not been examined as a marker of vulnerability in the development of this disorder. The current study utilized a multi-method approach to examine the interplay between negative emotional reactivity and cumulative exposure to family adversity on the development of BPD symptoms across three years (ages 16–18) in a diverse, at-risk sample of adolescent girls (N=113). A latent variable of negative emotional reactivity was created from multiple assessments at age 16: (1) self-report, (2) emotion ratings to stressors from ecological assessments across one week, and (3) observer-rated negative affectivity during a mother-daughter conflict discussion task. Exposure to family adversity was measured cumulatively between ages 5 and 16 from annual assessments of family poverty, single parent household, and difficult life circumstances. Results from latent growth curve models demonstrated a significant interaction between negative emotional reactivity and family adversity, such that exposure to adversity strengthened the association between negative emotional reactivity and BPD symptoms. Additionally, family adversity predicted increasing BPD symptoms during late adolescence. These findings highlight negative emotional reactivity as a marker of vulnerability that ultimately increases risk for the development of BPD symptoms

Deliberate clinical inertia: Using meta-cognition to improve decision-making

Deliberate clinical inertia is the art of doing nothing as a positive response. To be able to apply this concept, individual clinicians need to specifically focus on their clinical decision-making. The skill of solving problems and making optimal clinical decisions requires more attention in medical training and should play a more prominent part of the medical curriculum. This paper provides suggestions on how this may be achieved. Strategies to mitigate common biases are outlined, with an emphasis on reversing a 'more is better' culture towards more temperate, critical thinking. To incorporate such an approach in medical curricula and in clinical practice, institutional endorsement and support is required

Personnel/Human Resources Management Issues Between 1927-1981: A Replication

This study represents a historical analysis of personnel/human resource topics/issues of the last 55 years. The contents of 6,412 articles published in two journals are categorized and examined Issues that have either dominated the journals or have been neglected are identified, and the importance and origination of these issues are clarified by placing them in a historical context Methodological issues of this analysis are discusse