259 research outputs found
School-Based Telehealth: Identifying Self-Perceived Barriers and Facilitators of School Nurses to Improve Telehealth Operational Methods
Teacher Education and Internship: An Evaluation of Alignment Between Preparation, Practice, and the Necessity of Engagement with Social Emotional Learning
Teacher education programs are established to create opportunities for preservice teachers to learn actively through course work and practicum experiences. This mixed methods study looked to understand preservice perceptions of their program post covid and to assess their perceived proficiency as an educator, by examining expectations placed on preservice teachers to indicate that there is a gap in their understanding of important concepts related to pedagogy and their application of best practices. The preservice teacher survey indicated a positive experience during their practicum experiences but the skill application for behavior management, flexibility, and classroom processes indicated limited experience and little empathetic understanding. The aim of this study is to reevaluate teacher education programs to better support and provide authentic opportunities for pedagogical skill development before graduation
Out of sight, out of mind: ethnic inequalities in child protection and out-of-home care intervention rates
This paper examines the interlocking roles of ethnicity and deprivation in producing inequities in the proportion of children who are subject to state child protection interventions. In contrast to the USA, ethnic inequities have had little attention in research or policy in the UK and across Europe, and administrative data are limited and methodologically weak. A study of over 10 per cent of all children on child protection plans or who were looked after in out-of-home care in England in March 2012 is reported. Children from ethnic minority categories were much more likely than 'White' children to be living in disadvantaged areas and this has to be taken into account when examining intervention rates. Controlling for deprivation and examining small subgroups of the broad ethnic categories radically alters the simple understanding that 'Black' children are overrepresented compared to White amongst children in out-of-home care, while 'Asian' children are underrepresented. While this study could not explain these patterns, it reinforces the importance of both socio-economic circumstances and ethnicity for understanding inequities in intervention rates. The evidence underlines the powerful moral and economic case for action to reduce inequities in powerful state interventions in family life, not only in England, but internationally
The marfan syndrome: Abnormal aortic elastic properties
Aortic distensibility and aortic stiffness index were measured at the ascending aorta (3 cm above the aortic valve) and the mid-portion of the abdominal aorta from the changes in echocardiographic diameters and pulse pressure in 14 patients with the Marfan syndrome and 15 age- and gender-matched normal control subjects. The following formulas were used: 1) Aortic distensibility = 2(Changes in aortic diameter)/(Diastolic aortic diameter) (Pulse pressure); and 2) Aortic stiffness index = ln(Systolic blood pressure)/(Diastolic blood pressure)(Changes in aortic diameter)/Diastolic aortic diameter. Pulse wave velocity was also measured.Compared with normal subjects, patients with the Marfan syndrome had decreased aortic distensibility in the ascending and the abdominal aorta (2.9 ± 1.3 vs. 5.6 ± 1.4 cm2 dynes-1, p < 0.001 and 4.5 ± 2.1, vs. 7.7 ± 2.5, cm2 dynes-1, p < 0.001, respectively) and had an increased aortic stiffness index in the ascending and the abdominal aorta (10.9 ± 5.6 vs. 5.9 ± 2.2, p < 0.005 and 7.1 ± 3.1 vs. 3.9 ± 1.2, p < 0.005, respectively). Aortic diameters in the ascending aorta were larger in these patients than in normal subjects, but those in the abdominal aorta were similar in the two groups. Linear correlations for both aortic distensibility and stiffness index were found between the ascending and the abdominal aorta (r = 0.85 and 0.71, respectively). Pulse wave velocity was more rapid in the patients than in the normal subjects (11.6 ± 2.5 vs. 9.5 ± 1.4 m/s, respectively, p < 0.01).Thus, aortic elastic properties are abnormal in patients with the Marfan syndrome irrespective of the aortic diameter, which suggests an intrinsic abnormality of the aortic arterial wall
Non-market strategy as a framework for exploring commercial involvement in health policy: a primer
This paper outlines the role of non-market strategy and its relevance to public health. Three broad categories of non-market activity are described: corporate political activity, Corporate Social Responsibility (CSR) and legal activity, with examples relevant to public health. The importance to public health researchers of considering business activity through a non-market lens has been outlined. Using a non-market strategy perspective can assist with understanding the commercial determinants of health and analysing the writing of the ‘rules of the game’
Increasing Advanced Care Planning in an Ambulatory Care Setting
Maine is experiencing an increasing percentage of its population being over 65 years old. Advanced Care Planning (ACP) is an important part of this aging population medical care so those ends of life preferences are known well in advance. An adult internal medicine clinic in a large academic tertiary medical center decided to create a performance improvement project that addressed ACP with embedded workflows.
The goal of this project was to have a minimum of 40% of patients 65 or older have an Advanced Care Directive or Serious Illness Conversation documented in EPIC.
Baseline metrics demonstrated that ACP discussion rates were less than 12%. A root cause analysis demonstrated several reasons for this low percentage. Several countermeasures were instituted to include a KPI that addressed intern/resident education, daily reminders at morning huddles and email reminders that ACP should be included in pre-visit planning.
In the seven months since the start of this performance improvement project, the documented ACP discussion rate increased to 22.2%.
Next steps include continued compliance monitoring, teach providers to review ACP related reports and ongoing data vigilance
Preclinical/subclinical rheumatoid arthritis-associated interstitial lung disease: misleading terms with potentially deleterious consequences
Interstitial lung disease (ILD) is a leading cause of mortality in patients with rheumatic diseases, including rheumatoid arthritis. The 5-year mortality rate is twice as high in patients with rheumatoid arthritis-associated ILD than in patients with rheumatoid arthritis without ILD. Moreover, a report showed that mortality rates in patients with disease codes for rheumatoid arthritis-associated ILD remained unchanged from 2005–18, even though the overall rheumatoid arthritis mortality rate declined during this time period. Despite the evidence that ILD contributes to premature death in rheumatoid arthritis, screening for ILD in patients with rheumatoid arthritis is not routinely performed in clinical practice and numerous questions remain regarding the management of rheumatoid arthritis-associated ILD
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