Associations Among Domestic Violence Exposure, Depressive Symptoms, and Substance Use Among Adolescent Residents of Urban Detroit

Medical Schoolhttps://deepblue.lib.umich.edu/bitstream/2027.42/149439/1/WilliamSturdavant_1.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149439/2/WilliamSturdavant_2.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149439/3/WilliamSturdavant_3.ppt

Developing Nurse and Physician Questionnaires to Assess Primary Work Areas in Intensive Care Units

The objective of the study was to develop instruments for describing and assessing some aspects of design of the primary work areas of nurses and physicians in intensive care units (ICUs). Separate questionnaires for ICU physicians and nurses were developed. Items related to individual- and unit-level design features of the primary work areas of nurses and physicians were organized using constructs found in the literature. Items related to staff satisfaction and staff use of time in relation to primarywork area designwere also included. All items and constructs were reviewed by experts for content validity and were modified as needed before use. The final questionnaires were administered to a convenience sample of 4 ICUs in 2 large urban hospitals. A total of 55 nurses and 29 physicians completed the survey. The Cronbach α was used to measure internal consistency, and factor analysis was used to provide construct-related validity. Convergent and discriminant validity were assessed through examining bivariate correlations between relevant scales/items. Analysis of variance was used to identify whether the between-group member responses were significant among the 4 units. The Cronbach α values for all except 3 preliminary scales indicated acceptable reliability. Factor analysis indicated that some preliminary scales could be partitioned into subscales for finer descriptions of the primary work areas. Correlational analysis provided strong evidence of convergent and discriminant validity of all the scales and subscales. The significance level of F-statistics showed that the units were significantly different from each other, providing evidence of more between-unit variance than within-unit variance. Therefore, the questionnaires developed in the study offer a promising departure point for rigorous description and evaluation of the primary work areas in relation to staff satisfaction and use of time in ICUs at a time when the importance of such studies is growing.This research was supported by the MacArthur Collaborative Practice Award of the School of Nursing and the University of Kansas Endowment Association, the Office of Grants and Research Award of the School of Nursing, and the General Research Fund of the University of Kansas

Sturdavantmap.jpg

Seven formations of the Upper Cretaceous Nanaimo Group sedimentary rocks are exposed on Saturna and Tumbo Islands. These formations are, from oldest to youngest, the Extension-Protection, Cedar District, DeCourcy, Northumberland, Geoffrey, Spray, and Gabriola. The rocks represent four successive cycles of deltaic sedimentation, the oldest and the youngest of which are incompletely exposed in the thesis area. A composite section of maximum thickneis for the formations exposed on Saturna and Tumbo Islands is 9, 776 feet; however, the formations vary significantly in thickness along strike. The Extension-Protection Formation, consisting of conglomerates and lithic wackes, represents the upper part of a delta complex. The lower part of the cycle is not exposed in the thesis area. The conglomerates are interpreted as having been deposited in the bed load and point bar subenvironments of highly competent streams. The sandstones overlying the conglomerates are interpreted as marine topset sands. The Cedar District Formation, the lower part of the Cedar District-DeCourcy deltaic cycle, overlies the Extension-Protection Formation with an angular discordance of about 50. The Cedar District Formation consists of repetitively interbedded and normally graded sandstones, siltstones, and mudstones, which were probably deposited as turbidites. The Cedar District strata are interpreted as delta-slope deposits. Conformably overlying and intertonguing with the Cedar District Formation are the channel-mouth bar arkosic and lithic wackes of the DeCourcy Formation. Distributary channel conglomerates overlie the marine sandstones which are in turn overlain by marine channelmouth bar sandstones. Pa leocurrent data indicate that the Cedar District-DeCourcy deltaic complex prograded in an east-southeasterly direction. The Northumberland Formation, the lower part of the Northumberland-Geoffrey deltaic cycle, conconformably overlies the DeCourcy Formation. Most of the Northumberland Formation was deposited as prodelta mudstones. However, the lower and upper parts of the formation were deposited in delta-slope environments, indicating a transition from and to the marine sandstones of the DeCourcy and Geoffrey Formations, respectively. The Geoffrey Formation intertongues with the Northumberland Formation and consists almost entirely of channel-mouth bar sandstones with local distributary channel conglomerates. The source of the sediments for the Northumberland-Geoffrey deltaic cycle was to the west or northwest. Paleocurrent data indicate that the sandstones of the Geoffrey Formation were distributed in a north to south direction around the mouths of distributary channels by longshore currents. Overlying and intertonguing with the Geoffrey Formation is the predominantly mudstone Spray Formation, most of which is not exposed in the thesis area. The Spray Formation was deposited as turbidites and/or seasonal flood deposits in a delta-slope environment. Overlying and intertonguing with the Spray Formation is the Gabriola Formation, the youngest formation exposed in the thesis area. The Gabriola Formation consists of bed load and point bar fluvial conglomerates, marine channel-mouth bar arkosic and lithic arenites, and topset conglomerates. Lithologies of the sandstones, pebble counts of the conglomerates, and sedimentary structures indicate a paleocurrent dispersal direction to the east or northeast for the Spray-Gabriola deltaic cycle. At least two major episodes of structural deformation have been recorded on Saturna Island. The first episode of structural deformations resulted in a series of north-south trending faults. The second episode of structural deformation resulted in a series of east-west trending faults and related folds (the Kulleet Syncline)

Sedimentary environments and structure of the Cretaceous rocks of Saturna and Tumbo Islands, British Columbia

Seven formations of the Upper Cretaceous Nanaimo Group sedimentary rocks are exposed on Saturna and Tumbo Islands. These formations are, from oldest to youngest, the Extension-Protection, Cedar District, DeCourcy, Northumberland, Geoffrey, Spray, and Gabriola. The rocks represent four successive cycles of deltaic sedimentation, the oldest and the youngest of which are incompletely exposed in the thesis area. A composite section of maximum thickneis for the formations exposed on Saturna and Tumbo Islands is 9, 776 feet; however, the formations vary significantly in thickness along strike. The Extension-Protection Formation, consisting of conglomerates and lithic wackes, represents the upper part of a delta complex. The lower part of the cycle is not exposed in the thesis area. The conglomerates are interpreted as having been deposited in the bed load and point bar subenvironments of highly competent streams. The sandstones overlying the conglomerates are interpreted as marine topset sands. The Cedar District Formation, the lower part of the Cedar District-DeCourcy deltaic cycle, overlies the Extension-Protection Formation with an angular discordance of about 50. The Cedar District Formation consists of repetitively interbedded and normally graded sandstones, siltstones, and mudstones, which were probably deposited as turbidites. The Cedar District strata are interpreted as delta-slope deposits. Conformably overlying and intertonguing with the Cedar District Formation are the channel-mouth bar arkosic and lithic wackes of the DeCourcy Formation. Distributary channel conglomerates overlie the marine sandstones which are in turn overlain by marine channelmouth bar sandstones. Pa leocurrent data indicate that the Cedar District-DeCourcy deltaic complex prograded in an east-southeasterly direction. The Northumberland Formation, the lower part of the Northumberland-Geoffrey deltaic cycle, conconformably overlies the DeCourcy Formation. Most of the Northumberland Formation was deposited as prodelta mudstones. However, the lower and upper parts of the formation were deposited in delta-slope environments, indicating a transition from and to the marine sandstones of the DeCourcy and Geoffrey Formations, respectively. The Geoffrey Formation intertongues with the Northumberland Formation and consists almost entirely of channel-mouth bar sandstones with local distributary channel conglomerates. The source of the sediments for the Northumberland-Geoffrey deltaic cycle was to the west or northwest. Paleocurrent data indicate that the sandstones of the Geoffrey Formation were distributed in a north to south direction around the mouths of distributary channels by longshore currents. Overlying and intertonguing with the Geoffrey Formation is the predominantly mudstone Spray Formation, most of which is not exposed in the thesis area. The Spray Formation was deposited as turbidites and/or seasonal flood deposits in a delta-slope environment. Overlying and intertonguing with the Spray Formation is the Gabriola Formation, the youngest formation exposed in the thesis area. The Gabriola Formation consists of bed load and point bar fluvial conglomerates, marine channel-mouth bar arkosic and lithic arenites, and topset conglomerates. Lithologies of the sandstones, pebble counts of the conglomerates, and sedimentary structures indicate a paleocurrent dispersal direction to the east or northeast for the Spray-Gabriola deltaic cycle. At least two major episodes of structural deformation have been recorded on Saturna Island. The first episode of structural deformations resulted in a series of north-south trending faults. The second episode of structural deformation resulted in a series of east-west trending faults and related folds (the Kulleet Syncline)

SturdavantCharlesD1976.pdf

Seven formations of the Upper Cretaceous Nanaimo Group sedimentary rocks are exposed on Saturna and Tumbo Islands. These formations are, from oldest to youngest, the Extension-Protection, Cedar District, DeCourcy, Northumberland, Geoffrey, Spray, and Gabriola. The rocks represent four successive cycles of deltaic sedimentation, the oldest and the youngest of which are incompletely exposed in the thesis area. A composite section of maximum thickneis for the formations exposed on Saturna and Tumbo Islands is 9, 776 feet; however, the formations vary significantly in thickness along strike. The Extension-Protection Formation, consisting of conglomerates and lithic wackes, represents the upper part of a delta complex. The lower part of the cycle is not exposed in the thesis area. The conglomerates are interpreted as having been deposited in the bed load and point bar subenvironments of highly competent streams. The sandstones overlying the conglomerates are interpreted as marine topset sands. The Cedar District Formation, the lower part of the Cedar District-DeCourcy deltaic cycle, overlies the Extension-Protection Formation with an angular discordance of about 50. The Cedar District Formation consists of repetitively interbedded and normally graded sandstones, siltstones, and mudstones, which were probably deposited as turbidites. The Cedar District strata are interpreted as delta-slope deposits. Conformably overlying and intertonguing with the Cedar District Formation are the channel-mouth bar arkosic and lithic wackes of the DeCourcy Formation. Distributary channel conglomerates overlie the marine sandstones which are in turn overlain by marine channelmouth bar sandstones. Pa leocurrent data indicate that the Cedar District-DeCourcy deltaic complex prograded in an east-southeasterly direction. The Northumberland Formation, the lower part of the Northumberland-Geoffrey deltaic cycle, conconformably overlies the DeCourcy Formation. Most of the Northumberland Formation was deposited as prodelta mudstones. However, the lower and upper parts of the formation were deposited in delta-slope environments, indicating a transition from and to the marine sandstones of the DeCourcy and Geoffrey Formations, respectively. The Geoffrey Formation intertongues with the Northumberland Formation and consists almost entirely of channel-mouth bar sandstones with local distributary channel conglomerates. The source of the sediments for the Northumberland-Geoffrey deltaic cycle was to the west or northwest. Paleocurrent data indicate that the sandstones of the Geoffrey Formation were distributed in a north to south direction around the mouths of distributary channels by longshore currents. Overlying and intertonguing with the Geoffrey Formation is the predominantly mudstone Spray Formation, most of which is not exposed in the thesis area. The Spray Formation was deposited as turbidites and/or seasonal flood deposits in a delta-slope environment. Overlying and intertonguing with the Spray Formation is the Gabriola Formation, the youngest formation exposed in the thesis area. The Gabriola Formation consists of bed load and point bar fluvial conglomerates, marine channel-mouth bar arkosic and lithic arenites, and topset conglomerates. Lithologies of the sandstones, pebble counts of the conglomerates, and sedimentary structures indicate a paleocurrent dispersal direction to the east or northeast for the Spray-Gabriola deltaic cycle. At least two major episodes of structural deformation have been recorded on Saturna Island. The first episode of structural deformations resulted in a series of north-south trending faults. The second episode of structural deformation resulted in a series of east-west trending faults and related folds (the Kulleet Syncline)

Exploring the Impact Factor: Medical Students Mentoring High School Students and Cultivating Cultural Humility

Purpose: Diversity at all levels of medical training remains relatively stagnant, despite efforts to address equity in medical schools. Early career-specific mentoring may address barriers to the pursuit of medical education for students underrepresented in medicine (URiM). By surveying a program that engages medical students as drivers of career-specific mentorship for URiM high school students, this study evaluates medical student mentors' experiences mentoring and seeks to develop a mentorship curriculum. Methods: The authors describe a medical student-led pipeline program, which connects medical students with URiM high school students. Medical student mentors participated in focus groups and gave written responses evaluating reasons for involvement, sociocultural attitudes, and skills needed for mentoring. Thematic analysis was applied. Results: Themes that emerged in this analysis include motivation to mentor, skills used to approach the mentoring relationship, and benefits to the mentor. Mentors felt their experiences had a high impact factor, and they employed dynamic discovery. It provided personal reward and a deeper understanding of disparities. Conclusion: Bringing medical school mentors together for peer to peer idea sharing, creating communities of practice, will help these students develop effective mentorship skills. A curriculum based on appreciative inquiry of mentors' strengths will enrich idea sharing, fostering cultural humility and avoiding burnout. Medical students involved in this program believe they gained benefits, including improving their mentorship skills, expanding their cultural humility, increasing their comfort with caring for underserved populations, and improving their ability to recognize health disparities

Mixed-methods Evaluation of an Expedited Partner Therapy Take-home Medication Program: Pilot Emergency Department Intervention to Improve Sexual Health Equity

Background: Treatment for partners of patients diagnosed with sexually transmitted infections (STI), referred to as expedited partner therapy (EPT), is infrequently used in the emergency department (ED). This was a pilot program to initiate and evaluate EPT through medication-in-hand (“take-home”) kits or paper prescriptions. In this study we aimed to assess the frequency of EPT prescribing, the efficacy of a randomized best practice advisory (BPA) on the uptake, perceptions of emergency clinicians regarding the EPT pilot, and factors associated with EPT prescribing.Methods: We conducted this pilot study at an academic ED in the midwestern US between August–October 2021. The primary outcome of EPT prescription uptake and the BPA impact was measured via chart abstraction and analyzed through summary statistics and the Fisher exact test. We analyzed the secondary outcome of barriers and facilitators to program implementation through ED staff interviews (physicians, physician assistants, and nurses). We used a rapid qualitative assessment method for the analysis of the interviews.Results: During the study period, 52 ED patients were treated for chlamydia/gonorrhea, and EPT was offered to 25% (95% CI 15%–39%) of them. Expedited partner therapy was prescribed significantly more often (42% vs 8%; P < 0.01) when the interruptive pop-up alert BPA was shown compared to not shown. Barriers identified in the interviews included workflow constraints and knowledge of EPT availability. The BPA was viewed positively by the majority of participants.Conclusion: In this pilot EPT program, expedited partner therapy was provided to 25% of ED patients who appeared eligible to receive it. The interruptive pop-up alert BPA significantly increased EPT prescribing. Barriers identified to EPT prescribing should be the subject of future interventions to improve provision of EPT from the emergency department