Virginia Commonwealth University Volunteer Doula Program Training Manual

A birth doula is a specially trained birth assistant who provides emotional, psychological and physical support and care to a pregnant and/or laboring woman. In providing this care, the doula helps the laboring woman and her support person achieve their most optimal birth experience. This is typically an unmedicated birth; however, doulas may attend any birth and be of profound assistance and comfort. This curriculum was written specifically for nursing students who are being trained as lay doulas. Unique in its approach and delivery, the curriculum is written with the nursing student in mind; particularly a student who has already been exposed to courses in anatomy, physiology and basic nursing concepts. However, it can easily be used with students who have not had this exposure, or exposure to specific women’s health content. While completing the course of study does not enable the student to sit for doula certification through a nationally recognized organization, it does provide valuable insight and baseline education necessary to fulfil their role. Students trained with this curriculum are prepared to attend women experiencing low risk, anticipated vaginal birth, as well as women who experience operative vaginal delivery and cesarean section. Additionally, specialty topics such as psychosocial concerns in the childbearing family, caring for the family experiencing birth of a special needs child, and breastfeeding education and advocacy are covered. Practice tips, safety alerts, and questions for reflection are highlighted in the margins of the curriculum, as well as links to external resources which may help build the student’s body of knowledge. Key Words: Curriculum design, women’s health, doula, childbirth, student doul

ENGAGE: Guided Activity-Based Gaming in Neurorehabilitation after Stroke: A Pilot Study

Introduction. Stroke is a leading cause of disability in healthy adults. The purpose of this pilot study was to assess the feasibility and outcomes of a novel video gaming repetitive practice paradigm, (ENGAGE) enhanced neurorehabilitation: guided activity-based gaming exercise. Methods. Sixteen individuals at least three months after stroke served as participants. All participants received concurrent outpatient therapy or took part in a stroke exercise class and completed at least 500 minutes of gaming. Primary baseline and posttest outcome measures included the Wolf motor function test (WMFT) and the Fugl-Meyer assessment (FMA). ENGAGE uses a game selection algorithm providing focused, graded activity-based repetitive practice that is highly individualized and directed. The Wilcoxon signed ranks test was used to determine statistical significance. Results. There were improvements in the WMFT (=0.003) and the FMA (=0.002) that exceeded established values of minimal clinically important difference. Conclusions. ENGAGE was feasible and an effective adjunct to concurrent therapy after stroke

Hand preference in the acquisition of beginning fencing skill

The purpose of this study was to investigate the relationship between hand preference and the acquisition of beginning foil fencing skill. The subjects included two classes of beginning fencing at the University of North Carolina at Greensboro in the fall semester 1974-75. The morning class had 18 subjects and the afternoon class had 14 subjects. The hand preference score for each subject was determined at the beginning of the semester by administering the Crovitz and Zener Handedness Questionnaire. The morning class subjects were assigned to use the nonpreferred hand as the fencing hand for the entire semester while the afternoon class subjects were assigned to use the preferred hand. To determine foil fencing skill, the Bower General Fencing Ability Test was administered twice during the semester. At the end of the semester, round robin tournaments were held in each class to get another indicator of fencing skill. The relationship between the hand preference scores and the fencing skill test scores was analyzed by using the Pearson product-moment method of correlation. The significance level was set at a 0.05 critical value for a two-tailed test. No correlation coefficients were found to be significant in either group

Geochemical characterization of shallow groundwater at the Cranfield aquifer and numerical simulation: Can pH and carbonate parameters be used to detect potential CO2 leakage at geological CO2 sequestration sites?

Bureau of Economic Geolog

Activated mutant NRasQ61K drives aberrant melanocyte signaling, survival, and invasiveness via a rac1-Dependent mechanism

Around a fifth of melanomas exhibit an activating mutation in the oncogene NRas that confers constitutive signaling to proliferation and promotes tumor initiation. NRas signals downstream of the major melanocyte tyrosine kinase receptor c-kit and activated NRas results in increased signaling via the extracellular signal–regulated kinase (ERK)/MAPK/ERK kinase/mitogen-activated protein kinase (MAPK) pathways to enhance proliferation. The Ras oncogene also activates signaling via the related Rho GTPase Rac1, which can mediate growth, survival, and motility signaling. We tested the effects of activated NRasQ61K on the proliferation, motility, and invasiveness of melanoblasts and melanocytes in the developing mouse and ex vivo explant culture as well as in a melanoma transplant model. We find an important role for Rac1 downstream of NRasQ61K in mediating dermal melanocyte survival in vivo in mouse, but surprisingly NRasQ61K does not appear to affect melanoblast motility or proliferation during mouse embryogenesis. We also show that genetic deletion or pharmacological inhibition of Rac1 in NRasQ61K induced melanoma suppresses tumor growth, lymph node spread, and tumor cell invasiveness, suggesting a potential value for Rac1 as a therapeutic target for activated NRas-driven tumor growth and invasiveness

What do measures of patient satisfaction with the doctor tell us?

Objective: To gain an understanding of how patient satisfaction (PS) with the doctor (PSD) is conceptualized through an empirical review of how it is currently being measured. The content of PS questionnaire items was examined to (a) determine the primary domains underlying PSD, and (b) summarize the specific doctor-related characteristics and behaviors, and patient-related perceptions, composing each domain. Methods: A scoping review of empirical articles that assessed PSD published from 2000 to November 2013. MEDLINE and PsycINFO databases were searched. Results: The literature search yielded 1726 articles, 316 of which fulfilled study inclusion criteria. PSD was realized in one of four health contexts, with questions being embedded in a larger questionnaire that assessed PS with either: (1) overall healthcare, (2) a specific medical encounter, or (3) the healthcare team. In the fourth context, PSD was the questionnaire's sole focus. Five broad domains underlying PSD were revealed: (1) Communication Attributes; (2) Relational Conduct; (3) Technical Skill/Knowledge; (4) Personal Qualities; and (5) Availability/Accessibility. Conclusions: Careful consideration of measurement goals and purposes is necessary when selecting a PSD measure. Practice implications: The five emergent domains underlying PSD point to potential key areas of physician training and foci for quality assessment

Bridging the divide between intuitive social-ecological value and sustainability in the Manica Highlands of southern Africa (Zimbabwe-Mozambique)

Southern African mountains remain poorly studied as social-ecological systems (SES) and are poorly represented in the global mountain discourse. However, these mountains provide essential ecosystem services (ES) that underpin local and regional development. Quantitative data on ES, their representation in policy, and the political will for sustainable management are limited. We demonstrate this using the Manica Highlands (MH; Zimbabwe—Mozambique): benefiting one million immediate and five million downstream beneficiaries, the seven identified ES are supported in the literature but lack recent quantitative data needed to persuade policymakers for action to promote sustainability. The ES are most at risk from mining, alien invasive species, rapid land transformation, and climate change – yet fine-scale quantitative data to inform mountain-specific policy on these are also lacking. We recommend a ‘science to policy to action’ agenda for the MH, but highlight that the greatest challenge to achieving sustainability is a lack of effective governance; therefore it may be difficult to change ‘immediate benefits’-thinking to higher ideals that would render the ES of the MH sustainable. As a result, academics, civic society, policy makers and governance instruments should work closely together to quantify the value of the MH, and to formulate specific policy for the MH.Travel and workshops (2015) were supported by the Swiss National Science Foundation (SNF; Grant No. IZ07Z0_160871), and a draft manuscript was supported by a South African National Research Foundation post-doctoral fellowship for VRC (2014–2016). The manuscript was completed with support from a University of the Free State (UFS) Afromontane Research Unit Post-doctoral Fellowship (for JDD), and publication costs were covered by the UFS.http://www.elsevier.com/locate/ecoser2020-10-01hj2019Plant Production and Soil Scienc

Public–private partnership in higher education provision in Tanzania: implications for access to and quality of education

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