A qualitative investigation of masculine identity after traumatic brain injury

Men are twice as likely as women to experience a traumatic brain injury (TBI), suggesting that aspects of masculine identity contribute to how people acquire their brain injuries. Research also suggests that masculine identity impacts on how people manage their health experiences. The current study aimed to explore the experience of masculine identity following TBI. Individual interviews were conducted with 10 men aged 21–67 years who had experienced a TBI. All were living in the community. Interpretative phenomenological analysis was used to consider lived experiences and to explore the meaning of the TBI experience in relation to masculine identity. Three superordinate themes emerged from the analysis: doing life and relationships differently, self-perceptions and the perceived view of others, and managing the impact of TBI as a man. These themes are considered in relation to how participants' experiences interacted with dominant social ideals of masculine identity. The findings highlighted how masculine identity may be a valuable aspect of self in considering threats to and reconstruction of self-identity after TBI. Aspects of gender identity should be considered in order to promote engagement, support adjustment and achieve meaningful outcomes in rehabilitation

The relationship between adolescent rumination and maternal rumination, criticism and positivity

Rumination predicts depression in adults and adolescents. The development of rumination has been linked to parenting practices, but only limited research has investigated this and research has tended to rely on self-report parenting measures. To investigate the relationship between female adolescent rumination and maternal modelling, criticism and positivity using an observational measure of parental behaviour. A cross-sectional design was used. Daughters aged 16-18 years and their mothers (n = 154 dyads) completed questionnaire measures of rumination and affect. Mothers of girls with rumination scores in the upper and lower quartile (both n = 26) also completed the Five Minute Speech Sample, which was used to measure maternal criticism and positivity. Mothers of low rumination girls made significantly more positive comments about their daughters than the mothers of high ruminators. Mothers made very few critical comments. Self-reported rumination was not correlated in mothers and daughters, suggesting a lack of support for the potential role of modelling. Overall, low maternal positivity was associated with rumination in female adolescents. There was no evidence that maternal rumination or criticism were associated with adolescent rumination. The results suggest a number of implications for future research, including the need for prospective longitudinal studies using observational parenting measures

Personal storytelling in mental health recovery

Purpose: Creating more positive individual narratives around illness and identity is at the heart of the mental health care recovery movement. Some recovery services explicitly use personal storytelling as an intervention. This paper looks at individual experiences of a personal storytelling intervention, a recovery college Telling My Story course. Design/methodology/approach: Eight participants who had attended the Telling My Story course offered at a UK recovery college were interviewed. Data were analysed using Interpretative Phenomenological Analysis. Findings: Five key themes emerged: a highly emotional experience, feeling safe to disclose, renewed sense of self, two-way process and a novel opportunity. Originality/value: The findings suggest that storytelling can be a highly meaningful experience and an important part of the individual’s recovery journey. They also begin to identify elements of the storytelling process which might aid recovery, and point to pragmatic setting conditions for storytelling interventions to be helpful. More time could be dedicated to individuals telling their story within UK mental health services, and we can use this insight into the experience of personal storytelling to guide any future developments

An Exploratory Study of Principals\u27 Attitudes Regarding the Provision of Special Education Services Using the Traditional Special Education Model Compared to Using the Response to Intervention Model

The purpose of this study was to explore the attitudes of principals regarding the provision of special education services using the traditional special education model compared to using the response to intervention model. The major research and related research questions were identified by the investigator to explore the attitudes of Illinois public elementary school principals regarding special education services, in relation to: (1) resources; (2) amount of faculty time spent; and (3) the role of the principal. The major research question and the related research question was addressed through seven survey questions, six through Likert–scaled questions and one through an open ended question. To address the research objectives, the researcher conducted a pilot test with three Illinois elementary school principals from a south suburban school district in Illinois. The sample for this study is purposeful, rather than random and is based on the attitudes of public Illinois elementary school principals. The sample is limited to 15 Illinois school districts across DuPage County, Will County and Cook County, and included 68 elementary schools across the 15 school districts. The elementary schools used in this study have student populations ranging from kindergarten (K) to eight (8) grades. Of the 68 surveys sent to this representative sample of principals, 39 were returned. The 39 respondents was a 60% response rate. The study revealed that over 90% of the majority of the 39 respondents regarding special education services attitude reflected that more resources are used for response to intervention model compared to traditional special education model. The results further indicated that the majority of the 39 respondents\u27 attitudes indicate that the amount of faculty time spent was greater in the use of the response to intervention model than in the traditional special education model. Lastly, the majority of the 39 respondents\u27 attitudes towards the role of the principal were greater in the area of response to intervention model than in the traditional special education model. Results of the study suggested the majority of Illinois elementary public school principal respondents felt their attitude towards the use of the response to intervention model is greater than their attitude towards the use of the traditional special education model

Virtual Delivery of Stress Management and Resiliency Training (SMART) During the COVID-19 Pandemic to Hematology/Oncology Fellows: A Pilot Study

Introduction: Medical trainees experience a high degree of stress that predisposes them to burnout. This pilot study tested a scalable approach to deliver a validated resilience program (Stress Management and Resiliency Training (SMART)) among Hematology/Oncology fellows at an academic medical center. Methods: This was a mixed-methods, prospective, single-arm clinical trial involving Hematology/Oncology fellows at Mayo Clinic in Rochester, MN, USA. Four one-hour training sessions were conducted virtually with 26 fellows. Stress, burnout, and emotional resilience were measured at baseline, three months, and six months post-intervention using the Perceived Stress Scale (PSS-10), Maslach Burnout Inventory (MBI-HSS), and Connor-Davidson Resilience Scale (CD-RISC2). Changes in mean scores were assessed using paired t-tests. Feasibility and acceptability data were obtained during a virtual focus group. Results: Statistically significant improvements in mean stress (p = 0.004) and professional achievement (p \u3c 0.001) were seen at three months post-intervention. At six months post-intervention, mean stress (p \u3c 0.001) and professional achievement (p = 0.032) continued to improve, while improvements in emotional exhaustion (p = 0.001) and depersonalization (p \u3c 0.001) also became significant. Focus group participants found the program beneficial and reported improved stress and work performance as a result of participation. Conclusion: Virtual implementation of the SMART program is feasible and resulted in improvements in stress and burnout. Focus group participants found the training beneficial, reporting lower stress and improved work performance

A Prospective Study of Prepregnancy Dietary Iron Intake and Risk for Gestational Diabetes Mellitus

OBJECTIVE It is important to identify modifiable factors that may lower gestational diabetes mellitus (GDM) risk. Dietary iron is of particular interest given that iron is a strong prooxidant, and high body iron levels can damage pancreatic β-cell function and impair glucose metabolism. The current study is to determine if prepregnancy dietary and supplemental iron intakes are associated with the risk of GDM. RESEARCH DESIGN AND METHODS A prospective study was conducted among 13,475 women who reported a singleton pregnancy between 1991 and 2001 in the Nurses’ Health Study II. A total of 867 incident GDM cases were reported. Pooled logistic regression was used to estimate the relative risk (RR) of GDM by quintiles of iron intake controlling for dietary and nondietary risk factors. RESULTS Dietary heme iron intake was positively and significantly associated with GDM risk. After adjusting for age, BMI, and other risk factors, RRs (95% CIs) across increasing quintiles of heme iron were 1.0 (reference), 1.11 (0.87–1.43), 1.31 (1.03–1.68), 1.51 (1.17–1.93), and 1.58 (1.21–2.08), respectively (P for linear trend 0.0001). The multivariate adjusted RR for GDM associated with every 0.5-mg per day of increase in intake was 1.22 (1.10–1.36). No significant associations were observed between total dietary, nonheme, or supplemental iron intake and GDM risk. CONCLUSIONS These findings suggest that higher prepregnancy intake of dietary heme iron is associated with an increased GDM risk

Teacher support, preparedness and resilience during times of crises and uncertainty: COVID-19 and education in the Global South

The COVID-19 pandemic has exacerbated existing education inequities, further marginalising those with poor and limited education opportunities, particularly in conflict, fragile and insecure contexts (Sayed & Singh, 2020). In the Global South, the COVID-19 pandemic compounds existing crises, frailties and inequities as the impoverished suffer food insecurity, physical conflict and crises of health and water. Drawing on research, commissioned by the Open Society Foundation and Education International, based on interviews with purposefully selected teachers’ union and government officials in eight African countries and a detailed desk-based review, the paper examines the role of teachers in education policy responses to the pandemic and the kinds of support (or lack thereof) availed to teachers. Using the conceptual framing of de Sousa Santos’ (2001,2014) sociology of absences and cognitive injustice, the paper demonstrates that teachers have been absent in policymaking processes, and have not been adequately provided with the necessary professional development and psychosocial support to navigate the uncertainties and  pedagogical requirements imposed by the COVID-19 pandemi

Access to In-Patient Stroke Services and Multidisciplinary Team (MDT) Rehabilitation: Current Demands and Capacity.

The objective of this project was to analyse the current access to in-patient stroke services and MDT rehabilitation in an acute stroke centre and to compare these services to the recommended “National Clinical Guidelines and Recommendations for the Care of People with Stroke and TIA” (IHF 2010). A retrospective chart review was carried out, recording activity statistics of all patients admitted with acute stroke over a three-month period. 73 patients (male=40, 54.8%) were included. Patients were discharged from the stroke service after a mean stay of 20.2 days (SD.= 19.3). 76.7% (N=56) of patients were admitted to the acute stroke unit (ASU). The mean length of time from admission to first assessment 3.4 days (SD.=2.68), with an average of 138 minutes of treatment received per day across all disciplines. This is compared to the IHF’s recommendation of patients being assessed within 24-48 hours of admission and receiving 180 minutes of treatment across all disciplines. As demands for stroke MDT services increase, it is important to recognise the benefits of increasing staff and resources to maintain and continue to improve standards of care

Visualization of microbe-dietary remnant interactions in digesta from pigs, by fluorescence in situ hybridization and staining methods; effects of a dietary arabinoxylan-rich wheat fraction

This study investigated how the addition of a specific hydrocolloid, arabinoxylan (AX), to the pig diets containing red meat, affected the gut microbiota in terms of changes to the bacterial community dynamics. Fluorescence in situ hybridization (FISH) was used to enumerate both broad groups and particular bacterial species, and showed systematic differences in pigs fed AX. In addition, the role of bacteria in the fermentation of dietary substrates was studied by visualizing direct associations between the bacteria and substrate particles. To achieve this, novel methods of combining histological staining or enzymatic labelling with FISH protocols were established. In this way, undigested and/or unfermented remnants of meat, endogenous mucin, and several plant cell wall hydrocolloids (cellulose, lignin and arabinoxylan) were distinguished, together with large intestine microbiota under brightfield and/or confocal laser scanning microscopy (CLSM). It was evident that no apparent direct associations occurred between specific classes or groups of bacteria and meat, mucin, lignin or AX remnants. In contrast, bacteria belonging to Clostridium clusters XIVa and XIVb formed a strong (P < 0.01) direct association with cellulose remnants in the pig digesta in the caecum

Cell trafficking through the choroid plexus

The choroid plexus is a multifunctional organ that sits at the interface between the blood and cerebrospinal fluid (CSF). It serves as a gateway for immune cell trafficking into the CSF and is in an excellent position to provide continuous immune surveillance by CD4+ T cells, macrophages and dendritic cells and to regulate immune cell trafficking in response to disease and trauma. However, little is known about the mechanisms that control trafficking through this structure. Three cell types within the choroid plexus, in particular, may play prominent roles in controlling the development of immune responses within the nervous system: the epithelial cells, which form the blood-CSF barrier, and resident macrophages and dendritic cells in the stromal matrix. Adhesion molecule and chemokine expression by the epithelial cells allows substantial control over the selection of cells that transmigrate. Macrophages and dendritic cells can present antigen within the choroid plexus and/or transmigrate into the cerebral ventricles to serve a variety of possible immune functions. Studies to better understand the diverse functions of these cells are likely to reveal new insights that foster the development of novel pharmacological and macrophage-based interventions for the control of CNS immune responses