Land Grant Application- Williams, Nathaniel (New York)

Land grant application submitted to the Maine Land Office for Nathaniel Williams for service in the Revolutionary War.https://digitalmaine.com/revolutionary_war_mass/1395/thumbnail.jp

Assessing mental health clinicians’ intentions to adopt evidence-based treatments: reliability and validity testing of the evidence-based treatment intentions scale

Background: Intentions play a central role in numerous empirically supported theories of behavior and behavior change and have been identified as a potentially important antecedent to successful evidence-based treatment (EBT) implementation. Despite this, few measures of mental health clinicians’ EBT intentions exist and available measures have not been subject to thorough psychometric evaluation or testing. This paper evaluates the psychometric properties of the evidence-based treatment intentions (EBTI) scale, a new measure of mental health clinicians’ intentions to adopt EBTs. Methods: The study evaluates the reliability and validity of inferences made with the EBTI using multi-method, multi-informant criterion variables collected over 12 months from a sample of 197 mental health clinicians delivering services in 13 mental health agencies. Structural, predictive, and discriminant validity evidence is assessed. Results: Findings support the EBTI’s factor structure (χ2 = 3.96, df= 5, p = .556) and internal consistency reliability (α = .80). Predictive validity evidence was provided by robust and significant associations between EBTI scores and clinicians’ observer-reported attendance at a voluntary EBT workshop at a 1-month follow-up (OR = 1.92, p \u3c .05), self-reported EBT adoption at a 12-month follow-up (R2 = .17, p \u3c .001), and self-reported use of EBTs with clients at a 12-month follow-up (R2 = .25, p \u3c .001). Discriminant validity evidence was provided by small associations with clinicians’ concurrently measured psychological work climate perceptions of functionality (R2 = .06, p \u3c .05), engagement (R2 = .06, p \u3c .05), and stress (R2 = .00, ns). Conclusions: The EBTI is a practical and theoretically grounded measure of mental health clinicians’ EBT intentions. Scores on the EBTI provide a basis for valid inferences regarding mental health clinicians’ intentions to adopt EBTs. Discussion focuses on research and practice applications

Feasibility and Acceptability of Two Incentive-Based Implementation Strategies for Mental Health Therapists Implementing Cognitive-Behavioral Therapy: A Pilot Study to Inform a Randomized Controlled Trial

Background: Informed by our prior work indicating that therapists do not feel recognized or rewarded for implementation of evidence-based practices, we tested the feasibility and acceptability of two incentive-based implementation strategies that seek to improve therapist adherence to cognitive-behavioral therapy for youth, an evidence-based practice. Methods: This study was conducted over 6 weeks in two community mental health agencies with therapists (n = 11) and leaders (n = 4). Therapists were randomized to receive either a financial or social incentive if they achieved a predetermined criterion on adherence to cognitive-behavioral therapy. In the first intervention period (block 1; 2 weeks), therapists received the reward they were initially randomized to if they achieved criterion. In the second intervention period (block 2; 2 weeks), therapists received both rewards if they achieved criterion. Therapists recorded 41 sessions across 15 unique clients over the project period. Primary outcomes included feasibility and acceptability. Feasibility was assessed quantitatively. Fifteen semi-structured interviews were conducted with therapists and leaders to assess acceptability. Difference in therapist adherence by condition was examined as an exploratory outcome. Adherence ratings were ascertained using an established and validated observational coding system of cognitivebehavioral therapy. Results: Both implementation strategies were feasible and acceptable—however, modifications to study design for the larger trial will be necessary based on participant feedback. With respect to our exploratory analysis, we found a trend suggesting the financial reward may have had a more robust effect on therapist adherence than the social reward. Conclusions: Incentive-based implementation strategies can be feasibly administered in community mental health agencies with good acceptability, although iterative pilot work is essential. Larger, fully powered trials are needed to compare the effectiveness of implementation strategies to incentivize and enhance therapists’ adherence to evidence-based practices such as cognitive-behavioral therapy

Steam Men, Edisons, Connecticut Yankees: Technocracy and Imperial Identity in Nineteenth-Century American Fiction

This dissertation analyzes the representation of technology in U.S. popular fiction of the nineteenth century, particularly as it relates to concepts of imperial expansion that shore up the period's constructions of American identity. The proto-science fiction works of Edgar Allan Poe, Edward S. Ellis, Luis Senarens, Mark Twain, Pauline Hopkins, and Garrett P. Serviss all imagine technology's ability to facilitate expansion and construct an American technocratic ideal. As these dime novels and popular works establish the dominant template for the portrayal of technologically enhanced exploration, they articulate two mutually reinforcing narratives tied to U.S. empire-building and power. First, these works imagine scenarios in which technology enables the same kind of travel and violent conquest found in imperialism, but develops such ideas into a recurring motif that frequently resists or complicates outright jingoism or nationalism. Second, they consider the role that technologically enhanced exploration plays in supporting a broader U.S. imperial identity, frequently by reiterating earlier, prevailing articulations regarding what it meant to be American. What begins as a narrative that imagines the possibilities of technology becomes a means to imagine scenarios in which prevailing views of race, religion, and history can be examined and reasserted

Cannabinoid Receptor 2 Expression and its Role in Echinacea Signaling

Echinacea, a commonly used herbal supplement, is publicized for its antioxidant and immunostimulatory properties. It has been used to treat the common cold and upper respiratory infections but has more recently been touted as a potential target for chemotherapeutic treatment. Echinacea is believed to work through the cannabinoid receptor 2 (CBR2), a G-protein coupled receptor primarily expressed in inflammatory and immune-competent cells. Activation of CBR2 is believed to induce the MAPK pathway as well as increase levels of cAMP. Recent research has shown tumor expression of CBR2 which has been correlated to a decreased patient prognosis though the cellular pathway has not yet been elucidated. This study was designed to gain a clearer understanding of the relationship between Echinacea, the cell cycle and CBR2. To assess the effect of Echinacea on cell growth, HeLa and human diploid fibroblast (HDF) cells were seeded and treated for 24 hours with 0, 25, 50 or 100 ug/ml of the water solubilized extract. The effect on cyclin A, cyclin E levels was assessed using the luciferase reporter assay. Additionally the presence of the CBR2 receptor was determined by using immunofluorescence and immunoblot analysis. Our results show that cyclin activity appeared to be positively correlated to tumor cell proliferation following increased treatments of Echinacea. Expression of CBR2 was visualized using immunofluorescence and accumulated protein levels were assessed by imunoblot analysis. CBR2 was detected in both cell lines at varying levels. With these results it is hypothesized that the Echinacea may be activating CBR2 and inducing the MAPK pathway. In turn, the MAPK pathway activated the cyclins and caused increased cell proliferation

A Repeated Cross-Sectional Study of Clinicians’ Use of Psychotherapy Techniques During 5 Years of a System-Wide Effort to Implement Evidence-Based Practices in Philadelphia

Background: Little work investigates the effect of behavioral health system efforts to increase use of evidence-based practices or how organizational characteristics moderate the effect of these efforts. The objective of this study was to investigate clinician practice change in a system encouraging implementation of evidence-based practices over 5 years and how organizational characteristics moderate this effect. We hypothesized that evidence-based techniques would increase over time, whereas use of non-evidence-based techniques would remain static. Method: Using a repeated cross-sectional design, data were collected three times from 2013 to 2017 in Philadelphia’s public behavioral health system. Clinicians from 20 behavioral health outpatient clinics serving youth were surveyed three times over 5 years (n = 340; overall response rate = 60%). All organizations and clinicians were exposed to system-level support provided by the Evidence-based Practice Innovation Center from 2013 to 2017. Additionally, approximately half of the clinicians participated in city-funded evidence-based practice training initiatives. The main outcome included clinician self-reported use of cognitive-behavioral and psychodynamic techniques measured by the Therapy Procedures Checklist-Family Revised. Results: Clinicians were 80% female and averaged 37.52 years of age (SD = 11.40); there were no significant differences in clinician characteristics across waves (all ps \u3e .05). Controlling for organizational and clinician covariates, average use of CBT techniques increased by 6% from wave 1 (M= 3.18) to wave 3 (M= 3.37, p = .021, d = .29), compared to no change in psychodynamic techniques (p = .570). Each evidence-based practice training initiative in which clinicians participated predicted a 3% increase in CBT use (p = .019) but no change in psychodynamic technique use (p = .709). In organizations with more proficient cultures at baseline, clinicians exhibited greater increases in CBT use compared to organizations with less proficient cultures (8% increase vs. 2% decrease, p = .048). Conclusions: System implementation of evidence-based practices is associated with modest changes in clinician practice; these effects are moderated by organizational characteristics. Findings identify preliminary targets to improve implementation

Organizational Culture and Climate Profiles: Relationships with Fidelity to Three Evidence-Based Practices for Autism in Elementary Schools

Background: Implementation researchers have typically studied organizational culture and climate by testing whether individual dimensions are linked to the implementation of evidence-based practices (EBPs) rather than examining how the overarching social context influences implementation. This approach may limit implementation theory and strategy development to the extent that individual dimensions of culture and climate interact, mutually reinforce or counteract one another, or exhibit non-linear relationships. This study tests whether empirically identifiable culture and climate profiles emerge in a sample of organizations and examines how these profiles relate to EBP fidelity and work attitudes that support EBP sustainment, focusing on three EBPs for youth with autism delivered in schools as an example. Methods: The study included 65 elementary schools in the U.S. that implemented three EBPs—discrete trial training, pivotal response training, and visual schedules—for youth with autism. Organizational culture and climate and work attitudes were assessed using the Organizational Social Context measure at the beginning of the school year. Observations of EBP fidelity occurred mid school-year. We used bias-adjusted stepwise latent profile modeling to (1) identify subpopulations of schools that share similar culture and climate profiles, and (2) test for mean differences across profiles in observed EBP fidelity and teacher and staff work attitudes. Results: Controlling for region, four profiles best characterized the organizational cultures and climates of schools. Teachers and staff in schools with a comprehensive profile (high proficiency culture, positive climate) exhibited higher fidelity to two of three EBPs (d’s = .95 to 1.64) and reported superior work attitudes (d’s = .71 to 1.93) than teachers and staff in all other schools. Teachers and staff in supportive schools (low rigidity culture, positive climate) had better work attitudes, but not better fidelity, than those in schools with indifferent (low culture/climate, elevated stress) and constrained (high rigidity and resistance, high stress) profiles. Conclusions: Organizational culture and climate profiles are a strong predictor of EBP fidelity and work attitudes that support EBP sustainment, highlighting the importance of an organization’s overarching social context when developing implementation theory and strategies. Strategies that foster a comprehensive profile may improve EBP implementation

Design and Implementation of a Fixture for Robotic Welding

The Cal Poly IME department recently purchased a robotic welder. The faculty would like to see this robot incorporated into the welding class. The robot was capable of moving, but was not able to perform a weld prior to this project. This problem is addressed by creating a demonstration part for the welding class. The objectives that need to be complete for this to be possible is designing a part, designing a fixture, analyzing the cost of robotic welding, and implement welding the part in the class. The part is designed with specific requirements in mind. The fixture is designed using an approach from “A Review on Design of Fixtures.” The results of this project are a completed part and fixture. There were several issues that occurred when fabricating the fixture. This resulted in a fixture that was incapable of producing parts that met the requirements. The robotic welding process is shown to be impractical for this application from an economic standpoint. The robotic welder is now fully operational and with little effort can be used in the welding class

Sustainable Deimplementation of Continuous Pulse Oximetry Monitoring in Children Hospitalized with Bronchiolitis: Study Protocol for the Eliminating Monitor Overuse (EMO) Type III Effectiveness-Deimplementation Cluster-Randomized Trial

Background: Methods of sustaining the deimplementation of overused medical practices (i.e., practices not supported by evidence) are understudied. In pediatric hospital medicine, continuous pulse oximetry monitoring of children with the common viral respiratory illness bronchiolitis is recommended only under specific circumstances. Three national guidelines discourage its use for children who are not receiving supplemental oxygen, but guideline-discordant practice (i.e., overuse) remains prevalent. A 6-hospital pilot of educational outreach with audit and feedback resulted in immediate reductions in overuse; however, the best strategies to optimize sustainment of deimplementation success are unknown. Methods: The Eliminating Monitor Overuse (EMO) trial will compare two deimplementation strategies in a hybrid type III effectiveness-deimplementation trial. This longitudinal cluster-randomized design will be conducted in Pediatric Research in Inpatient Settings (PRIS) Network hospitals and will include baseline measurement, active deimplementation, and sustainment phases. After a baseline measurement period, 16–19 hospitals will be randomized to a deimplementation strategy that targets unlearning (educational outreach with audit and feedback), and the other 16–19 will be randomized to a strategy that targets unlearning and substitution (adding an EHR-integrated clinical pathway decision support tool). The primary outcome is the sustainment of deimplementation in bronchiolitis patients who are not receiving any supplemental oxygen, analyzed as a longitudinal difference-in-differences comparison of overuse rates across study arms. Secondary outcomes include equity of deimplementation and the fidelity to, and cost of, each deimplementation strategy. To understand how the deimplementation strategies work, we will test hypothesized mechanisms of routinization (clinicians developing new routines supporting practice change) and institutionalization (embedding of practice change into existing organizational systems). Discussion: The EMO trial will advance the science of deimplementation by providing new insights into the processes, mechanisms, costs, and likelihood of sustained practice change using rigorously designed deimplementation strategies. The trial will also advance care for a high-incidence, costly pediatric lung disease. Trial registration: ClinicalTrials.gov,NCT05132322. Registered on November 10, 2021

Ingredients for High and Low Quality Out-of-School Programming

poster abstractAn increasing percentage of our nation’s children are participating in some form of out-of-school time (OST) programming. One estimate reports that from 1995 to 2005, the percent of K-8 students participating in OST programs rose from six to 20 percent. One of the most prevalent forms of OST programs are after-school programs (ASPs). Traditionally, ASPs vary in terms of providers and offerings. Many are community-based or take place within schools. Activities include academics, sports, arts, enrichment, or some combination of each. As a result of this convergence of stakeholders and purposes within the after-school field, assessing program quality has been notably difficult. The purpose of the current research was to investigate the strength of school and after-school partnerships in place within six ASPs and the subsequent connection between these partnerships and after-school program quality. This mixed-methods study draws from the findings of an evaluation of a multi-site school-based after-school program in a large Midwestern city as a result of funding from a 21st Century Community Learning Centers grant. Data include program observations, staff questionnaires, site director interviews, and a student survey regarding the after-school environment. Findings reveal that programs with strong partnerships between the school day and after-school staff showed higher quality after-school program implementation. Conversely, when school day staff demonstrated avoidant behaviors near the after-school programs run in their schools, or considered them to be little more than after-school child care, afterschool programs showed lower quality implementation. In addition to identifying positive characteristics of school/after-school partnerships linked to overall program quality, an analysis matrix compiling high and low quality “ingredients” was created based upon these findings. Varying degrees of program features appeared to mediate a program’s implementation fidelity, level of student engagement, structural constraints, and overall program quality