3,118 research outputs found

    Sexual Trafficking: Developing a Teaching Strategy for Emergency Department Registered Nurses

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    Human trafficking is a rapidly growing problem in the United States. This multibillion dollar criminal industry denies freedom to approximately 21 to 27 million people around the world. Through coercion or withholding of an individual’s legal documents, vulnerable people are forced to perform labor or sexual acts for the benefit or personal gain of others. Over 80% of victims seek medical help during their captivity, but go unnoticed due to healthcare professional’s lack of knowledge and training on the population. This study consisted of a two-step approach. The first involved a literary review of sexual trafficking. Next, a pilot study was conducted where registered nurses in the emergency department were given an educational intervention with a pre and post-survey to monitor knowledge gained. Results showed significant knowledge gain following the educational intervention. This suggests that sexual trafficking educational interventions for registered nurses may aide in the identification and subsequent assistance for sexual trafficking victims

    Are We To Be Forever Trapped Between the Two? The Internet, Modernity, and Postmodernity in the Early 21st Century

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    Social theory has traditionally argued that the modern and the postmodern are chronologically ordered (that is, the postmodern comes after the modern) and mutually exclusive. I find, however, that contemporary American society is full of elements of both the modern/industrial and the postmodern/postindustrial. The Internet serves as an example of one social site in which these two concepts are in constant contact and often in tension. Based on an examination of the relationship between the modern/ industrial and the postmodern/postindustrial on the Internet, we can begin to determine whether or not the concepts of modern and postmodern accurately describe 21st century society

    Using stepped-care approaches within internet-based interventions for youth anxiety: Three case studies.

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    Background There are a lack of clear guidelines for the dissemination of Internet-based cognitive behaviour therapy (ICBT) for childhood and adolescent anxiety in routine care. While self-guided ICBT has greater reach than therapist-guided ICBT, it is plagued by problems of low program adherence and many young people are not successfully treated. It is important that we identify models of ICBT that are accessible, but provide the right support, at the right time to those who need it. Stepped-care models of ICBT offer one potential solution. Objective This case study examined the application of stepped-care within an ICBT intervention for childhood and adolescent anxiety, in which young people were stepped up from self-guided to therapist-guided ICBT. Methods Three case studies are presented and include young males (aged 11–12 years) who participated in BRAVE Stepped-Care, a new ICBT program incorporating two treatment steps: Step 1 – five sessions of self-guided ICBT and Step 2 – five sessions of therapist-guided ICBT. Participants completed diagnostic assessments at pre- and post-treatment, along with a battery of self-report questionnaires. Step-up requirements were determined at a mid-treatment assessment. Treatment response was determined by change on diagnostic severity and presence of diagnosis and changes in self-reported anxiety symptoms (through T-scores and Reliable Change Indices). Results In-depth examination of the three case studies showed that decisions to step-up from Step 1 to Step 2 were complex and required consideration of program engagement and adherence, as well as changes on self-reported anxiety, behavioural indicators of anxiety and parent perspectives. Results showed that non-responders at mid-treatment who were stepped-up to therapist-guided ICBT after Step 1 were able to increase engagement and response to treatment in Step 2, such that they were free of their primary anxiety diagnosis at post-treatment. Conclusions The findings highlight the importance of early assessment of engagement and non-response within self-guided ICBT programs for youth anxiety and the positive changes that can subsequently occur when therapist-guidance is introduced mid-treatment for non-responders. The efficacy of stepped-care ICBT models needs to be confirmed in larger randomised controlled trials

    Considering Vermont\u27s Future in a Changing Climate: The First Vermont Climate Assessment

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    The Vermont Climate Assessment (VCA) paints a vivid picture of a changing climate in Vermont and calls for immediate strategic planning to sustain the social, economic and environmental fabric of our state. The VCA is the first state-scale climate assessment in the country and speaks directly to the impacts of climate change as they pertain to our rural towns, cities and communities, including impacts on Vermont tourism and recreation, agriculture, natural resources and energy

    Are routinely collected NHS administrative records suitable for endpoint identification in clinical trials? Evidence from the West of Scotland coronary prevention study

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    Background: Routinely collected electronic patient records are already widely used in epidemiological research. In this work we investigated the potential for using them to identify endpoints in clinical trials.<p></p> Methods: The events recorded in the West of Scotland Coronary Prevention Study (WOSCOPS), a large clinical trial of pravastatin in middle-aged hypercholesterolaemic men in the 1990s, were compared with those in the record-linked deaths and hospitalisations records routinely collected in Scotland.<p></p> Results: We matched 99% of fatal study events by date. We showed excellent matching (97%) of the causes of fatal endpoint events and good matching (.80% for first events) of the causes of nonfatal endpoint events with a slightly lower rate of mismatching of record linkage than study events (19% of first study myocardial infarctions (MI) and 4% of first record linkage MIs not matched as MI). We also investigated the matching of non-endpoint events and showed a good level of matching, with .78% of first stroke/TIA events being matched as stroke/TIA. The primary reasons for mismatches were record linkage data recording readmissions for procedures or previous events, differences between the diagnoses in the routinely collected data and the conclusions of the clinical trial expert adjudication committee, events occurring outside Scotland and therefore being missed by record linkage data, miscoding of cardiac events in hospitalisations data as ‘unspecified chest pain’, some general miscoding in the record linkage data and some record linkage errors.<p></p> Conclusions: We conclude that routinely collected data could be used for recording cardiovascular endpoints in clinical trials and would give very similar results to rigorously collected clinical trial data, in countries with unified health systems such as Scotland. The endpoint types would need to be carefully thought through and an expert endpoint adjudication committee should be involved.<p></p&gt

    Enhanced carbon storage through management for old-growth characteristics in northern hardwood-conifer forests

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    Forest management practices emphasizing stand structural complexity are of interest across the northern forest region of the United States because of their potential to enhance carbon storage. Our research is part of a long-Term study evaluating silvicultural treatments that promote late-successional forest characteristics in northern hardwood-conifer forests. We are testing the hypothesis that aboveground biomass development (carbon storage) is greater in structural complexity enhancement (SCE) treatments when compared to conventional uneven-Aged treatments. Structural complexity enhancement treatments were compared against selection systems (single-Tree and group) modified to retain elevated structure. Manipulations and controls were replicated across 2-ha treatment units at two study areas in Vermont, United States. Data on aboveground biomass pools (live trees, standing dead, and downed wood) were collected pre-And post-Treatment, then again a decade later. Species group-specific allometric equations were used to estimate live and standing dead biomass, and downed log biomass was estimated volumetrically. We used the Forest Vegetation Simulator to project no-Treatment baselines specific to treatment units, allowing measured carbon responses to be normalized against differences in site characteristics affecting tree growth and pre-Treatment stand structure. Results indicate that biomass development and carbon storage 10 yr post-Treatment were greatest in SCE treatments compared to conventional treatments, with the greatest increases in coarse woody material (CWM) pools. Structural complexity enhancement treatments contained 12.67 Mg/ha carbon in CWM compared to 6.62 Mg/ha in conventional treatments and 8.84 Mg/ha in areas with no treatment. Percentage differences between post-Treatment carbon and simulated/projected baseline values indicate that carbon pool values in SCE treatments returned closest to pre-harvest or untreated levels over conventional treatments. Total carbon storage in SCE aboveground pools was 15.90% less than that projected for no-Treatment compared to 44.94% less in conventionally treated areas. Results from classification and regression tree models indicated treatment as the strongest predictor of aboveground C storage followed by site-specific variables, suggesting a strong influence of both on carbon pools. Structural enhancement treatments have the potential to increase carbon storage in managed northern hardwoods. They offer an alternative for sustainable management integrating carbon, associated climate change mitigation benefits, and late-successional forest structure and habitat

    Bridging the Climate Information Gap: A Framework for Engaging Knowledge Brokers and Decision Makers in State Climate Assessments

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    Large-scale analyses like the National Climate Assessment (NCA) contain a wealth of information critical to national and regional responses to climate change but tend to be insufficiently detailed for action at state or local levels. Many states now engage in assessment processes to meet information needs for local authorities. The goals of state climate assessments (SCAs) should be to provide relevant, actionable information to state and local authorities, and to generate primary sources, build networks and inform stakeholders. To communicate local climate impacts to decision makers, SCAs should express credibility, salience and legitimacy. They can provide information (e.g., case studies, data sets) and connect stakeholders to the NCA and its process. Based on our experience in the Vermont Climate Assessment (VCA), we present a framework to engage decision makers in SCAs using a fluid network of scientific experts and knowledge brokers to conduct subject area prioritization, data analysis and writing. The VCA addressed economic, environmental and social impacts of climate change at local scales to increase resiliency and manage risk. Knowledge brokers communicated VCA findings through their own stakeholder networks. We include a qualitative impact evaluation, and believe our framework for interaction among scientists, knowledge brokers and stakeholders to be an effective structure for SCAs and a transformative experience for students

    Beyond the Lone Hero: Providing Supports for New Teachers in High-Needs Schools

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    This essay examines the activities and challenges encountered in a partnership between a faculty of education and a local school board in Toronto, Canada. The goal was to address concerns over a 40% drop-out rate amongst Black students in the Toronto District School Board. Teachers were to identify areas of concern, and to use university resources to investigate and improve work with students. Initially, findings were disappointing, teachers often felt isolated working on their own, and some administrators perceived the project as disruptive to the overall running of the school. Faculty came to the realization that to help support their own graduates they needed to shift priorities from research to providing opportunities for dialogue, and to acknowledge the positions and perspectives of a variety of participants in the system
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