Spoken Stories, Spoken Word: An Insurgent Practice for Restorative Education

This paper uses the terminology of whiteness, settler colonialism, culturally responsive pedagogy, and restorative education to interrogate the usage of spoken word in schools. I argue that spoken word can function as a form of resistance to white colonialist practices and as an advocate of emotional learning and critical education. This paper focuses on representation, student empowerment, and identity exploration in the context of education institutions. It crosses borders between education and authenticity, between classrooms and real life, and between teachers and students. I aim to ground this essay in the American Studies discipline as it discusses systems of power in the United States and seeks to disrupt dominant narratives through spoken word as an alternative education strategy for dismantling white supremacy and validating marginalized identities. This work is only a small part of the larger conversation on restorative justice in education

Meaning and Practice of Palliative Care for Hospitalized Older Adults with Life Limiting Illnesses

Objective. To illustrate distinctions and intersections of palliative care (PC) and end-of-life (EOL) services through examples from case-centered data of older adults cared for during a four-year ethnographic study of an acute care hospital palliative care consultation service. Methods. Qualitative narrative and thematic analysis. Results. Description of four practice paradigms (EOL transitions, prognostic uncertainty, discharge planning, and patient/family values and preferences) and identification of the underlying structure and communication patterns of PC consultation services common to them. Conclusions. Consistent with reports by other researchers, study data support the need to move beyond equating PC with hospice or EOL care and the notion that EOL is a well-demarcated period of time before death. If professional health care providers assume that PC services are limited to assisting with and helping patients and families prepare for dying, they miss opportunities to provide care considered important to older individuals confronting life-limiting illnesses

A multi-response multilevel model with application in nurse care coordination

<p>Due to the aging of our society, patient care needs to be well coordinated within the health care team in order to effectively manage the overall health of each patient. Staff nurses, as the patient's “ever-present” health care team members, play a vital role in the care coordination. The recently developed Nurse Care Coordination Instrument (NCCI) is the first of its kind that enables quantitative data to be collected to measure various aspects of nurse care coordination. Driven by this new development, we propose a multi-response multilevel model with joint fixed effect selection and joint random effect selection across multiple responses. This model is particularly suitable for modeling the unique data structure of the NCCI due to its ability of jointly modeling of multilevel predictors, including demographic and workload variables at the individual/nurse level and characteristics of the practice environment at the unit level and multiple response variables that measure the key components of nurse care coordination. We develop a Block Coordinate Descent algorithm integrated with an Expectation-Maximization framework for model estimation. Asymptotic properties are derived. Finally, we present an application to a data set collected across four U.S. hospitals using the NCCI and discuss implications of the findings.</p

Multiple data sources fusion for enterprise quality improvement by a multilevel latent response model

<div><p>Quality improvement of an enterprise needs a model to link multiple data sources, including the independent and interdependent activities of individuals in the enterprise, enterprise infrastructure, climate, and administration strategies, as well as the quality outcomes of the enterprise. This is a challenging problem because the data are at two levels—i.e., the individual and enterprise levels—and each individual's contribution to the enterprise quality outcome is usually not explicitly known. These challenges make general regression analysis and conventional multilevel models non-applicable to the problem. This article a new multilevel model that treats each individual's contribution to the enterprise quality outcome as a latent variable. Under this new formulation, an algorithm is developed to estimate the model parameters, which integrates the Fisher scoring algorithm and generalized least squares estimation. Extensive simulation studies are performed that demonstrate the superiority of the proposed model over the competing approach in terms of the statistical properties in parameter estimation. The proposed model is applied to a real-world application of nursing quality improvement and helps identify key nursing activities and unit (a hospital unit is an enterprise in this context) quality-improving measures that help reduce patient falls.</p> </div

From Gut to Blood: Spatial and Temporal Pathobiome Dynamics during Acute Abdominal Murine Sepsis

Abdominal sepsis triggers the transition of microorganisms from the gut to the peritoneum and bloodstream. Unfortunately, there is a limitation of methods and biomarkers to reliably study the emergence of pathobiomes and to monitor their respective dynamics. Three-month-old CD-1 female mice underwent cecal ligation and puncture (CLP) to induce abdominal sepsis. Serial and terminal endpoint specimens were collected for fecal, peritoneal lavage, and blood samples within 72 h. Microbial species compositions were determined by NGS of (cell-free) DNA and confirmed by microbiological cultivation. As a result, CLP induced rapid and early changes of gut microbial communities, with a transition of pathogenic species into the peritoneum and blood detected at 24 h post-CLP. NGS was able to identify pathogenic species in a time course-dependent manner in individual mice using cfDNA from as few as 30 microliters of blood. Absolute levels of cfDNA from pathogens changed rapidly during acute sepsis, demonstrating its short half-life. Pathogenic species and genera in CLP mice significantly overlapped with pathobiomes from septic patients. The study demonstrated that pathobiomes serve as reservoirs following CLP for the transition of pathogens into the bloodstream. Due to its short half-life, cfDNA can serve as a precise biomarker for pathogen identification in blood

5-FU therapeutic drug monitoring as a valuable option to reduce toxicity in patients with gastrointestinal cancer

IF 5.168International audienceAims:5-FU is used as the main backbone of chemotherapy regimens for patients with colorectal and other gastrointestinal cancers. Despite development of new strategies that allowed enhancing clinical effectiveness and tolerability of 5-FU, 10-30% of patients treated with 5-FU-based regimens experience severe treatment-related toxicity. In our study, we evaluated the 5-FU exposure-toxicity relationship and investigated the efficacy of PK-guided dosing in increasing tolerability of 5-FU-based chemotherapy.Results:50.7% of patients required dose adjustments after cycle 1. Percentage of patients within 5-FU AUC range was 49.3%, 66.9%, 61.0% at cycle 1, 2 and 3 respectively (p = 0.002 cycle 1 vs cycle 2). At all 3 cycles, lower incidences of grade I/II toxicities were observed for patients below or within range compared with those above range (19.4% vs 41.3%, p < 0.001 respectively).Conclusions:Our analysis confirms that the use of BSA-guided dosing results in highly variable 5-FU exposure and strongly suggests that PK-guided dosing can improve tolerability of 5-FU based chemotherapy in patients with gastrointestinal cancers, thus supporting 5-FU therapeutic drug monitoring.Methods:155 patients with gastrointestinal cancers, who were to receive 5-FU-based regimens were included in our study. At cycle 1, the 5-FU dose was calculated using patient's Body Surface Area (BSA) method. A blood sample was drawn on Day 2 to measure 5-FU concentration. At cycle 2, the 5-FU dose was adjusted using a PK-guided dosing strategy targeting a plasma AUC range of 18-28 mg·h/L, based on cycle 1 concentration. Assessments of toxicity was performed at the beginning of every cycle

sj-pdf-1-aei-10.1177_15345084241226593 – Supplemental material for The Influence of English Learner Status on Maintenance of Oral Reading Fluency Growth

Supplemental material, sj-pdf-1-aei-10.1177_15345084241226593 for The Influence of English Learner Status on Maintenance of Oral Reading Fluency Growth by Kirsten J. Truman, Ethan R. Van Norman, David A. Klingbeil, Madeline C. Schmitt, Peter M. Nelson and David C. Parker in Assessment for Effective Intervention</p

sj-pdf-2-aei-10.1177_15345084241226593 – Supplemental material for The Influence of English Learner Status on Maintenance of Oral Reading Fluency Growth

Supplemental material, sj-pdf-2-aei-10.1177_15345084241226593 for The Influence of English Learner Status on Maintenance of Oral Reading Fluency Growth by Kirsten J. Truman, Ethan R. Van Norman, David A. Klingbeil, Madeline C. Schmitt, Peter M. Nelson and David C. Parker in Assessment for Effective Intervention</p

Harmonization of delirium severity instruments: a comparison of the DRS-R-98, MDAS, and CAM-S using item response theory

Abstract Background This study aimed to describe the level of agreement of three commonly used delirium instruments: the Delirium Rating Scale-Revised-98 (DRS-R-98), Memorial Delirium Assessment Scale (MDAS), and Confusion Assessment Method-Severity (CAM-S). Methods We used data from a prospective clinical research study, in which a team of trained lay interviewers administered each instrument along with supporting interview and cognitive assessments in the same group of patients daily while in the hospital (N = 352). We used item response theory methods to co-calibrate the instruments. Results The latent traits underlying the three measures, capturing the severity of a delirium assessment, had a high degree of correlation (r’s > .82). Unidimensional factor models fit well, facilitating co-calibration of the instruments. Across instruments, the less intense symptoms were generally items reflecting cognitive impairment. Although the intensity of delirium severity for most in the sample was relatively low, many of the item thresholds for the delirium severity scales are high (i.e., in the more severe range of the latent ability distribution). This indicates that even people with severe delirium may have a low probability of endorsing the highest severity categories for many items. Co-calibration enabled us to derive crosswalks to map delirium severity scores among the delirium instruments. Conclusion These delirium instruments measure the same underlying construct of delirium severity. Relative locations of items may inform design of refined measurement instruments. Mapping of overall delirium severity scores across the delirium severity instruments enabled us to derive crosswalks, which allow scores to be translated across instruments, facilitating comparison and combination of delirium studies for integrative analysis