148 research outputs found
Outsider Women: Understanding Women’s Roles in White Supremacist Deradicalization
Prior scholarship has suggested that women of color and other outsiders (i.e., those not affiliated with White supremacist hate groups) have significantly facilitated the deradicalization of White supremacist hate group members. However, few empirical studies focus on the lived experiences of outsider women who have helped hate group members disengage and deradicalize. Thus, the purpose of the current study was to explore the experiences of women who facilitated the disengagement and deradicalization of White supremacist hate group members. The first author conducted interviews among four women who had significant experience regarding the phenomenon of interest. Using interpretative phenomenological analysis (IPA) as a methodological framework, the authors identified five themes from participants’ rich descriptions of their experiences facilitating hate group exit: (a) identifying love as driving force behind exit facilitation, (b) developing their exit facilitation approach, (c) experiencing costs of helping others exit, (d) identifying areas for increased external exit support, and (e) offering recommendations for hate group exit facilitation. By examining this specific population, we hoped to gain insights into new avenues of development for disengagement and deradicalization interventions.
Editorial Note: An error was corrected in Table 1 in the annex. A corrected version was uploaded an published January 11, 2024
What factors affect implementation of early rehabilitation into intensive care unit practice? A qualitative study with clinicians
Purpose To identify the barriers and enablers that influence clinicians' implementation of early rehabilitation in critical care. Materials and methods Qualitative study involving 26 multidisciplinary participants who were recruited using purposive sampling. Four focus groups were conducted using semistructured questions to explore attitudes, beliefs, and experiences. Data were transcribed verbatim and thematic analysis was performed. Results Six themes emerged, as follows: (1) the clinicians' expectations and knowledge (including rationale for rehabilitation, perceived benefits, and experience), (2) the evidence for and application of rehabilitation (including beliefs regarding when to intervene), (3) patient factors (including prognosis, sedation, delirium, cooperation, motivation, goals, and family), (4) safety considerations (including physiological stability and presence of devices or lines), (5) environmental influences (staffing, resources, equipment, time, and competing priorities), and (6) culture and teamwork. Key strategies identified to facilitate rehabilitation included addressing educational needs for all multidisciplinary team members, supporting junior nursing staff, and potential expansion of physiotherapy staffing hours to closer align with the 24-hour patient care model. Conclusions Key barriers to implementation of early rehabilitation in critical care are diverse and include both clinician- and health care system–related factors. Research targeted at bridging this evidence-practice gap is required to improve provision of rehabilitation. © 2016 Elsevier Inc
Dental Education Economics: Challenges and Innovative Strategies
This article reviews current dental education economic challenges such as increasing student tuition and debt, decreasing funds for faculty salaries and the associated faculty shortage, and the high cost of clinic operations and their effect on the future of dentistry. Management tactics to address these issues are also reviewed. Despite recent efforts to change the clinical education model, implementation of proposed faculty recruitment and compensation programs, and creation of education- corporate partnerships, the authors argue that the current economics of public dental education is not sustainable. To remain viable, the dental education system must adopt transformational actions to re-engineer the program for long-term stability. The proposed re-engineering includes strategies in the following three areas: 1) educational process redesign, 2) reduction and redistribution of time in dental school, and 3) development of a regional curriculum. The intent of these strategies is to address the financial challenges, while educating adequate numbers of dentists at a reasonable cost to both the student and the institution in addition to maintaining dental education within research universities as a learned profession
Targeted full energy and protein delivery in critically ill patients : A pilot randomized controlled trial (FEED Trial)
Background
International guidelines recommend greater protein delivery to critically ill patients than they currently receive. This pilot randomized clinical trial aimed to determine whether a volume-target enteral protocol with supplemental protein delivered greater amounts of protein and energy to critically ill patients compared with standard care.
Methods
Sixty participants received either the intervention (volume-based protocol, with protein supplementation) or standard nutrition care (hourly-rate-based protocol, without protein supplementation) in the intensive care unit (ICU). Coprimary outcomes were average daily protein and energy delivery. Secondary outcomes included change in quadriceps muscle layer thickness (QMLT, ultrasound) and malnutrition (subjective global assessment) at ICU discharge.
Results
Mean (SD) protein and energy delivery per day from nutrition therapy for the intervention were 1.2 (0.30) g/kg and 21 (5.2) kcal/kg compared with 0.75 (0.11) g/kg and 18 (2.7) kcal/kg for standard care. The mean difference between groups in protein and energy delivery per day was 0.45 g/kg (95% CI, 0.33–0.56; P < .001) and 2.8 kcal/kg (95% CI, 0.67–4.9, P = .01). Muscle loss (QMLT) at discharge was attenuated by 0.22 cm (95% CI, 0.06–0.38, P = .01) in patients receiving the intervention compared with standard care. The number of malnourished patients was fewer in the intervention [2 (7%) vs 8 (28%); P = .04]. Mortality and duration of admission were similar between groups.
Conclusions
A high-protein volume-based protocol with protein supplementation delivered greater amounts of protein and energy. This intervention was associated with attenuation of QMLT loss and reduced prevalence of malnutrition at ICU discharge
Improving health care quality for racial/ethnic minorities: a systematic review of the best evidence regarding provider and organization interventions
BACKGROUND: Despite awareness of inequities in health care quality, little is known about strategies that could improve the quality of healthcare for ethnic minority populations. We conducted a systematic literature review and analysis to synthesize the findings of controlled studies evaluating interventions targeted at health care providers to improve health care quality or reduce disparities in care for racial/ethnic minorities. METHODS: We performed electronic and hand searches from 1980 through June 2003 to identify randomized controlled trials or concurrent controlled trials. Reviewers abstracted data from studies to determine study characteristics, results, and quality. We graded the strength of the evidence as excellent, good, fair or poor using predetermined criteria. The main outcome measures were evidence of effectiveness and cost of strategies to improve health care quality or reduce disparities in care for racial/ethnic minorities. RESULTS: Twenty-seven studies met criteria for review. Almost all (n = 26) took place in the primary care setting, and most (n = 19) focused on improving provision of preventive services. Only two studies were designed specifically to meet the needs of racial/ethnic minority patients. All 10 studies that used a provider reminder system for provision of standardized services (mostly preventive) reported favorable outcomes. The following quality improvement strategies demonstrated favorable results but were used in a small number of studies: bypassing the physician to offer preventive services directly to patients (2 of 2 studies favorable), provider education alone (2 of 2 studies favorable), use of a structured questionnaire to assess adolescent health behaviors (1 of 1 study favorable), and use of remote simultaneous translation (1 of 1 study favorable). Interventions employing more than one main strategy were used in 9 studies with inconsistent results. There were limited data on the costs of these strategies, as only one study reported cost data. CONCLUSION: There are several promising strategies that may improve health care quality for racial/ethnic minorities, but a lack of studies specifically targeting disease areas and processes of care for which disparities have been previously documented. Further research and funding is needed to evaluate strategies designed to reduce disparities in health care quality for racial/ethnic minorities
Annotated Bibliography of Research in the Teaching of English
Since 2003, RTE has published the annual “Annotated Bibliography of Research in the Teaching of English,” a list of curated and annotated works reviewed and selected by a large group of dedicated educator-scholars in our field. The goal of the annual bibliography is to offer a synthesis of the research published in the area of English language arts within the past year for RTE readers’ consideration. Abstracted citations and those featured in the “Other Related Research” sections were published, either in print or online, between June 2020 and June 2021. The bibliography is divided into nine sections, with some changes to the categories this year in response to the ever-evolving nature of research in the field. Small teams of scholars with diverse research interests and background experiences in preK–16 educational settings reviewed and selected the manuscripts for each section using library databases and leading scholarly journals. Each team abstracted significant contributions to the body of peer-reviewed studies that addressed the current research questions and concerns in their topic area
Cholangiocyte organoids can repair bile ducts after transplantation in the human liver.
Organoid technology holds great promise for regenerative medicine but has not yet been applied to humans. We address this challenge using cholangiocyte organoids in the context of cholangiopathies, which represent a key reason for liver transplantation. Using single-cell RNA sequencing, we show that primary human cholangiocytes display transcriptional diversity that is lost in organoid culture. However, cholangiocyte organoids remain plastic and resume their in vivo signatures when transplanted back in the biliary tree. We then utilize a model of cell engraftment in human livers undergoing ex vivo normothermic perfusion to demonstrate that this property allows extrahepatic organoids to repair human intrahepatic ducts after transplantation. Our results provide proof of principle that cholangiocyte organoids can be used to repair human biliary epithelium
A randomized controlled trial of interventions to enhance patient-physician partnership, patient adherence and high blood pressure control among ethnic minorities and poor persons: study protocol NCT00123045
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