Jesuit Worldwide Learning Graduations in Kakuma Refugee Camp and Dzaleka Refugee Camp July 2018

In July 2018, Father John Fitzgibbons, S.J. and Father Daniel Hendrickson, S.J., Presidents of Regis and Creighton Universities, respectively, hosted the Graduation Ceremonies at Kakuma Refugee Camp, Kenya and Dzaleka Refugee Camp, Malawi. Fifty students received Diplomas in Liberal Studies during the ceremonies. This article includes a brief description of Jesuit Worldwide Learning precedes Father Fitzgibbons’ speech to the graduates

A Balancing Act - Reflections on 37 Years at Regis University: An Interview with Fr. Michael J. Sheeran, S.J., President, Regis University

Father Michael Sheeran, S.J., who became the 23rd president of Regis University on January 1, 1993, will officially retire from this appointment May 31, 2012. Father Sheeran arrived at Regis University in 1975 as assistant professor of history and political science and director of Student Academic Services. He was named academic dean of Regis College in 1977 and in 1982 became academic vice president. Every facet of his tenure as Regis University President underscores and supports a deep belief that the role of a Jesuit, Catholic university is to serve as a catalyst to further the common good of the community at large. Jesuit Higher Education: A Journal (JHE) asked Father Sheeran to reflect on his accomplishments as well as the future of Regis University

Immersion Research Education: Students as Catalysts for International Collaboration Research

Background:  This paper describes an international nursing and health research immersion program. Minority students from the USA work with an international faculty mentor in teams conducting collaborative research. The Minority Health International Research Training (MHIRT) program students become catalysts in the conduct of cross-cultural research. Aim:  To narrow the healthcare gap for disadvantaged families in the USA and partner countries. Methods:  Faculty from the USA, Germany, Italy, Colombia, England, Austria and Thailand formed an international research and education team to explore and compare family health issues, disparities in chronic illness care, social inequities and healthcare solutions. USA students in the MHIRT program complete two introductory courses followed by a 3-month research practicum in a partner country guided by faculty mentors abroad. The overall program development, student study abroad preparation, research project activities, cultural learning, and student and faculty team outcomes are explored. Results:  Cross-fertilization of research, cultural awareness and ideas about improving family health occur through education, international exchange and research immersion. Faculty research and international team collaboration provide opportunities for learning about research, health disparities, cultural influences and healthcare systems. The students are catalysts in the research effort, the dissemination of research findings and other educational endeavours. Five steps of the collaborative activities lead to programmatic success. Conclusions:  MHIRT scholars bring creativity, enthusiasm, and gain a genuine desire to conduct health research about families with chronic illness. Their cultural learning stimulates career plans that include international research and attention to vulnerable populations

A scattered landscape: assessment of the evidence base for 71 patient decision aids developed in a hospital setting

Background Recent publications reveal shortcomings in evidence review and summarization methods for patient decision aids. In the large-scale "Share to Care (S2C)" Shared Decision Making (SDM) project at the University Hospital Kiel, Germany, one of 4 SDM interventions was to develop up to 80 decision aids for patients. Best available evidence on the treatments' impact on patient-relevant outcomes was systematically appraised to feed this information into the decision aids. Aims of this paper were to (1) describe how PtDAs are developed and how S2C evidence reviews for each PtDA are conducted, (2) appraise the quality of the best available evidence identified and (3) identify challenges associated with identified evidence. Methods The quality of the identified evidence was assessed based on GRADE quality criteria and categorized into high-, moderate-, low-, very low-quality evidence. Evidence appraisal was conducted across all outcomes assessed in an evidence review and for specific groups of outcomes, namely mortality, morbidity, quality of life, and treatment harms. Challenges in evidence interpretation and summarization resulting from the characteristics of decision aids and the type and quality of evidence are identified and discussed. Conclusions Evidence reviews in this project were carefully conducted and summarized. However, the evidence identified for our decision aids was indeed a "scattered landscape" and often poor quality. Facing a high prevalence of low-quality, non-directly comparative evidence for treatment alternatives doesn't mean it is not necessary to choose an evidence-based approach to inform patients. While there is an urgent need for high quality comparative trials, best available evidence nevertheless has to be appraised and transparently communicated to patients

RENaBack: low back pain patients in rehabilitation—study protocol for a multicenter, randomized controlled trial

Background: Millions of people in Germany suffer from chronic pain, in which course and intensity are multifactorial. Besides physical injuries, certain psychosocial risk factors are involved in the disease process. The national health care guidelines for the diagnosis and treatment of non-specific low back pain recommend the screening of psychosocial risk factors as early as possible, to be able to adapt the therapy to patient needs (e.g., unimodal or multimodal). However, such a procedure has been difficult to implement in practice and has not yet been integrated into the rehabilitation care structures across the country. Methods: The aim of this study is to implement an individualized therapy and aftercare program within the rehabilitation offer of the German Pension Insurance in the area of orthopedics and to examine its success and sustainability in comparison to the previous standard aftercare program. The study is a multicenter randomized controlled trial including 1204 patients from six orthopedic rehabilitation clinics. A 2:1 allocation ratio to intervention (individualized and home-based rehabilitation aftercare) versus the control group (regular outpatient rehabilitation aftercare) is set. Upon admission to the rehabilitation clinic, participants in the intervention group will be screened according to their psychosocial risk profile. They could then receive either unimodal or multimodal, together with an individualized training program. The program is instructed in the clinic (approximately 3 weeks) and will continue independently at home afterwards for 3 months. The success of the program is examined by means of a total of four surveys. The co-primary outcomes are the Characteristic Pain Intensity and Disability Score assessed by the German version of the Chronic Pain Grade questionnaire (CPG). Discussion: An improvement in terms of pain, work ability, patient compliance, and acceptance in our intervention program compared to the standard aftercare is expected. The study contributes to provide individualized care also to patients living far away from clinical centers.German Pension Insurance Berlin-Brandenburg and Central GermanyPeer Reviewe

Making shared decision-making (SDM) a reality: protocol of a large-scale long-term SDM implementation programme at a Northern German University Hospital

Introduction: Shared decision-making (SDM) is not yet widely used when making decisions in German hospitals. Making SDM a reality is a complex task. It involves training healthcare professionals in SDM communication and enabling patients to actively participate in communication, in addition to providing sound, easy to understand information on treatment alternatives in the form of evidence-based patient decision aids (EbPDAs). This project funded by the German Innovation Fund aims at designing, implementing and evaluating a multicomponent, large-scale and integrative SDM programme-called SHARE TO CARE (S2C)-at all clinical departments of a University Hospital Campus in Northern Germany within a 4-year time period. Methods and analysis S2C tackles the aforementioned components of SDM: (1) training physicians in SDM communication, (2) activating and empowering patients, (3) developing EbPDAs in the most common/relevant diseases and (4) training other healthcare professionals in SDM coaching. S2C is designed together with patients and providers. The physicians' training programme entails an online and an in situ training module. The decision coach training is based on a similar but less comprehensive approach. The development of online EbPDAs follows the International Patient Decision Aid Standards and includes written, graphical and video-based information. Validated outcomes of SDM implementation are measured in a preintervention and postintervention evaluation design. Process evaluation accompanies programme implementation. Health economic impact of the intervention is investigated using a propensity-score-matched approach based on potentially preference-sensitive hospital decisions. Ethics and dissemination Ethics committee review approval has been obtained from Medical Ethics Committee of the Medical Faculty of the Christian-Albrechts-University Kiel. Project information and results will be disseminated at conferences, on project-hosted websites at University Hospital Medical Center Schleswig Holstein and by S2C as well as in peer-reviewed and professional journals

Modelo para el comportamiento de planificación de los cuidados a largo plazo

Propósito: Explicar el contexto dinámico de la Planificación del Cuidado a Largo Plazo (LTCP) previos a la crisis, a través del desarrollo y la prueba de un modelo derivado del trabajo de Organización Sistémica de Friedemann, que es consistente con la literatura. Adicionalmente, probar las concepciones teóricas acerca de personas blancas, hispanas y no hispanas y personas negras no hispanas entre los 55 y los 70 años de edad.Diseño y métodos: Dos grupos de enfoque fueron guiados a validar los constructos propuestos y los elementos de la encuesta desarrollados para medirlos. Subsecuentemente, la encuesta fue aplicada en entrevistas telefónicas con 153 residentes de Miami-Dade, Florida. Las respuestas fueron sometidas a análisis confirmatorios y explo- *El soporte para esta investigación se recibió de Grant IR03AG20326 del National Institute on Aging (Instituto Nacional sobre el Envejecimiento), Washintong D.C., E.E.U.U. ratorios para desarrollar y probar el modelo. Las diferencias demográficas y étnicas fueron probadas mediante el uso de procedimientos de análisis de varianza y regresión.Resultados: El análisis confirmó el estilo de respuesta de control dentro de tres ámbitos de planeación: área financiera, bienestar-habilidad funcional y socio-ambiental. La respuesta de aceptación pareció significar una actitud que se traduce en aceptación hacia la ayuda en los tres ámbitos. Fueron evidentes diferencias étnicas pero no de género. Conclusiones: Los resultados proporcionaron un modelo de LTCP para futuras pruebas. Entender el proceso de LTCP formará las bases para intervenciones educativas

Dietary strategies of Pleistocene Pongo sp. and Homo erectus on Java (Indonesia)

During the Early to Middle Pleistocene, Java was inhabited by hominid taxa of great diversity. However, their seasonal dietary strategies have never been explored. We undertook geochemical analyses of orangutan (Pongo sp.), Homo erectus and other mammalian Pleistocene teeth from Sangiran. We reconstructed past dietary strategies at subweekly resolution and inferred seasonal ecological patterns. Histologically controlled spatially resolved elemental analyses by laser-based plasma mass spectrometry confirmed the preservation of authentic biogenic signals despite the effect of spatially restricted diagenetic overprint. The Sr/Ca record of faunal remains is in line with expected trophic positions, contextualizing fossil hominid diet. Pongo sp. displays marked seasonal cycles with ~3 month-long strongly elevated Sr/Ca peaks, reflecting contrasting plant food consumption presumably during the monsoon season, while lower Sr/Ca ratios suggest different food availability during the dry season. In contrast, omnivorous H. erectus shows low and less accentuated intra-annual Sr/Ca variability compared to Pongo sp., with δ13C data of one individual indicating a dietary shift from C4 to a mix of C3 and C4 plants. Our data suggest that H. erectus on Java was maximizing the resources available in more open mosaic habitats and was less dependent on variations in seasonal resource availability. While still influenced by seasonal food availability, we infer that H. erectus was affected to a lesser degree than Pongo sp., which inhabited monsoonal rain forests on Java. We suggest that H. erectus maintained a greater degree of nutritional independence by exploiting the regional diversity of food resources across the seasons