Implementation of a Virtual Journal Club in a Clinical Nursing Setting

Healthcare practice is increasingly focused on delivering care that is based on published research evidence. Staff development nurses can institute journal clubs to teach nursing staff critical appraisal of research articles and ways to translate research findings into clinical practice. Unfortunately, attending meetings regularly is often a challenge for nurses, and relatively few have the knowledge and expertise to adequately critique research articles. One way to bridge the limitations of accessibility and limited research expertise of journal club members is to establish a virtual journal club. This article describes one hospital\u27s experience with developing a virtual journal club

Predictors of lifestyle behaviors, trust of health care provider, and utilization of health services among adolescents living in a rural area.

Background: Adolescents have elevated morbidity and mortality rates associated with risk-taking behaviors, but utilize health services at low levels. There is little evidence concerning health behavior, trust of health care provider, or utilization of health services among adolescents living in rural areas. Purpose: The purpose of this study was to examine individual characteristic variables and determine the extent to which these variables influence lifestyle behaviors, trust of health care provider (HCP), and utilization of health services among adolescents attending public high school in rural Indiana. Methods: This study used a cross-sectional, quantitative design. Instruments used in this study were the Wake Forest Interpersonal Trust in Physician scale, Adolescent Lifestyle Questionnaire, the Stanford Health Care Utilization Questionnaire, and an investigator-developed individual characteristic survey. Hierarchical multiple regression evaluated individual characteristic variables as predicting lifestyle behaviors and trust of HCP, while negative binomial regression predicted number of HCP visits and number of emergency room visits in the past 12 months. Results: Correlations, analysis of variance, and Kruskal-Wallis tests evaluated relationships between variables. Trust of HCP was predicted by usual source of care, health insurance, lifestyle behavior, and transportation difficulty. Lifestyle behavior was predicted by self-rated health, age, trust of HCP, and sex. Predictors of number of HCP visits were sex, household income, self-rated health, self-perceived need, health insurance, and number of ER visits, while household income and number of HCP visits predicted number of ER visits. Conclusion: This study adds to the evidence regarding health services utilization and lifestyle behavior, while providing an initial reliable quantitative measurement of trust of HCPs among American adolescents living in a rural area. Results of this study demonstrate the importance of having a HCP as a usual source of care and the need for school-based health services in rural areas. Future research should test the Wake Forest Trust in Physician scale among diverse adolescent samples, measure intention to seek health services beliefs, and evaluate informal sources of health information among rural adolescents. Additionally, research should evaluate the risk for or existence of chronic health conditions using biological markers among adolescents living in a rural area, along with behavior interventions to prevent or self-manage identified chronic health conditions. With approximately 22% of American adolescents living in rural areas and therefore at risk for poor outcomes, it is imperative that the research community place greater attention on the health of rural dwelling adolescents

Resource Use in the Trinational Sangha River Region of Equatorial Africa: Histories, Knowledge Forms, and Institutions

This volume is based on an international conference, “Natural Resource Use Relations in the Trinational Sangha River Region of the Northwest Congo Basin,” held at Yale University in September 1997. In recognition of the bilingual context in which conservation occurs in the three countries of the Sangha region — Cameroon, Central African Republic, and Congo — all sessions of the conference were conducted simultaneously in French and English. This publication, which is a complete rendering of the conference papers and discussion sessions, is available in its entirety in both French and English

Socioeconomic Deprivation and Cardiometabolic Risk Factors in Individuals with Type 1 Diabetes: T1D Exchange Clinic Registry

Aims: Social determinants of health (SDOH) influence cardiovascular health in the general population; however, the degree to which this occurs in individuals with type 1 diabetes (T1D) is not well understood. We evaluated associations among socioeconomic deprivation and cardiometabolic risk factors (hemoglobin A1c, low-density lipoprotein, blood pressure, body mass index, physical activity) in individuals with T1D from the T1D Clinic Exchange Registry. Methods: We evaluated the association between the social deprivation index (SDI) and cardiometabolic risk factors using multivariable and logistic regression among 18,754 participants ages 13 – 90 years (mean 29.2 ± 17) in the T1D Exchange clinic registry from 6,320 zip code tabulation areas (2007–2017). Results: SDI was associated with multiple cardiometabolic risk factors even after adjusting for covariates (age, biological sex, T1D duration, and race/ethnicity) in the multivariable linear regression models. Those in the highest socially deprived areas had 1.69 (unadjusted) and 1.78 (adjusted) times odds of a triple concomitant risk burden of poor glycemia, dyslipidemia, and hypertension. Conclusions: Persistent SDOH differences could account for a substantial degree of poor achievement of cardiometabolic targets in individuals with T1D. Our results suggest the need for a broader framework to understand the association between T1D and adverse cardiometabolic outcomes

Is Upright Exploratory Play Influenced by Partial Body Weight Support in Infants with Down Syndrome?

Is Upright Exploratory Play Influenced by Partial Body Weight Support in Infants with Down Syndrome? Sofia Hardin, SPT; Christa Lum, SPT Mentor: Julia Looper, PT, PhD Background: Children with Down syndrome (DS) typically present with delayed gross motor skills, which may negatively impact their development in other realms, such as cognition and language. The partial body-weight supported system (PBWSS) is a possible early intervention for infants with DS in physical therapy settings and in the community to facilitate motor development through exploratory play. Purpose: To explore the effects of a PBWSS on upright play positions during exploratory play among infants with DS. Upright play positions include kneeling, squatting, standing, cruising, supported stepping, and walking. Methods: (N=3). Researchers used a 9x9ft play environment that included the PBWSS and toys. Infants under the age of three attended nine one-hour sessions over the course of three weeks. Infants moved freely within the space and interacted with researchers and present family members. Researchers behavior-coded the first 30 minutes of play for the first and last session with the PBWSS for each infant. Gross motor behaviors were coded for specific motions during the first 2 seconds of every 6 second interval for the duration of the 30 minute play time, totaling to 300 observations. Results: Observations of upright play increased in the last session compared to the first for all three infants, increasing from 33% to 40.67% for infant 1, 15.67% to 49.67% for infant 2 and 39.33% to 47.67% for infant 3. Conclusion: The PBWSS seemed to influence upright play positions during exploratory play for infants with DS and is worth further exploration

Китаб Ибрагима Хосеневича из коллекции Национальной библиотеки Республики Беларусь как исторический источник : реферат к дипломной работе / Инна Чеславовна Кевра; БГУ, Исторический факультет, Кафедра источниковедения; науч. рук. Белявский А.М.

The construct of individualism–collectivism (IND-COL) has become the definitive standard in cross-cultural psychology, management, and related fields. It is also among the most controversial, in particular, with regard to the ambiguity of its dimensionality: Some view IND and COL as the opposites of a single continuum, whereas others argue that the two are independent constructs. We explored the issue through seven different tests using original individual-level data from 50 studies and meta-analytic data from 149 empirical publications yielding a total of 295 sample-level observations that were collected using six established instruments for assessing IND and COL as separate constructs. Results indicated that the dimensionality of IND-COL may depend on (a) the specific instrument used to collect the data, (b) the sample characteristics and the cultural region from which the data were collected, and (c) the level of analysis. We also review inconsistencies, deficiencies, and challenges of conceptualizing IND-COL and provide guidelines for developing and selecting instruments for measuring the construct, and for reporting and meta-analyzing results from this line of research

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

Depressive symptoms and trust of healthcare provider in rural adolescents: Relationships and predictors

The purpose of this study was to evaluate associations among depressive symptoms, trust of healthcare provider, and health behavior in adolescents who live in a rural area. Two hundred twenty-four adolescents aged 14-19 years old attending public high school in the Midwestern United States were surveyed. Results showed a diagnosis of depression, trust of healthcare provider, health awareness, and stress management predicted depressive symptoms in adolescents living in a rural area. Healthcare providers should take extra care to promote trust in the healthcare provider-patient relationship with adolescents and to follow guidelines for annual screening of adolescents for depressive symptoms. Nursing implications include adolescent psychoeducation to improve health awareness and stress management.National Institutes of Health; Rural Nurses Organizatio

The Impact of Caregiving on Caregivers&apos; Medication Adherence and Appointment Keeping

Abstract The purpose of this study was to examine the relationships between care demands and caregivers&apos; medication adherence and health appointment keeping. A cross-sectional correlational design was used to survey a convenience sample of 45 informal caregivers of persons with dementia. Pearson product-moment correlations and hierarchical multiple regressions were used to examine the relationships among study variables. Nearly one third of caregivers reported frequently or occasionally missing medication doses and nearly a half reported not being able to fully keep appointments with health care providers. Female gender, care duration, and care-recipient activities of daily living were significant predictors for medication adherence and appointment keeping. Caregivers&apos; education and weekly caregiving hours contributed significantly to their medication adherence. Interventions are needed to help caregivers keep health appointments and adhere to their medications