Search

This survey research compares the structure and practices of 7 community studio art programs for artists with disabilities in Europe to 8 studio art therapy programs in the United States. Art therapy and disability arts literature was reviewed to establish a theoretical context for this project. A survey research method was used, with statistical and narrative analysis to interpret the data. In general, more similarities than differences were found between the two samples. The theoretical and philosophical implications of these comparisons are discussed with respect to expanding models of art therapy practice. (Contains 2 tables.)

Background: Family caregivers are family members or friends of care recipients who assist with activities of daily living, medication management, transportation, and help with finances among other activities. As a result of their caregiving, family caregivers are often considered a population at risk of experiencing increased stress, isolation, and loneliness. During the COVID-19 pandemic in the US, social isolation and decrease in social activities were a top concern among older adults and their family caregivers. Using secondary analysis of survey data as part of a multi-site implementation trial of a caregiver skills training program, we describe differences in caregiver experiences of loneliness before and during the COVID-19 pandemic. Methods: Health and wellbeing surveys of family caregivers were collected on 422 family caregivers of veterans before and during COVID-19. Logistic regression modeling examined whether the loneliness differed between caregiver groups pre vs during COVID-19, using the UCLA 3-item loneliness measure. Rapid directed qualitative content analysis of open-ended survey questions was used to explore the context of how survey responses were affected by the COVID-19 pandemic. Results: There were no significant differences in loneliness between caregivers pre vs during COVID-19. In open-ended responses regarding effects of COVID-19, caregivers described experiencing loneliness and social isolation; why they were unaffected by the pandemic; and how caregiving equipped them with coping strategies to manage negative pandemic-related effects. Conclusion: Loneliness did not differ significantly between pre vs during COVID-19 caregivers. Future research could assess what specific characteristics are associated with caregivers who have resiliency, and identify caregivers who are more susceptible to experiencing loneliness. Understanding caregiver loneliness could assist other healthcare systems in developing and implementing caregiver support interventions. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic illuminated shortcomings in the ability of community hospitals in the United States to respond to crises of this nature. This has led to questions about the effectiveness of community hospital disaster preparedness. A study of hospital preparedness in New York State in 2017 revealed a number of barriers to preparedness. Among the most significant are economic barriers, given that disaster preparedness is not a reimbursable cost like patient care. The economic challenges have been exacerbated by a decline in federal disaster preparedness funding in recent years. Reflecting on previous writings, the author provides several options for overcoming these barriers to ensure hospitals are better prepared for future disasters. [ABSTRACT FROM AUTHOR]

This study reviewed state and District of Columbia (DC) health department guidelines for the use of face masks by healthcare workers during the COVID-19 pandemic via an October 2020 internet search and compared these guidelines to those from the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC). Guidelines varied between states and DC with respect to N95 face mask and surgical mask use, as well as to extended use and re-use of N95 masks. Uniform guidance based on emerging evidence should be required for creating policy and procedures for healthcare workers during this and future pandemics. [ABSTRACT FROM AUTHOR]

Against Medical Advice (AMA) discharges pose significant challenges to the healthcare system, straining patient-clinician relationships while contributing to avoidable morbidity and mortality. Furthermore, though these discharges culminate in patients' departure from hospitals, their effects reverberate long after, propagated by clinician notes stored in patients' medical records. These notes capture exceptionally fraught interactions between patients and providers, describing the circumstances surrounding breakdowns in clinical relationships. Additionally, they represent just one side of complex, contentious social interactions, for in describing AMA discharges, clinician notewriters quite literally have the last word. For these reasons, notes documenting AMA discharges provide insight into the ways in which clinicians conceptualize, characterize, and propagate power differentials in the contemporary healthcare system. Here, we present a qualitative thematic analysis of 185 notes documenting AMA discharges from a large urban US medical center, interpreting note dynamics through three sociological models of power analysis: (i) the distributive model of power promulgated by Max Weber, (ii) the collectivist power model characterized by Talcott Parsons and Hannah Arendt, and (iii) structural interpretations of power developed by Michel Foucault. We argue that in documenting AMA discharges, clinicians appear to conceive of their relationship with patients in almost exclusively distributive terms, which in turn contributes to an adversarial dynamic whereby both patients and clinicians ultimately suffer disempowerment. We furthermore argue that by facilitating clinicians' recognition of power's collectivist and structural dimensions, we may help transform breakdowns in patient-clinician relationships into opportunities for collaboration. • Against Medical Advice (AMA) discharges pose key challenges during hospitalizations. • Sociologists have posited alternative, collectivist and structural, models of power. • Notes documenting AMA discharges reveal clinicians' conceptualization of power. • Clinicians conceive of power almost exclusively in distributive terms. • Applying alternative power models to clinical practice may promote humanistic care. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, created the need for an effective vaccine. Questions arose about allocating the initial limited supplies in the United States. We present four allocation models and compare their characteristics for ethically meeting the health needs of the population. The literature shares broad agreement on guiding ethical principles with those of the four proposed models for vaccine allocation, featuring the concepts of utilitarianism, prioritarianism, equity, and reciprocity. We conclude that the "Interim Framework for COVID-19 Vaccine Allocation and Distribution in the United States" from the Johns Hopkins Bloomberg School of Public Health is the most comprehensive and ethically sound. We recommend government officials and policymakers at all levels consider the principles and objectives in this model as US COVID-19 vaccination distribution efforts continue. This model may serve as an effective framework for initial vaccine distribution efforts during future epidemic and pandemic events. [ABSTRACT FROM AUTHOR]

While there is ample research examining the short- and long-term effects of juvenile incarceration (broadly defined), less is known about the specific consequences of the most common form of youth incarceration, juvenile detention. We conducted a Rapid Evidence Review (RER), limiting our search to the past 10 years to include studies that captured modern juvenile justice practices, to assess the body of literature evaluating the effects of juvenile detention on youth outcomes. Our initial search yielded over 1,800 articles, but only three ultimately met criteria for inclusion in our review. We conclude that there is a profound lack of research regarding the consequences of juvenile detention, an issue that affects a large number of youth in the United States. [ABSTRACT FROM AUTHOR]

The video essay is an opportunity for students to record their words and combine other visual elements to complete the typical requirements of a standard written paper. Applicable across disciplines and pedagogically aligned with an honors ethos of self-directed learning, video essays allow for individual and collaborative forms of expression while providing unique approaches to compositional assessment on an array of subjects. [ABSTRACT FROM AUTHOR]

Objective. To validate a risk index that estimates the likelihood of overdose or serious opioidinduced respiratory depression (OIRD) among medical users of prescription opioids. Subjects and Methods. A case-control analysis of 18,365,497 patients with an opioid prescription from 2009 to 2013 in the IMS PharMetrics Plus commercially insured health plan claims database (CIP). An OIRD event occurred in 7,234 cases. Four controls were selected per case. Validity of the Risk Index for Overdose or Serious Opioid-induced Respiratory Depression (RIOSORD), developed previously using Veterans Health Administration (VHA) patient data, was assessed. Multivariable logistic regression was used within the CIP study population to develop a slightly refined RIOSORD. The composition and performance of the CIP-based RIOSORD was evaluated and compared with VHA-based RIOSORD. Results. VHA-RIOSORD performed well in discriminating OIRD events in CIP (C-statistic 5 0.85). Additionally, re-estimation of logistic model coefficients in CIP yielded a 0.90 C-statistic. The resulting comorbidity and pharmacotherapy variables most highly associated with OIRD and retained in the CIP-RIOSORD were largely concordant with VHARIOSORD. These variables included neuropsychiatric and cardiopulmonary disorders, impaired drug excretion, opioid characteristics, and concurrent psychoactive medications. The average predicted probability of OIRD ranged from 2% to 83%, with excellent agreement between predicted and observed incidence across risk classes. Conclusions. RIOSORD had excellent predictive accuracy in a large population of US medical users of prescription opioids, similar to its performance in VHA. This practical risk index is designed to support clinical decision-making for safer opioid prescribing, and its clinical utility should be evaluated prospectively. [ABSTRACT FROM AUTHOR]

A randomized controlled trial was used to examine the impact of an attachment-based, teacher-child, dyadic intervention (Banking Time) to improve children's externalizing behavior. Participants included 183 teachers and 470 preschool children (3-4 years of age). Classrooms were randomly assigned to Banking Time, child time, or business as usual (BAU). Sparse evidence was found for main effects on child behavior. Teachers in Banking Time demonstrated lower negativity and fewer positive interactions with children compared to BAU teachers at post assessment. The impacts of Banking Time and child time on reductions of parent- and teacher-reported externalizing behavior were greater when teachers evidenced higher-quality, classroom-level, teacher-child interactions at baseline. An opposite moderating effect was found for children's positive engagement with teachers. [ABSTRACT FROM AUTHOR]

Objective Multiunit housing (MUH) residents are susceptible to secondhand smoke (SHS) exposure, which can transfer between living units. This review summarises existing scientific literature relevant to smoke-free MUH, discusses knowledge gaps and provides recommendations for future research to inform public health action. Data sources We conducted a systematic search of peer-reviewed articles using three databases: EBSCOhost CINAHL, PubMed and Web of Science. Study selection Article titles, abstracts and text were reviewed to ascertain three inclusion criteria: (1) English language; (2) conducted in the USA; (3) reported on baseline data, development, implementation or evaluation of smoke-free MUH. Data extraction We used a multistep process to identify eligible articles: (1) two reviewers separately evaluated article titles; (2) two reviewers separately evaluated abstracts and (3) one reviewer read each article and determined inclusion eligibility. Data synthesis We identified and included 35 articles published during 2001-2014, grouped based on broad themes: MUH resident (n=16); MUH operator (n=6); environmental monitoring and biomarkers (n=9); economic (n=2); legal (n=3); and implementation process and policy impact (n=8). Studies with multiple themes were included in all relevant groups. Conclusions Existing literature has focused on selfreported, cross-sectional studies of MUH residents and operators; some studies of environmental markers, biomarkers and economic indicators have also been conducted. Future research on smoke-free MUH policy compliance and enforcement, and on the impact of these policies on smoking behaviours and health outcomes, could further inform public health planning, policy and practice. Despite these gaps, the current literature provides sufficient evidence for action to eliminate SHS exposure in MUH. [ABSTRACT FROM AUTHOR]

Background/Context: As increasing attention is paid to preparing students to succeed in school, the development and adoption of research-based curricula have become progressively more important. However, many curricular designs lack a basis in scientific evidence; research and curricular design are frequently treated as two separate enterprises. Purpose/Objective: In this paper, we present the Research on Curriculum Design (RCD) model, first advanced by Clements in 2007, with results from its application to the design and iterative development of pre-kindergarten mathematics and science curricula. Research Design: RCD is an example of design-based research, with the additional specific goals of the production of an effective curriculum and the evolution of theoretical guidelines to inform future curricular designs. Our implementation spanned two years and involved iterative development and testing of two, year-long curricula. Findings/Results: Application of RCD methods informed our understandings of the target population, the knowledge and skills to be developed, and the theoretical and research-based models that guided the designs. Subsequent iterative development and evaluation in five pre-K classrooms enabled refinement of the curricular design, as well as the evolution of design guidelines useful for informing future curriculum development efforts. A culminating test of the resulting curricula in eight pre-K classrooms suggests the success of the RCD approach, yielding high-quality, high-fidelity teacher implementation, with teacher fidelity and curricular dosage predicting students' mathematics learning gains across the year. Conclusions/Recommendations: Results support the value of the RCD model for achieving research-based curricula that have the potential to effectively support teachers in their practice and positively impact children's early learning. [ABSTRACT FROM AUTHOR]

Background: Prophylactic antibiotics decrease surgical site infection (SSI) rates, and their timing, choice, and discontinuation are measured and reported as part of the Surgical Care Improvement Project (SCIP). The aim of this study was to assess the comparative effectiveness of the SCIP-approved antibiotics for SSI prevention.Methods: This retrospective cohort study utilized national Veterans Affairs (VA) data on patients undergoing elective hip or knee arthroplasty from 2005 to 2009. Data on prophylactic antibiotics were merged with VA Surgical Quality Improvement Program data to identify patient and procedure-related risk factors for SSI. Patients were stratified by documented penicillin allergy. Chi-square and Wilcoxon rank-sum tests were used to compare SSI rates among patients receiving SCIP-approved prophylactic antibiotics.Results: A total of 18,830 elective primary arthroplasties (12,823 knee and 6007 hip) were included. Most patients received prophylactic cefazolin as the sole agent (81.9%), followed by vancomycin as the sole agent (8.0%), vancomycin plus cefazolin (5.6%), and clindamycin (4.5%). Documented penicillin allergy accounted for 54.1% of cases involving vancomycin administration compared with 94.6% of cases involving clindamycin. The overall thirty-day SSI rate was 1.4%, and the unadjusted rate was 2.3% with vancomycin only, 1.5% with vancomycin plus cefazolin, 1.3% with cefazolin only, and 1.1% with clindamycin. Unadjusted analysis of penicillin-allergic patients revealed an SSI rate of 2.0% with vancomycin only compared with 1.0% with clindamycin (p = 0.18). For patients without penicillin allergy, the SSI rate was 2.6% with vancomycin only compared with 1.6% with vancomycin plus cefazolin (p = 0.17) and 1.3% with cefazolin only (p < 0.01).Conclusions: Current SCIP guidelines address antibiotic timing but not antibiotic dosage. (The generally accepted recommendation for vancomycin is 15 mg/kg.) Although vancomycin is a narrower-spectrum antibiotic than either cefazolin or clindamycin, our finding of higher SSI rates following prophylaxis with vancomycin only may suggest a failure to use an appropriate dosage rather than an inequality of antibiotic effectiveness.Level Of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]