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Health Care Professionals Approaches to Screening for Perinatal Mood and Anxiety Disorders in Adolescents
No full textPerinatal mood and anxiety disorders (PMADs) are one of the most common complications of childbirth. While they impact up to 50% of adolescent mothers, PMADs are frequently underdiagnosed and undertreated. Left untreated, PMADs can lead to dysregulated maternal-child connections, maternal suicide, and altered cognitive development in children. Front-line Health Care Professionals are in a critically significant position to screen, and diagnose PMADs. However, there is a lack of research on their experiences and approaches to screening for PMADs. The purpose of this informed grounded theory study was to begin to understand current practices for screening for PMADs from participants who treat pregnant and parenting adolescents, and to understand participants’ experiences with PMADs in adolescents. Method included individual interviews with a purposeful sampling of eight front-line Health Care Professionals who have experience treating pregnant and parenting adolescences. Interviews were transcribed and analyzed using open, axial, and selective order and iterative constant comparison. Three main themes emerged throughout the data:1) inconsistent practices for screening adolescents for PMADs, 2) barriers to screening, and 3) future recommendations. Within the core themes, 10 categories and 11 subcategories were revealed in the data. The data analyses demonstrated that Health Care Professionals do not asses risk factors for PMADs in adolescents in a structured and consistent manner. Participants explained professional, patient-specific, cultural, and systemic limitations in addressing PMADs in adolescents. Participants also identified recommendations and a call to action to address the significant gaps in providing appropriate screening to adolescents
Older Adults’ Valuation of Group Therapeutic Factors
No full textOlder adults often differ from younger adults in the frequency and presentation of mental health disorders, and group psychotherapy is an intervention that may uniquely benefit them. Research into how older adults in group therapy value the therapeutic factors can inform development of interventions that are specific to the developmental needs of those in later life. In this study, group therapy members (N = 28) age 55 and older were surveyed as to their valuation of the therapeutic factors. The therapeutic factors that participants most valued were group cohesiveness, instillation of hope, and socializing techniques. These results suggest that the most helpful aspects of the group therapy experience to older adults are relief from social isolation, benefit from seeing others get better, and practice forming more meaningful relationships
Feasibility and Acceptability of Mindfulness-Based Relapse Prevention and Adjunct Mobile Technology in Rural Communities
Get PDFWhile problematic substance use transcends geographic regions, rural communities appear to be especially impacted. More prevalent problematic substance use and associated problems in these areas are exacerbated by lack of consistent access to evidence-based practices. Mindfulness-Based Relapse Prevention (MBRP) combines standard cognitive-behavioral relapse prevention with formal and informal mindfulness training, and may be a novel and effective treatment approach for substance use disorders (SUD) in these isolated areas. The current study explored feasibility and acceptability, and potential differences in variance accounted for by group randomization on substance use and secondary outcomes, between MBRP and treatment as usual (TAU) in a rural treatment setting, as well as the impact of a specially designed mobile application on treatment engagement and enactment. No differences were observed in variance of substance use or secondary outcome by groups; however, participants in TAU vs. MBRP were more likely to drop out of treatment against medical advice. The mobile application did not appear to impact treatment engagement or enactment. Implications and limitations are discussed
Volume 24 Issue 4 Introduction: From the Guest Editor
No full textToday it’s hard to imagine life without a smartphone, but broadcast television, travel to the moon, MARC records, personal computers, email, the Internet, online library catalogs, cell phones, video on demand, virtual reality, and digital archive collections all came about in one human generation.
Throughout that generation of disruptive and innovative technologies, librarians have served the public good by providing the conceptual skills to organize and describe information and provide or facilitate access to it. Moreover, libraries, through cooperatives and information sharing agreements, have made possible the construction of massive data systems that serve our nation’s needs with respect to heritage content, contemporary awareness and future planning.
And that’s the foundation of this special issue of the OLA Quarterly on digital repositories and data harvests. In this issue, experts from Oregon’s libraries, Larry Landis (OSU), Mark Dahl and Zachariah Selley (Lewis & Clark), Sarah Seymore (UO), Becca Evans (SOU), Julia Simic (UO) and Ryan Wick (OSU), Beth Dehn (Oregon Heritage Commission), and Ross Fuqua and Arlene Weible (Oregon State Library) describe their work to develop important collections that have been or will be harvested and shared broadly with users throughout the world. These aren’t siloed collections that live solely in a local database or on one institution’s server. These are world-class collections, shared globally to enrich human existence
Using a Motor GCS Score or “Patient Does Not Follow Commands” to Replace the Glasgow Coma Scale for Predicting Severe Injury in Trauma Patients
No full textBackground: To assess an injured patient’s condition and to triage the patient to the appropriate facility, out-of-hospital providers use the Glasgow Coma Scale (GCS) even though the GCS has known inconsistent results. A GSC motor (GCS-m) less than 6 or “patient does not follow commands” would be an acceptable substitution to the full GCS to simplify trauma triage.
Method: An exhaustive literature search using MEDLINE-Ovid, Web Science, and CINAHL was conducted. The following search terms were used: “patient does not follow commands” and “Glasgow Coma Scale” which yielded 2 studies. Studies were assessed for quality using GRADE criteria.
Results: Studies confirmed that a simpler determination of “patient does not follow commands” can be as accurate as the total GCS score. One study showed that the difference between total GCS score less than or equal to 13 and GCS-m score less than 6 or “patient does not follow commands” were below their prespecified 5% threshold and thus clinically unimportant. The full GCS scale was found to be more sensitive and slightly less specific than the GCS-m score less than 6 for predicting an injury severity scale (ISS) greater than 15, with overall similar accuracy. Another study validated that GCS-m score less than 6 or “patient does not follow commands” had similar accuracy to the full GCS scale for multiple trauma outcomes, and the graphed sensitivity versus specificity was nearly identical for the GCS-m less than 6 and full GCS scores.
Conclusion: The simpler determination of GCS-m less than 6 or “patient does not follow commands” effectively predicts serious injury similarly to the more complicated total GCS score. The differences in specificity and sensitivity between GCS-m score less than 6 and total GCS score were similar, and accuracy were the same. It is recommended that the simpler “patient does not follow commands” replace the total GCS for out-of-hospital trauma triage.
Keywords: Glasgow Coma Scale and “patient does not follow commands
Impact of exercise on the hemodynamics of intraocular pressure, blood pressure, retinal vessel density and ocular perfusion pressure in healthy subjects
No full textAbstract
Purpose: The purpose of this study is to look at the effect of dynamic and isometric exercise on systemic and ocular hemodynamics, such as heart rate, blood pressure, vessel density of radial papillary capillary (RPC), and how it relates to intraocular pressure (IOP) on healthy subjects.
Methods: In a prospective study design,participants performed two types of exercise: dynamic (aerobic cycling) vs isometric (strength training with resistance band). The subject’s IOP, heart rate, blood pressure, and retinal vessel density was measured pre- and post-exercise. The ocular perfusion pressure was calculated using the collected data.
Results:Forty participants (20 male, 20 female) between the ages of 18 and 30 years old (mean=24.3 years old, SD=3.4 years old) were enrolled. The effect of exercise type (dynamic vs. isometric) was significantly different forIOP (P =0.008), ocular perfusion pressure (OPP) (P \u3c0.001), systolic blood pressure(SBP) (p \u3c0.001), diastolic blood pressure(DBP) (P =0.02), heart rate(HR) (p \u3c0.001), superior nasal (SN) (P =.019). Exercise had a significant effect on OPP (p \u3c0.001), SBP (p \u3c0.001), HR (p \u3c0.001), RPC (p \u3c0.001), SN (P =0.002), nasal superior (NS) (P =0.004), nasal inferior (NI) (p \u3c0.001), inferior nasal (IN) (p \u3c0.001), inferior temporal (IT) (p \u3c0.001) in three different periods (baseline, treatment, and recovery). There was a moderately negative relationship between IOP and OPP (r (240) = -0.490, p \u3c0.01). There was also a significant but weak relationship between IOP and measurements of DBP (r(240) = 0.134, P =0.038) and ST (r(221)= 0.192, P =0.004). A positive relationship was found between OPP with SBP (r (240) = 0.677, p \u3c0.001) and OPP with DBP (r (240) = 0.660,p \u3c0.001) largely because SBP and DBP are the variables used to calculate OPP.OPP was also positively correlated with HR (r(240) = 0.461, p \u3c0.001and TS region (r(219) = 0.178,P =0.008) and negatively correlated to IN (r(222) = -0.148, P =0.028) and IT (r(222) = -0.159, P =0.017). Regression analysis showed vessel density of inferior/superior sectors were negatively related to OPP, the temporal sector was positively related to OPP, and the association between the nasal sector and OPP was not significant.
Conclusion: Dynamic exercise led to IOP decreas as OPP increased. After dynamic exercise, superior nasal vessel density % decreased more relative to isometric exercise from baseline. This decrease in retinal capillary engorgement in turn increases ocular perfusion pressure, which is preventative for glaucoma
Exploring Multiple Identities in Children’s Literature With Project LIT
No full textOnly in the last 20 years have we seen seeds of intersectional identities planted in children’s/ young adult literature. Even in this shift, the majority of authors writing books with diverse characters are white. In 2017, 31 percent of published Kidlit contained diverse characters, yet only 7 percent published were written by Black, Latinx, and Native authors combined (Jalissa, 2018).
I work in the Beaverton School District. Forty-eight percent of our students are white, which means students of color are the majority. Yet, 87 percent of our teachers are white (Oregon Department of Education, 2018). The staff/student ethnicity ratio is problematic for most of our students needing “mirrors” in their learning environment. Until this balances out in districts around Oregon, literature can serve these students in reflective ways, as well as providing windows to peer into each others’ lives and cultures.
As a librarian, it is imperative for me to display books in which every student at our middle school can see their reflections. In those same reads, different students will gain empathy for others. Which book will impact which student may not be easy to predict. Ensuring the library is stocked with encouraging stories emphasizing diversity, equity, and inclusion is under my control. How else can I provide mirrors, windows, and sliding glass doors to our learning community? I found a way using the Project LIT model