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Situated Learning and Interprofessional Education: An Educational Strategy Using an Apprenticeship Model to Develop Research Skills for Practice
Get PDFInterprofessional education (IPE) offers an opportunity to train health professional students to develop research skills, collaboratively, while working on authentic healthcare problems. The situated learning educational model offers a unique way of structuring IPE experiences to incorporate the healthcare context, Communities of Practice, and meaningful participation of all learners. This paper will discuss an educational strategy developed to support the role progression of interprofessional research students within a project that is embedded in an authentic healthcare problem that has implications for IPE program development. The authors present a visual model that supports understanding of the development of knowledge and skills of learners that has implications for IPE, educational training, and research practice
Infant Mortality and Racism in the United States
Get PDFSignificant health disparities exist in the United States with regard to infant mortality, a sensitive indicator of a nation’s health. The US has one of the highest infant mortality rates among OECD countries at nearly 6 infant deaths for every 1,000 live births. The rate for Black Americans (11.11 per 1,000) is more than double the rate for White Americans (5.06 per 1,000). Black American women are at higher risk of experiencing risk factors for infant mortality including preterm birth, low birthweight, and prenatal stress. The experience of racism from childhood through adulthood (personal experiences, vicarious experiences, and institutionalized structural racism) is likely a significant contributor to the disparity in infant mortality. This paper reviews the evidence for this and examines racism as a public heath issue
Breaking down barriers: Serving the first-generation student in today\u27s academic library
Get PDFAs colleges, universities, and academic libraries work to adapt their student recruitment, retention, and support services to meet the needs of an increasingly diverse student population, one group of students merits special attention: first-generation college students. This program presents the results of research into the challenges first-generation students face in transitioning to college and initial recommendations for the design of academic library services to support these students’ academic success
Efficacy of Methylphenidate in the Geriatric Population for Fall Prevention
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Background: Approximately one-third of people aged 65 years and over who are not living in institutions fall at least once a year, with higher rates among those living in institutions. One half of older adults who are hospitalized as a result of a fall survive one year later.The importance of fall prevention in older adults is well researched, with many established community based programs in the United States focusing on exercise and fundamental education for fall reduction. However, new options for prevention are being explored. Executive function and gait, both related to falls, may be improved by methylphenidate, providing a promising option for fall prevention in older adults.
Methods: An exhaustive literature search using MEDLINE-PubMed, Web of Science, and Clinical Key was conducted. The following search terms were used: “methylphenidate falls prevention,” “methylphenidate older adults,” and “falls prevention methylphenidate.” Eligibility criteria were used to screen studies. These studies included the use of single dose methylphenidate versus placebo to measure efficacy in falls prevention. GRADE was used to assess quality of the resulting studies.
Results: Two studies were included in this systematic review, meeting the inclusion and exclusion criteria. One study was a double-blind RCT in 30 healthy older adults testing improvement of executive, motor and balance function. Another study in 26 older adults without dementia but with subjective complaints of memory problems tested the modification of markers for fall risk. These studies have medium quality of evidence based on GRADE guidelines.
Conclusion: These studies found that methylphenidate improved gait and executive function in older adults, and should be considered by clinicians as a method of fall prevention in this population. These results warrant further investigation of methylphenidate use in fall prevention with large-scale studies.
Keywords: Methylphenidate, older adults, and fall preventio
Sleeve Gastrectomy Compared to Gastric Bypass as a Treatment for Type 2 Diabetes in those with a BMI \u3c 35
Get PDFBackground: Thirty million people in the United States have diabetes, of which, nearly 90% are considered overweight or obese. Bariatric surgery, with the two most popular types being sleeve gastrectomy (SG) and gastric bypass (GB), is currently indicated as a treatment of type 2 diabetes (T2D) in those with a BMI \u3e 35. However, recent studies have shown bariatric surgery to be an effective treatment in those with BMI \u3c 35. Therefore, the aim of this systematic review was to determine if SG is comparable to GB for treating T2D in those with a BMI \u3c 35.
Methods: An exhaustive literature search was completed using the following search engines: CINAHL-EBSCOhost, Web of Science, and MEDLINE-PubMed, and the following search terms: bariatric surgery, type 2 diabetes, and BMI \u3c 35. The quality of relevant articles was assessed using the GRADE Working Group guidelines.
Results: A total of 2 studies met specific inclusion criteria and were included in this systematic review. Both studies were randomized controlled trials. One study of 60 overweight or non-morbidly obese adults with T2D found GB to be superior to SG in regards to treating T2D. The other study consisted of 64 overweight or non-morbidly obese adults with T2D and found that there was no significant difference in the remission or improvement of T2D between SG and GB.
Conclusion: Whether GB is superior to SG remains unclear; however, SG may be a reasonable alternative to GB. Other studies with larger sample sizes, longer follow-ups, and the use of non-surrogate outcomes are needed to elucidate the differences in SG and GB for treating T2D in those with a BMI \u3c 35
Association of Weight Fluctuation and Increased Mortality in Middle-Aged Populations
Get PDFBackground: Obesity, a growing epidemic worldwide, has been linked to several comorbid conditions including, but not limited to, heart disease, type 2 diabetes mellitus, and certain types of cancer. To both prevent and treat obesity-associated comorbidities, it is common practice for healthcare providers to prescribe weight loss as a medical intervention. Unfortunately, many individuals who lose weight are unable to maintain it long-term. Therefore, people who are obese commonly experience several weight loss and regain cycles over the course of their lives. The question this review aims to answer is whether these weight fluctuations have an adverse effect on middle-aged individuals’ lifespans and, if so, what can be done to achieve improved weight maintenance.
Methods: An exhaustive search of available medical literature was performed using CINAHL, MEDLINE, and Web of Science. Key terms included: weight fluctuation and mortality. The quality of eligible studies was assessed using GRADE guidelines.
Results: The literature search yielded 33 studies, 4 of which were relative to the clinical question while meeting eligibility criteria. One of the 4 studies was a randomized control trial while the remaining 3 were observational studies. Each of the 4 studies found that weight fluctuations in middle-aged populations are linked to a significant increase in mortality. However, unlike the other studies, the Wannamethee et al study stated these results were markedly attenuated when accounting for other morbidities. While these results are thought-provoking and potentially practice-changing, the quality of the evidence was not shown to be strong. Per the GRADE guidelines, the quality of the randomized control trial was moderate while the quality of the 3 observational studies was very low.
Conclusion: Weight fluctuations in middle-aged populations may be associated with an increased risk of mortality. However, to obtain a more definitive answer, future studies should avoid self-reported data. Additionally, forthcoming research might consider looking at the degree of weight fluctuation to determine if there is a dose-response gradient. Lastly, a distinction between intentional versus unintentional weight fluctuations should be accounted for in subsequent studies. Being that there may be an association between weight fluctuations and increased risk of mortality in middle-aged populations, healthcare providers using weight loss as an intervention to prevent or treat comorbid conditions associated with obesity must be prepared to provide ongoing encouragement and support of weight loss maintenance.
Keywords: Weight fluctuations, mortality, middle-aged population
Inmates and Dogs: A Phenomenological Study of Male Inmates’ Experiences in a Prison - Based Animal Program
No full textIn this phenomenological qualitative study, eight male inmates in an Oklahoma prison were interviewed about their experiences training dogs in a prison-based animal program. The interviews were coded and analyzed, and three overarching and intersecting themes were developed: enhanced skills and knowledge, meaningful connections, and positive emotions. The themes extended across three separate but intersecting domains: intrapersonal, interpersonal, and community. Implications of the results and future directions for research are discussed