2313 research outputs found
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Suozzi\u27s Strategy: Holding Town Halls in Hopes of a Campaign Breakthrough [Media Interview]
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Ethical Issues in ABA-based Service Provision for Autism in Limited-Resource Contexts: A Case Example of the People’s Republic of China
No full textRecommendations for intervention for young children with autism spectrum disorders (ASD) focus on early, intensive, and often individual intervention based on methods of applied behavior analysis. In much of the world, there are few options for early intervention. This article examines this question: in a context where intensive and high staff-to-student ratio intervention is not possible, how can provision of high-quality evidence-based intervention be ensured? We consider the case of China, where intervention for young children with autism is provided at diverse educational organizations, and funding limitations impact teacher-to-student ratio. Due to challenges, rigorous use of evidence-based methods often lags behind best practices. This article presents an ethical analysis of the choices educators face and research-based recommendations consistent with the ethical analysis. Given the current context, we recommend a socially valid approach of systematically using group instruction based on ABA principles to increase the effectiveness and intensity of each aspect of intervention programs. While focused on the case of China, recommendations and analysis have implications for other settings with limited resources
Concept Analysis of Systems Thinking in the Context of Interprofessional Practice and Improved Patient Outcomes
No full textAim: The purpose of this study was to explore the definition and application of systems thinking (ST) in interprofessional practice and improved patient outcomes.
Background: Nurse educators need a universal definition of ST to implement in curricula to foster quality and safety while enhancing outcomes for nursing students.
Method: The QSEN RN-BSN Task Force used the hybrid model of concept analysis to identify the process of fostering ST in clinical and didactic learning experiences and how ST changed over time from the perspective of educators.
Results: The definition of ST in the context of interprofessional practice and outcomes was a dynamic, analytical process that looks at complex patterns, relationships, and connections within elements and structures, resulting in the ability to recognize the whole picture.
Conclusion: The concept of ST in the context of interprofessional practice and improved patient outcomes may be integrated within nursing curricula
Examining the Role of Physical Activity Interventions in Modulating Androgens and Cardiovascular Health in Postmenopausal Women: A Narrative Review
No full textA growing body of literature has examined the role of physical activity (PA) in modifying the effects of estrogen withdrawal on cardiovascular health in postmenopausal women, but the impact of PA on androgens is less clear. Changes in androgen concentrations following regular PA may improve cardiovascular health. This narrative review summarizes the literature assessing the impact of PA interventions on androgens in postmenopausal women. The association between changes in androgen concentrations and cardiovascular health following PA programs is also examined. Randomized controlled trials were included if they (i) implemented a PA program of any type and duration in postmenopausal women and (ii) measured changes in androgen concentrations. Following PA interventions, no changes in androstenedione, conflicting changes in dehydroepiandrosterone/dehydroepiandrosterone-sulfate, and increases in sex hormone–binding globulin concentrations were found. Total testosterone decreased following aerobic PA but increased after resistance training. Most aerobic PA interventions led to reductions in free testosterone. A combination of caloric restriction and/or fat loss enhanced the influence of PA on most androgens. Evidence exploring the relationship between changes in androgens and cardiovascular health indicators was scarce and inconsistent. PA has shown promise in modifying the concentrations of some androgens (free and total testosterone, sex hormone–binding globulin), and remains a well-known beneficial adjuvant option for postmenopausal women to manage their cardiovascular health. Fat loss influences the effect of PA on androgens, but the synergistic role of PA and androgens on cardiovascular health merits further examination. Many research gaps remain regarding the relationship between PA, androgens, and cardiovascular disease in postmenopausal women
Barriers and Facilitators to Chronic Pain Management for Women
No full textA qualitative research design with an action research approach was utilized to identify barriers and facilitators to women seeking healthcare for chronic pain. Katherine Kolcaba’s theory of comfort was the framework that guided this study. In total, four women were interviewed using structured interviews designed to explore these barriers and facilitators to help gain a better understanding of the process and their experiences. Inductive content analysis was used to identify themes from the participant’s responses. These themes included facilitators of “self-advocating and persistence” and “seeing the whole picture” as well as barriers which included, “feeling dismissed”, “stigmatized”, and experiencing “gender bias”. By focusing on the facilitators to managing chronic pain, healthcare providers can improve quality of care for women, improve the patient-provider relationship, and reform practice to eliminate gender bias
Periphyton C and N Stable Isotopes Detect Agricultural Stressors in Low-Order Streams
No full textShifts in the stable isotope signatures of C and N in ecological materials have the potential to indicate environmental disturbances. This study examined the δ13C‰ and δ15N‰ ratios of stream water and periphyton from low-order streams in a landscape influenced by agricultural activities. Our key purpose was to assess the influence of best management practice (BMP) presence and age on C and N isotope values as a potential water-quality assessment. We collected stream water and periphyton from 19 streams within the Upper Delaware River watershed in New York, USA, in each of 4 management categories: 1) recently applied BMP treatments, 2) long-standing BMPs, 3) streams lacking BMPs, and 4) minimally disturbed reference streams. We sampled and analyzed water and periphyton for δ13C‰ and δ15N‰ in a repeated-measures design (BMP category × time) from April to November 2013. There were large seasonal differences in stream water δ13C-dissolved organic C (DIC)‰ and δ15NO3-N‰, with strong differences between reference and agricultural streams. Periphyton δ13C‰ and δ15N‰ values also differed strongly across streams draining land with agricultural activities, with 85% higher periphyton δ15N‰ signals in all agricultural categories vs reference streams. Periphyton diatom and chlorophyte taxonomic proportions showed the strongest relationship with periphyton δ13C‰ values, where diatoms were negatively associated with increasing δ13C‰. These results suggest that aqueous and periphytic stable isotopes were sensitive in detecting persistent effects of agriculture on these streams despite BMP mitigation, where nutrient (orthosphosphate, nitrite, and ammonia) levels were non-indicative. These results also suggest that BMPs may not have fully eliminated the negative impacts of agricultural stressors on water quality in impacted streams