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Improving the Discussion of Suicide Prevention: A Quality Improvement Project
No full textSuicide is currently the second leading cause of death among adolescents in the United States and the third leading cause of death in this age group worldwide.1,2 Suicide prevention is understandably a growing focus in pediatrics. Currently, at the Children’s Hospital Outpatient Clinic, that is staffed by pediatric resident physicians, suicidal ideation is screened for using a PHQ-9 screen. However, at the time this study was initiated and completed, the TEEN screen was utilized. After the screening is performed, regardless of type, it is up to the provider to address these findings in a safe and effective manner. The goal of this quality improvement project was to develop and implement a suicide safety plan for patients who express suicidal ideation and to increase resident’s comfortability when discussing suicide prevention with patients. Google Forms were used to survey pediatric residents to obtain preliminary data, as well as data following each PDSA cycle. For our first PDSA cycle, the initial suicide safety plan was introduced. After feedback provided by residents, the safety plan was then converted to a flowsheet style format for the second PDSA cycle. Both formats were then compared to assess the use and associated resident comfort. Suicidal ideation is a prevalent issue in pediatrics as evidenced by our preliminary data which reported that out of 30 residents, 26 (86.7%) have encountered a patient with suicidal ideation. However, the percentage of residents who rated themselves a 5, or “very comfortable”, on a scale of 1-5 with 1 being “not comfortable at all,” when discussing suicide with patients was just 13.3%. With each phase of our study, the percentage of residents who rated themselves a 5, or “very comfortable” increased from 40.9% to 50%, respectively. Our data indicates that the implementation of such a plan did increase resident comfort by acting as a template for which to guide discussion with patients and their families for a very important topic in adolescent health
Sad Music Listening: What is it Good For? An Exploratory Study of Motivations for Listening to Sad Music
No full textThis study sought to bolster research related to the function of sad music listening. Music listening is a common coping strategy for individuals attempting to cope with and manage different emotional states, including negative or sad moods and emotions. Research surrounding self-reported reasons or motivations for listening to sad music outlines several factors that appear to serve as mood-management strategies. However, there are discrepancies among these motivations across research, which thus far has consisted of qualitative interviews of participants. (Garrido & Schubert, 2011; Saarikallio & Ekkila, 2007; Van den Tol & Edwards, 2013). Additionally, it is unclear whether listening to sad music helps promote adaptive problemsolving strategies, such as reflection, serves as a means for expressive suppression through distraction, or if negative attentional biases increase sad music listening (Garrido & Schubert, 2013b; Gotlib et al., 2004; Wenzlaff & Bates, 1998). The current study utilized quantitative data collected from 221 undergraduate students at a Midwestern university. Consistent with hypotheses, results produced Diversion and Emotional Arousal factors as motivations for listening to sad music in addition to four other components: Catharsis/Validation, Mood Repair/Relaxation, Memory Retrieval, and Mental Work/Reflection. All but one component (Diversion) predicted sad music listening. Contrary to hypotheses, the current study did not find support that those who endorsed reflection as a motivator for listening to sad music tended to engage in rumination more than reflection. Findings revealed that contrary to hypotheses, the component of Diversion was not associated with expressive suppression. Given the relationship between sad music listening and depressive symptoms in this study, results have clinical implications that may be considered when treating those with depression who listen to sad music
Dermatoglyphic Fluctuating Asymmetry in Schizotypy
No full textSchizotypy has been linked with many of the proposed endophenotypes of schizophrenia, but research is limited on the relationship between schizotypy and dermatoglyphic fluctuating asymmetry. The present study sought to examine relationships between schizotypy, dermatoglyphic fluctuating asymmetry, handedness, and season of birth. 146 undergraduate students were identified as schizotypes (n = 52) or controls (n = 94) based on the Multidimensional Schizotypy Scale and had their finger and palm prints collected along with completing additional measures of schizotypy and handedness. Schizotypes did not exhibit a greater degree of dermatoglyphic fluctuating asymmetry, negative schizotypy was associated with increased absolute finger ridge count discordance, palmar A-B ridge count was associated with increased non-right handedness, and schizotypes were nearly twice as likely to be born in the winter months. These findings provide further support for dermatoglyphic fluctuating asymmetry as an endophenotype of schizophrenia. Limitations of the present study and recommendations for future research are discussed
Working Outside the Box: Advertising Campaigns, Downtown Revitalization, and Community Engagement
No full textThis descriptive analysis of an Advertising Campaigns course demonstrates how measured risk-taking can help establish a “virtuous cycle of improvement” between universities and communities. Student engagement in downtown revitalization efforts was supported by a flexible syllabus, strategic classroom management, and strong partnerships. The essay emphasizes the process of making curricular decisions that align with instructors’ experience, talent, and goals. When teaching outside of the box instructors should choose models that complement their own expertise and talents
Consortium, University, and Program Impact on Regional Economy and Community
No full textCommunity engagement in higher education has become increasingly widespread. As a consequence, universities find themselves learning how to integrate community engagement on their own, from each other, and, hopefully, from their community partners. This article discusses three distinct cases–a consortium, university, and program–and their impacts on a regional economy and community. In addition to illustrating intentional macro to micro community engagement practices, the article notes key findings from regional institutional collaborations. Further, the article recommends benchmarks for evaluating the quality and effective practice of community engagement
Safer Spaces: Creating a Supportive Rehabilitation Environment for Gay, Transgender and Questioning Youth
No full textThis manuscript describes Safer Spaces, a semester-long outreach program between faculty, students and the Augusta Youth Detention Center Campus (AYDC). The purpose of the project was two-fold: (a) to meet an expressed need of a state agency and (b) to create a unique opportunity for university outreach and service learning. Safer Spaces centered on assessing and meeting the needs of staff and adjudicated youth with resources about gay and transgender identity development in a predominantly African American facility with a group of interdisciplinary service-learning students in Counseling-Psychology, Recreation and Leisure Studies, and Women’s Studies
Service Learning Projects in the Public Relations Writing Course
No full textThis study explores the pedagogical effectiveness of service learning in the Public Relations Writing course. Surveys of students and their nonprofit clients, student reflection papers, and comparisons of grades in service-learning vs. non-service-learning sections found that the service-learning approach resulted in greater understanding of course content, higher grades on writing assignments, and greater appreciation for diverse cultures. Clients said students lightened staff workloads, brought new ideas, and enabled them to better meet community needs
Reading Beyond Research Results: The Hidden Curriculum in a College and Urban High Schools Partnership
No full textThe article draws from a study of a Gear Up partnership between a predominantly white middle class college and four urban high schools with a majority of low-income students of color. Teacher education candidates participated in community engagement through Gear Up at four urban high schools. The study shows that both college and high school students benefited from the partnership. However, employing internal and anticolonial theoretical lenses reveals the hidden curriculum that the positive results attained from the partnership may serve to buttress the myth of dominant culture’s supremacy
Community Service in Saudi Arabian Universities: A Comparative Study
No full textA comparative analysis is presented of community service activities in Saudi Arabian Universities. The methodology includes literature surveys, benchmarking, questionnaires, and focus group meetings. Community service definitions and activities are surveyed around the world. A benchmarking comparison is made between community service programs in 10 major Saudi universities and 20 top American universities. The current status of community service in Saudi universities is evaluated, and several improvement strategies are proposed
Adolescent Femoral Neck Fractures: A Case Study on Initial Surgical Intervention, Avascular Necrosis Development, and Subsequent Total Hip Arthroplasty
No full textBackground: The patient sustained a femoral neck fracture at the age of 13 after slipping and falling in his home. He was seen in the Emergency Department the same day and underwent a closed reduction and percutaneous pinning procedure the following morning. Ten weeks after returning to full weightbearing, and 13.5 weeks after his initial fracture, he developed stress fractures of the medial distal femoral and proximal tibial metaphyses. He experienced gradual worsening of hip pain and difficulty with ambulation between 11 to 13 months post-closed reduction and percutaneous pinning (CRPP). Avascular necrosis and collapse of the femoral head was identified on radiograph, and he underwent hardware removal. Magnetic resonance imaging was performed to assess the extent of the lesion for surgical planning. It was determined that the defect was too large to be a candidate for a femoral head allograft transplant, and it was recommended he undergo a total hip replacement. His total hip arthroplasty (THA) was performed 5 months following his hardware removal and 19 months after his initial fracture. Interventions and Timeline: Table. Diagnostics: Figure 1 and Figure 2. Uniqueness: The overall incidence of avascular necrosis after a proximal femoral neck fracture in pediatric patients aged 0 to 18 is 22%. However, this has been found to vary based on the Delbet fracture type and age of the patient. This patient met both criteria for higher risk factors of developing avascular necrosis (AVN), which are aged over 12 and a Delbet Type I or II proximal femoral neck fractures They identify 61% increased likelihood in those older than 12 when compared to their younger counterparts and 32% increased risk in Types I and II when compared to Types III and IV. The overall incidence following a Type II fracture, as is the case for this patient, is 32%, and the incidence for a Type I fracture is 45%. This study found no correlation between AVN development and reduction type or treatment time within 24 hours. The overall conversion rate from femoral neck CRPP to THA in adults is 10.4% at an average of 11.2 months post-operatively. Furthermore, it is suspected that there is a higher incidence of conversion in younger adults when compared to their older counterparts, so it may be reasonable to assume the same in the pediatric population. After discovering the femoral head collapse, this patient underwent a hardware removal in a staged fashion before his THA, similar to previously reported literature. Removing retained pediatric hardware at the time of THA has resulted in increased intraoperative time, length of stay, need for bone grafting, risk of intraoperative complications/fracture, loosening of the implants, and ultimate need for revision. The recommendation is to wait 3 to 6 months between hardware removal and THA. Outcomes: The patient in this case is currently 7.5 months post THA and is doing well. He rates his pain at a 0/10 and is no longer taking oral analgesics or using a crutch for ambulation. Key points moving forward are consistent follow-up appointments to monitor deterioration of the implants. Since the expected lifespan of the artificial joint ranges from 10 to 20 years, in the pediatric patients, it is extremely important to replace poly lining before becoming metal-on-metal, avoiding a potential revision. Additional concerns in the pediatric THA patient include a future leg length discrepancy as the patient continues to grow and mature. The current plan of care in the event of an acquired leg length discrepancy is to manage with shoe lifts/inserts as long as possible, and if needed, replace the femoral stem/neck with a longer one