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Anthropogenic edges impact howler monkey (Alouatta palliata) feeding behaviour in a Costa Rican rainforest.
No full textUsing Ambiguous Loss to Address Perceived Control During the COVID-19 Pandemic
Get PDFThe concepts of ambiguous loss and perceived control will be used to explore ways to embrace the unknown during COVID-19. By defining COVID-19 as an ambiguous loss, effective therapeutic interventions emerge that can guide clinicians in creating lasting change amidst widespread uncertainty. Four ambiguous loss interventions will be proposed to alleviate the distress of living in fearful semi-isolation for an unknown period of time. In paradoxically embracing uncertainty, clients can create new hope in the context of a global pandemic. New hope is the ideal outcome when coping with ambiguous loss. In literature on ambiguous loss, the concept of new hope has yet to be recognized as a form of second-order change
Observations on the Relationship between Resilience and Mindfulness
Get PDFIn the last three decades, mindfulness and resilience have received extensive scholarly attention. Research has burgeoned and they have both become “buzz words” in the social sciences and mental health fields. That said, they are often presented as unrelated qualities, skills, or states, and few studies and texts have examined their linkages and/or how they complement each other. Masten’s (2001, 2009) seminal papers and subsequent book (2014) that presented resilience as “ordinary magic” have had large impacts on resilience scholarship, bringing forth that resilience is much more of a common human occurrence and proclivity than previously considered. In this paper, we explore the potential for mindfulness to be a potentially overlooked and ubiquitous protective factor in the development and maintenance of resilience. To achieve this, we propose that mindfulness is fundamental to resilience by investigating linkages between mindfulness and resilience yet to be thoroughly explored in the literature, and discuss how mindfulness is logically connected to resilience. Likewise, we suggest that the complementary interplay between mindfulness and resilience is readily applicable and highly germane, as mindfulness may beget resilience and vice versa
Staff Perceptions of the Health Call Center Workplace Environment
Get PDFThe complexities of the Health Call Center (HCC) amidst of a pandemic has caused an uptick in nurses and staff experiencing physical, emotional, and mental fatigue. An increase in sick calls during peak call days and times, breakroom discussion related to workload and competing patient and clinical priorities, and the consistent need to care for patients and caregivers, while maintaining familial and fiscal responsibilities and priorities contribute to the exhaustion of the nurses. The purpose of this Quality Improvement (QI) project was to use a structured survey tool and open-ended questions to identify HCC nurses’ perceptions of stressors and burnout in the HCC workplace. The burning platform was to validate work-related stressors caused by the perceived internal and external forces which can assist the leadership team in formulating stress management solutions to promote a healthy and productive HCC work environment. The primary outcome objective was to measure burnout using a descriptive design with the Maslach Burnout InventoryTM Human Services Survey for Medical Personnel (MBI-HSSMP) and to perform a thematic analysis of open-ended questions to understand the nurses’ perspectives about potential work-related stressors in the HCC environment that could lead to burnout. Results indicated nurses had lower scores for Emotional Exhaustion (EE) and Depersonalization (D), and high scores for Personal Accomplishment (PA) representing healthier behaviors and decreased burnout characteristics. Thematic analysis findings revealed themes related to standard work, process changes, clinical tools, operational practices, and organizational culture. In the HCC, the QI project recognized the domains of Emotional Exhaustion, Depersonalization, the looming COVID-19 pandemic, and standard work variations as potential work-related stressors of HCC nurses that could lead to burnout
Clinical Effectiveness of an Outpatient Multidisciplinary Chronic Pain Management Telementoring Service
No full textObjective: The objective of this study was to assess the effectiveness of a Pain E-Consult Program (PEP), a multidisciplinary telementoring service based on the Extension for Community Healthcare Outcomes (ECHO) model to reduce opioid use in the outpatient setting. Materials and Methods: This was a retrospective matched cohort study conducted in an integrated health care delivery system. Adult patients without cancer and with a 90-day morphine milligram equivalent (MME) ≥30 mg/d between April 1, 2016, and June 30, 2017, were included. Patients whose primary care clinician received the PEP (observation) were compared with usual care (control) patients. Observation patients were matched up to 1:5 to control patients. Outcomes included change in MME and initiation of nonopioid alternative medications. Multivariable regression analyses were performed. Results: A total of 665 patients were matched: 125 and 540 in the observation and control groups, respectively. Patients were primarily female, white, and Medicare beneficiaries. The observation group had a statistically significantly greater decrease in median MME/day during the 6-month (-7.4 vs. 1.5 mg, P=0.002) and 12-month (-15.1 vs. -2.8 mg, P\u3c0.001) follow-up and rates of ≥20% decrease (6 mo: 41.6% vs. 24.6%, P=0.003; 12 mo: 48.0% vs. 32.6%, P=0.017). There were no differences in the rates of initiation of nonopioid alternative medications. Conclusions: A PEP was associated with greater reductions in MME/day compared with usual care despite similar rates of nonopioid alternative medication initiation. A prospective randomized study of this program should be undertaken to confirm these findings
Driving Out Fear in the Nontraditional Classroom: Five Practical Strategies From Neuroscience to Build Adult Student Success
No full textAlthough enrollment of nontraditional students in higher education is skyrocketing, the failure rate of these students is staggering. They come to a university full of fear and misgivings for a variety of reasons, and it keeps them from succeeding. Referencing the neuroscience of fear, this article offers practical strategies for university educators that will help nontraditional students, not only succeed but also flourish in higher education
Lateral Corticospinal Tract and Dorsal Column Damage: Predictive Relationships With Motor and Sensory Scores at Discharge From Acute Rehabilitation After Spinal Cord Injury
No full textObjective: To determine if lateral corticospinal tract (LCST) integrity demonstrates a significant predictive relationship with future ipsilateral lower extremity motor function (LEMS) and if dorsal column (DC) integrity demonstrates a significant predictive relationship with future light touch (LT) sensory function post spinal cord injury (SCI) at time of discharge from inpatient rehabilitation. Design: Retrospective analyses of imaging and clinical outcomes. Setting: University and academic hospital. Participants: A total of 151 participants (N=151) with SCI. Interventions: Inpatient rehabilitation. Main Outcome Measures: LEMS and LT scores at discharge from inpatient rehabilitation. Results: In 151 participants, right LCST spared tissue demonstrated a significant predictive relationship with right LEMS percentage recovered (β=0.56; 95% confidence interval [CI], 0.37-0.73; R=0.43; P\u3c.001). Left LCST spared tissue demonstrated a significant predictive relationship with left LEMS percentage recovered (β=0.66; 95% CI, 0.50-0.82; R=0.51; P\u3c.001). DC spared tissue demonstrated a significant predictive relationship with LT percentage recovered (β=0.69; 95% CI, 0.52-0.87; R=0.55; P\u3c.001). When subgrouping the participants into motor complete vs incomplete SCI, motor relationships were no longer significant, but the sensory relationship remained significant. Those who had no voluntary motor function but recovered some also had significantly greater LCST spared tissue than those who did not recover motor function. Conclusions: LCST demonstrated significant moderate predictive relationships with lower extremity motor function at the time of discharge from inpatient rehabilitation, in an ipsilesional manner. DC integrity demonstrated a significant moderate predictive relationship with recovered function of LT. With further development, these neuroimaging methods might be used to predict potential deficits after SCI and to provide corresponding targeted interventions
Rural School Nurses Face Challenges in Colorado: A Qualitative Study
No full textRural school nurses are on the front lines of providing health care for children and families in rural Colorado, but there is little research from their perspective. To fill this gap, a descriptive phenomenological study examined the experiences of nine rural school nurses through in-person audiotaped interviews. Analysis of data revealed three main themes: (1) rural school nurses’ efforts to meet students’ extensive physical and mental health issues, (2) school nurses struggle to help rural students in extreme poverty, and (3) communication challenges experienced by rural school nurses. The findings of this study give voice to the experiences and challenges faced by rural school nurses in southern Colorado
Solidarity and Global Citizenship: A Photo Essay
No full textIn May of 2019, faculty and staff members at Loyola Marymount University traveled to Costa Rica for a weeklong immersion program. Prior to departure, facilitators encouraged Fellows to take photographs throughout their travels in Costa Rica. Participants were also invited to reflect on the photographs’ relationship to solidarity and global citizenship. Upon return to Los Angeles, the editors of this collection provided all Fellows with a prompt and invitation to address our theme by submitting a photo from the trip and brief reflection: “How does this photo express your understanding (or some aspect) of solidarity and global citizenship?” Presented in this essay are some of the Fellows’ photographs and reflections