Walden University
  • Minneapolis, MN, United States
Recent publications
Mixed research findings on peer feedback indicate that its efficiency seems to be influenced by its characteristics, its mindful cognitive processing, and the presence of justifications. Further, these aspects seem to positively or negatively affect cognitive load in the recipient. In a 2 × 3 design, we systematically varied types of peer feedback (elaborated specific feedback with/without justifications) on an essay and sender’s competence (high/average/low). We measured cognitive load during the peer-feedback reading and performance tasks and correlated eye tracking data with performance measures to infer mindful cognitive processing. We found an interaction effect of justifications and sender’s competence on text-revision performance. The impact of justifications on text-revision performance was moderated by cognitive load. Mindful cognitive processing seemed to increase when more transitions between text elements occurred, however, more intense mindful cognitive processing did not necessarily lead to better performance but rather served a compensatory purpose to sustain performance.
Purpose: This study aimed to examine physical activity (PA) as a protective measure of health outcomes among sexual minority (SM) and heterosexual adults. Methods: Using data from the 2018 National Health Interview Survey, differences in key health outcomes between three groups (heterosexual, SM, and "other") and the mediating effects of PA were explored. Chi-square tests were used to examine group differences. Multinomial logistic regression models were fit to examine associations between PA and health outcomes (body mass index [BMI], psychological distress, health status, and use of alcohol, cigarettes, and e-cigarettes). Results: Compared with heterosexual respondents, "other" adults had higher levels of BMI above 24.9 and were less active; SM respondents had elevated levels of alcohol use, smoking, binge drinking, and psychological distress, and reported worse overall health status. Unadjusted models showed that PA served as a protective factor for BMI above 30 and health status for all groups. PA was also protective for BMI below or above 18.5-24.9, smoking, psychological distress, and health status for both heterosexual and SM groups. Alternatively, PA behaved as a risk factor for alcohol use and binge drinking for all groups. Adjusted modeling removed PA as a risk factor for light alcohol use and binge drinking for SM respondents and added a protective factor for e-cigarette use for heterosexual respondents. Conclusion: This study adds to current literature on health disparities affecting SM populations and the health benefits associated with PA. Further research is needed to explore tailored PA intervention for SM populations and those who mark "other," "something else," "don't know," or refuse to answer questions on sexual orientation.
Organizational changes occur frequently and impact the way people work. Training is an important part of the change process, and often the last exposure prior to the change comes from the training process. Because of this, training should address both the organizational and the individual’s response to change, including personal and emotional factors. Learning professionals should be familiar with change theories and have the ability to incorporate evidence-based change methods into training for the best learning outcomes.
Background: Nigeria has an estimated TB prevalence of 219 per 100,000 population. In 2019, Nigeria diagnosed and notified 27% of the WHO-estimated cases of all forms of TB and contributed 11% of the missing TB cases globally. Objective: To assess TB underreporting by type and level of health facility (HF), and associated factors in Lagos State, Nigeria. Methodology: Quantitative secondary data analysis of TB cases was conducted in 2015. χ2 test was used to assess the association between treatment initiation, TB underreporting, local government area (LGA) and HF characteristics. Results: Overall, 2,064 persons with bacteriologically confirmed TB (15.5%) were not matched to patients in sampled TB registers. Treatment status was unknown for 86 cases (IQR 55-97) per LGA. LGAs with higher case-loads had higher proportions of cases with unknown TB status. Discrepant reporting of treated TB was also common (60% HFs). Primary-level TB treatment facilities and unengaged private facilities were less likely to notify. Conclusion: There was TB under-reporting across all types and levels of HFs and LGAs. There is a need to revise or strengthen the process of supervision and data quality assurance system at all levels.
Satisfaction is a critical aspect of student success in online education. In this systematic review, we examine 98 articles which studied various aspects of online learner satisfaction. We specifically analyzed publication patterns, context, research methodology, research instruments, and research themes and factors pertaining to online learner satisfaction research. Among these 98 studies, the journal Internet and Higher Education published the highest number of articles (n = 8), and the majority of studies were conducted in the United States (n = 37). Thirty five percent of the studies were conducted with undergraduate students. The majority of the studies (89%) was quantitative, 68% were descriptive, and 94% used surveys. Learner characteristics was the most examined theme, followed by engagement and course delivery. Program quality, assessment, and learner support were some of the themes that were least studied. In 46 studies researchers adopted or modified existing items or instruments to measure student satisfaction. The framework benefits both online learning practitioners and researchers.
In 2009, the New Zealand Police implemented a comprehensive program called Policing Excellence, which provided the platform for the introduction of Prevention First in 2011. In 2014, Police Scotland implemented a prevention strategy. The strategy implemented by New Zealand was designed to place the victims of crime and the prevention of crime at the foreground of their service delivery, with the view that in the longer-term, crime would decrease, while the strategy introduced by Police Scotland was designed to increase the effectiveness of their service delivery. This article examines the differences between the processes used to adopt the strategies and how they were used after their implementation. Both strategies were introduced as a response to the criminal environment and to decrease the occurrence of crime, but neither strategy have resulted in large decreases in the level of crime or in an increase in the confidence held by the public. The review found that the strategies have not achieved what was originally intended and argues for a more comprehensive and theoretical basis for designing policing strategies to ensure that crime is reduced.
Accurate assessment of donor quality at the time of organ offer for liver transplantation candidates may be inadequately captured by the donor risk index (DRI). We sought to develop and validate a novel objective and simple model to assess donor risk using donor level variables available at the time of organ offer. We utilized national data from candidates undergoing primary LT (2013‐2019) and assessed prediction of graft failure 1 year after LT. ID2EAL score: The final components were donor Insulin dependent diabetes mellitus, Donor type (DCD or DBD), cause of Death=CVA, serum creatinine, Age, height and weight (length). The ID2EAL score had better discrimination than DRI using bootstrap corrected concordant index over time, especially in the current era. We explored donor‐recipient matching. Relative risk of graft failure ranged from 1.15‐3.5 based on relevant donor‐recipient matching by the ID2EAL score. As an example, for certain recipients, a young DCD donor offer was preferable to an older DBD with relevant comorbidities. The ID2EAL score may serve as an important tool for patient discussion about donor risk and decisions regarding offer acceptance. In addition, the score may be preferable to succinctly capture donor risk in future organ allocation that considers continuous distribution.
In 2019 Sonoma County experienced four power shutoffs including a major power shutoff to 180,000 residents (78,261 households). A few weeks later, the Kincade Fire sparked burning 77,758 acres and requiring the evacuation of 186,000 residents (80,870 households). Immediately following the major power shutoff and Kincade Fire, the Sonoma County Department of Emergency Management circulated a public survey (two surveys total) to gain insight into the disaster response and the residents’ experiences. The survey provides a highly visible and accessible entry point for local governments to reach out and connect with residents during or immediately after a disaster. To shift from simply sharing information with the community to actively seeking input and creating a dialogue so quickly could help local agencies move more rapidly and effectively into recovery. This article provides a descriptive analysis of the qualitative data collected in these survey questions. Residents mentioned mental stress most frequently, with many being concerned events would lead to their death or the death of others. Residents also voiced their frustration with the sequence of events, areas subject to evacuation, and the ways they received - or did not receive - alerts. Recommendations developed from the data analysis include improving information about mental health support for residents, providing more detailed information to residents during an event, and targeting preparedness for the community members especially those with access and functional needs. Finally, the recent emergence of neighborhood preparedness groups was helpful to many residents during the events. These groups promoted improved preparedness and support provide support during difficult times. Using the survey to prioritize and support these efforts will help the County and its partners build more sustainable and effective resilience in the community.
Training models provide the guidelines and process steps that can help organize and streamline training development. Several training models have been developed, and while the models have some similarities, they differ in both the focus of the model and the use of the model in development of training. This chapter will focus on three widely used training models: Merrill’s five principles for instructional design, Gagne’s nine events of instruction, and the ADDIE model. Merrill’s five principles for instructional design provide a problem-based model and address the learners’ current phase of learning, enabling learners to solve real-life issues. Gagne’s nine events of instruction focus on producing successful training through the design and delivery of the instructional content intended to engage learners and increase the success of learning outcomes. The ADDIE model is focused on the process of developing training from start to finish. An overview of each training framework will include application of each framework through practice examples.
Background: Artificial intelligence (AI) deals with development of algorithms that seek to perceive one's environment and perform actions that maximize one's chance of successfully reaching one's predetermined goals. Objective: To provide an overview of the basic principles of AI and its main studies in the fields of glaucoma, retinopathy of prematurity, age-related macular degeneration and diabetic retinopathy. From this perspective, the limitations and potential challenges that have accompanied the implementation and development of this new technology within ophthalmology are presented. Design and setting: Narrative review developed by a research group at the Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil. Methods: We searched the literature on the main applications of AI within ophthalmology, using the keywords "artificial intelligence", "diabetic retinopathy", "macular degeneration age-related", "glaucoma" and "retinopathy of prematurity," covering the period from January 1, 2007, to May 3, 2021. We used the MEDLINE database (via PubMed) and the LILACS database (via Virtual Health Library) to identify relevant articles. Results: We retrieved 457 references, of which 47 were considered eligible for intensive review and critical analysis. Conclusion: Use of technology, as embodied in AI algorithms, is a way of providing an increasingly accurate service and enhancing scientific research. This forms a source of complement and innovation in relation to the daily skills of ophthalmologists. Thus, AI adds technology to human expertise.
This brief report provides an overview of lessons learned through evaluation of the first five years of the NIA-funded South Carolina-Advancing Diversity in Aging Research (SC-ADAR) undergraduate program, whose goal is to increase the number of qualified underrepresented minority (URM) students who pursue scientific graduate studies in programs focusing on medicine, science, technology, engineering, and mathematics and aging. Partnering with five Historically Black Colleges and Universities in South Carolina, we implemented a research training approach that included two consecutive summers of research training in a University of South Carolina faculty laboratory, as part of a comprehensive 24-month research education program. In addition to the mentored research experience in a laboratory, students had coursework in the biology of aging and social gerontology, with additional workshops tailored to emergent student needs including basic academic skills development, work-life management skills, reflective social experiences, and enhanced support in the transition from undergraduate to graduate school. We provide an overview of lessons learned throughout the early program period, and a description of the iterative changes we made in the program in response to this learning, all of which have been incorporated into the existing SC-ADAR program.
Sexual assault is a prevailing problem for active duty women in the United States military. We explore the unique nature of military culture and explain the military's dual pathway process for reporting sexual assault. In addition, we describe, in depth, evidence-based theoretical approaches applicable for counselors to use in their work with female service members who are survivors of sexual assault. Finally, we discuss sexual assault resources available to military clients and the steps counselors can take to engage in advocacy for and with this population.
Aim: To examine the concept of Leadership Presence. Background: Presence is an essential factor in a leader's repertoire. However, the concept is not well-defined, or the significance understood on how leadership presence affects individual and organizational outcomes. Design: Walker and Avant's modified method of concept analysis DATA SOURCE: Literature from multiple scholarly databases were searched. The search terms "leadership," "presence," "physical presence," and "leadership presence" were imputed using established inclusion criteria: full text, peer-reviewed, and printed in the English language from 2016 to 2021. Review methods: Articles examined to determine the context of leadership presence and to understand and identify the antecedents, attributes, and consequences of leadership presence. Results: Eighteen articles met inclusion criteria and were examined. Antecedents consisted of elements that represented the internal complexity of the organization and the presence of external threats. Attributes included a leader's emotional intelligence, a vision for improvement, and a commitment to successful caring and patient outcomes. Consequences evolved from organizational and individual elements of leadership presence. Conclusion: By understanding the concept of leadership presence, nurse leaders can appreciate the meaning, implications, and contributions of this concept and employ leadership factors that influence nurse, patient, and organizational outcomes.
Objectives : Antimicrobial resistance (AMR) is a consequence of inappropriate actions, including irrational antimicrobial prescribing and use. AMR remains an emergent and significant public health threat, particularly in low and middle-income countries (LMICs), including Nigeria. Optimizing antimicrobial (AM) use through functional hospital antimicrobial stewardship (AMS) programs is one of the strategies to control the spread of AMR. Literature is replete with evidence, but few studies examined the contextual factors limiting AMS functionality at the facility levels. This study explored the intrinsic contextual factors shaping AMS practice at the three-tiered levels of care. Methods : This was a qualitative case study with a purposeful sample size of 30 participants drawn from two primary, two secondary, and two tertiary health facilities in Nigeria. Data were coded and categorized for thematic analysis. Results : Emergent themes include lack of AMS programs, inadequate guidelines, lack of modern equipment and incorrect diagnosis, absence of continuous medical education, imbalance of power among professionals, and pervasive external influence of pharmaceutical marketing companies. These finding demonstrate that the AMS program is lacking or poorly implemented at the three-tiered level of care. Conclusion : We recommended that health facilities establish AMS programs in line with World Health Organization's stepwise approach. These challenges, if addressed, will promote the successful performance of the AMS program, contributing to rational AM use at all levels of care. Since primary health centres constitute 85.4% of all health facilities, customizing the AMS core elements at this level will contribute to achieving the goals of universal health care.
Benign mature cystic teratomas a b s t r a c t Ovarian dermoid cysts, also known as mature teratomas, are benign embryonal tumors with a slow growth rate. They are the consequence of ectodermal components becoming trapped along with their closure sites and account for the most common germinative ovarian tumor in reproductive-aged women. These patients may have a reduced risk of morbidity if they receive an accurate diagnosis and extensive follow-up care. These cysts are often evaluated using one of the following imaging techniques: computed tomography, magnetic resonance imaging, pelvic ultrasonography, or transvaginal ultrasound. Laparoscopy and laparotomy are the 2 surgical procedures typically used to remove persistent or exceptionally large cysts. Leakage of cyst contents during surgery is a common postoperative complication that can seldom, but occasionally, results in chemical peritonitis. We discuss a case of a significant dermoid cyst that developed in an older woman and was successfully removed via laparo-scopic surgery. This instance is instructive for other physicians who may encounter a similar pathology.
Background: Premature mortality from noncommunicable diseases (NCDs) is a contemporary development challenge. Low-income and lower-middle-income countries are disproportionately affected, with the poorest in society considered the most vulnerable. A paucity of literature exists on how leadership practices at the implementation level relate to ensuring readiness for NCD services. Objective: This study investigated any relationship between leadership practices and readiness for NCD services. Methods: This correlational study investigated any relationship between leadership practices at the county level and readiness for NCD services in Kenya using secondary data from a 2013 Service Availability and Readiness Assessment survey. Correlation and multiple linear regression tests were used to determine the strength and direction of any relationship between leadership practices (annual work planning, therapeutic committees, and supportive supervision), and NCD readiness (county readiness score). Findings: The findings indicated a statistically significant relationship between therapeutic committee (p = .002) and supportive supervision practices (p = .023) and NCD readiness. Leadership practices also had a statistically significant predictive relationship with NCD readiness (p = .009). Conclusion: Health leaders should ensure that leadership practices that have a predictive relationship with NCD readiness, such as therapeutic committee activities and supportive supervision visits, are implemented appropriately. Further, county health leaders should pay particular attention to the implementation of these leadership practices at nonpublic and Tiers 2, 3, and 4 health facilities that had lower NCD readiness scores.
Clean, fresh, and safe drinking water is essential to human health and well-being. Occasionally, biological contaminants taint surface water quality used for human consumption and recreation. Microcystins (MCs) and nodularins (NODs) are toxic monocyclic peptides produced by cyanobacteria in fresh and brackish water. These secondary metabolites can reach hazardous concentrations, impairing surface drinking water supplies and thereby increasing the risk of exposure to consumers. Inconsistent screening of MCs and NODs is not uncommon in drinking water systems and no provisional guidance value has been established in Florida to protect community and public health. We performed a case study of two Florida lakes supplying drinking water to adjacent communities for the purpose of monitoring MCs and NODs over the potential peak algae bloom season (June-August). An indirect competitive enzyme-linked immunosorbent assay (icELISA) was employed to analyze concentrations of total MCs and NODs in environmental water samples from Lake Manatee and Lake Washington. Toxin concentrations were similar in each lake, averaging 0.19 μg/L. The highest toxin concentration (0.46 μg/L) was reported in Lake Manatee at Site 15, a location where other toxin concentrations demonstrated statistical significance with toxins detected at Sites 6 (p = 0.014) and 8 (p = 0.011). Inferential analyses from the Kruskal-Wallis H Test revealed a statistically significance difference in toxin concentrations by sampling month within the two Floridian drinking water systems (p < 0.001). Furthermore, phosphate and nitrite concentrations strongly correlated with total MCs and NODs in each lake (p < 0.01). Although results indicate a low probable health risk from cyanotoxins, more research is needed to understand the intrinsic nature of MCs and NODs by examining their prevalence, distribution, and dynamics in surface drinking water supplies serving nearby communities.
Over time, the number of fatal police shootings captured on video has increased, bringing national and international attention to racism and the deleterious effects on the Black community, specifically Black men. As a result, there is increased awareness of the impact of trauma, particularly racial trauma. This chapter explores racism and racial discrimination from interactions with police officers, the external force of digital media, and its impact on the mental health of Black men. Clinicians should have an awareness and knowledge base of racial trauma and working with Black men; therefore, the implications for practice and treatment include how clinicians should respond in the therapeutic setting with Black men during this pivotal time.
BACKGROUND: Some pharmaceutical company sales representatives are using bribes to encourage increasing medication prescriptions. In 2012, GlaxoSmithKline paid $3 billion on a felony charge related to bribing doctors to prescribe the company’s medications. Using Hunt and Vitell’s general theory of marketing ethics, the purpose of this qualitative multiple case study was to explore strategies some sales managers in the pharmaceutical industry used to improve marketing training to reduce unethical sales representative behavior. MATERIALS AND METHODS: Data were collected from company reports and documents provided by sales managers and semistructured interviews with five sales managers of different pharmaceutical companies in the northeast region of the United States. Data were analyzed using thematic analysis and Yin’s 5‑step process of compiling, disassembling, reassembling, interpreting, and concluding thematic data analysis. RESULTS: Three themes emerged from data analysis: developing ethical standards, developing organizational policy, and implementing training and development programs. A key recommendation is that pharmaceutical sales managers identify ethical standards to inculcate in their business practices to achieve ethical marketing training that can result in sales representatives’ ethical behavior. The implications for positive social change include the potential for sales managers to develop strategies to reduce unethical behavior in the pharmaceutical industry. CONCLUSION: Reducing unethical behavior may lead to more trust between patients and physicians, improving patient satisfaction and promoting prosperity for the community through enhancing the quality of health care.
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Vasileios Margaritis
  • School of Health Sciences
Gary Burkholder
  • College of Health Sciences and College of Social and Behavioral Sciences
Scott O McDoniel
  • School of Health Sciences
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Head of institution
Jonathan Kaplan
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