bluuebunny/crossref_metadata_2025 huggingface dataset:
Hyperglycaemia in comatose survivors of out-of-hospital cardiac arrest
Authors: Russo Juan J , James Tyler E , Hibbert Benjamin , Ramirez F Daniel , Simard Trevor , Osborne Christina , Bernick Jordan , Wells George A , Le May Michel R ,   for the CAPITAL Investigators
Published: December 2017

Background:

The optimal blood glucose target during the early hospitalisation of comatose survivors of out-of-hospital cardiac arrest (OHCA) has not been established.

Methods:

In a retrospective cohort study, we examined clinical outcomes in relation to mean blood glucose during the first 96 hours of hospital admission in comatose survivors of OHCA with an initial shockable rhythm. Mean blood glucose was assessed as a continuous (primary analysis) and categorical variable: <6 mmol/L, 6 to <8 mmol/L and ⩾8 mmol/L. Co-primary outcomes were the rates of death during the index hospitalisation and severe neurological dysfunction at discharge. We used multivariable logistic regression analyses to adjust for baseline differences in patient and index event characteristics.

Results:

Among 122 eligible patients, death and severe neurological dysfunction occurred in 29 (24%) and 40 (33%) patients, respectively. Higher mean blood glucose levels during the first 96 hours of admission were associated with increased odds of death (odds ratio (OR): 1.50; 95% confidence interval (CI): 1.17–1.92; p = 0.001) and severe neurological dysfunction (OR: 1.42; 95% CI: 1.11–1.80; p = 0.004). The associations between mean blood glucose and the odds of death (OR: 1.35; 95% CI: 1.04–1.76; p = 0.02) and severe neurological dysfunction (OR: 1.28; 95% CI: 1.00–1.64; p = 0.05) persisted after adjusting for age, time from cardiac arrest to return of spontaneous circulation (ROSC) and vasoactive agent use. There was no interaction between age, time from cardiac arrest to ROSC or a history of diabetes mellitus and the relationship between mean blood glucose and co-primary outcomes.

Conclusions:

In comatose survivors of OHCA with initial shockable rhythms, higher mean blood glucose levels during the first 96 hours of admission are associated with increased rates of death and severe neurological dysfunction.
Non-occlusive mesenteric ischaemia in out of hospital cardiac arrest survivors
Authors: Wurm Raphael , Cho Anna , Arfsten Henrike , van Tulder Raphael , Wallmüller Christian , Steininger Philipp , Sterz Fritz , Tendl Kristina , Balassy Csilla , Distelmaier Klaus , Hülsmann Martin , Heinz Gottfried , Adlbrecht Christopher
Published: December 2017

Background and aim of the study:

Non-occlusive mesenteric ischaemia (NOMI) is characterised by hypoperfusion of the intestines without evidence of mechanical obstruction, potentially leading to extensive ischaemia and necrosis. Low cardiac output appears to be a major risk factor. Cardiopulmonary resuscitation aims at restoring blood flow after cardiac arrest. However, post restoration of spontaneous circulation, myocardial stunning limits immediate recovery of sufficient cardiac function. Since after successful cardiopulmonary resuscitation patients are often ventilated and sedated, NOMI might be underdiagnosed and potentially life-saving treatment delayed.

Material and methods:

A prospectively maintained multi-purpose cohort of out of hospital cardiac arrest survivors, who had successful restoration of spontaneous circulation, was used for this retrospective database analysis. Patients’ charts were screened for clinical, radiological or pathological evidence of NOMI and clinical data were collected.

Results:

Between 2000 and 2014, 1780 patients who were successfully resuscitated after out of hospital cardiac arrest were screened for NOMI. Twelve patients (0.68 %) suffered from NOMI and six of those died (50 %). Patients suffering from NOMI tended to have a longer duration until restoration of spontaneous circulation (27 vs. 20 min, p=0.128) and had significantly higher lactate (14 mmol/l vs. 8 mmol/l, p=0.002) and base deficit levels at admission (−17 vs. −10, p=0.012). Median leukocyte counts in NOMI patients peaked at the day of diagnosis.

Conclusion:

NOMI is a rare but life-threatening and potentially curable complication following successful cardiopulmonary resuscitation. Lactate and base deficit at admission could help to identify patients at risk for developing NOMI who might benefit from increased clinical attention.
Systolic mitral annulus velocity is a sensitive index for changes in left ventricular systolic function during inotropic therapy in patients with acute heart failure
Authors: Husebye Trygve , Eritsland Jan , Bjørnerheim Reidar , Andersen Geir Ø
Published: December 2017

Background:

Echocardiography is recommended for assessment of left ventricular systolic function in patients with acute heart failure but few randomised trials have validated techniques like tissue Doppler (TDI) and speckle tracking (STE) in patients with acute heart failure following ST-elevation myocardial infarction.

Methods:

This was a substudy from the LEAF (LEvosimendan in Acute heart Failure following myocardial infarction) trial (NCT00324766 ), which randomised 61 patients developing acute heart failure, including cardiogenic shock, within 48 hours after ST-elevation myocardial infarction, double-blind to a 25-hour infusion of levosimendan or placebo. TDI-derived systolic mitral annulus velocity (S′), STE-derived global longitudinal strain (Sl) and strain rate (SRl) were measured at baseline, day 1, day 5 and after 42 days.

Results:

Datasets rejected for analyses were 2% (TDI) and 17% (STE). S′ increased by 23% in the levosimendan group versus 8% in the placebo group from baseline to day 1 ( p= 0.011) and by 30% vs. 3% from baseline to day 5 ( p <0.0005). Significant, but less pronounced, improvements in global Sl ( p = 0.025 and p = 0.032) and in global SRl ( p = 0.046 and p = 0.001) in favour of levosimendan were also present.

Conclusion:

S′ by TDI and STE-derived Sl and SRl were sensitive indices for changes in left ventricular systolic function related to treatment with levosimendan. However, S′ by TDI was more feasible and sensitive and might be preferred for assessment of changes in left ventricular systolic function in critically ill patients with acute heart failure receiving inotropic therapy.
Relative survival and excess mortality following primary percutaneous coronary intervention for ST-elevation myocardial infarction
Authors: Brogan Richard A , Alabas Oras , Almudarra Sami , Hall Marlous , Dondo Tatendashe B , Mamas Mamas A , Baxter Paul D , Batin Phillip D , Curzen Nick , de Belder Mark , Ludman Peter F , Gale Chris P
Published: December 2017

Background:

High survival rates are commonly reported following primary percutaneous coronary intervention for ST-elevation myocardial infarction, with most contemporary studies reporting overall survival.

Aims:

The aim of this study was to describe survival following primary percutaneous coronary intervention for ST-elevation myocardial infarction corrected for non-cardiovascular deaths by reporting relative survival and investigate clinically significant factors associated with poor long-term outcomes.

Methods and Results:

Using the prospective UK Percutaneous Coronary Intervention registry, primary percutaneous coronary intervention cases ( n=88,188; 2005–2013) were matched to mortality data for the UK populace. Crude five-year relative survival was 87.1% for the patients undergoing primary percutaneous coronary intervention and 94.7% for patients <55 years. Increasing age was associated with excess mortality up to four years following primary percutaneous coronary intervention (56–65 years: excess mortality rate ratio 1.61, 95% confidence interval 1.46–1.79; 66-75 years: 2.49, 2.26–2.75; >75 years: 4.69, 4.27–5.16). After four years, there was no excess mortality for ages 56–65 years (excess mortality rate ratio 1.27, 0.95–1.70), but persisting excess mortality for older groups (66–75 years: excess mortality rate ratio 1.72, 1.30–2.27; >75 years: 1.66, 1.15–2.41). Excess mortality was associated with cardiogenic shock (excess mortality rate ratio 6.10, 5.72–6.50), renal failure (2.52, 2.27–2.81), left main stem stenosis (1.67, 1.54–1.81), diabetes (1.58, 1.47–1.69), previous myocardial infarction (1.52, 1.40–1.65) and female sex (1.33, 1.26–1.41); whereas stent deployment (0.46, 0.42–0.50) especially drug eluting stents (0.27, 0.45–0.55), radial access (0.70, 0.63–0.71) and previous percutaneous coronary intervention (0.67, 0.60–0.75) were protective.

Conclusions:

Following primary percutaneous coronary intervention for ST-elevation myocardial infarction, long-term cardiovascular survival is excellent. Failure to account for non-cardiovascular death may result in an underestimation of the efficacy of primary percutaneous coronary intervention.
Educational strategies for colonoscopy bowel prep overcome barriers against split‐dosing: A randomized controlled trial
Authors: Andrealli Alida , Paggi Silvia , Amato Arnaldo , Rondonotti Emanuele , Imperiali Gianni , Lenoci Nicoletta , Mandelli Giovanna , Terreni Natalia , Spinzi Giancarlo , Radaelli Franco
Published: December 2017

Background

A split‐dose (SD) regimen is crucial for colonoscopy quality. Compliance with SD for early morning colonoscopy is generally poor. The present study evaluated whether pre‐colonoscopy counselling, in addition to a dedicated leaflet, might increase SD uptake.

Methods

Consecutive 50–69‐year‐old patients undergoing screening colonoscopy before 10 a.m. were randomized to either receive written information only on bowel preparation (Written Group, WG) or written and oral instructions (Written and Oral Group, WaOG). The leaflet strongly encouraged SD adoption. The primary endpoint was the number of patients adopting SD in each group. The secondary endpoints were predictors of SD uptake, compliance with preparation schemes and cleansing adequacy.

Results

A total of 286 patients (143 WG, 143 WaOG) were enrolled (mean age 59.6 ± 6.1 years, men 49.3%). SD was adopted by 114 and 125 patients in the WG and WaOG, respectively (79.7% versus 87.4%, p  = 0.079). No significant differences were observed for the proportion of patients with full compliance with preparation scheme (97.9% versus 97.2%, p  = 0.99) and of procedures with adequate bowel cleansing (95.6% versus 95.1%, p  = 0.77). At multivariate analysis, a > 1 h travel time to the endoscopy service was inversely correlated with SD uptake (odds ratio (OR) 0.30, 95% confidence interval (CI) 0.09–0.98).

Conclusions

Our leaflet guaranteed satisfactory uptake of SD and excellent adherence to the preparation scheme for early morning colonoscopy. Its use might marginalize the need for additional oral instructions, particularly in open‐access settings.
Annuloplasty for Aortic Regurgitation in Infantile Takayasu Arteritis: A Case Report
Authors: Linnemeier Laura , Sharma Richa , Srivastava Nayan , Turrentine Mark
Published: December 2017

Aortic regurgitation (AR) is a life-threatening complication of Takayasu arteritis (TA). Takayasu arteritis is a large-vessel vasculitis with a predominance in young adolescent and adult females. Inflammation involves the aorta and its major branches resulting in arterial dilatation, stenosis, aneurysm, occlusion, and thrombosis formation. Pediatric TA cases have been reported to also cause severe complications such as coronary aneurysms, retinopathy, and hypertension due to renovascular stenosis. In this report, we present a rare occurrence of infantile TA with severe AR requiring surgical intervention after failing medical therapy. Due to the patient’s age and clinical status, a valve-sparing aortic annuloplasty with aortoplasty was performed.
Takotsubo Cardiomyopathy Complicating Percutaneous Pulmonary Valve Implantation in a Child
Authors: Dalla Pozza Robert , Lehner Anja , Ulrich Sarah , Näbauer Michael , Haas Nikolaus A. , Heineking B.
Published: December 2017

Takotsubo cardiomyopathy describes a sudden onset cardiomyopathy with acute impairment of left ventricular function and spontaneous resolution over time. Only a few cases of Takotsubo cardiomyopathy in childhood have been described. We report the case of a 12-year-old girl with repaired tetralogy of Fallot who experienced acute onset of left ventricular dysfunction without coronary arterial involvement, suggesting Takotsubo cardiomyopathy, during an interventional catheterization procedure. Cardiogenic shock necessitated mechanical circulatory support with extracorporeal membrane oxygenator for ten days and mechanical ventilation for 12 days. The girl recovered without sequelae. Percutaneous pulmonary valve implantation was performed four months later without complications. Unusual aspects of this case include the use of mechanical circulatory support during the recovery phase of Takotsubo cardiomyopathy in a patient with congenital heart disease.
Melody Transcatheter Pulmonary Valve Placement in a HeartMate II Patient
Authors: Moe Tabitha G. , Staley Linda , Graziano Joseph N.
Published: December 2017

Transcatheter pulmonary valve placement is emerging as a standard therapy for dysfunctional right ventricular outflow tract conduits. The Melody transcatheter pulmonary valve is indicated for use in the management of pediatric and adult patients with right ventricular outflow tract conduits measuring at least 16 mm in diameter. This is the first reported case of placement in a patient with a left ventricular assist device. We outline the preprocedural evaluation process, the procedural methods, and the outcomes of a successful implantation in a complex patient. With a team-based approach including thoughtful preprocedural evaluation, and close monitoring, successful deployment of a transcatheter pulmonary valve is possible in complex patients in the setting of mechanical circulatory support.
Valve-Sparing Root and Total Arch Replacement for Cutis Laxa Aortopathy
Authors: Yetman Anji T. , Hammel James , Sanmann Jennifer N. , Starr Lois J.
Published: December 2017

Aortic aneurysms requiring surgery in early childhood are rare. Herein we describe the case of a three-year-old with massive aneurysmal aortic dilation secondary to the rare and often lethal genetic disorder, cutis laxa. Initial thoracic aortic aneurysm gene panel was negative. Parents of the child were not known to be consanguineous, but high-density SNP array revealed several regions of homozygosity. This prompted targeted sequence analysis that identified a novel homozygous missense mutation in the gene for cutis laxa, EFEMP2. The patient underwent aortic valve–sparing aortic root and ascending aorta replacement and total aortic arch replacement, with continuous, moderately hypothermic cardiopulmonary bypass, using a dual cannulation technique. He was discharged well on the third postoperative day and remains free of aneurysmal disease at two-year follow-up.
Gender Gaps
Authors: Lindstrom Lauren , Harwick Robin M. , Poppen Marcus , Doren Bonnie
Published: December 2017

Young women with disabilities face multiple barriers in making the transition from high school to meaningful careers. This study used focus groups and individual interviews with high school girls with disabilities, college women with disabilities, high school special education teachers, school administrators and employers to examine career development and transition needs for young women with disabilities. Barriers and supports were identified in four major categories: a) individual/interpersonal skills, b) career options, c) school system issues, and d) disability needs. Recommendations for practice are discussed.
Using Video Modeling Delivered Through iPods to Teach Vocational Tasks to Young Adults With Autism Spectrum Disorders
Authors: Kellems Ryan O. , Morningstar Mary E.
Published: December 2017

The purpose of this study was to evaluate the effectiveness of using video modeling delivered through a portable media player (Apple video iPod) as a means of teaching job-related tasks to four young adults with autism spectrum disorders. The videos were enhanced by adding written instructions. Results indicated that using the iPod was associated with immediate and substantial gains in the percentage of steps completed correctly. All of the participants demonstrated maintenance of the acquired tasks. In addition, all four of the young adults were able to use the video iPod independently. Social validity data indicated that using an iPod was a socially acceptable and appropriate way to deliver a video modeling intervention in some community employment settings
“Challenge Me!”
Authors: Cranmer Gregory A. , Brann Maria , Weber Keith D.
Published: December 2017

Confirmation theory is a theoretical framework that forwards that the communication of acceptance and challenge to recipients promotes prosocial environments that foster positive affect, attitudes, and behaviors. This study utilized confirmation theory to better understand the influence of coaches’ use of confirmation on athletes’ satisfaction and motivation to play their sport. Data collected from 132 former high school athletes indicated that the challenge dimension of coach confirmation uniquely and strongly predicts athletes’ satisfaction with their sport experiences, satisfaction with their communication with head coaches, and their motivation to play. These findings emphasize sport as a unique context of confirmation in which athletes prioritize their development and constructive criticism and demonstrate that confirmation is an effective coaching behavior that should be integrated into coaches’ everyday practices.
National Proxy 2.0
Authors: Finlay Christopher J.
Published: December 2017

The affordances of social media technologies increasingly allow Olympians to directly communicate with global audiences. Olympians can thus become more powerful autonomous discursive actors, threatening traditional Olympic power dynamics that have protected lucrative Olympic media streams. And yet, Olympians have yet to use social media technology to fully exercise their autonomy. This article adopts a social construction of technology lens within a larger critical discourse analysis framework to analyze the reticent behavior of social media–enabled Olympians. It is suggested that their social media voices are constrained by a powerful set of obligations to their nation-state. These obligations can be understood as ritualistic deep play national proxy identifications, which are constructed and reinforced by Olympic policies and practices, as well as larger sociocultural contextual factors. This argument is explicated through an analysis of Olympics policy documents and case studies from the first two Olympiads, where social media had a major impact: the London 2012 Games and the Sochi 2014 Winter Games.
23 Players, 23 Voices
Authors: Hayes Sauder Molly , Blaszka Matthew
Published: December 2017

This study’s purpose was to contribute to the understanding of athlete self-presentation on Twitter by focusing on the communication strategies of an entire team of female athletes during an international mega-event, with special attention given to how the athletes’ communication changed in the surrounding time periods. Content analysis was performed on tweets from all 23 players on the U.S. Women’s National Soccer Team during 30-day time periods before, during, and after the 2015 World Cup. Findings revealed an overall tendency towards backstage communication, with some commonalities between the self-presentation styles utilized by individual athletes on the team. In addition, there were organic, intuitive changes in the players’ self-presentation across various time periods. Further, analysis of follower engagement via retweets indicated greater interest in athletes’ backstage communication compared to front stage. These findings yield implications for future research and practical application, which are examined in the discussion.
Nutritional Insufficiency as a Predictor for Adverse Outcomes in Adult Spinal Deformity Surgery
Authors: Phan Kevin , Kim Jun S. , Xu Joshua , Di Capua John , Lee Nathan J. , Kothari Parth , Vig Khushdeep S. , Dowdell James , Cho Samuel K.
Published: December 2017

Study Design:

Retrospective analysis of prospectively collected data.

Objective:

The effect of malnutrition on outcomes after general surgery has been well reported in the literature. However, there is a paucity of data on the effect of malnutrition on postoperative complications during adult deformity surgery. The study attempts to explore and quantify the association between hypoalbuminemia and postoperative complications.

Methods:

A retrospective cohort analysis was performed on the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database from 2010 to 2014. Patients (≥18 years of age) from the NSQIP database undergoing adult deformity surgery were separated into cohorts based serum albumin (<3.5 or >3.5 g/dL). Chi-square and multivariate logistic regression models were used to identify independent risk factors.

Results:

A total of 2236 patients met the inclusion criteria for the study, of which 2044 (91.4%) patients were nutritionally sufficient while 192 (8.6%) patients were nutritionally insufficient. Multivariate logistic regressions revealed nutritional insufficiency as a risk factors for mortality (odds ratio [OR] = 15.67, 95% confidence interval [CI] = 6.01-40.84, P < .0001), length of stay ≥5 days (OR = 2.22, 95% CI = 1.61-3.06, P < .0001), any complications (OR = 1.82, 95% CI = 1.31-2.51, P < .0001), pulmonary complications (OR = 2.29, 95% CI = 1.29-4.06, P = .005), renal complications (OR = 2.71, 95% CI = 1.05-7.00, P = .039), and intra-/postoperative red blood cell transfusion (OR = 1.52, 95% CI = 1.08-2.12, P = .015).

Conclusions:

This study demonstrates that preoperative hypoalbuminemia is a significant and independent risk factor for postoperative complications, 30-day mortality, and increased length of hospital in patients undergoing adult deformity surgery surgery. Nutritional status is a modifiable risk factor that can potentially improve surgical outcomes after adult deformity surgery.
Predictive Factors for the Outcome of Surgical Treatment of Lumbar Spondylolysis in Young Sporting Individuals
Authors: Debnath Ujjwal K. , Scammell B. E. , Freeman Brian J. C. , McConnell Jeffrey R.
Published: December 2017

Study Design:

Retrospective consecutive case series.

Objectives:

Only few sporting individuals with symptomatic lumbar pars injuries require surgical repair and it is often difficult to predict the outcome following surgery. The factors that predict the outcome after direct repair of lumbar pars defect was evaluated clinically and statistically. The preoperative background variables both subjective and objective as well as radiological evaluation were used in a multiple regression model to find the strong predictors of postoperative outcome as measured by VAS (visual analogue scores), ODI (Oswestry Disability Index) and SF-36 (Short Form).

Methods:

Fifty-two consecutive young sporting individuals with a mean age of 19 years (range 8-30 years) were treated surgically for lumbar pars defect confirmed on imaging studies (ie, single-photon emission computed tomography, computed tomography, and magnetic resonance imaging). Fifty patients completed the VAS, ODI, and SF-36 questionnaires as a part of their assessment. Preoperative background variables were used in a multiple regression model to find the strongest predictor of postoperative outcome as measured by ODI. Ethical approval was taken by the institutional review board.

Results:

Buck’s screw repair of the pars defect was carried out in 44 patients (33 males, 11 female): unilateral in 8 patients (7 males, 1 female) and bilateral in 36 patients (26 males, 10 females). Although age at surgery showed linear colinearity (ρ = 0.32, P < .05), it was not significant in the model. The most consistent association with the preoperative VAS score were the pre- and postoperative ODI scores, that is, ρ = 0.51 ( P < .01) and ρ = 0.33 ( P < .05), respectively. In the bilateral group, with Buck’s repair at a single level, that is, 33 of 36 (93%) patients had returned to sports at a mean time of 7.5 months (range 6-12 months). Overall, 44 of 52 (84%) individuals had returned to their sports with posttreatment ODI score of <10. The stepwise regression modeling suggested 6 independent factors (preoperative ODI, preoperative SF-36 physical component summary (PCS), Buck’s repair, multiple operations, professionalism, and pars defect at L3), as the determinants of the outcome (ie, postoperative ODI) in 80.9% patients (R2 = 0.809).

Conclusions:

The outcome after direct repair of pars defect in those younger than 25 years runs a predictable course. Professionalism in sports has a high impact on the outcome. Preoperative ODI and SF-36 PCS scores are significant predictors of good functional outcome. The regression equation can predict the outcome in 80.9% sporting individuals undergoing Buck’s repair.
Slapjack Shuffle: Teaching Instructional Method Selection Using Playing Cards
Authors: Klein Nicole Aydt
Published: December 2017

A key skill for the health education specialist is mastery of instructional strategies, especially as they relate to program implementation. Providing classroom experiences for undergraduate public health and health education students to be able to creatively and appropriately match methods to learning objectives is essential to successful future programs and initiatives. By completing the Slapjack Shuffle activity, students experience different teaching methods and match them to appropriate learning objective domains. Using decks of playing cards and guided by the instructor, students experience five different teaching methods (verbal instructions, demonstration, lecture, audiovisual, and peer instruction) to determine the advantages and disadvantages of using each when teaching a psychomotor skill. The lesson concludes with a game designed to create a physiological stress response to illustrate how a health educator could introduce the topic of stress management to a target population. Suggestions for assessing student mastery of the concepts taught include traditional assessment and student teaching demonstration. Student feedback for the activity is positive, with most reporting the activity as effective and memorable.
Increasing Self-Efficacy Among Future Health Educators: An Exploratory Study Using Service Learning
Authors: Rahn Rhonda N. , Shipley Meagan , Szucs Leigh E. , McDonald Skye , Holden Caitlin
Published: December 2017

Background. Service learning is a pedagogical tool that involves students delivering a service, linked to course learning outcomes, to the community and measured through acquisition of knowledge, attitudes, and skills along with overall satisfaction of the experience. Undergraduate students enrolled in a peer health education course, collaborated with campus health promotion staff, in a semester-long service learning project to plan, implement, and evaluate a campus-wide health fair. Purpose. The purpose of the study was to examine how participation in a service learning project affected students’ self-efficacy aligned with the seven Areas of Responsibilities (AoR) of Certified Health Education Specialists. Method. The multimethod design used pre- and posttest results and reflective writing samples to evaluate changes in students’ ( n = 58) self-efficacy related to the seven AoR of Certified Health Education Specialists. Students completed semistructured reflective journals responding to overall satisfaction, barriers to implementation, and significance of the learning experience and health fair on their professional development. Results. Results indicated students’ self-efficacy increased across all AoR, with the largest improvements reported in Areas III, V, and VI. Students described feeling competent responding to questions and directing attendees to available on- and off-campus resources. Results emphasized overall satisfaction with the service learning health fair project, uniquely the importance of applying information from the classroom setting to the real world. Conclusions. Service learning opportunities in classroom settings and professional preparation programs aid in preparing future leaders within the field of health education to exemplify the seven AoR with competency and confidence.
Academic Internships: To Take or Not to Take? Students’ Assessments of Public Health Fieldwork
Authors: Crowell Tara L.
Published: December 2017

While academic internships can play irreplaceable roles by providing students hands-on learning opportunities, allowing them to collaborate with faculty, and strengthening ties between colleges and their communities, continued assessment of these experiences is still imperative. An academic internship has been described as a three-way partnership among a college or university, the internship site, and the student, but the role the institution plays can differ significantly. Several years ago, the Association of Schools of Public Health included field experience (such as internships) as a Critical Components Element of an Undergraduate Major in Public Health. Hence, this study investigates not only how Public Health students evaluate their internship site but also their experience with their school during the internship process. Survey data from 219 undergraduate students, on completion of their internships from Fall 2012 to Spring 2016, were collected. Results posit that public health students report the academic institution provided support and guidance, while their internship site provided a valuable learning experience both interpersonally and professionally. Also, students recommend this experience and provide valuable feedback for future internship partnerships. Considering internships are integral parts of many preprofessional degree programs, it is imperative that programs develop and implement systematic ways to assess these programs. This study provides valuable insight into this process along with identifying students’ perceptions of the academic internship and the role that both the site and the institution played in facilitating their learning.
Student and Faculty Perspectives on the Use of Movies in Public Health Pedagogy
Authors: Wade Christopher H. , Barrientos Tyler , Macarulay Marc , Alderson Whitney , Shibale Portney C. , Le Cathy
Published: December 2017

Introduction. Movies can be used in public health pedagogy to illustrate concepts and build students’ connection to the material. This study describes the perspectives of undergraduates and faculty on effective strategies for using movies to achieve key public health learning outcomes. Method. In this cross-sectional study, a survey was administered to undergraduate majors in health studies ( n = 109) and faculty who teach health-related courses ( n = 27). The survey included measures of usage and attitudes toward pedagogical applications of movies, which were informed by Bloom’s Taxonomy and the Core Competencies for Public Health Professionals. Results. Students and faculty expressed favorable attitudes toward the use of movies in undergraduate public health education. Additionally, both groups endorsed the usefulness of movies for affective and cognitive learning outcomes, with appraisals of affective learning being significantly higher. Movies were most frequently applied to building the core public health competencies of analyzing public health issues, communicating effectively, relationship building, and cultural competency. Among students, 74% stated that watching health-related movies reinforced their current career trajectory, encouraged them to consider other careers, or changed their choice of career. Discussion. Preparation of the future public health workforce requires students to develop both cognitive skills and an emotional connection to efforts that address health-related challenges. The findings of this study indicate that movies support both types of learning outcomes and therefore deserve further investigation as pedagogical tool in population health instruction.
Assessing Awareness of and Interests in Public Health Among Undergraduate Students Without Declared Majors
Authors: Shendell Derek G. , Gourdine Amber , Yuan Melody
Published: December 2017

There are underrepresented fields in both undergraduate-level (UG) and graduate-level public health (PH) professional preparation in the United States. Demand for employment and a diversified work force in PH is growing. To understand how well UG students are aware of and knowledgeable about PH, a survey was conducted at a large urban statewide public university in the Northeastern United States. Students solicited to participate in the anonymous online survey conducted in PsychData were first- and second-year undeclared major UG students during March to April 2015 (spring semester). Of 138 consenting respondents, there were 101 validated, complete sets of responses. Variables included student course enrollment, whether parental occupation influences student choice of majors, and perceived quality of available curricula. More UG students were enrolled in introductory statistics among the PH-related courses asked about; those courses fulfilled multiple UG major requirements and could play greater roles in student awareness of PH, that is, opportunities via PH faculty/staff/guest lectures. Implications of findings include providing students hands-on experiences late in high school and early UG years, and advisors mentioning PH to students interested in basic sciences.
Using Mind Mapping to Identify Research Topics: A Lesson for Teaching Research Methods
Authors: Kernan William D. , Basch Corey H. , Cadorett Valerie
Published: December 2017

Mind mapping is a brainstorming technique that allows users to deconstruct complex topics by creating a graphical representation of constituent subtopics and related themes. The aim of this article is to illustrate how the mind mapping technique was used to assist undergraduate health education students in developing topic ideas for a descriptive research study. Each fall semester since 2008, a mind mapping activity was used in an introductory undergraduate health research methods course to provide health education students with a structured activity aimed at the identification of a researchable health topic and the selection of a specific aspect of that topic that warrants further study. After the construction of the mind map, students developed structured research questions and a list of key search terms that served as the foundation for a review of the literature and the development of a questionnaire for a descriptive research study. To illustrate this instructional strategy, three example mind maps are provided with detailed commentary. Discussion includes suggestions on how instructors could scaffold the mind mapping activity with individual feedback and collaborative learning to enhance critical thinking.
Suggestions for Strengthening the Public Health Leadership Development Model
Authors: Grimm Brandon , Tibbits Melissa , Maloney Shannon , Johansson Patrik , Siahpush Mohammad
Published: December 2017

For over 20 years the current model of Public Health Leadership Institutes (PHLIs) has been the primary model for “leadership” development. Past studies have shown that the model is successful in increasing participants’ knowledge and developing individual skills. However, limited evidence suggests that the model leads to outcome-based results. This review compares the current PHLI model with traditional corporate leadership development models and determines that the PHLI model is in fact related more closely with a “leader” development model. Additionally, it is suggested that it is not possible to measure outcome-based results because of the limitations of the current model. Finally, recommendations are made to refine the model to make it more closely aligned with a true “leadership” development model, thus making it more effective at educating and training the current public health workforce.
Transformational Learning in Undergraduate Public Health Education: Course Design for Generation Z
Authors: Gardner Jolynn K. , Ronzio Cynthia , Snelling Anastasia
Published: December 2017

Community partnerships provide an invaluable and practical teaching opportunity for undergraduate public health education programs. This is especially true when working with Generation Z students who desire meaningful, effective learning experiences. The continued strong interest of Generation Z undergraduates in public health and health promotion, combined with their skills and learning preferences, provides a strong rationale for utilization of community-based learning strategies. It could be argued, however, that programs must go beyond providing service learning and reflection opportunities. Indeed, experiential learning has come under criticism for lack of engagement with community-based organizations served by students and a lack of evidence on the quality or utility of the “services” provided. In this light, we constructed a transformational model of learning, where students complete tangible, timely projects with community partner organizations. In this model, all parties benefit: The students experience an often-profound learning opportunity through project execution; the community partners benefit from the skills, insight, time, and talents of the students; and the undergraduate program is able to assess a novel marker of student achievement—evaluation of a real-world application of public health skills and knowledge.
Service Learning: A Useful Pedagogy to Engage Community Health Education Students in a Resource Management and Grant Writing Course
Authors: Bentley Kelly M. , Swan Stephanie A.
Published: December 2017

Individuals in the health and social service arena are often required to obtain programmatic funds through grant and proposal writing; however, in this highly competitive era, these funding avenues have become more difficult to obtain. The literature is limited and mainly related to curriculum practices used to prepare students to work in the field of community health. A Resource Management and Grant Writing course taught in an undergraduate program that prepares students for Community Health Education Specialist certification uses a service-learning approach to teach specific National Commission for Health Education Credentialing knowledge and skills, including components of a grant. This article describes a successful service-learning process employed with these students.
Blending Pedagogical Approaches in Public Health Education: The ADOPT Model
Authors: Thomas McKinley , Clack Lesley , Plaspohl Sara
Published: December 2017

Background. Developmental groundwork in the health professions begins with specialized training, knowledge acquisition, and critical thinking skills, each reliant on authentic pedagogical approaches. In response to student recommendations, and to provide a novel approach to content delivery, the authors developed a theory-based teaching model focused on activity, discussion, objectives, presentation, and transition (ADOPT). Purpose. The purpose of this article is to discuss the ADOPT model, evaluative data, and potential uses within the public health classroom. Method. To date, the model has been implemented within five content areas: disease continuum, epidemiology, environmental health, human sexuality, and research methods. Each classroom session focused on content-specific material delivered through each of the five model components with delivery order unique to each session. At the conclusion of the semester, students were asked to complete a 15-item Likert-type survey and two open-ended items regarding model efficacy. Evaluation. Assessment results from 119 students are encouraging. Measures of general course efficacy were similar between undergraduate and graduates with mean 10-point Likert-type scores of 8.3 and 8.5, respectively. Both groups reported 8.1 when asked about the benefits of the multimodal approach. Average scores on five items related to model components were 8.1 for undergraduates and 7.9 for graduates. The discussion component was given the highest score, whereas “group work” was given the lowest. Conclusion. The ADOPT model offers a promising approach toward delivery of public health content. Future iterations will enhance group interactions and explore model use within the context of distributive learning.
Using Digital Stories to Educate Public Health Students About Local Social Determinants of Health
Authors: Hackett Martine , Humayun Laraib
Published: December 2017

Digital stories are short videos that use narrative structures to address issues from a personal perspective. They have been used to educate populations about health topics, including teen pregnancy, cancer screening, and substance abuse. Social determinants of health and structural inequalities are known contributors to health inequity and are a set of fundamental concepts for public health students to understand, particularly within local communities. To address this issue, a digital story was created by an instructor of undergraduate and graduate public health courses with both the instructor’s personal narrative and commentary when driving between adjacent racially segregated neighborhoods in a suburb near where she lives. The health disparities and the connection between place and health were highlighted in the narration. Public health students at a university that borders the communities featured were shown the video, pre- and posttests were administered ( n = 119) and a paired t test was performed to measure differences in the students’ knowledge about social determinants of health. An open-ended question about the video was also analyzed. Students demonstrated increased understanding of social determinants of health ( p < .001), local health inequity ( p < .001), and residential segregation ( p < .000). Qualitative responses indicated that students had seen these differences in local neighborhoods but were unaware of the connection between residential segregation and health. Digital stories, particularly rooted in local neighborhoods, can be an effective way to educate undergraduate and graduate students about social determinants of health.
Strengthening Communities of Inquiry Online and Offline: Exploring the Benefits and Challenges of Including Service-Learning in a Fully Online Women’s Global Health Course
Authors: Early Jody , Lasker Grace A.
Published: December 2017

Online learning is no longer novel in higher education. Decades of research have proven it to be an effective modality for learning when designed and facilitated well to students who are ready and supported to participate in this type of instruction. With demand increasing for online and blended course and program offerings, faculty and practitioners who work in health education and promotion are pressed to adopt new paradigms of teaching and course development that engage the learner and cover professional competencies (many skills-based). While service-learning has become an integral facet of higher education, embraced by many disciplines for its positive influence on student learning and community, service-learning and community-based projects are not commonly part of online learning. Working in and with communities provides students opportunities to experience transformative moments that help them not only develop academically and professionally but also lead to increased social consciousness about the world around them. There is a need for empirical studies that explore the integration of service-learning in fully online health promotion courses. This article presents findings and lessons learned from a pilot project that explored the impact of service-learning on community of inquiry measures (e.g., cognitive presence, teacher presence, and social presence). The authors introduce a new online course model in health promotion that includes service-learning or other forms of community engagement.
Designing an E-Learning Health Promotion Course: Meeting the National Benchmarks
Authors: Kanekar Amar
Published: December 2017

The purpose of this coaching article is to assist health education academicians and specialist practitioners to understand the design of a fully distance learning health program and planning course applying the Quality Matters and Blackboard Exemplary Course rubric frameworks. Quality Matters is a nationally recognized, faculty-centered, peer-review process designed to certify the quality of online and blended courses and online components. The Blackboard Exemplary course framework uses best practices in designing engaging online courses with detailed feedback and course improvement. This article is a peer to peer teaching effort of step by step application of various rubric features, used nationally, providing examples of its applications toward a distance learning course. Additionally, the course designer discusses literature related to the evidence base of Quality Matters and some of the limitations of using course design tools.
Novice Health and Wellness Coaches: Implication for Professional Preparation
Authors: Broadbear Jim , Broadbear Barbara
Published: December 2017

Higher education programs are increasingly involved in the preparation of health and wellness coaches. The preparation of entry-level coaches in undergraduate programs presents unique challenges and opportunities as students are simultaneously novice learners in higher education, health professions, and coaching. Therefore, faculty need to consider the unique skills needed by health and wellness coaches and the characteristics of undergraduate learners when designing undergraduate coaching education programs. As students move into the evidence-based profession of health and wellness coaching, they must acquire essential knowledge and skills while going through a period of significant personal development. The journey from novice to competent entry-level coach takes commitment and focused effort by students and faculty alike, supported by a thoughtful design of undergraduate programs. Design elements include a coach-the-coach approach, an emphasis on self-development, explicitly teaching the thinking skills inherent to coaching, and the progressive immersion of experiential learning. These approaches could maximize the success of novices in becoming competent, entry-level health and wellness coaches.
Linking urban sprawl and income segregation – Findings from a stylized agent-based model
Authors: Guo Cheng , Buchmann Carsten M , Schwarz Nina
Published: December 2017

Urban sprawl and income segregation are two undesired urban patterns that occur during urban development. Empirical studies show that income level and inequality are positively correlated with urban sprawl and income segregation, respectively. However, the relationship between urban sprawl and income segregation is not only rarely investigated but also shows ambiguous empirical results when it is. Therefore, in this study, we built a stylized agent-based model with individual behaviours based on Alonso’s bid rent theory and ran simulations with different combinations of income level and income inequality. We measured the overall emergent patterns with indicators for urban sprawl and income segregation. The model confirms the established positive correlations between income level and urban sprawl and between income inequality and segregation. Furthermore, the model shows a negative correlation between urban sprawl and income segregation under free market conditions. The model indicates that without any policy implementation, a city will either suffer from urban sprawl or income segregation. Thus, this study serves as a starting point to study the effects of different urban planning policies on these two urban problems.