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1.
J Sch Health ; 90(3): 212-223, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31894581

RESUMO

BACKGROUND: Violence and bullying perpetration among boys are major public health problems. We address gaps in the literature by examining: (1) how risk and protective factors co-occur, and (2) how different risk/protection profiles are associated with violence and bullying perpetration among adolescent boys. METHODS: Data came from the population-based 2016 Minnesota Student Survey. The analytic sample included boys in grades 8, 9, and 11 (N = 63,818). Latent profile analyses identified patterns of 22 behavioral, intrapersonal, family, and school and community risk/protective factors. Logistic regression analyses examined how these patterns related to violence and bullying perpetration. RESULTS: We identified 5 groups: Class 1: Low risk, high safety, high connectedness; Class 2: Low risk, moderate safety, moderate connectedness; Class 3: Moderate risk, high safety, moderate connectedness; Class 4: High risk, moderate safety, low connectedness; and Class 5: High risk, low safety, low connectedness. Compared to Class 1, Class 5 students had the highest odds of all for violence and bullying perpetration. Class 4 students also demonstrated high odds of violence and bullying, compared to Class 1. Though not as high as Classes 4 or 5, Class 2 and 3 students showed higher odds for both outcomes, compared to Class 1. CONCLUSIONS: Substantive variations exist in boys who engage in violence and bullying. We highlight cumulative, co-occurring risk factors, connectedness to parents and other prosocial adults (eg, teachers), and school and neighborhood safety as important factors to address in school health programs seeking to prevent violence and bullying perpetration among boys.

2.
Longit Life Course Stud ; 10(1): 51-85, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31481978

RESUMO

This longitudinal study examines how the time that youth spend in activities during high school may contribute to positive or negative development in adolescence and in early adulthood. We draw on data from 1103 participants in the longitudinal Youth Development Study, followed from entry to high school to their mid-twenties. Controlling demographic, socioeconomic, and psychological influences, we estimate the effects of average time spent on homework, in extracurricular activities, and with friends during the four years of high school on outcomes measured in the final year of high school and twelve years later. Our results suggest that policies surrounding the implementation and practice of homework may have long-term benefits for struggling students. In contrast, time spent with peers on weeknights was associated with both short- and long-term maladjustment.

3.
J Surg Educ ; 76(2): 354-361, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30146460

RESUMO

OBJECTIVE: We aimed to evaluate resident operative times in relation to postgraduate year (PGY), case difficulty and resident stress while performing a single surgical procedure. DESIGN: We prospectively examined operative times for 268 laparoscopic cholecystectomies, and analyzed relationships between PGY, case difficulty, and resident surgeon stress utilizing electrodermal activity. Each case operative times were divided into 3 separate time periods. Case Start and End times were recorded, as well as the time between the start of the operation and the time until the cystic structures were divided (Division). Case difficulty was determined by multiple trained observers with a high inter-rater concordance. SETTING: University of Missouri, a tertiary academic medical institution. PARTICIPANTS: All categorical general surgery residents at our institution. RESULTS: For each operative time period examined during laparoscopic cholecystectomy, operative time increased, with each incremental increase in difficulty resulting in approximately 130% longer times. Minimal differences in operative times were seen between PGY levels, except during the easiest cases (Start-End times: 38.5 ± 10.4 minutes vs 34.2 ± 10.8 minutes vs 28.9 ± 10.9 minutes, p 0.002). Resident stress poorly correlated with operative times regardless of case difficulty (Pearson coefficient range 0.0-0.22). CONCLUSIONS: Operative times are longer with increasing case difficulty. PGY level and resident surgeon stress appear to have minimal to no correlation with operative times, regardless of case difficulty.

4.
J Surg Educ ; 76(1): 234-241, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29983346

RESUMO

OBJECTIVE: Surgical simulation has become an integral component of surgical training. Simulation proficiency determination has been traditionally based upon time to completion of various simulated tasks. We aimed to determine objective markers of proficiency in surgical simulation by comparing novel assessments with conventional evaluations of technical skill. DESIGN: Categorical general surgery residents completed 10 laparoscopic cholecystectomy modules using a high-fidelity simulator. We recorded and analyzed simulation task times, as well as number of hand movements, instrument path length, instrument acceleration, and participant affective engagement during each simulation. Comparisons were made to Objective Structured Assessment of Technical Skill (OSATS) and Accreditation Council for Graduate Medical Education Milestones, as well as previous laparoscopic experience, duration of laparoscopic cholecystectomies performed by participants, and postgraduate year. Comparisons were also made to Fundamentals of Laparoscopic Surgery task times. Spearman's rho was utilized for comparisons, significance set at >0.50. SETTING: University of Missouri, Columbia, Missouri, an academic tertiary care facility. PARTICIPANTS: Fourteen categorical general surgery residents (postgraduate year 1-5) were prospectively enrolled. RESULTS: One hundred forty simulations were included. The number of hand movements and instrument path lengths strongly correlated with simulation task times (ρ 0.62-0.87, p < 0.0001), FLS task completion times (ρ 0.50-0.53, p < 0.0001), and prior real-world laparoscopic cholecystectomy experience (ρ -0.51 to -0.53, p < 0.0001). No significant correlations were identified between any of the studied markers with Accreditation Council for Graduate Medical Education Milestones, Objective Structured Assessment of Technical Skill evaluations, total previous laparoscopic experience, or postgraduate year level. Neither instrument acceleration nor participant engagement showed significant correlation with any of the conventional markers of real-world or simulation skill proficiency. CONCLUSIONS: Simulation proficiency, measured by instrument and hand motion, is more representative of simulation skill than simulation task time, instrument acceleration, or participant engagement.

5.
J Surg Educ ; 75(6): e78-e84, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30337262

RESUMO

PURPOSE: Nondesignated preliminary residents (N-DPRs) in General Surgery face difficult challenges of overcoming failure to match and quickly reentering the match again with little time to significantly improve their application. Programs with N-DPRs should take seriously their responsibility for helping these residents obtain a successful career path just as they do for their categorical residents. This study evaluates an intervention to improve the matching of N-DPRs into desired positions. METHODS: We evaluated the match results of N-DPRs at a single institution over an 8-year period. The first 4 years served as the historical control (Group 1), while the following 4 years of N-DPRs underwent a focused intervention (Group 2). Group 2 underwent an 8-step process: (1) a phone call shortly after supplemental offer and acceptance program (SOAP) to discuss strategy, (2) a 1-hour N-DPR specific orientation, (3) targeted meetings to identify reasons for an unsuccessful match, and personal statement revision in July, (4) mock interviews in August, (5) mid-interview cycle meetings to review strategy and trajectory, (6) meetings in January to prioritize rank lists, (7) meetings the week before the match to discuss plan if match is unsuccessful, and (8) meeting on Monday of Match Week. We determined the N-DPRs initial choice of specialty, specialty obtained after their N-DPR year, and career choice changes that occurred during their preliminary years for both groups. Comparisons and statistical analysis were then completed. RESULTS: There were 40 N-DPRs in the program over the last 8 years. Group 1, the 4 years before the curriculum, had only 13 of the 16 (81%) N-DPRs obtain a desired position. Group 2, the 4 years following intervention, had all 24 (100%) N-DPRs obtain a desired position. This was a significant improvement (number needed to treat (NNT) = 5.38, p = 0.027). There were no significant differences between groups in regard to the N-DPRs maintaining their original specialty of choice (44% vs 50%). CONCLUSIONS: The implementation of an N-DPR curriculum significantly improved the probability of N-DPRs to obtain desired positions. Over half of the N-DPRs obtained a position in a specialty different from what they originally applied. Programs should consider aiding N-DPRs in navigating toward a different career path.


Assuntos
Currículo , Cirurgia Geral/educação , Candidatura a Emprego , Fatores de Tempo
6.
Subst Use Misuse ; 53(11): 1859-1868, 2018 09 19.
Artigo em Inglês | MEDLINE | ID: mdl-29509085

RESUMO

BACKGROUND: Parents and peers both influence the development of adolescent substance misuse, and the Social Interaction Learning (SIL) model provides a theoretical explanation of the paths through which this occurs. OBJECTIVE: The SIL model has primarily been tested with conduct outcomes and in US samples. This study adds to the literature by testing the SIL model with four substance use outcomes in a sample of Australian youth. METHOD: We used structural equation modeling to test the fit of the SIL model to a longitudinal sample (n = 907) of students recruited in grade 5 in Victoria, Australia participating in the International Youth Development Study, who were resurveyed in grades 6 and 10. RESULTS: The model fit was good (χ2(95) = 248.52, p < .001; RMSEA = .04 [90% CI: .036 - .049]; CFI = .94; SRMR = .04). Path estimates from parenting to antisocial behavior and from antisocial behavior to antisocial peers were significant. In turn, having antisocial peers was significantly related to alcohol use, binge drinking, tobacco use, and marijuana use. From parenting, only the direct path to marijuana use was significant, but indirect effects were significant. CONCLUSIONS: The SIL model illustrates that parenting plays an early role in the formation of adolescent peer relations that influence substance misuse and identifies etiological pathways that can guide the targets of prevention. The SIL pathways appear robust to the Australian social and policy context.


Assuntos
Comportamento do Adolescente/psicologia , Relações Interpessoais , Modelos Psicológicos , Comportamento Social , Estudantes/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Consumo de Bebidas Alcoólicas/psicologia , Feminino , Humanos , Masculino , Fumar Maconha/psicologia , Poder Familiar , Grupo Associado , Uso de Tabaco/psicologia , Vitória
7.
Prev Sci ; 19(4): 570-578, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29150747

RESUMO

Adolescent substance use continues to be a significant public health problem. Parent training interventions are effective preventive strategies to reduce youth substance use. However, little is known about differences in effectiveness for youth across demographic characteristics. This review assessed the effectiveness of parent training programs at reducing adolescent substance use by participant gender, age, and race/ethnicity. Pubmed/MEDLINE, ERIC, CINAHL, and PsycINFO were searched from database origin to October 31, 2016. We included randomized controlled trials that evaluated parent training interventions; reported youth initiation or use of tobacco, alcohol, or other illicit substances; and included adolescents aged 10 to 19. Two independent reviewers extracted data. Disagreements were resolved by consensus or a third researcher. Data were synthesized using harvest plots stratified by participant demographics. A total of 1806 publications were identified and reviewed; 38 unique studies were included. Risk of bias of included studies was high. No studies targeted male teens or youth in late adolescence. Few studies targeted Asian-American, Black/African-American, or Hispanic/Latino adolescents. Overall, interventions including male and female youth and youth in early adolescence (age 10 to 14 or in 5th to 8th grade) were more beneficial than interventions including female-only or both young and older adolescents. Programs tailored to specific racial/ethnic groups, as well as programs designed for youth from multiple races/ethnic groups, were effective. Current evidence supports the benefits of offering parenting guidance to all families with adolescent children, regardless of the gender, age, or race/ethnicity of the adolescent.


Assuntos
Poder Familiar , Pais/educação , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Adolescente , Criança , Feminino , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Adulto Jovem
8.
J Surg Res ; 218: 144-149, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28985841

RESUMO

BACKGROUND: Surgical resident ability to accurately evaluate one's own skill level is an important part of educational growth. We aimed to determine if differences exist between self and observer technical skill evaluation of surgical residents performing a single procedure. MATERIALS AND METHODS: We prospectively enrolled 14 categorical general surgery residents (six post-graduate year [PGY] 1-2, three PGY 3, and five PGY 4-5). Over a 6-month period, following each laparoscopic cholecystectomy, residents and seven faculty each completed the Objective Structured Assessment of Technical Skills (OSATS). Spearman's coefficient was calculated for three groups: senior (PGY 4-5), PGY3, and junior (PGY 1-2). Rho (ρ) values greater than 0.8 were considered well correlated. RESULTS: Of the 125 paired assessments (resident-faculty each evaluating the same case), 58 were completed for senior residents, 54 for PGY3 residents, and 13 for junior residents. Using the mean from all OSATS categories, trainee self-evaluations correlated well to faculty (senior ρ 0.97, PGY3 ρ 0.9, junior ρ 0.9). When specific OSATS categories were analyzed, junior residents exhibited poor correlation in categories of respect for tissue (ρ -0.5), instrument handling (ρ 0.71), operative flow (ρ 0.41), use of assistants (ρ 0.05), procedural knowledge (ρ 0.32), and overall comfort with the procedure (ρ 0.73). PGY3 residents lacked correlation in two OSATS categories, operative flow (ρ 0.7) and procedural knowledge (ρ 0.2). Senior resident self-evaluations exhibited strong correlations to observers in all areas. CONCLUSIONS: Surgical residents improve technical skill self-awareness with progressive training. Less-experienced trainees have a tendency to over-or-underestimate technical skill.


Assuntos
Colecistectomia Laparoscópica/educação , Competência Clínica , Cirurgia Geral/educação , Internato e Residência , Autoavaliação , Cirurgiões/psicologia , Adulto , Colecistectomia Laparoscópica/normas , Docentes de Medicina , Feminino , Humanos , Curva de Aprendizado , Masculino , Missouri , Estudos Prospectivos , Cirurgiões/educação , Cirurgiões/normas
9.
Psychoneuroendocrinology ; 86: 87-95, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28926761

RESUMO

Symptomatology of depression among children who have (vs. have not) experienced maltreatment is greater in severity, more resistant to conventional treatment, and associated with elevated risk for suicide. Recent evidence implicates perturbations in stress regulatory systems and heightened negative self-appraisals as factors that increase the severity of psychopathology experienced by depressed maltreated (vs. non-maltreated) youth. Likely explanatory mechanisms for these differences are disturbances in the function of the hypothalamic-pituitary axis (HPA) and persistent negative self-referential biases supported by prefrontal cortex function including the dorsal anterior cingulate cortex (dACC). The cortisol awakening response (CAR) and dACC activity during a self-appraisal task were assessed in maltreated and non-maltreated depressed youth. Hierarchical linear models were employed to model the CAR. Maltreatment group, dACC activity during positive and negative self-appraisals as well as other key predictors, were included in the models. Post hoc analyses explored explanations for significant differences. Results indicated that maltreated depressed youth exhibited a higher CAR compared to non-maltreated youth. At low levels of dACC activity during processing of negative self-descriptors maltreated and non-maltreated depressed youth's CAR did not differ. However, at elevated levels of dACC activity during processing of negative self-descriptors maltreated depressed youth exhibited significantly higher CAR compared to non-maltreated depressed youth.


Assuntos
Depressão/fisiopatologia , Giro do Cíngulo/metabolismo , Hidrocortisona/metabolismo , Adolescente , Maus-Tratos Infantis/psicologia , Depressão/metabolismo , Transtorno Depressivo/fisiopatologia , Feminino , Giro do Cíngulo/fisiologia , Humanos , Hidrocortisona/análise , Acontecimentos que Mudam a Vida , Masculino , Córtex Pré-Frontal/metabolismo , Córtex Pré-Frontal/fisiopatologia , Saliva , Estresse Psicológico/fisiopatologia
10.
J Youth Adolesc ; 46(11): 2289-2304, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28584921

RESUMO

Involvement in bullying and sexual harassment in adolescence is associated with a variety of internalizing, externalizing, and health-risk behaviors. Yet, the two behaviors are often studied independently. The current study examined how bullying and sexual harassment co-occur and whether social connections protected youth from risk patterns. The data for this study come from the 2013 Minnesota Student Survey (N = 121,311; 50% female, 74% White, 26% received free or reduced-price lunch; M age = 14.9, SD = 1.3). Students reported on bullying and sexual harassment victimization and perpetration. Using latent class analysis, youth were classified into five patterns: High-Risk of All Forms of Victimization and Perpetration (7%), Relational and Cyberbullying Victimization (17%), Sexual Harassment Victimization and Perpetration (8%), Physical Bullying Perpetration (6%), and Low-Risk (62%). Compared to the low-risk class, the four other classes had lower levels of social connections, particularly with teachers and parents. Older youth (9th and 11th grade students) were at greater risk for the sexual harassment pattern, while younger youth (8th grade students) were at greater risk for bullying patterns. The results indicate that efforts to reduce bullying should also address sexual harassment and social connections with adults.


Assuntos
Bullying/estatística & dados numéricos , Vítimas de Crime/estatística & dados numéricos , Assédio Sexual/estatística & dados numéricos , Adolescente , Feminino , Humanos , Masculino , Minnesota , Pais , Fatores de Proteção , Professores Escolares , Estudantes , Inquéritos e Questionários
11.
J Surg Educ ; 74(4): 674-680, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28373078

RESUMO

OBJECTIVE: Within the realm of surgical education, there is a need for objective means to determine surgical competence and resident readiness to operate independently. We propose a novel, objective method of assessing resident confidence and clinical competence based on measurement of electrodermal activity (EDA) during live surgical procedures. We hypothesized that with progressive training, EDA responses to the stress of performing surgery would exhibit decline, elucidating an objective correlate of clinical competence. DESIGN: EDA was measured using galvanic skin response sensors worn by residents performing laparoscopic cholecystectomy on sequential live human patients over an 8-month period. Baseline, phasic (peak) and tonic EDA responses were measured as a fractional change from baseline. SETTING: University of Missouri, Columbia, Missouri, an academic tertiary care facility. PARTICIPANTS: Fourteen categorical general surgery residents and 5 faculty surgeons were voluntarily enrolled and participated through completion. RESULTS: Tonic fractional change (FCTONIC) was highest in PGY3 residents compared with postgraduate year (PGY) 1 and 2 residents (7.199 vs. 2.100, p = 0.004, 95% CI: 8.58-1.61 and PGY4 and 5 residents (7.199 vs. 2.079, p = 0.002, 95% CI: 8.38-0.29). Phasic fractional change in EDA (FCPHASIC) exhibited a progressive decline across resident training levels, with PGY1 and 2 residents having the highest response, and faculty displaying the lowest FCPHASIC responses. Statistical differences were seen between FCPHASIC faculty and PGY4 and 5 (3.596 vs. 6.180, p = 0.004, 95% CI: 0.80-4.36), PGY4 and 5, and PGY3 (6.180 vs. 15.998, p = 0.003, 95% CI: 3.33-16.3), as well as among all residents and faculty (13.057 vs. 3.596, p = 0.004, 95% CI: 15.8-3.1). CONCLUSION: Phasic EDA changes decrease with increasing clinical competence. For those participants with the lowest and highest levels of competence, tonic EDA changes are minimal. Tonic EDA changes follow an inverse-U shape with differing levels of clinical competence.


Assuntos
Colecistectomia Laparoscópica/educação , Competência Clínica , Educação de Pós-Graduação em Medicina , Avaliação Educacional/métodos , Resposta Galvânica da Pele/fisiologia , Adulto , Feminino , Humanos , Internato e Residência , Masculino
12.
Am J Prev Med ; 52(3 Suppl 3): S275-S278, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28215380

RESUMO

Over the past 30 years, prevention science in the adolescent health field has moved from interventions focused on preventing single problem behaviors to efforts employing a dual approach, addressing risk factors that predict problems while simultaneously nurturing protective factors and promoting positive development. Through an examination of previous research and empirical case examples with vulnerable youth, this article considers the hypothesis that adolescents' sense of connectedness to caring adults acts as a protective factor against a range of risk behaviors. Multivariate analyses with existing data examined indicators of youth-adult connectedness among two groups at high risk for poor health outcomes: (1) mentor-youth relationship quality in an urban, ethnically diverse sample of students in a school-based mentoring program (2014 survey, N=239); and (2) parent-youth connectedness in a statewide sample of high school students who reported homelessness in the past year (2013 survey, N=3,627). For youth in the mentoring program, a high-quality youth-mentor relationship was significantly associated with positive social, academic, and health-related behaviors. Among students who experienced homelessness, all measures of parent connectedness were significantly associated with lower sexual risk levels. Collectively, findings from these analyses and previously published studies by this research group provide evidence that strong, positive relationships with parents and other caring adults protect adolescents from a range of poor health-related outcomes and promote positive development. Youth-adult connectedness appears to be foundational for adolescent health and well-being. Program, practice, and policy decisions should consider what strengthens or hinders caring, connected youth-adult relationships.


Assuntos
Saúde do Adolescente , Tutoria , Poder Familiar , Adolescente , Adulto , Idoso , Feminino , Jovens em Situação de Rua , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Sexual , Adulto Jovem
13.
Body Image ; 18: 96-107, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27352103

RESUMO

The goal of this study was to examine the ways in which transgender youth experience their bodies with regard to gender and body size. Ninety transgender youth and young adults completed in-depth interviews in eight metropolitan areas of the United States, Canada, and Ireland. Using a queer perspective, qualitative analyses revealed two broad conceptual categories: body dissatisfaction and body satisfaction. Within these categories, participants focused on body issues related to gender characteristics and body size. Findings revealed evidence of self-criticism and social distress related to body image dissatisfaction and self-acceptance and social acceptance related to body image satisfaction. Data demonstrated how gender, body size, and the intersection of gender and body size influenced personal perceptions of body dissatisfaction and satisfaction. Developmental processes were evident: participants further along in consolidating a gender identity described gaining a sense of social awareness, self-acceptance, and body satisfaction reflecting a sense of resilience.


Assuntos
Imagem Corporal/psicologia , Pessoas Transgênero/psicologia , Adolescente , Tamanho Corporal , Canadá , Comparação Transcultural , Feminino , Identidade de Gênero , Humanos , Entrevista Psicológica , Irlanda , Masculino , Satisfação Pessoal , Pesquisa Qualitativa , Estados Unidos , Adulto Jovem
14.
J Med Internet Res ; 18(6): e169, 2016 06 22.
Artigo em Inglês | MEDLINE | ID: mdl-27334833

RESUMO

BACKGROUND: Some evidence suggests parents are drawn to media-based interventions over face-to-face interventions, but little is known about the factors associated with parents' use of Internet-based or Internet-enhanced programs, especially among military families. Research is needed to understand characteristics of parents who may be most likely to use online components or attend face-to-face meetings in order to ensure maximum engagement. OBJECTIVE: In this study, we examined characteristics that predict various patterns of Internet use and face-to-face attendance in a parenting program designed for military families. METHODS: An ecological framework guided analysis of differences in patterns of Internet-based use and face-to-face attendance by parents' demographic characteristics (gender, education, employment, and child age), incentives offered, and number of months the parent was deployed. We reported differences in the total number of online components completed over the 14 modules, total number of face-to-face sessions attended, and the use of different types of online components accessed (videos, downloadable handouts, mindfulness exercises, knowledge checks, and downloadable summaries). Then, we computed multinomial logistic regression accounting for nestedness (parents within families) to examine associations between demographic, programmatic, and military-related characteristics and patterns of engagement (use of online components and attendance at face-to-face sessions). RESULTS: Just over half (52.2%, 193/370) of the participants used the online components at least once, and the majority of participants (73.2%, 271/370) attended at least 1 face-to-face session. An examination of different patterns of participation revealed that compared with those who participated primarily in face-to-face sessions, parents who participated online but had little face-to-face participation were more likely to have received incentives than those who did not (95% CI 1.9-129.7). Among participants who had been deployed, those who had earned a 4-year degree (95% CI 1.0-2.2) and those who had been offered incentives to participate online (95% CI 2.1-58.6) were more likely to be highly engaged in online components and attend face-to-face compared with those who attended primarily face-to-face. However, those with a high number of months of deployment (95% CI 0.6-1.0) were less likely to be in the pattern of highly engaged in online components and face-to-face attendance. Compared with those who participated primarily face-to-face, deployed mothers were about 4 times more likely to engage in moderate online use with face-to-face attendance than deployed fathers (95% CI 1.21-11.83) and participate primarily online (95% CI 0.77-25.20). CONCLUSIONS: Results imply that parents may be drawn to different delivery options of a parenting program (online components vs face-to-face sessions) depending on their education level, incentives to engage in online components, and their military-related experience. Results suggest potential directions for tailoring Internet-based interventions.


Assuntos
Internet , Família Militar , Poder Familiar , Pais , Adulto , Criança , Pré-Escolar , Escolaridade , Características da Família , Feminino , Humanos , Renda , Masculino , Motivação
15.
Fam Syst Health ; 34(1): 15-30, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26618640

RESUMO

BACKGROUND: To date there has been limited success with childhood obesity prevention interventions. This may be due in part, to the challenge of reaching and engaging parents in interventions. The current study used a community-based participatory research (CBPR) approach to engage parents in cocreating and pilot testing a childhood obesity prevention intervention. Because CBPR approaches to childhood obesity prevention are new, this study aims to detail the creation, including the formation of the citizen action group (CAG), and implementation of a childhood obesity prevention intervention using CBPR methods. METHOD: A CBPR approach was used to recruit community members to partner with university researchers in the CAG (n = 12) to create and implement the Play It Forward! childhood obesity intervention. The intervention creation and implementation took 2 years. During Year 1 (2011-2012), the CAG carried out a community needs and resources assessment and designed a community-based and family focused childhood obesity prevention intervention. During Year 2 (2012-2013), the CAG implemented the intervention and conducted an evaluation. Families (n = 50; 25 experimental/25 control group) with children ages 6-12 years participated in Play It Forward! RESULTS: Feasibility and process evaluation data suggested that the intervention was highly feasible and participants in both the CAG and intervention were highly satisfied. Specifically, over half of the families attended 75% of the Play It Forward! events and 33% of families attended all the events. CONCLUSION: Equal collaboration between parents and academic researchers to address childhood obesity may be a promising approach that merits further testing.


Assuntos
Promoção da Saúde/métodos , Obesidade Pediátrica/prevenção & controle , Adulto , Criança , Participação da Comunidade/métodos , Pesquisa Participativa Baseada na Comunidade , Comportamento Alimentar/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Minnesota , Pais/psicologia , Obesidade Pediátrica/psicologia , Desenvolvimento de Programas
16.
J Surg Educ ; 71(4): 480-5, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24776880

RESUMO

OBJECTIVE: The purpose of this study was to analyze the decay of information with multiple sequential patient handoff reports given by third-year medical students who have not had standardized patient handoff training. METHODS: We examine the information decay of quantitative parameters included in 2 different simulated patient history and physical handoffs conducted among third-year medical students. Both student self-surveys and third party observer surveys tracked accuracy of information. A total of 93 students were surveyed for the first patient scenario and 103 students were surveyed for second patient scenario. Survey data were aggregated into 2 separate spreadsheets, one for each patient scenario tested. A total of 16 data points pertaining to the checklist were analyzed for common trends in handoff accuracy and information decay. RESULTS: Quantitative analysis of information passed between handoffs showed that between the 2 case scenarios, there was a consistent loss of information between one presenter to the next. Overall, 33% of information was lost between the first and third handoffs. Within the progression of individual handoffs, a narrative decay was demonstrated. There was a regression in handoff accuracy, trending down to an average of only 45% of information being passed on successfully by the time each presenter reached the last piece of information in their patient presentation. When examining the survey data points that had greater than an 80% success rate of being included in the handoffs, there appeared to be no correlation between their inherent qualities. CONCLUSIONS: This study showed there is a significant decrease in accuracy of information during sequential patient handoff exercises. The information decay may be a result of time, memory, or relevance of the information to the student. Future studies incorporating teaching effective handoffs early in the clinical curriculum would be an area of future research.


Assuntos
Transferência da Responsabilidade pelo Paciente , Adulto , Lista de Checagem , Competência Clínica/normas , Comunicação , Humanos , Disseminação de Informação , Erros Médicos/prevenção & controle , Transferência da Responsabilidade pelo Paciente/organização & administração , Transferência da Responsabilidade pelo Paciente/normas , Transferência da Responsabilidade pelo Paciente/estatística & dados numéricos , Estudantes de Medicina
17.
J Surg Educ ; 70(4): 508-13, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23725939

RESUMO

OBJECTIVE: The aim of the study was to determine whether a standardized orientation to basic laparoscopy makes a positive effect on the experience of third-year medical students. STUDY DESIGN: Fifty-three third-year medical students at the University of Missouri, Columbia were randomly divided into 2 groups during their clerkship orientation. Both groups received a 40-minute laparoscopic hands-on training simulation guided by instructors. However, only 1 group was given a 20-minute multimedia presentation on introduction to laparoscopy that covered equipment, set up, troubleshooting, and different methods of access into the abdomen. Both groups were given a preclerkship and postclerkship survey where students were asked to rate their experience, comfort, and interest in surgery on a 10-point Likert scale. RESULTS: Hundred percent of the students receiving the combined hands-on training simulation and the 20-minute presentation felt that the experience helped during their clerkship (p = 0.002) and 92% felt it had a positive effect (p = 0.501). In contrast, only 72% of the group that received the hands-on training simulation alone found it helpful (p = 0.029) and 86% thought it had a positive effect (p = 0.508). There was no statistical difference between either group with regard to their perceived comfort with assistance in the operating room and with laparoscopy. Neither experience had a statistical effect on a students' interest in surgery as a career. CONCLUSIONS: Our results demonstrate how a standardized orientation to basic laparoscopy can make a positive effect on a student's experience; however, it fails to transition into a student's interest in surgery as a profession or in their perceived comfort level in the operating room. Our study suggests that a student's surgical interest is highly variable and composed of multiple experiences that occur during their clerkship that ultimately affects their perception of surgery as a field and profession.


Assuntos
Atitude do Pessoal de Saúde , Educação de Graduação em Medicina/métodos , Laparoscopia/educação , Laparoscopia/normas , Escolha da Profissão , Avaliação Educacional , Feminino , Humanos , Masculino , Missouri , Multimídia , Estudos Prospectivos , Adulto Jovem
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