Using the social ecological model to identify drivers of nutrition risk in adult day settings serving East Asian older adults
education; support; united-states; care; impact; guidelines; programs; perspective; community; malnutrition
Adult day care (ADC) centers provide community-based care (including meals) to frail, ethnically diverse older adults, many of whom are at risk for malnutrition. To support the development of interventions to benefit ADC users, the authors aimed to identify barriers and facilitators of healthy nutrition among ADC users born in Vietnam and China. Semi-structured qualitative interviews were conducted among ADC stakeholders to identify barriers and facilitators. Data were analyzed using Braun and Clarke's six-step method and organized within the framework of the Social Ecological Model. Facilitators of good nutrition included adherence to traditional diet at the ADC center, peer networks, and access to ethnic grocers. Poor health, family dynamics, and loneliness all contributed to poor nutrition, as did the restrictive nature of nutrition programs serving ADC users in the United States. Individual, relationship, organizational, community, and policy level factors play a role in ADC users' nutritional status. Targeted nutrition interventions should leverage culturally congruent relationships between ADC users and staff and include advocacy for enhancement of federal programs to support this population.
Sadarangani TR; Johnson JJ; Chong SK; Brody A; Trinh-Shevrin C
Research in Gerontological Nursing
2020
2020-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.3928/19404921-20191210-02" target="_blank" rel="noreferrer noopener">10.3928/19404921-20191210-02</a>
Teaching Population Health: A Competency Map Approach To Education
academic-medical-center; community; Education & Educational Research; Health Care Sciences & Services; perspective; public-health
A 2012 Institute of Medicine report is the latest in the growing number of calls to incorporate a population health approach in health professionals' training. Over the last decade, Duke University, particularly its Department of Community and Family Medicine, has been heavily involved with community partners in Durham, North Carolina, to improve the local community's health. On the basis of these initiatives, a group of interprofessional faculty began tackling the need to fill the curriculum gap to train future health professionals in public health practice, community engagement, critical thinking, and team skills to improve population health effectively in Durham and elsewhere. The Department of Community and Family Medicine has spent years in care delivery redesign and curriculum experimentation, design, and evaluation to distinguish the skills trainees and faculty need for population health improvement and to integrate them into educational programs. These clinical and educational experiences have led to a set of competencies that form an organizational framework for curricular planning and training. This framework delineates which learning objectives are appropriate and necessary for each learning level, from novice through expert, across multiple disciplines and domains. The resulting competency map has guided Duke's efforts to develop, implement, and assess training in population health for learners and faculty. In this article, the authors describe the competency map development process as well as examples of its application and evaluation at Duke and limitations to its use with the hope that other institutions will apply it in different settings.
Kaprielian V S; Silberberg M; McDonald M A; Koo D; Hull S K; Murphy G; Tran A N; Sheline B L; Halstater B; Martinez-Bianchi V; Weigle N J; de Oliveira J S; Sangvai D; Copeland J; Tilson H H; Scutchfield F D; Michener J L
Academic Medicine
2013
2013-05
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1097/ACM.0b013e31828acf27" target="_blank" rel="noreferrer noopener">10.1097/ACM.0b013e31828acf27</a>
Career Adaptability In Childhood
construct; exploration; life-span; perspective; Psychology; vocational maturity
Childhood marks the dawn of vocational development, involving developmental tasks, transitions, and change. Children must acquire the rudiments of career adaptability to envision a future, make educational and vocational decisions, explore self and occupations, and problem solve. The authors situate child vocational development within human life span and life course development paradigms and career development theory. They then consider the theoretical origins of career adaptability and examine it as a critical construct for construing vocational development. Two models derived from career construction theory offer guides for research and counseling practice designed to foster development through work and other social roles.
Hartung P J; Porfeli E J; Vondracck F W
Career Development Quarterly
2008
2008-09
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1002/j.2161-0045.2008.tb00166.x" target="_blank" rel="noreferrer noopener">10.1002/j.2161-0045.2008.tb00166.x</a>
Development Through Work And Play
benefits; career adaptability; career developrnent; leisure; life coursed; life-role salience; life-span; perspective; Psychology; Psychology; roles; Super's theory; work and play
Adopting a work-play framework that attends to the adaptive, self-enhancing potential of play in work and human development contributes to an enhanced conceptualization of careers, both within career theory generally and the developmental perspective on careers specifically. Such a framework also promotes investigations of the connections between these life domains. Five proposals are made to imbue the developmental perspective on careers with a work-play fusion. These proposals examine how a work-play integration in vocational development theory, research, and counseling practice can foster optimal human development and therein aim to advance a revitalized developmental paradigm of career. Ultimately, theory construction and research inquiry that comprehends and investigates an integration of life roles in the domains of work and play could foster adaptability in human life-span development. (C) 2002 Elsevier Scicilce (USA).
Hartung P J
Journal of Vocational Behavior
2002
2002-12
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1006/jvbe.2002.1884" target="_blank" rel="noreferrer noopener">10.1006/jvbe.2002.1884</a>
Identifying Families' Shared Disease Experiences Through A Qualitative Analysis Of Online Twin-to-twin Transfusion Syndrome Stories
children; Emotions; Health; high-risk pregnancy; information; laser-surgery; Lived experience; Obstetrics & Gynecology; parents; perspective; prenatal-diagnosis; psychological-aspects; Psychosocial; Qualitative; stress; Twin-to-twin transfusion syndrome (TTTS)
Fischbein R; Meeker J; Saling J R; Chyatte M; Nicholas L
Bmc Pregnancy and Childbirth
2016
2016-07
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1186/s12884-016-0952-6" target="_blank" rel="noreferrer noopener">10.1186/s12884-016-0952-6</a>
HARD CHOICES - THE GYNECOLOGIC CANCER-PATIENTS END-OF-LIFE PREFERENCES
attitudes; physicians; Oncology; perspective; Obstetrics & Gynecology; care; quality; cardiopulmonary resuscitation
Few reports in gynecologic literature have addressed patient preferences about terminal care. In light of the current discussions about end-of-life decision-making, a study was designed to assess the desires of patients with gynecologic cancer. A questionnaire was completed by 108 patients under treatment for gynecologic cancer at the University of Michigan Medical Center and by 39 patients from the routine gynecology clinic at the same institution. Participants were asked about their reactions to a poor prognosis, their desires for the location of terminal care, and their preferences for withdrawing or withholding life-sustaining technologies. Five percent of these cancer patients anticipated giving up the fight against their disease. Seventy-eight percent specifically expressed resolve to continue the fight against their disease. Feedback from these patients about their end-of-life preferences served to define the concept ''fight.'' A majority preferred to receive care at home. Ninety percent of these cancer patients could envision their conditions deteriorating to the point that they would not want ventilator support. Thirty-four percent could envision refusing surgery for another life-threatening condition; 37%, a time when artificial nutrition would be refused; 22%, a time when antibiotics would be rejected. This study suggests that limiting the use of artificial respiratory support while continuing the use of artificial nutrition and hydration support would be consistent with the preferences of gynecologic cancer with end-stage disease. (C) 1994 Academic Press, Inc.
Brown D; Roberts J A; Elkins T E; Larson D; Hopkins M
Gynecologic Oncology
1994
1994-12
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1006/gyno.1994.1306" target="_blank" rel="noreferrer noopener">10.1006/gyno.1994.1306</a>
Learning and teaching in dermatology - A practitioner's guide
education; Dermatology; feedback; primary care; united-states; perspective; excellence; expertise; national survey; need; states-medical-schools
Background: The explosion of medical knowledge, the influence of( )communications technology, and the pressures for health care reform challenge dermatologists to learn efficiently and teach effectively. Observations: The vast body of material on teaching and learning in the education literature contrasts sharply with the limited information on these topics in the dermatology literature. Gaining an understanding of these approaches to learning provides a foundation for the design of personal continuing medical education plans and lesson plans for students. Practical teaching skills are emphasized in this review. Conclusions: Learning and leaching skills can be improved through study. Successful teaching often produces positive feedback, which can lead to renewed enthusiasm for educating clinicians in the field of dermatology.
Brodell R T; Wile M Z; Chren M M; Bickers D R
Archives of Dermatology
1996
1996-08
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1001/archderm.132.8.946" target="_blank" rel="noreferrer noopener">10.1001/archderm.132.8.946</a>
Personality and medical specialty choice: A literature review and integration
personality; Psychology; physicians; performance; perspective; residents; specialty choice; indicator; 5-factor model; traits; myers-briggs type
This review examines the literature on personality and medical specialty choice. First, it describes studies categorized by medical specialties that to date have used the same measures: Adjective Check List, California Psychological Inventory, Sixteen Personality Factor Questionnaire, and Myers-Briggs Type Indicator. Then it integrates these results using the framework provided by the Five-Factor Model of personality. This model provides a method to organize the personality descriptors associated with medical specialties and to summarize information in ail understandable mid meaningful way. Conclusions drawn from the review Suggest 0 a loose association between a few personality factors and particular medical specialties. Recommendations for further research on personality and medical specialities encourage shifting from the "variable" to the "person" approach and studying how different personalities succeed in the same specialty.
Borges N J; Savickas M L
Journal of Career Assessment
2002
2002-08
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1177/10672702010003006" target="_blank" rel="noreferrer noopener">10.1177/10672702010003006</a>
ASPEN - Past, present, and future
clinical nutrition; e.-rhoads-lecture; enteral nutrition; medicine; nitrogen-metabolism; Nutrition & Dietetics; obesity; perspective; presidential-address; society; specialized nutrition support
It is a privilege and an honor for met to have the opportunity to serve as the 31st president of the American Society for Parental and Enteral Nutrition (A.S.P.E.N.) and to deliver the 2008 Presidential Address. I will review how our Society was started and how it has progressed, share where our Society is today, and, most important, project what I see as the future of our Society.
Vanek V W
Journal of Parenteral and Enteral Nutrition
2008
2008-09
Journal Article
<a href="http://doi.org/10.1177/0148607108321711" target="_blank" rel="noreferrer noopener">10.1177/0148607108321711</a>
DOOR-TO-BALLOON TIMES FROM FREESTANDING EMERGENCY DEPARTMENTS MEET ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION REPERFUSION GUIDELINES
care; Emergency Medicine; freestanding emergency department; global registry; hospital; infarction; interhospital transfer; mortality; percutaneous coronary intervention; perspective; primary angioplasty; randomized-trials; ST-segment elevation myocardial; system; united-states
Background: Freestanding emergency departments (FEDs) introduce a challenge to physicians who care for the patient with an ST-segment elevation myocardial infarction (STEMI) because treatment is highly time dependent. FEDs have no percutaneous coronary intervention (PCI) capabilities, which necessitates transfer to a PCI-capable facility or fibrinolysis. Study Objective: Our aim was to determine the proportion of STEMI patients who arrived to an FED and were subsequently transferred for PCI and met the door-to-balloon reperfusion guidelines of 90 min. Methods: This was a dual-center retrospective cohort review of all patients 18 years and older who were diagnosed with an STEMI and presented to the main hospital-affiliated FEDs. Electronic medical records and emergency medical services documentation were reviewed for all cases since the opening of the FEDs in July 2007 and August 2009, respectively. Key time points were abstracted and statistical evaluation was performed using Fisher's exact test. Results: A total of 47 patients met inclusion criteria. Median door-to-transport time was 34 min (inter-quartile range [IQR] 15 min). Median transport time from the FEDs to the main hospital catheterization laboratory was 21 min (IQR 5 min). Median arrival at the catheterization laboratory-to-balloon time was 25 min (IQR 13 min). Median total door-to-balloon time was 83 min (IQR 10.5 min), with 78.7% meeting the American Heart Association's recommended guidelines of <= 90 min. Conclusion: STEMI patients initially seen at two FEDs achieved door-to-balloon time goals of < 90 min. (C) 2014 Elsevier Inc.
Simon E L; Griffin P; Medepalli K; Griffin G; Williams C J; Hewit M; Lloyd T S
Journal of Emergency Medicine
2014
2014-05
Journal Article
<a href="http://doi.org/10.1016/j.jemermed.2013.08.089" target="_blank" rel="noreferrer noopener">10.1016/j.jemermed.2013.08.089</a>
Specific and Diversive Career Exploration During Late Adolescence
antecedents; behavior; career; college-students; confidence; decision-making process; diversive; employability; exploration; high-school-students; indecision; perspective; planning; Psychology; self-efficacy; specific; validation; Vocational identity
The exploration literature suggests that career exploration may be separated into two distinct forms. Diversive career exploration involves learning broadly about the world of work and the self, whereas specific career exploration involves an in-depth investigation focused on aligning one's perceptions of self and career prospects. The goal of the current study was to validate the structure of career exploration over time as being composed of diversive and specific forms. The study was conducted on a diverse sample of 308 college and work-bound youth, 19-22 years old, who were assessed annually three times. Structural equation modeling was used to test a longitudinal measurement model and the structural relationships corresponding to the noted distinction between the forms of exploration. Associations between exploration and several additional indicators of career development were further assessed. The results support the theoretically derived distinction between diversive and specific career exploration and demonstrate that they are differentially linked to career indecision, confidence, and planning. Implications for research and practice are offered in light of the results.
Porfeli E J; Skorikov V B
Journal of Career Assessment
2010
2010-02
Journal Article
<a href="http://doi.org/10.1177/1069072709340528" target="_blank" rel="noreferrer noopener">10.1177/1069072709340528</a>
Children's vocational development: A research rationale
adolescence; career development; exploration; identity development; internet; occupational aspirations; perspective; Psychology; states; web
Vocational development research mid interventions have focused primarily on adolescents and young adults. The lack of attention to career development antecedents in children has led to a serious neglect of this period of life when the foundation is laid for career choices and outcomes in later life. A harmful by-product is the frequent preclusion of gender-atypical occupational pathways by boys and especially by girls. To address this situation, the authors recommend identifying a core set of constructs that describe children's vocational development and developing sound instruments to measure them, leading to a longitudinal study ranging from childhood to early adulthood.
Porfeli E J; Hartung P J; Vondracek F W
Career Development Quarterly
2008
2008-09
Journal Article
<a href="http://doi.org/10.1002/j.2161-0045.2008.tb00163.x" target="_blank" rel="noreferrer noopener">10.1002/j.2161-0045.2008.tb00163.x</a>
Psychometric Properties of a Career Exploratory Outcome Expectations Measure
adolescence; aspirations; career; career exploratory outcome expectations; Childhood career development; exploration; item response theory; outcome expectations; participation; perspective; Psychology; self-efficacy; social-cognitive model; students
Social cognitive career theory and research are advanced by increasing attention to career outcome expectations and by applying this theory earlier in the life span. This article offers the career exploratory outcome expectations construct as a means of applying the more general construct of career outcome expectations during the childhood period and introduces the psychometric characteristics of the Career Exploratory Outcome Expectations Scale (CEOES). Employing data from 446 fifth graders and item response theory (IRT), the CEOES presents a one-dimensional structure with a four-category Likert-type response scale. Favorable results of person- and item-separation reliability were found and the scale appears to perform equally well for both genders. The CEOES also demonstrated concurrent validity through positive associations with established self-efficacy measures. The CEOES constitutes a useful measure to study aspects of career outcome expectations in childhood, and psychometric findings affirm its use in the career assessment literature.
Oliveira I M; Taveira M D; Cadime I; Porfeli E J
Journal of Career Assessment
2016
2016-05
Journal Article
<a href="http://doi.org/10.1177/1069072715580577" target="_blank" rel="noreferrer noopener">10.1177/1069072715580577</a>
Emotional aspects of childhood career development: importance and future agenda
adolescence; antecedents; Childhood career development; consequences; Education & Educational Research; emotion; exploration; identity; narratives; perspective; predictors; Psychology; Social-emotional development; socialization; work
Childhood is a central period for career and social-emotional development. However, the literature covering childhood career development and the role of emotions in careers is scarce. In this article, we advocate for the consideration of emotions in childhood career development. Emotional aspects of children's career exploration, key-figures and interests, as well as of childhood antecedents of lifelong career processes are presented. Relations between childhood emotion, behavior, functioning and learning are also presented. Conclusions center on a call for focused study of the role of emotion in childhood career development and how such an agenda will advance the literature.
Oliveira I M; Taveira M D; Porfeli E J
International Journal for Educational and Vocational Guidance
2015
2015-07
Journal Article
<a href="http://doi.org/10.1007/s10775-015-9303-9" target="_blank" rel="noreferrer noopener">10.1007/s10775-015-9303-9</a>
Career Preparedness and School Achievement of Portuguese Children: Longitudinal Trend Articulations
academic-achievement; adaptability; adolescence; aspirations; career development; career preparedness; childhood; exploration; interventions; perspective; predictors; Psychology; psychometric properties; school achievement; trend
Social Cognitive Career Theory suggests that students' preparedness for the school-to-work transition is a developmental process. Middle school children explore various careers, obtain feedback about their academic progress, and develop career self-efficacy and outcome expectations. These processes advance provisional educational/occupational goals. The literature has suggested articulations between career and academic development and how both vary across demographic characteristics, but longitudinal studies linking these processes are scarce. This study tested articulations between career preparedness and academic achievement during middle school years and employed gender and geographical location as potential moderators affecting the linkage between career and school domains. Participants included 429 children (47.8% girls) from northern (69.5%) and central Portugal (30.5%) followed across four occasions of measurement (M-ageWave1 = 10.23, SD = 0.50). Data was collected with school records, the Multidimensional Scales of Perceived Self-Efficacy, Career Exploratory Outcome Expectations Scale, Childhood Career Exploration Inventory and Childhood Career Development Scale. Average and orthnormalized linear, quadratic and cubic trends were computed. Pearson correlation coefficients suggested positive and statistically significant associations between career exploratory outcome expectations and academic achievement average trends. Career planning and self-efficacy expectations were negatively associated with academic achievement quadratic trends. Multiple linear regression models suggested that career exploratory outcome expectations and career planning were respectively statistically significant predictors of the average and quadratic trends of academic achievement. Gender moderated the association between the career variables and academic achievement linear trends as well as the relation of career planning and self-efficacy with academic achievement cubic trends. Additionally, the geographical location moderated the association between the average trend of career exploratory outcome expectations and academic achievement as well as tended to moderate the relation between the career variables and academic achievement quadratic trends. Future research could seek to explore the role of context in shaping the trajectories and linkages between career and academic progress with a more representative sample of participants from a broader array of geographical locations. This study advances extant literature by affirming the longitudinal relationship between the school and work domains in youth, which might sustain practices aimed at fostering students' career preparedness and academic achievement.
Oliveira I M; Taveira M D; Porfeli E J
Frontiers in Psychology
2017
2017-04
Journal Article
<a href="http://doi.org/10.3389/fpsyg.2017.00618" target="_blank" rel="noreferrer noopener">10.3389/fpsyg.2017.00618</a>