\u3ci\u3eAcross the Bridge: The Merrimack Undergraduate Research Journal\u3c/i\u3e Submission Guidelines

Manuscript submissions are always welcome! Detailed submission guidelines, including dates for the inaugural issue to be published in Spring 2019, for manuscript submissions to Across the Bridge.https://scholarworks.merrimack.edu/mc_pubs/1002/thumbnail.jp

Elevated Baseline C-Reactive Protein as a Predictor of Outcome After Aneurysmal Subarachnoid Hemorrhage: Data From the Simvastatin in Aneurysmal Subarachnoid Hemorrhage (STASH) Trial.

BACKGROUND: There remains a proportion of patients with unfavorable outcomes after aneurysmal subarachnoid hemorrhage, of particular relevance in those who present with a good clinical grade. A forewarning of those at risk provides an opportunity towards more intensive monitoring, investigation, and prophylactic treatment prior to the clinical manifestation of advancing cerebral injury. OBJECTIVE: To assess whether biochemical markers sampled in the first days after the initial hemorrhage can predict poor outcome. METHODS: All patients recruited to the multicenter Simvastatin in Aneurysmal Hemorrhage Trial (STASH) were included. Baseline biochemical profiles were taken between time of ictus and day 4 post ictus. The t-test compared outcomes, and a backwards stepwise binary logistic regression was used to determine the factors providing independent prediction of an unfavorable outcome. RESULTS: Baseline biochemical data were obtained in approximately 91% of cases from 803 patients. On admission, 73% of patients were good grade (World Federation of Neurological Surgeons grades 1 or 2); however, 84% had a Fisher grade 3 or 4 on computed tomographic scan. For patients presenting with good grade on admission, higher levels of C-reactive protein, glucose, and white blood cells and lower levels of hematocrit, albumin, and hemoglobin were associated with poor outcome at discharge. C-reactive protein was found to be an independent predictor of outcome for patients presenting in good grade. CONCLUSION: Early recording of C-reactive protein may prove useful in detecting those good grade patients who are at greater risk of clinical deterioration and poor outcome.Financial support: British Heart Foundation. None of the authors have any personal or institutional financial interest in drugs or materials in the manuscript. PJK and PJH are supported by the Cambridge NIHR BRC and PJH is supported by a NIHR Research Professorship. We also acknowledge the support of the Cambridge Clinical Trials Unit, UK Clinical Research Network and all 35 participating sites.This is the final version of the article. It first appeared from Wolters Kluwer via http://dx.doi.org/10.1227/NEU.000000000000096

An evaluation of a short course in mindfulness for Health Visitor Practice Teachers

Practice Teachers (PTs) participated in an 8 week course, Mindfulness Based Cognitive for well-being and resilience. The evaluation was undertaken using three (3) evidenced based questionnaires: Perceived stress(PSS) (Cohen et al 1983), Self-Compassion Score SCS (Neff 2003) and Five Facet Mindfulness Questionnaire (FFMQ) (Baer et al 2006) to identify outcomes for the mindfulness training. Findings indicate the impact on personal wellbeing and professional practice with recommendations for retention of students & Health Visitor (HV) workforce. Summary Mindfulness skills to support top performance and good mental health were offered in eight two-hour sessions to 18 Practice Teachers from September- December 2014 and was evaluated. The course drew on the approach of Mindfulness Based Cognitive Therapy, where participants learn to focus their attention and develop the possibility of creating the space for reflection and response rather than reacting to life’s difficulties. Participants had the opportunity to develop self–care and self-compassion in the sessions as well as in between sessions and which research has shown can have a positive effect on others. Compassion is a contemporary theme in the CNO’s strategy to return to the fundamentals of nursing; mindfulness enables the foundation of practising compassion on self and ultimately to practice compassion with others we work and care for. The attendees were encouraged to review and refresh their practice through with the ultimate planned outcome, to reduce student attrition and prevent breakdown of the practice placement. However, this is a the complex area of adult learning and the nature of student attrition from courses as well as from the workforce cannot necessarily be reduced to one factor. The practice of mindfulness can have an influential effect on health, well-being and resilience, as shown by scientific and medical evidence. This experiential course was neither therapy nor religious instruction but an effective means of helping to alleviate stress and promoting well-being, resilience and flourishing. The course was delivered at a time when practitioners, including PTs were experiencing an increase of student numbers and service delivery changes with associated imperative data collection. The perception of practitioners about the declared increase in the HV workforce (DH 2011) to support and implement these changes was not evident and the evaluation indicates the need for self-care and resilience in the workforce which includes students and practitioners. The project outcomes make recommendations based on the impact of this mindfulness training with PTs to inform future developments within the programme and practice education as well as the HV workforce where a number of interventions call for 'mindfulness' with infants, children and families

Mobilizing in borderline citizenship regimes : a comparative analysis of undocumented migrants’ collective actions

This article seeks to explain how and why groups and networks of undocumented migrants mobilizing in Berlin, Montréal, and Paris since the beginning of the 2000s construct different types of claims. The authors explore the relationship between undocumented migrants and state authorities at the local level through the concept of the citizenship regime and its specific application to undocumented migrants (which they describe as the “borderline citizenship regime”). Despite their common formal exclusion from citizenship, nonstatus migrants experience different degrees and forms of exclusion in their daily lives, in terms of access to certain rights and services, recognition, and belonging within the state (whether through formally or nonformally recognized means). As a result, they have an opportunity to create different, specific forms of leeway in the society in which they live. The concurrence of these different degrees of exclusion and different forms of leeway defines specific conditions of mobilization. The authors demonstrate how the content of their claims is influenced by these conditions of mobilization

Cross-national variations in reported discrimination among people treated for major depression worldwide : the ASPEN/INDIGO international study

No study has so far explored differences in discrimination reported by people with major depressive disorder (MDD) across countries and cultures. To (a) compare reported discrimination across different countries, and (b) explore the relative weight of individual and contextual factors in explaining levels of reported discrimination in people with MDD. Cross-sectional multisite international survey (34 countries worldwide) of 1082 people with MDD. Experienced and anticipated discrimination were assessed by the Discrimination and Stigma Scale (DISC). Countries were classified according to their rating on the Human Development Index (HDI). Multilevel negative binomial and Poisson models were used. People living in ‘very high HDI’ countries reported higher discrimination than those in ‘medium/low HDI’ countries. Variation in reported discrimination across countries was only partially explained by individual-level variables. The contribution of country-level variables was significant for anticipated discrimination only. Contextual factors play an important role in anticipated discrimination. Country-specific interventions should be implemented to prevent discrimination towards people with MDD

Our Way Across the Sea

Home, fare thee well! The oceans storm is o\u27er;The weary pen non woos the seaward wind;Fast speeds the bark, And now the less\u27ning shore Sinks in the wave, with those we leave behind.Fare, fare thee well! Land of the free;No tongue can tell, the love I bear to thee.Fare, fare thee well! Land of the free;No tongue can tell the love I bear to thee. 2We wreath no bowl to drink a gay good bye,For tears would fall unbidden in the wine;And while reflected was the mournful eye,The sparkling surface e\u27en would cease to shine.Then fare, fare well; Once more, once more,The oceans swell Now hides my native shore. 3See where yon star its Diamond light displays,Now seen, now hid behind the swelling sail,Hope rides in gladness on its streaming rays,And bids us on, and bribes the fav\u27ring gale.Then hope, we bend in joy to thee;And careless wend our way across the sea