Nourishing Movement: Nutrition for Parkinson\u27s Wellness

This doctoral capstone project was conducted in collaboration with Bridges for Parkinson\u27s, an organization designed to connect people living with Parkinson\u27s Disease to a community that engages them in a specialized fitness program that helps them rediscover hope and joy and connect them to other resources to improve overall quality of life. The primary objective was to understand the lived experience of individuals with PD and develop PD specific nutrition education and programming for PD fighters and their care partners to use in fighting back against PD. The specific nutrition topics in the education and programming include Whole Foods, Hydration, and Adaptive Cooking/Meal Preparation. The deliverables of the project include 2 nutrition articles and 2 interactive educational events. Other outcomes include earning specialty credentialing from STEADI and leading the PD case study at the Belmont IPE Home Modification Event

Exemplar unit initiative framework: Engaging faculty and staff to improve patient and student outcomes

Session presented on Monday, November 9, 2015: In an effort to fully explicate the academic service partnership between the University of Michigan School of Nursing and University of Michigan Health System, three pilot units were chosen to participate in the exemplar unit initiative (EUI). Work done previously in the partnership had made advances in student experiences but had not achieved improved patient outcomes. Objectives of the EUI included: (1) provide structure for improved communication and integration between clinical leadership and clinical faculty; (2) create an environment for a robust, mutually beneficial partnership aimed at improving patient care quality; and (3) ensure alignment with unit-specific goals and effective resource use to reach goals. Common goals included providing evidenced-based care and improving patient outcomes (e.g. falls, satisfaction with pain). These goals were attained through the implementation of specific EUI central and unit-level structure and process components. EUI Intervention: An EUI leadership team-Associate Dean for Clinical Practice, Director of Research and Innovation, and lead faculty-created the EUI intervention. The microsystem intervention was based on the Donabedian\u27s Quality Outcomes Model, which incorporates structure, process, and outcome into a linear model for understanding care quality (Table 1). 1 The structural component activities included consistent meetings for both unit and larger EUI teams. Teams met locally on the unit and then all local teams met with the central leadership team. This ensured opportunities for all members of the initiative to discuss (1) progress towards attaining goals; (2) changes needed in processes to achieve goals; (3) current state of the intervention and (4) problem-solve as needed. Additionally, the embedded faculty was expected to become an active member of the unit-based shared governance committee, providing leadership in an area aligned with their clinical expertise. Other ways that faculty became more embedded and a part of the unit team included meeting with nursing unit leadership, rounding on staff/students, providing expert consultation, problem-solving with staff on student issues, and generally being more visible on the unit. Process component activities provided guidance towards unit-specific area of focus and implementation strategies. Specifically, each microsystem/unit team identified a quality indicator goal and a professional practice model goal. Upon mutually identifying the goals, the team created an action plan (e.g. objective, key action steps, accountable person(s), and due dates). Another process component included rounding on the units by the EUI leadership team to understand the dynamics of the EUI and progress towards unit-specific goal attainment. Outcomes of the EUI were evaluated on an ongoing basis, including determination if the EUI intervention was actualized and identification of improvements in the microsystem unit quality and model of care goal. It was expected that patient care would be improved; student learning would be maximized as students were engaged in work around improving a specific quality indicator, and staff/students would be active members of the team. The EUI components were developed to provide guidance to the units, realizing each unit would individualize the intervention to align with the uniqueness of their respective microsystem. The initiative occurred over a 12-month timeframe, with specific touch points throughout the intervention to ensure progress towards reaching the EUI goals. EUI Evaluation: A primary aspect of the evaluation was determining the actualization of each of the EUI components. Each EUI components was reviewed to determine if the structure and processes were met/not met. Central Structure & Process Components: All of the central structure and process component activities were successfully implemented. All members of the EUI-including the EUI leadership team, nurse mangers, directors, and faculty-met monthly during the intervention. Additional members of the unit leadership team (e.g. CNS, unit-based committee lead) were asked to join the meeting very early on in the intervention, as it became clear they were needed to ensure intervention success. All members were highly engaged in the discussions, providing opportunities for reflection and learning from others. Quality indicators chosen by the units included patient satisfaction with instructions for home, patient satisfaction with pain, and falls; professional practice model goals included self-care efficacy and patient story-both critical elements in the health system\u27s nursing model of care. Rounding by EUI leadership began approximately four months after implementation of the EUI. Observations from the rounds included significant engagement of students, staff, and unit leadership in attaining the quality and model of care goal. Staff members articulated goals of the intervention, describing ways in which students were assisting with attaining those goals. Staff mentors reported students being more prepared and helpful to their practice. Faculty on the unit were identified as \u27one of them\u27, a valued member of the team. Additional process components, identified in a monthly meeting, included an individual meeting with each microsystem team and central leaders to gain clarity around quality metrics. Unit-based Structure and Process Components: Each of the unit based structure and process components were implemented, although the manner in which they were implemented varied across units. For example, the embedded faculty was asked to communicate with the staff nurse mentors the general learning expectations for each level of learner on the unit. One faculty member held \u27open houses\u27 for staff, providing an opportunity for the staff nurses to hear about learning expectations, as well as provide an avenue to give initiative feedback. Another faculty created and disseminated YouTube videos in collaboration with her students, outlining the student goals for the week throughout the semester. Another unit-based component was to ensure embedded faculty were actively engaged in the unit-based committee (UBC). All of the embedded faculty were members of the UBC and were involved in staff meetings. In one unit, the embedded faculty provided educational training to staff around skin/wound assessment and treatment. The additional components were achieved by all three pilot units. The faculty and unit leadership met both formally and informally throughout the intervention to review progress towards the goals, communicate initiatives at the school of nursing and health system, and evaluate current status of the EUI. Outcomes: Unit teams embraced each of the model components, operationalizing each structure and process in alignment with the unit environment. Unit leadership, faculty, staff, and students all described benefits of the EUI. As noted above, staff regarded the faculty as \u27part of the team\u27, feeling very confident in reporting any concerns they have related to student education. Students described improvements in their confidence levels around patient interviewing-a component of most unit action plans-as well as feeling engaged and \u27valued\u27 for the work they did towards improving quality. A second factor in determining the success of the EUI was to identify attainment of the two goals (e.g. quality goal, model of care goal) set forth by the respective units. In all three units, patient and/or student outcomes improved during the intervention. Specific findings will be discussed in the remaining presentations within this symposium. Conclusion: Evaluation of the EUI provided evidence that we were successfully able to embed faculty into a clinical unit, further strengthening the academic partnership. Many of the activities described by the unit teams portrayed that of a successful academic partnership, including frequent communication/open dialogue; appropriate allocation of shared resources; shared vision/goals/mission; trust, respect, and commitment. 2 Unit leadership, faculty, nurse mentors, and students all clearly identified the positive impact of the EUI on education and practice. Embedded faculty were completely integrated into the unit team, being seen as a valued team members, which led to trust, collaboration, ability to problem-solve, and open dialogue related to feedback on the initiative. Additionally, students were actively engaged in an initiative aimed at improving patient care. Staff members saw students as \u27value-added\u27 as they saw the impact their work had on improving clinical practice and outcomes. This model is mutually beneficial-impacting patient outcomes while developing staff and students in a collaborative team environment. This model will impact practice in the future by fostering nurses who not only have been trained around world-class clinical standards, but also how theory and research are applied in clinical practice. Using this approach, the next generation of nurses will become strong leaders who can facilitate the advancement of nursing science. Table 1: EUI Structure and Process Components: Central/System Processes EUI lead and unit teams meet monthly to discuss unit activities, improvements in care, and actualization of EUI components. A quality area of focus and one Patient Care Model goal is mutually identified. An action plan is developed based on the unit goals. EUI lead team rounds to understand dynamics of the CEI, and progress toward improving the QI area. Additional process components implemented based on unit needs. Unit-based Structures EUI lead and unit teams meet to determine unit priorities. The embedded faculty is an engaged member of the unit-based committee. The embedded faculty communicates with the nurse mentors the student learning expectations. Students review their daily learning goals with their mentor and faculty. The nurse manager seeks opportunities to embed faculty on the unit. The nurse manager communicates to faculty major unit initiatives/priorities. The unit team problem-solves as issues arise related to students, mentors, action plan. The nurse manager shares QI data with faculty as appropriate

Analyzing rhetoric : a frame analysis of the pro-life movement in the United States.

The purpose of this study is to consider the significance of rhetoric used by pro-life social movement organizations to frame the experience of abortion and to label those women who have participated in that experience. The study explores how frames are devised and how these frames are applied so that reality is organized in such a manner as to appear aligned with the religious, moral, and/or philosophical position of the pro-life movement. The study uses pro-life web pages to obtain data; then, analyzes the data for emerging themes and content. The general tasks of framing such as agenda setting are analyzed through the frames discovered in the data. These tasks and frames are constructed as a typology that shows the interactions between the tasks and the ideologies

The Role of Elementary Counselors as Perceived by Elementary Counselors and Principals in the State of Iowa

108 leaves. Advisor: Stuart TiedemanAmong educators there is a diversity of opinion regarding the elementary counselor's role. Consequently job descriptions, where they exist, are inconsistent and arbitrary. Some educators feel that the classroom teacher should be responsible for counseling responsibilities, while others recommend that a professionally trained counselor be on every elementary school staff. The disparity of views led the writer to initiate this investigation. Consequently, the goal is to examine the role of practicing elementary school counselors in Iowa as perceived by elementary school principals and the counselors themselves. A mail survey was used to gather information related to the elementary counselor's role. Ninety-eight elementary counselors and 97 elementary principals in Iowa were surveyed. The survey instrument consisted of an Information Sheet as well as an Opinionnaire. The data were tabulated to show how principals and counselors compare in their perceptions of elementary counselors' roles. The data yielded few differences in perception between principals and counselors. Often, where differences did occur, they were within groups. However, there were areas of principal-counselor disagreement community involvement, the importance of testing programs, the counselor's role in dealing with individual problems

The anthropology of extraction: critical perspectives on the resource curse

Attempts to address the resource curse remain focussed on revenue management, seeking technical solutions to political problems over examinations of relations of power. In this paper, we provide a review of the contribution anthropological research has made over the past decade to understanding the dynamic interplay of social relations, economic interests and struggles over power at stake in the political economy of extraction. In doing so, we show how the constellation of subaltern and elite agency at work within processes of resource extraction is vital in order to confront the complexities, incompatibilities, and inequities in the exploitation of mineral resources

Multidisciplinary Treatments, Patient Characteristics, Context of Care, and Adverse Incidents in Older, Hospitalized Adults

The purpose of this study was to examine factors that contribute to adverse incidents by creating a model that included patient characteristics, clinical conditions, nursing unit context of care variables, medical treatments, pharmaceutical treatments, and nursing treatments. Data were abstracted from electronic, administrative, and clinical data repositories. The sample included older adults hospitalized during a four-year period at one, academic medical facility in the Midwestern United States who were at risk for falling. Relational databases were built and a multistep, statistical model building analytic process was used. Total registered nurse (RN) hours per patient day (HPPD) and HPPDs dropping below the nursing unit average were significant explanatory variables for experiencing an adverse incident. The number of medical and pharmaceutical treatments that a patient received during hospitalization as well as many specific nursing treatments (e.g., restraint use, neurological monitoring) were also contributors to experiencing an adverse incident.</jats:p

'We could be rich':Unemployment, roadblocks and the rhythms of hydrocarbon work among the Guaraní of the Argentine Chaco

In the Argentine Chaco, indigenous Guaraní lives are deeply entangled with the oil and gas industry. In response to the hydrocarbon sector's shifting dynamics, unemployed Guaraní have found innovative ways to make claims and mobilise for temporary employment. This article emphasises the perspectives of these mobilised populations and describes the political difficulties that precarious labour forces confront. It also draws attention to the temporalities of extraction and to the accompanying rhythms of flexible employment. In doing so, it extends the concept of precarity to highlight continuities between the impermanence of employment and the instability of mobilisation

Projects of devotion : energy exploration and moral ambition in the cosmoeconomy of oil and gas in the Western United States

This project has received funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme under grant agreement No 715146. The authors also acknowledge the funding received to carry out this research from the Leverhulme Trust (ECF‐2013‐177) and the British Academy (EN150010).This article considers how people working in the oil and gas industry in Colorado perceive their involvement in energy exploration in relation to broader understandings of devotion, compassion, and outreach. I argue that although their energy projects may appear to merely echo companies’ formal promotional pitches, the oil field and corporate actors’ own moral ambitions reveal more-than-human cosmoeconomic visions of oil’s potentiality. This article thus demonstrates how multiple and diverging ethical registers intersect and inform the valuation of oil.Publisher PDFPeer reviewe