To assist teachers in fostering students' global citizenship dispositions through service experiences, this article reports findings from a case study that investigated one high school's global ...service club and its impact on former club members' global awareness and global citizenship dispositions. Data were collected from Web-based documents and interviews with the faculty advisor and four former members. Data were analyzed by using the constant comparison method to elicit the following findings: (1) fundraising and awareness campaigns, when connected to a larger global service network, can act as viable local actions to combat global poverty; (2) club involvement can produce adults who feel more globally aware, but who do not necessary display critical understandings of global issues; and (3) club involvement can have a positive impact on global citizenship dispositions as participants reported feelings of empowerment and personal/social responsibility, yet no former club members continued participation in global service initiates as adults. Findings suggest the need for structural support when establishing high school global service clubs and, to optimize critical justice aims, local service actions should be tied to a more formal global citizenship curriculum.
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BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
This study examined the experience of a first-year teacher's encounter with Confederate heritage while teaching about slavery and its legacy in a nearly all-white rural high school in a southern ...state. Data was collected in four interviews over the course of one academic year and through the participant's journaling of critical incidents in her classroom. Data was analyzed through a series of open and pattern coding. The teacher, identifying as a white suburban-raised Northern, adopted the framework of multiple perspectives to foster students' understandings about the harmfulness of Confederate symbols. Yet, the participant felt disillusioned and, at times, ineffective due to her limited experience in Neo-Confederate spaces, tensions between her white identity and teaching about race, her students' academic disinterest, and a lack of subject-specific mentoring. Findings demonstrate the presence of context-specific impediments, or hard contexts, that make the task of teaching hard history even more difficult in some settings and posit limitations of a multiple perspectives framework on issues of racial justice.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Study objective: To determine the prevalence of depression in geriatric ED patients and to assess recognition of geriatric depression by emergency physicians.
Methods: We conducted an observational ...survey of geriatric patients who presented to an urban, university-affiliated public hospital ED. A convenience sample of 259 patients aged 65 years or older were administered a brief, self-rated depression scale. Main outcome measures were prevalence of depression (using a predetermined cutoff score for detecting depression) and recognition of depression by the treating emergency physician, assessed by chart review.
Results: Seventy subjects (27%; 95% confidence interval CI, 22% to 32%) were rated as depressed. Depressed and nondepressed patients were not significantly different with regard to age, sex, race, or education. Forty-seven percent of nursing home residents were depressed, compared with 24% of those living independently (95% CI for difference of 23%, 6% to 41%). Patients who described their health as poor were also more likely to be depressed (33 of 65, 51%) than patients who reported their health to be good or fair (37 of 194, 19%) (95% CI for difference of 32%, 18% to 45%). Emergency physicians failed to recognize depression in all the patients found to be depressed on this scale (95% CI, 0 to 5%).
Conclusion: The prevalence of unrecognized depression in the geriatric ED patients we studied was high, especially in those who reported their health as poor. Use of a brief depression scale can aid recognition of depression in older patients, leading to appropriate referral and treatment. Meldon SW, Emerman CL, Schubert DSP, Moffa DA, Etheart RG: Depression in geriatric ED patients: Prevalence and recognition.
Ann Emerg Med August 1997;30:141-145.
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IJS, IMTLJ, KILJ, KISLJ, NUK, SBCE, SBJE, UL, UM, UPCLJ, UPUK
To assist rural teachers in fostering students’ democratic skills and dispositions, this article examines the convergence of literature on citizenship education, rural communities, and rural ...education and extrapolates the challenges and possibilities of rural citizenship education for proactive democratic life. Four assertions are elicited from a review of the literature to bring about cognizance to rural citizenship education for K-12 teachers and teacher educators: (a) civic republican notions of citizenship likely dominate rural communities, but liberal citizenship discourses may offer meaningful pathways for a proactive democratic life; (b) rural individualism must be assessed for its strengths and weaknesses; (c) economic hardships can lead to political distrust, but can also become fuel for citizen empowerment; and (d) rural social norms can jeopardize educational goals, so they must be acknowledged. Each assertion is accompanied by a discussion to elucidate the assertion and make recommendations on how to utilize rural possibilities to improve citizenship education. This article contributes to context-specific citizenship instruction and, therefore, the possibility of stronger democratic relationships in rural communities.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
This paper reports on a sequential mixed-methods (quan right arrow QUAL) study that explored rural Appalachian teachers' perspectives and pedagogical decisions about Global Citizenship Education ...(GCE). In phase one, a questionnaire was completed by social studies teachers (n=19) from remote and distant rural high schools located in Central Appalachia across two states. Closed-ended items were analyzed through descriptive statistics. Open-ended items were coded to elicit themes that helped to answer the research questions. In phase two, two participants from the original sample were interviewed to uncover their experiences navigating GCE in their unique community contexts. Findings suggest social studies teachers in rural Appalachia, while not using the exact terminology of global citizenship, support multiple types of global citizenship aims. They tend to perceive their communities as homogenous, isolated, and conservative, which presented both challenges to and stimuli for teaching global curricula. Participants tend to perceive much of their global curricula as contrarian in their communities and, therefore, rely on professional tact and community-based knowledge as rural natives to inform their pedagogical decisions.
We will determine if clinical characteristics can be useful in identifying depression in geriatric Emergency Department (ED) patients. We have provided a cross-sectional observational study of ...geriatric patients presenting to an urban university-affiliated public hospital. A brief self-rated depression scale (SRDS) was used to identify depression. Clinical characteristics, examined retrospectively, included chief complaint, chronic illnesses, mode and time of arrival and discharge disposition. Relative prevalence of depression was calculated for these clinical characteristics. 70 (27%; 95% Cl, 22% to 32%) of 259 patients were found to be depressed by the SRDS. Patients with nonspecific chief complaints were more commonly depressed than patients with system-specific chief complaints, but not significantly (relative prevalence 1.6; 95% Cl, 1.0 to 2.4; p = 0.19). The relative prevalence of depression also did not vary significantly when analyzed by specific chronic illness (
P = 0.42) except cardiac disease (1.6;95% Cl, 1.1 to 2.4), PM or night arrival (1.3; 95% Cl, 0.8 to 2.0; p = 0.17), ambulance use (1.1; 95% Cl, 0.7 to 1.7; p = 0.88), or need for medical admission (1.0; 95% Cl, 0.7 to 1.5;p = 0.97). Depression is common in geriatric ED patients. Clinical characteristics fail to identify elderly ED patients who are likely to be depressed. Use of a brief SRDS can aid in recognition of depression in this group.
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IJS, IMTLJ, KILJ, KISLJ, NUK, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
This qualitative study investigated the evolving perceptions of rurality of five Appalachian native, first-year teachers as influenced by their teacher preparation program. Findings suggested ...tensions between participants’ rural upbringings and programmatic and non-rural peer conceptions of rurality that surfaced during their program of study. Responses to these tensions included participants positioning themselves as “rural representatives” in their courses and, in some cases, the adoption of revised conceptions of rurality. Intra-Appalachian diversity, such as different childhood community types and childhood social class, influenced participants’ conceptualizations of rurality and their perceptions of its representation in their programs. The majority of participants perceived a trend toward generalized notions of rural place that were not necessarily representative of their personal experiences. Transitioning to first-year teachers, participants relied on their community-driven knowledge and teacher preparation to guide their practice in home or new rural, Appalachian communities
Global citizenship education (GCE) helps students conceptualize citizenship beyond national boundaries so they are capable of action in dealing with global issues like human rights and environmental ...sustainability. However, very little literature exists to assist rural teachers in implementing GCE as they face specific challenges due to the context of their schools. This paper identifies challenges rural educators encounter, such as conservative communities and geographic isolation, and details a Deweyan approach to GCE as a means to overcome these challenges. Specifically, we apply Dewey's democratic and learning theories to reconceptualize GCE around "student," "home," and "community life" to foster a more relevant curriculum that utilizes students' experiences. It emphasizes the utmost respect for local customs and culture by using them as sources of content for the curriculum while simultaneously extending citizenship thoughts and actions to the global arena.
To assess the effect of an antimicrobial stewardship program (ASP)–bundled initiative on the appropriate use of antibiotics for uncomplicated skin and soft tissue infections (uSSTIs) at 2 academic ...medical centers in Pittsburgh, Pennsylvania.
A retrospective preintervention and postintervention study was conducted to compare management of patients admitted with uSSTIs before and after the implementation of the bundled initiative. The preintervention period was from August 1, 2014, through March 31, 2015, and the postintervention period was from August 1, 2015, through March 31, 2016.
A total of 160 patients were included in the preintervention cohort, and 163 were included in the postintervention cohort. Compared with the preintervention group, the mean duration of therapy decreased (12.5 days vs 8.8 days; P<.001) and an appropriate duration of less than 10 days increased in more patients (20.6% 33 of 160 vs 68.7% 112 of 163; P<.001) in the postintervention period. Fewer patients were exposed to antimicrobials with extended gram-negative (44.4% 71 of 160 vs 9.2% 15 of 163; P<.001), anaerobic (39.4% 63 of 160 vs 9.8% 16 of 163; P<.001), and antipseudomonal (16.3% 26 of 160 vs 1.8% 3 of 163; P<.001) coverage. The mean length of stay decreased from 3.6 to 2.2 days (P<.001) without an increase in 30-day readmissions (6.3% 10 of 160 vs 4.9% 8 of 163; P=.64). The ASP made recommendations for 125 patients, and 96% were accepted.
Implementation of an ASP-bundled approach aimed at optimizing antibiotic therapy in the management of uSSTIs led to shorter durations of narrow-spectrum therapy as well as shorter hospital length of stay without adversely affecting hospital readmissions.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Social studies teachers are sensitive to local school and community values and, therefore, tactful when making decisions about their curriculum (Romanowski, 1996; Shaver, Davis, & Helburn, 1980; ...Thornton, 1989), including its citizenship aims (Saada, 2013; Sondel, 2015; Vinson, 1998). For this reason, scholars call for better contextual understandings of teachers’ curricular-instructional gatekeeping (Thornton, 1989; Vinson, 1998). Rural-specific examples of this phenomenon remain largely unexamined (Martin & Chiodo, 2007; Pattison-Meek, 2012), though rural schools make up 32.9% of all schools in the United States (Johnson, Showalter, Klein, & Lester, 2014) and rural communities offer distinct socio-geographic and socio-cultural contexts (Brown & Schafft, 2011). To address this research deficit, the current study sampled five government teachers in rural schools to examine their conceptualizations of citizenship education, perceptions of place, and the influences that affect their curricular-instructional gatekeeping. This study adopted a social constructionist perspective to explore the values and meanings participants placed on citizenship within their rural contexts. It utilized a grounded theory research design to sample government teachers from four “distant-rural” schools and collect data from three sources: interviews, classroom observations, and teaching artifacts. A constant comparison method of data analysis produced a theory to describe citizenship education in rural contexts. The theory consists of three themes that emerged from the data: (1) citizenship education as practical knowledge; (2) place-based learning for future (dis)placements; and (3) the gatekeeping triad. Descriptions of these themes and their relationships with one another illuminate the practices of citizenship education in rural areas and provide knowledge of the rural conditions that influence it. Findings suggest government teachers in rural areas need to become more critical of their treatment of place and citizenship to encourage place-conscious civic life.
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