Explore the vast range of titles available.

This article explores the value and application of using comic images to teach difficult political texts. We presented either visual or textual portions of the Constitution to 71 American 18- to 22-year-olds using Survey Monkey Audience, measuring and comparing their knowledge of the Constitution before and after viewing. Respondents viewing the comic of congressional duties experienced statistically significant gains in pretest to posttest mean knowledge scores. Respondents viewing the text also experienced an increase in mean scores pretest to posttest; however, these changes were smaller and not statistically significant. This indicates that students may better comprehend content from visual depictions of difficult texts. We conclude by providing an example of one way that we use comics of political texts as a tool for student learning in an international civics exchange program.

In recent years, mindfulness and meditation-based processes and interventions have received increasing clinical and scholarly attention in the trauma field due to their theoretical and clinical relevance to the etiology, maintenance, and treatment of posttraumatic stress disorder (PTSD). Indeed, there has been a proliferation of literature documenting associations between mindfulness as well as meditation and PTSD symptomatology and supporting the efficacy of such interventions for the treatment of PTSD. Mounting empirical evidence indicates that mindfulness- or meditation-based skills and/or intervention programs may serve as effective stand-alone or adjunctive interventions for PTSD. For populations with a high probability of exposure to intense or chronic potentially traumatizing events, such as police or military personnel, mindfulness- or meditation-based interventions may prevent the development of persistent PTSD. The goal of this chapter is to elucidate the construct of mindfulness in terms of the potential utility in the conceptualization and treatment of PTSD so as to stimulate further scholarly and clinical thought in this domain. Notably, distinct, though related, practices such as meditation are included so as to provide a broad-based picture of relevant clinical and empirical landscapes. The most salient research associated with posttraumatic stress/PTSD, mindfulness, and meditation is reviewed, and the clinical implications of mindfulness and meditation for the treatment of PTSD are discussed. Finally, future research directions that may inform both clinical and research efforts are suggested.

Why did it take the courage and conviction of thousands of men and women willing to walk off their jobs to support the HEU to make the government see the folly and spite of their egregious Bill 37?

Highbush blueberry (Vaccinium corymbosum) fruits contain substantial quantities of flavonoids, which are implicated in a wide range of health benefits. Although the flavonoid constituents of ripe blueberries are known, the molecular genetics underlying their biosynthesis, localization, and changes that occur during development have not been investigated. Two expressed sequence tag libraries from ripening blueberry fruit were constructed as a resource for gene identification and quantitative realtime reverse transcription-polymerase chain reaction primer design. Gene expression profiling by quantitative real-time reverse transcription-polymerase chain reaction showed that flavonoid biosynthetic transcript abundance followed a tightly regulated biphasic pattern, and transcript profiles were consistent with the abundance of the three major classes of flavonoids.Proanthocyanidins (PAs) and corresponding biosynthetic transcripts encoding anthocyanidin reducíase and leucoanthocyanidin reducíase were most concentrated in young fruit and localized predominantly to the inner fruit tissue containing the seeds and placentae. Mean PA polymer length was seven to 8.5 subunits, linked predominantly via B-type linkages, and was relatively constant throughout development. Flavonol accumulation and localization patterns were similar to those of the PAs, and the B-ring hydroxylation pattern of both was correlated with flavonoid-3'-hydroxylase transcript abundance. By contrast, anthocyanins accumulated late in maturation, which coincided with a peak in flavonoid-3-O-glycosyltransferase and flavonoid-3' 5'-hydroxylase transcripts. Transcripts of VcMYBPAl, which likely encodes an R2R3-MYB transcriptional regulator of PA synthesis, were prominent in both phases of development. Furthermore, the initiation of ripening was accompanied by a substantial rise in abscisic acid, a growth regulator that may be an important component of the ripening process and contribute to the regulation of blueberry flavonoid biosynthesis.

We developed and tested a Centering-based group antenatal (ANC) model in Malawi, integrating health promotion for HIV prevention and mental health. We present effectiveness data and examine congruence with only the Group ANC theory of change model, which identifies key processes as supportive relationships, empowered partners in learning and care, and meaningful services, leading to better ANC experiences and outcomes. We conducted a hybrid effectiveness-implementation trial at seven clinics in Blantyre District, Malawi, comparing outcomes for 1887 pregnant women randomly assigned to Group ANC or Individual ANC. Group effects on outcomes were summarized and evaluated using t-tests, Mann-Whitney, or Chi-squared tests. Adjusted for seven individual and two clinic-level baseline covariates, point estimates are reported for continuous outcomes using multivariable linear regression models. Adjusted for the same covariates, odds ratios are reported for categorical outcomes using logistic regression models. All statistical tests were two-sided, controlling for a Type I error probability of 0.01 due to multiple testing. Women in Group ANC had higher peer connectedness and pregnancy-related empowerment, recalled receiving more services, and discussed more health promotion topics. They experienced less wait time, greater satisfaction with care (Estimate = 1.21, 99% CI = 0.07, 2.35), and had a higher mean number of ANC contacts (Estimate = 0.74, 99% CI = 0.50, 0.98). Most women preferred Group ANC for a future pregnancy (81% in Individual ANC; 95% in Group ANC). Women in Group ANC had more diverse diets (Estimate = 0.35, 99% CI = 0.17, 0.53), were better prepared for birth (Estimate 0.32, 99% CI = 0.16, 0.48), more likely to use condoms consistently (OR= 1.07, 99% CI = 1.00, 1.14) and communicated more with partners. They reported less mental distress in late pregnancy (Estimate = -0.61, 99% CI = -1.20, -0.02). Exclusive breastfeeding, partner HIV testing and disclosure, facility-based delivery, postnatal care attendance, postpartum family planning, and low birth weight did not differ by ANC type. This effectiveness study of Malawi Group ANC, the first trial with individual randomization in a low-income country, maps outcomes to the theory of change, enhancing our understanding of Group ANC's diverse positive impacts. The integration of typically neglected health promotion topics into the model highlights its flexibility to address changing local and global needs. Based on study results, the Malawi Ministry of Health is introducing Group ANC at district-level trainings and exploring the logistics for nationwide adoption. With momentum and political will, better care and a positive healthcare experience can be achieved for women, infants, and families in Malawi and globally. ClinicalTrials.gov NCT03673709.

Background Clinical practice guidelines risk having little impact on healthcare if not effectively implemented. Theory informed, targeted implementation may maximise their impact. Our study explored barriers to and facilitators of guideline implementation and use by South African primary care nurses and allied healthcare workers in four provinces in South Africa. We also proposed interventions to address the issues identified. Methods We used qualitative research methods, comprising focus group discussions using semi-structured topic guides. Seven focus group discussions were conducted (48 providers) in four South African provinces (Eastern Cape, Western Cape, Kwazulu-Natal, Limpopo). Participants included mostly nurses, dieticians, dentists, and allied health practitioners, from primary care facilities in rural and peri-urban settings. The analysis proceeded in three phases. Firstly, two analysts conducted inductive thematic content analysis to develop themes of data. This was followed by fitting emergent themes to the Theoretical Domains Framework and finally to the associated Behaviour Change Wheel to identify relevant interventions. Results Participants are knowledgeable about guidelines, generally trust their credibility and are receptive and motivated to use them. Guidelines are seen by nurses to provide confidence and reassurance, as well as professional authority and independence where doctors are scarce. Barriers to guideline use include: inadequate systems for printed book distribution, insufficient and substandard photocopies, linguistic inappropriateness (e.g. complicated language, lack of summaries, unavailable in local languages), unsupportive auditing procedures, limited involvement of end-users in guideline development, and patchy training that may not filter back to all providers. Future aspirations identified include: improving the design features of guidelines, accessible places to find guidelines, making digitally-formatted versions available, more supplementary materials (e.g. posters) to support patient engagement, accessible clinical support following training, and in-facility training for all professional cadres to ensure fair access, similar levels of capability and interdisciplinary consistency. Conclusions South African primary care nurses and allied health practitioners have high levels of motivation to use guidelines, but face many systemic barriers. We used the Behaviour Change Wheel to suggest relevant, implementable interventions addressing identified barriers. This theory-informed approach may improve clinical guideline implementation and impact healthcare for South Africa.

We developed and tested a Centering-based group antenatal (ANC) model in Malawi, integrating health promotion for HIV prevention and mental health. We present effectiveness data and examine congruence with only the Group ANC theory of change model, which identifies key processes as supportive relationships, empowered partners in learning and care, and meaningful services, leading to better ANC experiences and outcomes. We conducted a hybrid effectiveness-implementation trial at seven clinics in Blantyre District, Malawi, comparing outcomes for 1887 pregnant women randomly assigned to Group ANC or Individual ANC. Group effects on outcomes were summarized and evaluated using t-tests, Mann-Whitney, or Chi-squared tests. Adjusted for seven individual and two clinic-level baseline covariates, point estimates are reported for continuous outcomes using multivariable linear regression models. Adjusted for the same covariates, odds ratios are reported for categorical outcomes using logistic regression models. All statistical tests were two-sided, controlling for a Type I error probability of 0.01 due to multiple testing. Women in Group ANC had higher peer connectedness and pregnancy-related empowerment, recalled receiving more services, and discussed more health promotion topics. They experienced less wait time, greater satisfaction with care (Estimate = 1.21, 99% CI = 0.07, 2.35), and had a higher mean number of ANC contacts (Estimate = 0.74, 99% CI = 0.50, 0.98). Most women preferred Group ANC for a future pregnancy (81% in Individual ANC; 95% in Group ANC). Women in Group ANC had more diverse diets (Estimate = 0.35, 99% CI = 0.17, 0.53), were better prepared for birth (Estimate 0.32, 99% CI = 0.16, 0.48), more likely to use condoms consistently (OR= 1.07, 99% CI = 1.00, 1.14) and communicated more with partners. They reported less mental distress in late pregnancy (Estimate = -0.61, 99% CI = -1.20, -0.02). Exclusive breastfeeding, partner HIV testing and disclosure, facility-based delivery, postnatal care attendance, postpartum family planning, and low birth weight did not differ by ANC type. This effectiveness study of Malawi Group ANC, the first trial with individual randomization in a low-income country, maps outcomes to the theory of change, enhancing our understanding of Group ANC's diverse positive impacts. The integration of typically neglected health promotion topics into the model highlights its flexibility to address changing local and global needs. Based on study results, the Malawi Ministry of Health is introducing Group ANC at district-level trainings and exploring the logistics for nationwide adoption. With momentum and political will, better care and a positive healthcare experience can be achieved for women, infants, and families in Malawi and globally.

We developed and tested a Centering-based group antenatal (ANC) model in Malawi, integrating health promotion for HIV prevention and mental health. We present effectiveness data and examine congruence with only the Group ANC theory of change model, which identifies key processes as supportive relationships, empowered partners in learning and care, and meaningful services, leading to better ANC experiences and outcomes. We conducted a hybrid effectiveness-implementation trial at seven clinics in Blantyre District, Malawi, comparing outcomes for 1887 pregnant women randomly assigned to Group ANC or Individual ANC. Group effects on outcomes were summarized and evaluated using t-tests, Mann-Whitney, or Chi-squared tests. Adjusted for seven individual and two clinic-level baseline covariates, point estimates are reported for continuous outcomes using multivariable linear regression models. Adjusted for the same covariates, odds ratios are reported for categorical outcomes using logistic regression models. All statistical tests were two-sided, controlling for a Type I error probability of 0.01 due to multiple testing. Women in Group ANC had higher peer connectedness and pregnancy-related empowerment, recalled receiving more services, and discussed more health promotion topics. They experienced less wait time, greater satisfaction with care (Estimate = 1.21, 99% CI = 0.07, 2.35), and had a higher mean number of ANC contacts (Estimate = 0.74, 99% CI = 0.50, 0.98). Most women preferred Group ANC for a future pregnancy (81% in Individual ANC; 95% in Group ANC). Women in Group ANC had more diverse diets (Estimate = 0.35, 99% CI = 0.17, 0.53), were better prepared for birth (Estimate 0.32, 99% CI = 0.16, 0.48), more likely to use condoms consistently (OR= 1.07, 99% CI = 1.00, 1.14) and communicated more with partners. They reported less mental distress in late pregnancy (Estimate = -0.61, 99% CI = -1.20, -0.02). Exclusive breastfeeding, partner HIV testing and disclosure, facility-based delivery, postnatal care attendance, postpartum family planning, and low birth weight did not differ by ANC type. This effectiveness study of Malawi Group ANC, the first trial with individual randomization in a low-income country, maps outcomes to the theory of change, enhancing our understanding of Group ANC's diverse positive impacts. The integration of typically neglected health promotion topics into the model highlights its flexibility to address changing local and global needs. Based on study results, the Malawi Ministry of Health is introducing Group ANC at district-level trainings and exploring the logistics for nationwide adoption. With momentum and political will, better care and a positive healthcare experience can be achieved for women, infants, and families in Malawi and globally.