Nyack College

To explore differences in employee- or employer-directed medical care for workplace injuries, related to the prolonged physical therapy (PT) and attorney involvement in the workers' compensation claim process. Eight thousand eight hundred fourteen rotator cuff tear claims filed to a nationwide insurance carrier from 2007 to 2022 were analyzed for difference in prolonged PT (≥360 days) and attorney involvement by medical direction groups. Employee-directed and shared employee- and employer-directed medical care had odds ratios of 1.41 and 1.58 for prolonged PT compared with employer direction, respectively. Employer-directed and shared employee and employer medical direction had odds ratios of 2.33 and 1.62 for attorney involvement compared with employee direction, respectively. Employee-directed medical care is associated with more PT, and employer-involved direction is associated with more attorney involvement.

ABSTRACT People with mental illness not only suffer from psychiatric symptoms but also have higher chances of having chronic diseases. Due to medical comorbidity, they tend to experience the decreased health-related quality of life (HRQOL). The benefits of physical activity are well known, but few studies have examined the role of physical activity between medical comorbidity and HRQOL among people with mental illness. The purpose of this study was to examine the effect of physical activity on psychological distress, medical comorbidity, and HRQOL. A total of 3,797 individuals with mental illness were selected from the 2013 Behavioral Risk Factor Surveillance System. Analyses included multiple regression, structural equation modeling, and bootstrapping to examine a moderated mediation effect. Medical comorbidity affects HRQOL as it is mediated by decreased psychological distress. Higher levels of physical activity diminished the impact of medical comorbidity on psychological distress, which in turn decreased the negative impact of medical comorbidity on HRQOL. Study findings highlight that increased levels of physical activity could benefit people with mental illness in decreasing psychological distress and improving HRQOL. The findings suggest that mental health service providers and stakeholders need to consider integrating physical activity interventions into services and comprehensive psychiatric rehabilitation.

The emergency responder community trains for and responds to many types of incidents on a daily basis and has done so for years. This experience with fires, emergency medical calls, chemical spills, confined spaces, and other common calls for assistance has helped responders develop an understanding of the problems and a confidence in solving them. Radiation from an accidental release in a facility or during transportation, or from a terrorist incident that causes radioactive materials to be released from their containment vessel, remains a cause of concern and fear. Emergency responders are a segment of the general population and share some of the same fears of radioactive materials as the whole population. Radioactive material incidents are not a common 911 call type. Radiation training has been included in emergency responder training standards for several decades and covers a broad range of topics from simple awareness and recognition to technical knowledge of the materials, detection and identification capabilities, self-protection, medical effects, and countermeasures to overall public and environmental safety and health. The safety factor of the radiation community has been very good, but without the actual response confidence in handling previous incident releases, many responders remain fearful of radiation. A single source site where responders can post and read after-action reports on actual radiation incidents may help communicate health and safety information, building responder confidence. Competencies in standards do not always translate into compliance in training curriculum and exercises. The fire service has been the key local response agency to radiation accidents for many years and has developed training programs that meet the competencies found in 29 CFR 1910.120 [q], How to Determine What Training is Required for Emergency Response Team Members, and the National Fire Protection Associations Standard 472: Competence of Responders to Hazardous Materials/Weapons of Mass Destruction Incidents. The majority of fire service responders in the United States are volunteers who often make decisions on what they train for based on the time available and their areas' hazard assessment. This has often caused radiation training to be limited at best. Communicating timely and accurate hazards and risks associated with radiation threats and incidents may increase the amount and level of training in response to these types of incidents. Many law enforcement and emergency medical services and other key disciplines did not address these standards requirements prior to 9/11, as they were considered outside their "normal" mission space. The change in the mission space caused by the new threat of radiological terrorism has required additional training and equipment. This training has started but will take time to impact the entire responder community, it will require funding for the training and equipment, and most of all, sustainment. Communicating the broad scope of capabilities necessary to safely manage a radiation incident and the requirement for all agencies to be involved may support the effort to train these disciplines in their new mission space. The serious and much publicized radiological incidents that have occurred during the lifetime of many of today's responder community (Chernobyl, Fukushima, and Three Mile Island) have added to this fear within the responder community. The majority of today's responder communities are between 21 and 50 y of age. In studies conducted in recent years by federal agencies, it was identified that this group did not receive the basics of nuclear information provided to the U.S. population at the start of the Cold War and the fear of a nuclear war. These studies have identified the gap that exists in understanding basic radiation terminology, protective actions including sheltering-in-place, informed evacuation, public messaging, and others. Despite studies like this, federal, state, and local public officials have been slow to communicate emergency action plans to the public for radiological and nuclear incidents. Emergency management agencies at all levels have action plans for natural events such as hurricanes, tornadoes, and coastal storms, and now they are including biological incidents and active shooters. Nuclear and radiological incident plans and protective actions need to be included and communicated to members of the public (and responders) in all media streams. Several federal agencies have been tasked with radiological and nuclear mission space, but this appears to remain fragmented without an organizing agency. The Domestic Nuclear Detection Office (U.S. Department of Homeland Security) remains in a detection and prevention mission and has provided a good amount of equipment, training, and coordination, but primarily among law enforcement organizations. The Federal Emergency Management Agency remains in the response mission but has limited outreach to the majority of response organizations. The U.S. Department of Health and Human Services (Assistant Secretary for Preparedness and Response) has stepped up its efforts in medical countermeasures, surge capabilities, and support services. All of this information and support comes to the responder community separately, and it is left to the local-level planners to piece it together. It needs to be coordinated and communicated as one source. Communications remains the top challenge for the responder community as we look to the new administration for a plan for radiological and nuclear preparedness: communicating public messaging on radiation terminology, how members of the public can protect themselves and expected public agency actions; communicating a coordinated response plan that includes all levels and agencies; communicating the necessary training; andcommunicating the recovery actions that will have to take place.

Maureen Kroning is an associate professor of nursing at Nyack (N.Y.) College and a per diem nurse supervisor in Suffern, N.Y. The author has disclosed no financial relationships related to this article.

This research study was designed to examine the effect of spiritual well-being and spirituality on state and trait anxiety. Two hundred and thirty-eight adults in the USA were surveyed using the State-Trait Anxiety Inventory, Duke University Religion Index, Spiritual Well-Being Scale, and Participant Questionnaire. Results indicate that spiritual well-being can predict 39.1% of an adult's state anxiety and 37.9% of trait anxiety. Furthermore, frequency of religious attendance, frequency of private religious activity, and intrinsic religiosity can predict 6.2% of an adult's state anxiety and 8.6% of trait anxiety. Recommendations for researchers and implications for clinicians are discussed.

Mental illness is a huge problem many people face in the U.S. and around the world. The American Psychiatric Nurses Association indicates there is a shortage of nurses in every level and role in psychiatric-mental health nursing. Raising up a generation of nurses who want to work with the mentally ill is a challenge for nurse educators. The use of role playing and simulation in the learning lab prior to entering the clinical setting and reflective journaling in the clinical rotation can improve undergraduate nursing students' mental health clinical experience.

Self-regulated learning is an important feature of child development and socialization processes that has been found to be positively associated with self-appraisal skills, growth of self-efficacy beliefs, and proactive behavioral and environmental control. Despite strong theoretical and empirical evidence linking self-regulatory competencies to learning experiences and self-efficacy beliefs, there is a need for the application of self-regulated learning to students’ psychosocial development in grades K-12. To address the gap in the literature, this chapter reviews research on Bandura’s social cognitive theory with particular emphasis on the role of social modeling and self-efficacy, where human agency is a function of a triadic reciprocal model. We also discuss four widely established models of self-regulated learning and in particular, the applications of Zimmerman’s three phases of self-regulated learning and Zimmerman’s four levels of development of self-regulatory competency to students in grades K-12. We conclude the chapter by highlighting educational implications and by making recommendations for future research.

The Associated Press reported on March 3, 2015, that Idaho State Senators opposed the daily invocation given by a Hindu because, according to state senator Sheryl Nuxoll, America is a “Christian nation.” Nuxoll and others who view America as the champion of Christianity not only in America but also around the world will be surprised to learn that the United States received more Christian missionaries in 2010 than any other country, according to the Center for the Study of Global Christianity at Gordon-Conwell Theological Seminary. One part of this perplexing reality may be attributed to the fact that the United States first sent missionaries to those countries that are now sending missionaries to America. For example, American Protestant missionaries first entered Korea in 1885 at a time when Christianity was banned and persecuted, but now South Korea is one of the largest senders of missionaries around the world, including to the United States.