Drug-resistant HTN (daytime ambulatory SBP > 135 mmHg)
At least three anti-hypertensive (including one diuretic)
eGFR > 45
Primary author + Year . | Kirstein (2022) . | Turagam-HFIB 2 (2021) . | Turagam-HFIB 1 (2021) . | Steinberg (2019) . | Kiuchi (2018) . | Kiuchi (2016) . | Pokushalov (2014) . |
---|---|---|---|---|---|---|---|
Study design . | RCT . | RCT . | RCT . | RCT . | RCT . | RCT . | RCT . |
Study groups . | PVI + RDN vs. PVI . | PVI + RDN vs. PVI . | PVI + RDN vs. PVI . | PVI + RDN vs. PVI . | PVI + RDN vs. PVI+ Spironolactone . | PVI + RDN vs. PVI . | PVI + RDN vs. PVI . |
Sample size (PVI + RDN/control) | 39/22 | 28/22 | 13/17 | 154/148 | 33/36 | 21/24 | 41/39 |
Inclusion criteria | Refractory paroxysmal or persistent AF Drug-resistant HTN (daytime ambulatory SBP > 135 mmHg) At least three anti-hypertensive (including one diuretic) eGFR > 45 | Paroxysmal or persistent AF Drug-resistant HTN (Office SBP ≥ 160 or DBP ≥ 100) At least one anti-hypertensive eGFR > 45 | Paroxysmal or persistent AF Drug-resistant HTN (Office SBP ≥ 160 or DBP ≥ 100) At least one anti-hypertensive eGFR > 45 | Paroxysmal AF Drug-resistant HTN (Office SBP ≥ 130 or DBP ≥ 80) At least one anti-hypertensive | Paroxysmal AF or symptomatic refractory AF Drug-resistant HTN (ambulatory SBP ≥ 130, ambulatory DBP ≥ 80) At least three anti-hypertensive eGFR ≥60 and microalbuminuria | Refractory paroxysmal or persistent AF Mostly drug-resistant HTN (130 > ambulatory SBP ≥ 100): mean of 3.2 anti-hypertensive agents, 2/3 with diuretic 30 ≤ eGFR ≤ 89 (or if eGFR > 60 and microalbuminuria) | Refractory paroxysmal or persistent AF Moderate drug-resistant HTN (Office BP ≥ 140/90) or severe drug-resistant HTN (Office BP ≥ 160/100) At least three anti-hypertensive (including one diuretic) eGFR ≥ 45 |
% PAF vs. % persistent AF | 50.8/49.2 | 70.0/30.0 | 66.7/33.3 | 100/0 | 100/0 | 60.0/40.0 | 43.8/56.2 |
Age (Mean ± SD) (PVI + RDN/control) | 66.3 ± 7.90/63.0 ± 9.90 | 64.0 ± 7.00/65.0 ± 8.00 | 59.0 ± 10.0/68.0 ± 9.00 | 59 (54–65) /60 (58–65) | 56.8 ± 6.50/58.4 ± 5.10 | 68.0 ± 9.0/66.0 ± 9.0 | 56.0 ± 6.00/56.0 ± 6.00 |
Female (%) (PVI + RDN/control) | 48.7/45.5 | 42.9/36.4 | 38.5/47.1 | 40.9/38.5 | 24.2/16.7 | 38.1/33.3 | 24.4/38.5 |
Baseline SBP (mmHg) (PVI + RDN/control) | 162.0 ± 18.60/167.1 ± 18.50 | 146.6 ± 20.6/143.4 ± 18.4 | 147.0 ± 31.0/153.0 ± 20.0 | 150.0 ± 9.50/151.0 ± 9.31 | 142.0 ± 6.00/140.0 ± 6.00 | Drug-controlled HTN | 163.0 ± 18.0/164.0 ± 17.0 |
Baseline DBP (mmHg) (PVI + RDN/control) | 87.5 ± 14.1/91.4 ± 10.6 | 81.4 ± 13.4/79.1 ± 12.4 | 84.1 ± 25.0/88.0 ± 12.0 | 90.0 ± 6.33/90.0 ± 9.31 | 103.0 ± 8.00/103.0 ± 7.00 | Drug-controlled HTN | 89.0 ± 11.0/88.0 ± 11.0 |
Baseline eGFR | 77.6 ± 17.4/72.7 ± 14.2 | NR | NR | 79.0 ± 11.0/76.0 ± 11.0 | 69.2 ± 6.70/66.7 ± 7.70 | 59.3 ± 13.3/60.5 ± 15.9 | 75.5 ± 9.20/77.0 ± 8.50 |
PVI method | Radiofrequency ablation | Radiofrequency ablation | Cryoballoon catheter | Radiofrequency ablation | Radiofrequency ablation | Radiofrequency ablation | Radiofrequency ablation |
RDN method | EnligHTN | Vessix | ThermoCool | Irrigated tip and RDN catheter | EnligHTN | Irrigated tip | ThermoCool ( = 20), Simplicity ( = 21) |
Follow-up (months) | 24 | 24 | 24 | 12 | 12 | 12 | 12 |
RCT, randomised controlled trial; PVI, pulmonary vein isolation; RDN, renal denervation; DBP, diastolic blood pressure; SBP, Systolic blood pressure; eGFR, estimated glomerular filtration rate; HTN, hypertension; AF, atrial fibrillation; BP, blood pressure; SD, standard deviation.
a Pokushalov (2014) reported grouped results from two different RCTs.
b This study reported data as median and interquartile range.
The pooled analysis showed that AF recurrence was significantly lower in the PVI + RDN (33.3%) group in contrast to the PVI (50.2%) group [RR = 0.67 (0.53, 0.85), P = 0.001, I 2 = 23%] ( Figure 2 ). The number needed to treat (NNT) to prevent recurrence was 5.9 patients. 19
Effect of renal denervation on atrial fibrillation recurrence.
All included trials reported follow-up data on blood pressure. One of the trials included patients with drug-controlled HTN and thus was excluded from the meta-analysis. 14 Kiuchi (2018) reported blood pressure as ambulatory as opposed to in-office. 15 To account for the difference in measurements of the outcome, SMDs were used. 10 Twelve-month follow-up data was used here.
The pooled results showed a significant decrease in systolic blood pressure (SBP), with medium effect size, as reflected by an SMD of 0.5 in the PVI + RDN group compared with the PVI alone group ( P < 0.05). Similarly, diastolic blood pressure (DBP) was reduced by an SMD of 0.43 ( P = 0.006) ( Figure 3A and C ). There was a high heterogeneity in both the SBP and DBP pooled analyses with I 2 values of 80 and 60%, respectively, and χ 2 test P -values ≤ 0.10.
Effect of renal denervation on blood pressure. Forest plots of standardised mean difference for ( A ) systolic blood pressure, ( B ) systolic blood pressure sensitivity analysis after HFIB-1 removal, ( C ) diastolic blood pressure, and ( D ) diastolic blood pressure sensitivity analysis after HFIB-1 removal.
Sensitivity analysis was conducted through the removal of the HFIB-1 trial ( Figure 3B and D ). This trial was removed to try and adjust for publication bias ( Figure 4 ). The results indicated a significant difference of P = 0.0002 for SBP and a significant difference of P < 0.00001 for DBP. Though the SBP and DBP pooled analyses heterogeneity decreased to I 2 of 69 and 22% respectively, considerable heterogeneity remained in the pooled SBP data ( Figure 3B and D ).
(B) Safety Outcomes
Funnel plot analysis.
Baseline and follow-up eGFR data for both PVI + RDN and PVI groups were reported in three trials. 14 , 15 , 18 The pooled analysis was conducted using the most recent follow-up data. There was an MD in eGFR of +7.19 mL/min/1.73 m 2 in the PVI + RDN group compared with the PVI alone group, but the difference was not significant ( P = 0.15) ( Figure 5A ). Owing to the large heterogeneity ( I 2 = 89%), a sensitivity analysis was conducted. Following the removal of Kirstein (2022), the results indicated a significant difference ( P < 0.00001) and reduced heterogeneity ( I 2 = 38%) ( Figure 5B ). This effect was not observed following the removal of any of the other papers.
Effect of renal denervation on estimated glomerular filtration rate. Forest plots of mean difference for ( A ) estimated glomerular filtration rate and ( B ) estimated glomerular filtration rate sensitivity analysis (Kirstein 2022 not included in pooled analysis).
Five trials reported data on peri- and post-procedural complications in both groups. 15–18 Kiuchi (2016) reported complications only in the PVI + RDN group and Pokushalov (2014) failed to specify the group in which the single complication (cardiac tamponade following PVI) occurred. 13 , 14
Steinberg (2019) and Pokushalov (2014) attributed all complications to the PVI procedure. 13 , 16 Procedural complications specifically related to RDN were reported in the HFIB-1 and Kirstein (2022) trials. Renal artery stenosis in the PVI + RDN group was reported in 3/13 (23.1%) patients in the HFIB-1 trial and 1/39 (2.56%) patients in the Kirstein’s (2022) study. 17 , 18 Participant recruitment for the HFIB-1 trial was terminated early due to complications. 17
Kirstein (2022) reported 12 non-fatal, peri-procedural complications in 9 patients across both groups (4/39 in the RDN + PVI group and 5/22 in the PVI group), but failed to specify what these events were. 18 Steinberg (2019) reported eight non-fatal major adverse cardiac events in each group. 16 Despite specifying what these events were, it failed to report how many patients experienced each event ( Table 2 ).
Peri- and post-procedural complications
Primary author + Year . | Kirstein (2022) . | Turagam-HFIB 2 (2021) . | Turagam-HFIB 1 (2021) . | Steinberg (2019) . | Kiuchi (2018) . | Kiuchi (2016) . | Pokushalov (2014) . | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Study groups . | PVI + RDN . | PVI . | PVI + RDN . | PVI . | PVI + RDN . | PVI . | PVI + RDN . | PVI . | PVI + RDN . | PVI . | PVI + RDN . | PVI . | PVI + RDN . | PVI . |
Renal artery stenosis | 1/39 | 0 | 0 | 0 | 3/13 | 0 | 0 | 0 | 0 | 0 | 0 | NR | 0 | 0 |
Stroke | 0 | 0 | 0 | 0 | 0 | 1/17 | ? | ? | 0 | 0 | 0 | NR | 0 | 0 |
Systemic embolism | 0 | 0 | 0 | 0 | 0 | 0 | ? | ? | 0 | 0 | 0 | NR | 0 | 0 |
Vascular/access-related complications e.g. femoral fistula, pseudoaneurysm, haematoma | 2/39 | 0 | 2/28 | 0 | 0 | 1/17 | 6/154 | 4/148 | 0 | 0 | 0 | NR | 0 | 0 |
Cardiac tamponade | 0 | 2/22 | 0 | 0 | 0 | 0 | 0 | 1/148 | 0 | 0 | 0 | NR | ? | ? |
Procedural death | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | NR | 0 | 0 |
Death during follow up | 0 | 0 | 0 | 0 | 0 | 0 | 2/154 | 2/148 | 0 | 0 | 0 | NR | 0 | 0 |
Transient phrenic nerve palsy | ? | ? | 0 | 0 | 0 | 0 | 1/154 | 1/148 | 0 | 0 | 0 | NR | 0 | 0 |
Pneumothorax | ? | ? | 0 | 0 | 0 | 0 | 0 | 1/148 | 0 | 0 | 0 | NR | 0 | 0 |
Renal artery dissection in procedure | 0 | 0 | 0 | 0 | 3/13 | 0 | 0 | 0 | 0 | 0 | 0 | NR | 0 | 0 |
Primary author + Year . | Kirstein (2022) . | Turagam-HFIB 2 (2021) . | Turagam-HFIB 1 (2021) . | Steinberg (2019) . | Kiuchi (2018) . | Kiuchi (2016) . | Pokushalov (2014) . | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Study groups . | PVI + RDN . | PVI . | PVI + RDN . | PVI . | PVI + RDN . | PVI . | PVI + RDN . | PVI . | PVI + RDN . | PVI . | PVI + RDN . | PVI . | PVI + RDN . | PVI . |
Renal artery stenosis | 1/39 | 0 | 0 | 0 | 3/13 | 0 | 0 | 0 | 0 | 0 | 0 | NR | 0 | 0 |
Stroke | 0 | 0 | 0 | 0 | 0 | 1/17 | ? | ? | 0 | 0 | 0 | NR | 0 | 0 |
Systemic embolism | 0 | 0 | 0 | 0 | 0 | 0 | ? | ? | 0 | 0 | 0 | NR | 0 | 0 |
Vascular/access-related complications e.g. femoral fistula, pseudoaneurysm, haematoma | 2/39 | 0 | 2/28 | 0 | 0 | 1/17 | 6/154 | 4/148 | 0 | 0 | 0 | NR | 0 | 0 |
Cardiac tamponade | 0 | 2/22 | 0 | 0 | 0 | 0 | 0 | 1/148 | 0 | 0 | 0 | NR | ? | ? |
Procedural death | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | NR | 0 | 0 |
Death during follow up | 0 | 0 | 0 | 0 | 0 | 0 | 2/154 | 2/148 | 0 | 0 | 0 | NR | 0 | 0 |
Transient phrenic nerve palsy | ? | ? | 0 | 0 | 0 | 0 | 1/154 | 1/148 | 0 | 0 | 0 | NR | 0 | 0 |
Pneumothorax | ? | ? | 0 | 0 | 0 | 0 | 0 | 1/148 | 0 | 0 | 0 | NR | 0 | 0 |
Renal artery dissection in procedure | 0 | 0 | 0 | 0 | 3/13 | 0 | 0 | 0 | 0 | 0 | 0 | NR | 0 | 0 |
PVI, pulmonary vein isolation; RDN, renal denervation; NR, not reported.
In certain studies, the method of random sequence generation and allocation concealment was not clearly defined. 13–15 There was the potential for performance bias in all the studies as the same operators performed both PVI and RDN, thus they were not blinded to the groups. Attrition bias was low for all studies except Kirstein (2022), with very low numbers lost to follow-up. In the Kirstein (2022) trial, there were 11 withdrawals and 5 missed visits during the follow-up period and no evidence of an intention-to-treat analysis being carried out. 18 HFIB-1 was terminated prematurely due to a large number of renovascular complications. 17 Therefore, pooled outcomes that included this study should be assessed with caution. All studies were unclear bias in at least one risk of bias domain ( Figure 6 ).
Cochrane RoB for randomized trials
The funnel plot for AF recurrence results show that study RRs are symmetrical around the overall RR and lie within or on the 95% CI limits, indicating a low risk of publication bias ( Figure 4 ).
This meta-analysis examined the findings from eight trials investigating the effects of RDN as an adjunct to PVI in the treatment of AF in patients with drug-resistant HTN. The pooled results showed that RDN alongside PVI significantly reduced 12-month AF recurrence, 12-month SBP and DBP.
HTN is the main risk factor for AF and currently the mainstay of treatment is a combination of lifestyle modification and drug therapy. 20 HTN is believed to have a neurogenic component, where the kidneys play an important role. It has been shown that the activation of efferent sympathetic renal nerve fibres results in: (i) renin release via β1 adrenoreceptor activation in the juxtaglomerular cells, with downstream activation of the renin–angiotensin–aldosterone system, (ii) increase in renal tubular sodium reabsorption via α adrenoceptors, and (iii) decrease in renal blood flow. 21 Ultimately, this leads to sodium and water retention, and increased systemic vascular resistance, which induces left atrial fibrosis and conduction block in the left atrium, and may potentially result in AF development. 22
Numerous studies have looked into the use of RDN in HTN treatment. 23 Blood pressure lowering effects are thought to be achieved by the ablation of renal sympathetic nerve fibres within the adventitial layer of the renal arteries. Consequently, reducing sensory input from the kidneys to the cerebral hypothalamic centres and modulating sympathetic outflow to kidneys, heart, and peripheral blood vessels. 24 Ultimately, this reduces cardiac stimulation and leads to reduced cardiac fibrosis, hypertrophy, and arrhythmogenicity. 25 Catheter ablation through PVI has been an effective modality in reducing recurrence of AF especially in patients with resistant AF to medical therapy. 26 By reducing sympathetic activity, RDN may have a concurrent anti-arrhythmic feature which might further reduce recurrence of AF post-catheter ablation.
Several clinical studies investigating RDN and PVI compared with PVI alone are ongoing. One of these trials is the prospective, randomised, controlled, multicentre ASAF trial ( ClinicalTrials.gov Identifier: NCT02115100). It aims to explore the time to first detection of AF > 30 s, in patients with paroxysmal or persistent AF with uncontrolled HTN or signs of sympathetic overdrive. Recruitment to this trial has been completed and the results would be of high impact. Another ongoing prospective, controlled, and randomised trial is the Ultrasound-Based Renal Sympathetic Denervation as Adjunctive Upstream Therapy During Atrial Fibrillation Ablation (ULTRA-HFIB) ( ClinicalTrials.gov Identifier: NCT04182620) which aims to recruit 160 patients undergoing AF ablation procedure. This trial aims to determine the role of RDN plus PVI in the prevention of AF recurrence and aims to be completed by December 2023.
RDN in adjunct to PVI has been shown to reduce AF recurrence and blood pressure and thus should be considered for the treatment of patients with AF and drug-resistant HTN. Though some studies reported peri-procedural complications arising from the RDN process (e.g. renal artery stenosis), differences in reporting across studies did not allow us to performed a pooled analysis. Importantly, the three trials reporting on eGFR suggested no harm or deterioration occurring as a result of RDN.
The main limitation of this meta-analysis is likely biases arising from individual included studies. Several measures were taken to mitigate the effect of biases including: (1) not including studies with duplicated patient populations; (2) funnel plot analysis to probe for publication bias; and (3) ensuring consistency in inclusion criteria. Despite this, other forms of bias such as language bias, arising from only including English language studies were still likely present. Another limitation is the inclusion of small, potentially underpowered studies. Yet, incorporating these smaller studies is important since they are likely to reflect any heterogeneity that might manifest in clinical settings. 27
All systematic reviews published on this topic, except for one, include duplicated patient populations by incorporating data from at least two trials by Pokushalov and colleagues (2012, 2014) and Romanov (2017). 13 , 28 , 29 Our review includes only Pokushalov (2014), as it encompasses also the participants from the 2012 trial. Romanov (2017) was excluded as it was a sub-analysis of patients from the two trials published by Pokushalov and colleagues with data from implantable cardiac monitors. This study stands as the first meta-analysis on this topic to exclusively include RCTs, to ensure that only higher quality evidence was utilised. It also incorporates the most recent data from the Kirstein (2022) trial. Notably, this is the only trial to date to conclude that RDN did not improve AF outcomes and is one of only two trials to report peri-procedural complications of RDN, thereby somewhat mitigating outcome-reporting bias. 18
None of the trials used invasive sham controls, considered by many to be a requirement for trials investigating device-based HTN therapies. 30 However, there is also evidence to suggest that the use of sham controls is no more effective than extensive use of 24-h ambulatory SBP. 31
This meta-analysis revealed that RDN alongside PVI significantly reduced 12-month AF recurrence, 12-month SBP and DBP. It would be valuable to expand the consideration of RDN as a treatment option for AF, in addition to PVI in patients with drug-resistant HTN. Given the potential benefits of RDN, additional trials in this area would be beneficial to further clarify the efficacy and safety of this approach in the AF population.
Karish Thavabalan is a final year MBBS student at UCL having graduated from Imperial College Business School with a 1st Class degree in Management. Passionate about advancing cardiovascular care, his expertise lies in the intersection of renal denervation and atrial fibrillation treatment. With a commitment to evidence-based medicine, his work aims to contribute valuable insights to the evolving field, fostering innovation and enhancing therapeutic strategies for individuals battling atrial fibrillation.
All data used in this article were retrieved from the eight included randomized controlled trials, and are available in the published versions of the manuscripts.
RP is supported by the UCL BHF Research Accelerator AA/18/6/34223, NIHR grant NIHR129463 and UKRI/ERC/HORIZON 10103153 Aristoteles.
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Coaching Copyright is a welcome addition to the body of literature focusing on copyright educators who are, by extension, coaches. The book follows a logical order, starting with the title topic, offering a framework to address issues, and then positioning this framework within an instructional context. The next chapters cover ways to connect with your audience, succeeded by employing the framework for particular audiences and topics, and ending with a report about a Library Science course. This publication concentrates on the people who teach copyright within academic libraries in the United States. The target audience is wide, regardless of formal job positions, and its utility stretches far beyond the core subject.
Keywords: copyright, instruction, coaching, education, teaching, copyright education, higher education
Myers, C. (2019). Coaching up the chain of command. In K. L. Smith and E. L. Ellis (Eds.), Coaching copyright (pp. 149–161). ALA Editions.
Smith, K. L. (2014). Owning and using scholarship: IP handbook for teachers and researchers. Association of College and Research Libraries. http://hdl.handle.net/1808/24738
Smith, K. L., & Ellis, E.L. (Eds.). (2019). Coaching copyright. ALA Editions.
Copyright (c) 2024 Emilie Regina Algenio
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OBM Integrative and Complementary Medicine is an international peer-reviewed Open Access journal published quarterly online by LIDSEN Publishing Inc. It covers all evidence-based scientific studies on integrative, alternative and complementary approaches to improving health and wellness.
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Collection: Stress, Burnout, and Trauma in Schools: Coping Strategies for Teachers, Staff, and Students
Received: March 02, 2023 | Accepted: May 10, 2024 | Published: May 24, 2024
OBM Integrative and Complementary Medicine 2024 , Volume 9, Issue 2, doi: 10.21926/obm.icm.2402030
Recommended citation: Schafer ES. Trauma in Schools: A Review of the Impact of Childhood Trauma and Assessment of a Potential Intervention. OBM Integrative and Complementary Medicine 2024 ; 9(2): 030; doi:10.21926/obm.icm.2402030.
© 2024 by the authors. This is an open access article distributed under the conditions of the Creative Commons by Attribution License , which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is correctly cited.
According to the National Survey of Children’s Health (NSCH), nearly 30 million children in the United States have experienced one or more types of significant childhood trauma. In the average public school, this statistic translates to as many as half of the students in a given teacher’s classroom. Children exposed to the toxic stress of trauma often experience negative consequences that affect their academic, psychological, socioemotional, and behavioral health. To aid educators in addressing this reality, trauma-informed care practices have increasingly begun to be translated into professional development opportunities for educators. Using the theoretical frameworks of trauma theory and transformational learning theory, this review of the literature provides a brief overview of trauma theory, the short- and long-term effects on children, the mechanisms involved in how trauma affects developmental outcomes, and the relevance of trauma in an educational setting. It also reviews the implementation of trauma-informed care as professional development in educational settings, examines research on educators’ awareness of beliefs and attitudes, and reviews how/whether knowledge and change in attitudes affect behavioral change.
Childhood trauma; trauma-informed care; school; adverse childhood experiences (ACEs); education; professional development
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Several terms or phrases used in the current review require definition. The terms for childhood trauma, in particular, are varied in the literature. The following section provides explanations for what is meant by each term in this document.
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Two theoretical frameworks provided the foundation for this review: trauma theory and transformational learning theory. Trauma theory provides the foundational understanding of the need for TIC training. Transformational learning theory explains how professional development can change teachers’ perceptions of trauma-impacted students and, in turn, their interactions with students.
28. Anda RF, Felitti VJ, Bremner JD, Walker JD, Whitfield C, Perry BD, et al. The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology. Eur Arch Psychiatry Clin Neurosci. 2006; 256: 174-186. [ CrossRef ]
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This scoping review of the literature includes, as a rationale for trauma-informed care training, a brief overview of trauma theory, the short- and long-term effects on children, the mechanisms involved in how trauma affects developmental outcomes, and the relevance of trauma in an educational setting. It then reviews the implementation of trauma-informed care as professional development in educational settings, examines research on educators’ awareness of beliefs and attitudes, and reviews how/whether knowledge and change in attitudes affect behavioral change. Finally, it includes a specific example of how a TIC training program was implemented and assessed.
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Figure 1 Domains of Impairment in Children Exposed to Trauma.
Table 1 Prevalence of ACEs by Category from 1998 Adverse Childhood Experiences Survey.
ACE Category | Women | Men | Total |
Percent (N = 9,367) | Percent (N = 7,970) | Percent (N = 17,337) | |
ABUSE | |||
Emotional Abuse | 13.1% | 7.6% | 10.6% |
Physical Abuse | 27% | 29.9% | 28.3% |
Sexual Abuse | 24.7% | 16% | 20.7% |
HOUSEHOLD CHALLENGES | |||
Intimate Partner Violence | 13.7% | 11.5% | 12.7% |
Household Substance Abuse | 29.5% | 23.8% | 26.9% |
Household Mental Illness | 23.3% | 14.8% | 19.4% |
Parental Separation or Divorce | 24.5% | 21.8% | 23.3% |
Incarcerated Household Member | 5.2% | 4.1% | 4.7% |
NEGLECT | |||
Emotional Neglect | 16.7% | 12.4% | 14.8% |
Physical Neglect | 9.2% | 10.7% | 9.9% |
Note : Reprinted from the Center for Disease Control and Prevention, https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/about.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fviolenceprevention%2Facestudy%2Fabout.html .
Table 2 Prevalence of ACEs by Category in 2010 from the Behavioral Risk Factor Surveillance System.
ACE Category | Women | Men | Total |
Percent (N = 32,539) | Percent (N = 21,245) | Percent (N = 53,784) | |
ABUSE | |||
Emotional Abuse | 34.1% | 35.9% | 35.0% |
Physical Abuse | 15.8% | 15.9% | 15.9% |
Sexual Abuse | 15.2% | 6.4% | 10.9% |
HOUSEHOLD CHALLENGES | |||
Intimate Partner Violence | 15.6% | 14.2% | 14.9% |
Household Substance Abuse | 27.2% | 22.9% | 25.1% |
Household Mental Illness | 19.3% | 13.3% | 16.3% |
Parental Separation or Divorce | 23.1% | 22.5% | 22.8% |
Incarcerated Household Member | 5.2% | 6.2% | 5.7% |
Note : Reprinted from the Center for Disease Control and Prevention, https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/ace-brfss.html .
40. Teicher MH, Rabi K, Sheu YS, Seraphin SB, Andersen SL, Anderson CM, et al. Neurobiology of childhood trauma and adversity. In: The impact of early life trauma on health and disease: The hidden epidemic. Cambridge, UK: Cambridge University Press; 2010. pp. 112-122. [ CrossRef ]
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51. Substance Abuse and Mental Health Services Administration. National Center for Trauma-Informed Care: The trauma-informed approach [Internet]. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2019. Available from: <a href="https://www.samhsa.gov/nctic/trauma-interventions">https://www.samhsa.gov/nctic/trauma-interventions</a>.
The next section presents one such school-wide philosophy.
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Compassionate Schools training seeks to provide educators the opportunity to experience transformational learning via exposure to a new trauma-informed lens through which to view students. When educators hear how trauma can present in their classroom, they may experience guilt for their previous poor handling of situations or discomfort with the ignorance uncovered by their new awareness. If this dissonance prompts self-reflection, critical analysis and discussion, concluding with a change in perspective, the first three stages of transformational learning have occurred. For example, a teacher may have had many interactions with a withdrawn, seemingly unengaged student. After several attempts to gain his attention, the teacher may conclude the student is uninterested, distracted, and/or lazy. If the student’s behavior continues, the teacher may feel justified in confirming her suspicion. When this teacher is confronted with the reality of the student’s traumatic history and the science of trauma theory, she may experience the necessary discomfort to question her previously held beliefs about the student and reevaluate his behavior in light of the new knowledge (i.e. that the student is overwhelmed, afraid of failure, or unable to self-regulate).
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Although trauma-informed care in schools has strong theoretical foundations and increasing implementation across the U.S., to date there is not a significant body of literature evaluating the effectiveness of trauma-informed professional development for educators. The next section details the few relevant studies that have been conducted.
68. Anderson EM, Blitz LV, Saastamoinen M. Exploring a school-university model for professional development with classroom staff: Teaching trauma-informed approaches. Sch Community J. 2015; 25: 113-134.
69. Goodwin-Glick KL. Impact of trauma-informed care professional development on school personnel perceptions of knowledge, dispositions, and behaviors toward traumatized students. Bowling Green, OH: Bowling Green State University; 2017.
70. Baker CN, Brown SM, Wilcox PD, Overstreet S, Arora P. Development and psychometric evaluation of the attitudes related to trauma-informed care (ARTIC) scale. Sch Ment Health. 2016; 8: 61-76. [ CrossRef ]
The mock house simulation is an opportunity for educators to experience a first-hand representation of the potential home life of a student who could be in their classroom. The CPTC staff combined data and evidence from multiple Spartanburg DSS/CPS cases to recreate a home ‘scene’ in several rooms. Participants were led through the different areas of the home (front porch, living room, kitchen, bathroom, and bedrooms) with the instruction to note evidence of child maltreatment and trauma.
71. Chafouleas SM, Johnson AH, Overstreet S, Santos NM. Toward a blueprint for trauma-informed service delivery in schools. Sch Ment Health. 2016; 8: 144-162. [ CrossRef ]
72. Maynard BR, Farina A, Dell NA, Kelly MS. Effects of trauma‐informed approaches in schools: A systematic review. Campbell Syst Rev. 2019; 15: e1018. [ CrossRef ]
73. Thomas MS, Crosby S, Vanderhaar J. Trauma-informed practices in schools across two decades: An interdisciplinary review of research. Rev Res Educ. 2019; 43: 422-452. [ CrossRef ]
It is undisputed that the experience of trauma is prevalent among the student body of our schools. As this review has shown, a primary intervention strategy of providing TIC professional development to school faculty, staff, and administration has much promise. Teachers need to be given both the understanding of how trauma impacts their students as well as the relevant tools and skills necessary to help them address it well. TIC professional development provides administration and educators a common language with which to discuss prevention, intervention, and even discipline. Many of the TIC trainings also include sessions devoted to self-care, boundaries, vicarious trauma, and compassion fatigue. These can prove invaluable to schools in the fight to inoculate teachers against increasing burnout. Students who have experienced the uniquely distressing pain of complex trauma deserve to interact with school staff who have an understanding of its impact on them. In turn, educators deserve to be well-prepared for entering the often-difficult journey of teaching survivors of childhood trauma.
The author did all the research work of this study.
The author has declared that no competing interests exist.
As a result of the significant disruption that is being caused by the COVID-19 pandemic, we are very aware that many researchers will have difficulty in meeting the timelines associated with our peer review process during normal times. Please do let us know if you need additional time. Our editor office will continue to remind you of the original timelines but we intend to be highly flexible at this time.
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Professor Katherine White and Assistant Professor Rishad Habib from Toronto Metropolitan University (UBC Sauder PhD alumni 2021) accepting the 2024 Sheth Foundation/Journal of Marketing Award
White, habib, and hardisty win the 2024 sheth foundation/journal of marketing award, how to shift consumer behaviors to be more sustainable: a literature review and guiding framework, katherine white, david hardisty, marketing & behavioural science division.
The research paper that introduces the SHIFT Framework, a pioneering and comprehensive approach to fostering sustainable consumer behaviors, has been honoured with the American Marketing Association (AMA)’s 2024 Sheth Foundation/Journal of Marketing Award. UBC Sauder authors Professor Katherine White and Associate Professor David Hardisty, along with Assistant Professor Rishad Habib from Toronto Metropolitan University (UBC Sauder PhD alumni 2021), received the award at the 2024 AMA Summer Academic Conference in Boston.
The annual Sheth Foundation/Journal of Marketing Award honours a Journal of Marketing article that has made long-term contributions to the field of marketing. An article is eligible for consideration to receive the award in the fifth year after its publication. The criteria for selection include the quality of the article’s contribution to theory and practice, its originality, its technical competence (if relevant), and its impact on the field of marketing.
The research paper “ How to SHIFT Consumer Behaviors to be More Sustainable: A Literature Review and Guiding Framework ” introduces the SHIFT Framework, an acronym representing five routes, or psychological factors, to help consumers adopt and foster more sustainable behaviour: Social influence, Habits, Individual self, Feelings and cognition, and Tangibility.
In making the announcement of the award winner, the selection committee noted that the SHIFT framework “has profoundly impacted marketing practice, influencing a wide array of stakeholders such as businesses, non-profits, and government organizations, with collaborations ranging from big brands to city governments and startups. This work has facilitated the application of the framework in various educational settings, including executive education, undergraduate, and PhD courses, where it’s used to develop and test sustainable behavior change strategies. Furthermore, the framework’s concepts have been distilled into accessible articles for a managerial audience in such publications like Harvard Business Review and The Conversation. Over 50 organizations, including major corporations and non-profits, have utilized the SHIFT Framework, showcasing its widespread application and dissemination through diverse channels such as conferences, webinars, and academic presentations.”
To learn more about the SHIFT Framework and to hear the authors present their findings, visit the AMA website here .
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IMAGES
COMMENTS
A literature review is a document or section of a document that collects key sources on a topic and discusses those sources in conversation with each other (also called synthesis ). The lit review is an important genre in many disciplines, not just literature (i.e., the study of works of literature such as novels and plays).
Step 5 - Write your literature review. Like any other academic text, your literature review should have an introduction, a main body, and a conclusion. What you include in each depends on the objective of your literature review. Introduction. The introduction should clearly establish the focus and purpose of the literature review.
Writing a literature review requires a range of skills to gather, sort, evaluate and summarise peer-reviewed published data into a relevant and informative unbiased narrative. Digital access to research papers, academic texts, review articles, reference databases and public data sets are all sources of information that are available to enrich ...
Example: Predictors and Outcomes of U.S. Quality Maternity Leave: A Review and Conceptual Framework: 10.1177/08948453211037398 ; Systematic review: "The authors of a systematic review use a specific procedure to search the research literature, select the studies to include in their review, and critically evaluate the studies they find." (p. 139).
A sophisticated literature review (LR) can result in a robust dissertation/thesis by scrutinizing the main problem examined by the academic study; anticipating research hypotheses, methods and results; and maintaining the interest of the audience in how the dissertation/thesis will provide solutions for the current gaps in a particular field.
When searching the literature for pertinent papers and reviews, the usual rules apply: be thorough, use different keywords and database sources (e.g., DBLP, Google Scholar, ISI Proceedings, JSTOR Search, Medline, Scopus, Web of Science), and. look at who has cited past relevant papers and book chapters.
Writing a literature review requires a range of skills to gather, sort, evaluate and summarise peer-reviewed published data into a relevant and informative unbiased narrative. Digital access to research papers, academic texts, review articles, reference databases and public data sets are all sources of information that are available to enrich ...
Literature reviews establish the foundation of academic inquires. However, in the planning field, we lack rigorous systematic reviews. In this article, through a systematic search on the methodology of literature review, we categorize a typology of literature reviews, discuss steps in conducting a systematic literature review, and provide suggestions on how to enhance rigor in literature ...
The best proposals are timely and clearly explain why readers should pay attention to the proposed topic. It is not enough for a review to be a summary of the latest growth in the literature: the ...
A literature review - or a review article - is "a study that analyzes and synthesizes an existing body of literature by identifying, challenging, and advancing the building blocks of a theory through an examination of a body (or several bodies) of prior work (Post et al. 2020, p. 352).Literature reviews as standalone pieces of work may allow researchers to enhance their understanding of ...
Stand-alone literature review articles. These provide an overview and analysis of the current state of research on a topic or question. ... You can find examples published in any number of academic journals, but there is a series of Annual Reviews of *Subject* which are specifically devoted to literature review articles. Writing a stand-alone ...
What is a literature review? A literature review is a piece of academic writing demonstrating knowledge and understanding of the academic literature on a specific topic placed in context. A literature review also includes a critical evaluation of the material; this is why it is called a literature review rather than a literature report. It is a ...
A literature review is a critical analysis and synthesis of existing research on a particular topic. It provides an overview of the current state of knowledge, identifies gaps, and highlights key findings in the literature. 1 The purpose of a literature review is to situate your own research within the context of existing scholarship ...
A literature review is a review and synthesis of existing research on a topic or research question. A literature review is meant to analyze the scholarly literature, make connections across writings and identify strengths, weaknesses, trends, and missing conversations. A literature review should address different aspects of a topic as it ...
This is why the literature review as a research method is more relevant than ever. Traditional literature reviews often lack thoroughness and rigor and are conducted ad hoc, rather than following a specific methodology. ... Often, if the aim is to publish in an academic journal, this will require a detailed description of the process or a ...
A literature review is a surveys scholarly articles, books and other sources relevant to a particular. issue, area of research, or theory, and by so doing, providing a description, summary, and ...
Step 2: Identify the literature. Start by searching broadly. Literature for your review will typically be acquired through scholarly books, journal articles, and/or dissertations. Develop an understanding of what is out there, what terms are accurate and helpful, etc., and keep track of all of it with citation management tools.
Literature Review is a comprehensive survey of the works published in a particular field of study or line of research, usually over a specific period of time, in the form of an in-depth, critical bibliographic essay or annotated list in which attention is drawn to the most significant works. Also, we can define a literature review as the ...
Purpose and Importance of the Literature Review. An understanding of the current literature is critical for all phases of a research study. Lingard 9 recently invoked the "journal-as-conversation" metaphor as a way of understanding how one's research fits into the larger medical education conversation. As she described it: "Imagine yourself joining a conversation at a social event.
Important aspects of a systematic literature review (SLR) include a structured method for conducting the study and significant transparency of the approaches used for summarizing the literature (Hiebl, 2023).The inspection of existing scientific literature is a valuable tool for (a) developing best practices and (b) resolving issues or controversies over a single study (Gupta et al., 2018).
The literature review section of an article is a summary or analysis of all the research the author read before doing his/her own research.This section may be part of the introduction or in a section called Background. It provides the background on who has done related research, what that research has or has not uncovered and how the current research contributes to the conversation on the topic.
A thorough, sophisticated literature review is the foundation and inspiration for substantial, useful research. The complex nature of education research demands such thorough, sophisticated reviews.
A Literature Review of Academic Performance, an Insight into Factors and their Influences on Academic Outcomes of Students at Senior High Schools January 2021 Open Access Library Journal 08(06):1-14
The Journal des sçavans (later spelled Journal des savants), established by Denis de Sallo, was the earliest academic journal published in Europe.Its content included obituaries of famous men, church history, and legal reports. [7] The first issue appeared as a twelve-page quarto pamphlet [8] on Monday, 5 January 1665, [9] shortly before the first appearance of the Philosophical Transactions ...
Journals on Oxford Academic; Books on Oxford Academic; ESC Publications. Issues ... Literature search and screening. ... 2014) and Romanov (2017). 13, 28, 29 Our review includes only Pokushalov (2014), as it encompasses also the participants from the 2012 trial. Romanov (2017) was excluded as it was a sub-analysis of patients from the two ...
The next chapters cover ways to connect with your audience, succeeded by employing the framework for particular audiences and topics, and ending with a report about a Library Science course. This publication concentrates on the people who teach copyright within academic libraries in the United States.
According to the National Survey of Children's Health (NSCH), nearly 30 million children in the United States have experienced one or more types of significant childhood trauma. In the average public school, this statistic translates to as many as half of the students in a given teacher's classroom. Children exposed to the toxic stress of trauma often experience negative consequences that ...
Psychosocial determinants of academic achievement in Ethiopian higher education students, 2024. Systematic review and meta-analysis Chalachew Kassaw, Valeriia Demareva, Misrak Negash, Yohanes Sime
The research paper that introduces the SHIFT Framework, a pioneering and comprehensive approach to fostering sustainable consumer behaviors, has been honoured with the 2024 Sheth Foundation/Journal of Marketing Award. UBC Sauder authors Professor Katherine White and Associate Professor David Hardisty, along with Assistant Professor Rishad Habib (Toronto Metropolitan University), received the ...