Obler, Susan; Schiorring, Eva
This report presents findings from an ethnographic study of technology integration and diffusion in two California community colleges. The study was commissioned to examine whether faculty behavior and student learning outcomes have changed as a result of @ONE instructional technology training and resources. The California Community Colleges…
Simpson, Mark D.
A study examined how well existing audience theory fits what really happens when writers write on the job. This ethnographic study focused on the process of revising one chapter from a guide to the DOS computer operating system designed for use by novices as well as intermediate and skilled users. Preliminary findings confirmed much of audience…
McIlroy, Guy; Storbeck, Claudine
This ethnographic study explores the identity development of 9 deaf participants through the narratives of their educational experiences in either mainstream or special schools for the Deaf. This exploration goes beyond a binary conceptualization of deaf identity that allows for only the medical and social models and proposes a bicultural…
Somerville, Claire; Featherstone, Katie; Hemingway, Harry; Timmis, Adam; Feder, Gene Solomon
Symptoms play a crucial part in the formulation of medical diagnoses, yet the construction and interpretation of symptom narratives is not well understood. The diagnosis of angina is largely based on symptoms, but a substantial minority of patients diagnosed with "non-cardiac" chest pain go on to have a heart attack. In this ethnographic study our aims were to understand: (1) how the patients' accounts are performed or enacted in consultations with doctors; (2) the ways in which ambiguity in the symptom narrative is managed by doctors; and (3) how doctors reach or do not reach a diagnostic decision. We observed 59 consultations of patients in a UK teaching hospital with new onset chest pain who had been referred for a specialist opinion in ambulatory care. We found that patients rarely gave a history that, without further interrogation, satisfied the doctors, who actively restructured the complex narrative until it fitted a diagnostic canon, detaching it from the patient's interpretation and explanation. A minority of doctors asked about chest pain symptoms outside the canon. Re-structuring into the canonical classification was sometimes resisted by patients who contested key concepts, like exertion. Symptom narratives were sometimes unstable, with central features changing on interrogation and re-telling. When translation was required for South Asian patients, doctors considered the history less relevant to the diagnosis. Diagnosis and effective treatment could be enhanced by research on the diagnostic and prognostic value of the terms patients use to describe their symptoms.
This study sought to better understand the cultural meaning of adulthood and disability in a large city in central Mexico. Using an ethnographic case study research design that included interviews and observations, this study addressed the research question: What is the cultural meaning and accompanying challenges of becoming an adult with…
Couch, Stephanie R.
This ethnographic study answers calls for research into the ways that virtual organizations (or innovation-driven collaborative teams) form and develop, what supports and constraints their development, and the leadership models that support the organizations' work. The study examines how a virtual organization emerged from an intersegmental…
Owens, Dorothea Jody
This ethnographic case study examines the dynamic relationship between culture and environmental education within the context of a specific Florida-based public education program. The School District of Hillsborough County (SDHC) offers the program through a three-day field trip to the study site, Nature's Classroom, and accompanying classroom…
McKee, Ann Marie
This is an ethnographic case study of the inclusion of a fifteen-year-old male with severe disabilities in general education classes in a four-year high school in a medium-sized Midwestern city. The study took place during the student's freshman and sophomore years. The investigator interviewed 17 of the participants in the student's inclusion;…
The study on which this paper is based examined the experiences of students in order to develop a theoretical and empirically grounded account of the dynamic social forces of inclusion and exclusion experienced by youth in their unique contexts of North American urban schooling. The ethnographic scenes, organized into four "beats,"…
Antonijevic, Smiljana; Cahoy, Ellysa Stern
This paper presents findings of a Mellon Foundation-funded study conducted at Penn State University in University Park during Fall 2012 that explored scholars' information practices across disciplines encompassing the sciences, humanities, and social sciences. Drawing on results of the Web-based survey and ethnographic interviews, we present…
Ethnography is a prominent research methodology in the recent times. It is popular not only in the field of Anthropology but also in many other social sciences. My doctorate thesis was also conducted through an ethnographic study examining the ways in which young Muslims of Indonesian background living in Australia construct their identity. In…
This study examined the instructional settings, pedagogical techniques, interpersonal dynamics and personal characteristics of a teacher and her adolescent students in a renowned private flute studio. Using ethnographic techniques including observations and interviews, four main themes emerged that seem to contribute to the satisfaction of the…
Rosser, Julee L.
In this research study, I sought to understand and describe the Women's and Gender Studies (WGS) Program at Berea College by exploring it through the experiences of students, faculty, administrators, and alumnae. I designed and implemented a feminist organizational ethnography. Organizational ethnography is a naturalistic, qualitative research…
Keating, David M; Rains, Stephen A
The reported study explored the implications of informal computer-mediated social support for the well-being of individuals coping with illness over the course of 3 years. A panel study was conducted in which respondents--bloggers writing about their experiences living with a health condition--reported on their perceptions of social support and well-being during 2010 and again during 2013. Among respondents who completed both questionnaires (n = 49), increases in support availability from family and friends were related to improvements in bloggers' health self-efficacy as well as improvements in bloggers' loneliness, particularly among those who also experienced increased support availability from blog readers. Increased blog reader support availability was associated with improvements in bloggers' health-related uncertainty. Among respondents who completed the initial questionnaire (N = 121), a survival analysis showed that neither support available from family and friends nor support from blog readers predicted continued health blogging over the 3-year period.
Averill, Jennifer B.
Objectives The objectives were to synthesize cumulative findings across three critical ethnographic, community-partnered studies in the southwestern United States and to describe the process of meta-ethnography for that analysis. Design The meta-ethnography followed the design of Noblit and Hare for constructing an analysis of composite data, informed by community-based participatory research and Stringer’s ethnographic strategies of Look-Think-Act. Sample The three studies occurred in rural settings of Colorado and New Mexico, engaging 129 total participants, along with community organizations and agencies as partners. Methods Methods consisted of detailed review of each original study, mapping of major concepts and themes, and general analysis, interpretation, and synthesis across the studies. Results Overall themes were: health is the capacity to care for oneself and do work, meaningful relationships are key in health care interactions, patterns of discrimination persist in rural settings, poor literacy and health literacy are barriers, and food insecurity is a growing concern for older rural adults. Conclusions Resolutions involve practice, policy and research and must incorporate all stakeholder groups in rural settings; a participatory approach is critical to prioritize and impact existing inequities; and work is needed to extend education and understanding of multiple cultures, groups, customs, and rural contexts. PMID:26416201
Gumpel, Thomas P; Zioni-Koren, Vered; Bekerman, Zvi
An ethnographic study in a 10th grade remedial class was undertaken in order to discern patterns of school bullying. Twenty 10th graders were observed over the course of one academic year as they interacted with their peers and teachers. The observations helped us identify dispositional and situational factors which influenced participant roles. In-depth interviews of students involved in school bullying showed how participants interpreted and explained their classroom behaviors. The analysis of the data gathered allowed the identification of four main actor roles recognized in the existing literature on bullying-the pure victim, the pure bully, the provocative-victim, and the bystander-as well as the differentiation between aggressive bullies and the bully managers. Most roles fluctuated according to specific circumstances and often appeared to be moderated by the teacher's management style and contextual variables. Some pupils assumed different roles in different contexts, sometimes changing roles within or between episodes. Teacher personality and style also had an impact on the frequencies and types of aggression and victimization. The use of an ethnographic research paradigm is discussed as an important supplement to positivistic studies of school bullying.
Todd, Nathan R
The current study provides an innovative examination of how and why religious networking organizations work for social justice in their local community. Similar to a coalition or community coordinating council, religious networking organizations are formal organizations comprised of individuals from multiple religious congregations who consistently meet to organize around a common goal. Based on over a year and a half of ethnographic participation in two separate religious networking organizations focused on community betterment and social justice, this study reports on the purpose and structure of these organizations, how each used networking to create social capital, and how religion was integrated into the organizations' social justice work. Findings contribute to the growing literature on social capital, empowering community settings, and the unique role of religious settings in promoting social justice. Implications for future research and practice also are discussed.
Oxford, John S; Oxford, Juliette R
From the time of the Spanish influenza pandemic in 1918 to the present seclusion of volunteers in quarantine units, either modified hotels, Phase I units or specially constructed clinics, have been key in investigating new vaccines and antivirals. Carefully selected healthy, young volunteers undergo a 10-12-day sojourn under intense medical supervision. Clinical sampling includes nasal and throat washes for virus recovery, blood for clinical chemistry, analysis of B- and T-cell response and, more recently, analysis of human genes responding to infection. The authors' studies are resulting in new developments of universal influenza vaccines that could stimulate and prime CD4 and CD8 cells to shared epitopes in all influenza A viruses. Ethnographic study has noted an absence of quarantine stress in the volunteers for the first time.
This ethnographic study examines how participatory spaces and citizenship are co-constituted in participatory healthcare improvement efforts. We propose a theoretical framework for participatory citizenship in which acts of citizenship in healthcare are understood in terms of the spaces they are in. Participatory spaces consist of material, temporal and social dimensions that constrain citizens’ actions. Participants draw on external resources to try to make participatory spaces more productive and collaborative, to connect and expand them. We identify three classes of tactics they use to do this: ‘plotting’, ‘transient combination’ and ‘interconnecting’. All tactics help participants assemble to a greater or lesser extent a less fragmented participatory landscape with more potential for positive impact on healthcare. Participants’ acts of citizenship both shape and are shaped by participatory spaces. To understand participatory citizenship, we should take spatiality into account, and track the ongoing spatial negotiations and productions through which people can improve healthcare. PMID:26038612
Buchanan, Marla; Keats, Patrice
Journalists who witness trauma and disaster events are at risk for physical, emotional, and psychological injury. The purpose of this paper is to present the results of a critical ethnographic study among 31 Canadian journalists and photojournalists with regard to coping strategies used to buffer the effects of being exposed to trauma and disaster events and work-related stress. The findings are the result of in-depth individual interviews and six workplace observations with journalists across Canada. The most commonly reported coping strategies were: avoidance strategies at work, use of black humor, controlling one's emotions and memories, exercise and other physical activities, focusing on the technical aspects, and using substances. Recommendations for addressing the effects of work-related stress within this population are provided.
Heydari, Abbas; Najar, Ali Vafaee; Bakhshi, Mahmoud
Background: Nurses are the main users of supplies and equipment applied in the Intensive Care Units (ICUs) which are high-priced and costly. Therefore, understanding ICU nurses’ experiences about resource management contributes to the better control of the costs. Objectives: This study aimed to investigate the culture of nurses’ working environment regarding the resource management in the ICUs in Iran. Patients and Methods: In this study, a focused ethnographic method was used. Twenty-eight informants among ICU nurses and other professional individuals were purposively selected and interviewed. As well, 400 hours of ethnographic observations as a participant observer was used for data gathering. Data analysis was performed using the methods described by Miles and Huberman (1994). Results: Two main themes describing the culture of ICU nurses regarding resource management included (a) consumption monitoring and auditing, and (b) prudent use. The results revealed that the efforts for resource management are conducted in the conditions of scarcity and uncertainty in supply. ICU nurses had a sense of futurism in the supply and use of resources in the unit and do the planning through taking the rules and guidelines as well as the available resources and their values into account. Improper storage of some supplies and equipment was a reaction to this uncertain condition among nurses. Conclusions: To manage the resources effectively, improvement of supply chain management in hospital seems essential. It is also necessary to hold educational classes in order to enhance the nurses’ awareness on effective supply chain and storage of the items in the unit stock. PMID:26889097
Sakellaris, George S; Charissis, Giorgos C
The aim of the study was to compare historical features, physical examination findings, and testicular color Doppler ultrasound in pediatric patients with epididymitis compared to testicular torsion and torsion of the appendix testes. A retrospective review of the medical records of 66 boys presenting with clinical aspects of acute scrotum over a 3-year period was performed. Sixty-six patients were included in the study (29 with epididymitis, 8 with testicular torsion and 12 with torsion of the appendix testis, 4 with scrotal abscesses, 5 with scrotal swelling, and 1 with inflamed epididymal cyst). The duration of symptoms ranged from 6 h to 4 days with a peak on the second day. Urine cultures and viral testes were negative in all patients. Color Doppler ultrasound was diagnostic for epididymitis in 28 patients (96.6%). Systemic intravenous antibiotics were given in all 29 patients with epididymitis. No patient showed signs of testicular atrophy in the follow-up. The increasing incidence of epididymitis should question the policy of routine exploration of the acute scrotum in children. The history and physical examination cannot reliably identify those boys who can be managed conservatively. Color Doppler ultrasound is a useful adjunct in the evaluation of the acute scrotum when physical findings are equivocal but it can also be misleading.
Rice-Lively, Mary Lynn
Describes an ethnographic study of the electronic community comprised of masters and doctoral students involved in a seminar on networking. Ethnographic research facilitated observation and description of the networked learning community. The exploration of the cultural meaning of class events led to enhanced understanding of online education and…
Crowell, Amanda; Kuhn, Deanna
Argumentation is increasingly recognized as a fundamental intellectual skill, but evidence suggests that few adolescents or adults are skilled arguers. This article reports on an extended (3-year, twice weekly) intervention designed to afford dense practice in dialogic argumentation to middle-school students from traditionally academically…
Fullilove, M T; Green, L; Fullilove, R E
OBJECTIVES: One factor contributing to the decay of inner-city areas, and to consequent excess mortality, is the massive loss of housing. This report studied the effects of a redevelopment project on social functioning in an inner-city community. METHODS: This ethnographic study included the following elements: a longitudinal study of 10 families living in renovated housing, repeated observations and photographing of the street scene, focus groups, and informal interviews with area residents. The project was located in the Bradhurst section of Harlem in New York City and was focused on a redevelopment effort sponsored by local congregations. RESULTS: Those who were able to move into newly renovated housing found that their living conditions were greatly improved. Neighborhood revitalization lagged behind the rehabilitation of individual apartment houses. This uneven redevelopment was a visual and sensory reminder of "what had been." Residents missed the warmth and social support that existed in Harlem before its decline. CONCLUSIONS: Rebuilding damaged housing contributes greatly to the well-being of inner-city residents. The current pace and scope of rebuilding are insufficient to restore lost vitality. Images FIGURE 1 PMID:10358672
The medium of television is an important manifestation of popular culture. Television stories and images frequently represent the position occupied by science and scientists in society. This study focuses on three questions. First, what is the form and content of the science that is constructed on television programs in which high school students see science? Second, how do television practitioners who deal with science approach and think about their work? Third, in what ways do high school students appropriate the science in these programs? Ethnographic methods, which did not include the technique of participant observation, were used to address these questions. Two types of text provided the basis for ethnographic analysis. First, text whose production was beyond the control of the researcher was used in the form of approximately 10 hours of programming, which included both fictional and non-fictional genres. Selection was based upon the results of questionnaires, in which students were asked to list those programs in which they saw the most science together with their reasons for each choice. Second, text whose production was somewhat within my control as researcher was used in the form of transcripts of interviews with television practitioners and students. In addition, written responses to the researcher's questions and transcripts of student discussion groups are texts that fall into this second category. The findings point to the centrality of the notion of the nature of science, which is constructed by a variety of factors. These include, first, story---representing events, people and the process of science on television. Story is shaped by plot, discourse, characters and genre. Second, images work to construct a nature of science and, in turn, constitute choices made about the composition, sequence and duration of shots. Third, who the television practitioners who produce a program are in conjunction with the culture of the institution they work for
Prewitt Diaz, Joseph O.; And Others
This report re-examines previously gathered ethnographic data derived from approximately 3,000 hours of interviews with migrants across the United States to determine what factors associated with migration affect children's educational outcomes. The data suggest the existence of a "culture of migrancy," which is manifested in similar…
Cooper, Joseph H.
The development of faith-based missionary aviation is a post-World War II phenomenon. The war effort demonstrated the value, utility, and global reach of aviation to remote, underdeveloped areas of the world. With the beginnings of a worldwide infrastructure for aviation, Christian aviators realized aviation could increase the range and effectiveness of their efforts to reach the world for Christ (Mellis, 2006). Although individual organizations provide statistical information and data about flight operations there is a lack of external evidence and relevant research literature confirming the scope and value of these faith based aviation organizations and operations. A qualitative, ethnographic study was conducted to document the activities of one faith-based aviation organization to gain an understanding of this little known aspect of civilian aviation. The study was conducted with Missionary Flights International (MFI) of Fort Pierce, FL which has been involved in faith-based, missionary aviation since its inception in 1964. As an aviation organization "MFI strives to offer affiliated missions the kind of efficient service and professionalism expected of an airline operation" (Missionary Flights International, 2013, p.1). MFI is a lifeline for missionaries to Haiti and the Dominican Republic, fulfilling their motto of "Standing in the Gap". MFI provides twice a week service to the island of Hispaniola and the Republic of Haiti. In this in-depth study insight and understanding was gained into the purpose of MFI, their daily routines and operations, and the challenges they face in maintaining their flight services to Haiti. This study provided documentation of the value and utility of such aviation efforts and of the individuals involved in this endeavor.
Jensen, Peter S.; Arnold, L. Eugene; Swanson, James M.; Vitiello, Benedetto; Abikoff, Howard B.; Greenhill, Laurence L.; Hechtman, Lily; Hinshaw, Stephen P.; Pelham, William E.; Wells, Karen C.; Conners, C. Keith; Elliott, Glen R.; Epstein, Jeffery N.; Hoza, Betsy; March, John S.; Molina, Brooke S. G.; Newcorn, Jeffrey H.; Severe, Joanne B.; Wigal, Timothy; Gibbons, Robert D.; Hur, Kwan
Objective: In the intent-to-treat analysis of the Multimodal Treatment Study of Children With ADHD (MTA), the effects of medication management (MedMgt), behavior therapy (Beh), their combination (Comb), and usual community care (CC) differed at 14 and 24 months due to superiority of treatments that used the MTA medication algorithm (Comb+MedMgt)…
Ribeiro, Fabiane Alves de Carvalho; de Moraes, Micaele Kedma Ribeiro; Caixeta, Joyce Cristina de Morais; da Silva, Jullieth Nadja; Lima, Amanda Sanches; Parreira, Samara Lamounier Santana; Fernandes, Viviane Lemos Silva
Objective: To analyze the perception of parents about secondhand smoking in their children's health. Methods: Ethnographic qualitative and quantitative study. We sought the point of view and understanding of the parents who were active smokers in relation to environmental tobacco smoke (ETS) and secondhand smoking. Mothers and fathers who are active smokers and that live with their children from seven different public schools in the city of Anápolis, Midwest Brazil, were interviewed in the first semester of in a reserved room in the schools. A descriptive and qualitative analysis was carried out through the ethnography. Results: 58 parents with an average time of smoking of 15.3 years and an average quantity of cigarettes smoked per day of 2 were interviewed. Among them, 59% did not know what ETS was, and 60% stated knowing what a secondhand smoker was. However, when questioned about their children as secondhand smokers, 52% did not consider them to be. Some parents knew some of the effects of secondhand smoking in the health of their children. However, the majority (52%) of them did not believe that their children would suffer any respiratory impairment or did not know about these impairments. Conclusions: Children were exposed to environmental tobacco pollution in their residence if one considers parental duration of smoking and average of cigarettes smoked per day. There was a lack of knowledge of the parents about ETS, secondhand smoking and the evils that cigarettes could cause in the health of their children. PMID:26298662
Poltorak, Mike; Leach, Melissa; Fairhead, James; Cassell, Jackie
In the context of the high-profile controversy that has unfolded in the UK around the measles, mumps and rubella (MMR) vaccine and its possible adverse effects, this paper explores how parents in Brighton, southern England, are thinking about MMR for their own children. Research focusing on parents' engagement with MMR has been dominated by analysis of the proximate influences on their choices, and in particular scientific and media information, which have led health policy to focus on information and education campaigns. This paper reports ethnographic work including narratives by mothers in Brighton. Our work questions such reasoning in showing how wider personal and social issues shape parents' immunisation actions. The narratives by mothers show how practices around MMR are shaped by personal histories, by birth experiences and related feelings of control, by family health histories, by their readings of their child's health and particular strengths and vulnerabilities, by particular engagements with health services, by processes building or undermining confidence, and by friendships and conversations with others, which are themselves shaped by wider social differences and transformations. Although many see vaccination as a personal decision which must respond to the particularities of a child's immune system, 'MMR talk', which affirms these conceptualisations, has become a social phenomenon in itself. These perspectives suggest ways in which people's engagements with MMR reflect wider changes in their relations with science and the state.
Gold, M A; Friedman, S B
Cadet basic training (CBT) at the U.S. Military Academy at West Point is an initial cadet experience designed to transition freshmen (new cadets) into the military. Challenge is an inherent component of CBT, and some challenging activities may be stressful. However, the nature and the impact of stress on health status have not been systematically investigated. An ethnographic technique, participant observation, was used to identify stressors and coping strategies among cadets aged 18 to 21 years participating in CBT. A company of 183 cadets, consisting of 123 new cadets and 60 supervising upperclass cadets from the U.S. Military Academy, was followed throughout the 6-week CBT in the summer of 1993. The investigator observed daily activities and participated in select field training experiences. Daily field observations were taped, and field notes were generated chronicling the experience. After CBT, 10 of the 60 upperclass cadets participated in a 20-minute structured interview. Field and interview notes were systematically reviewed to identify and categorize stressors and coping techniques. Stressors included anticipatory stress, time management pressures, sleep deprivation, performance evaluations, conflicts between teamwork and competitive grading, and inexperience in the leadership role. Coping techniques identified included perceiving social support, humor, and rationalization. Three new hypotheses were generated from the observations.
This study, which is part of a larger longitudinal ethnographic study of young deaf children, reports on deaf children's use of fingerspelling. The children observed were early signers using Swedish Sign Language (SSL) in communication with teachers and peers. This study centres on the functions of fingerspelling in the children's everyday…
Matsuoka, J.K; Minerbi, L.; Kanahele, P.; Kelly, M.; Barney-Campbell, N.; Saulsbury; Trettin, L.D.
This report makes available and archives the background scientific data and related information collected for an ethnographic study of selected areas on the islands of Hawaii and Maui. The task was undertaken during preparation of an environmental impact statement for Phases 3 and 4 of the Hawaii Geothermal Project (HGP) as defined by the state of Hawaii in its April 1989 proposal to Congress. Since the state of Hawaii is no longer pursuing or planning to pursue the HGP, DOE considers the project to be terminated. Information is included on the ethnohistory of Puna and southeast Maui; ethnographic fieldwork comparing Puna and southeast Maui; and Pele beliefs, customs, and practices.
Brown, Lorraine; Holloway, Immy
Using findings from an ethnographic study of international postgraduate students at a university in the south of England, this article offers a model of adjustment that is informed by the duration of the sojourn, from the initial stage to the month of students' departure from England. This study found that stress was at its height in the initial…
Mertin, Patricia Anne
This ethnographic study examines the role of Japanese students' culture and its effects on the rate of acquisition of academic English. It is based on observation of classes in Japanese schools, both in Japan and Germany, as well as in an international school, together with interviews, questionnaires, student responses and case studies over a…
The purpose of this study is to direct attention inside the walls of a juvenile correctional facility to closely examine the experiences and daily lives of adolescent inmates. The ethnographic data for this study were collected through participant-observation and extended interactions in a cottage for violent male offenders in one state's…
Krutilla, Jennifer O.; And Others
This pilot study used a multidisciplinary, ethnographic approach to evaluate effects of prenatal drug exposure on four cocaine/polydrug-exposed infants and their rural mothers/caregivers and to begin development of a model training program. The study involved document review of hospital and social services records, participant observation,…
“Healing circle” is a term that has been employed by a group of Northern California integrative medicine researchers as we embarked on an 8-year ethnographic study. As a clinical medical anthropologist and registered nurse specializing in integrative practice and behavioral health, I undertook this study with colleagues from various health disciplines. PMID:25105070
This is an ethnographic study of the literacy practices of a group of rural Northeastern Thai women participating in a community-based literacy programme. Field research for the study examined the women's literacy practices and domains of literacy use in daily life, and the strategies they used to negotiate day-to-day life tasks in the context of…
In this article, the author presents an ethnographic study that investigated the relationships that evolve when professional nurses who own a home health care agency write for multiple, conflicting corporate discourse communities, including their lawyers, management consultants, and marketing professionals. This study revealed that conflicting…
This ethnographic study of language shows the importance of educators' appropriate use of linguistic, nonlinguistic, and paralinguistic communication techniques when working with elementary students within two classrooms who have behavioral and emotional disorders. This study focused on communication techniques used by teachers and…
Bennett, Adrian T.
An ethnographic study of the intake process involving the formal assessment, placement, and educational programming of 12 Hispanic deaf/hearing impaired children, aged 3-8, in both a private school for the deaf and the New York City public schools, was conducted over a 2-year period (1984-1986). Participant observation, interviewing, and…
Kwon, Soonjung; Kristjánsson, Kristján; Walker, David I.
This article explores some of the hidden background behind the highly praised school results in South Korea. An ethnographic case study is used to cast light on how schooling is actually experienced by South Korean students. Two main results are reported from these data. First, evidence is presented of damaging "cultural elements" such…
Elsey, Christopher; Challinor, Alexander; Monrouxe, Lynn V.
Bedside teaching encounters (BTEs) involve doctor-patient-student interactions, providing opportunities for students to learn with, from and about patients. How the differing concerns of patient care and student education are balanced in situ remains largely unknown and undefined. This video ethnographic study explores "patient…
Canieso-Doronila, Maria Luisa
Thirteen marginal Philippine communities were examined in an ethnographic study of the meaning of functional literacy and whether literacy invariably promotes development. The 13 sites were purposely selected to provide a broad sampling from three standpoints: (1) major livelihood and form of economic activity (farming, fishing, urban poor,…
Kinsley, Kirsten M.; Schoonover, Dan; Spitler, Jasmine
In this study, researchers sought to capture students' authentic experience of finding books in the main library using a GoPro camera and the think-aloud protocol. The GoPro provided a first-person perspective and was an effective ethnographic tool for observing a student's individual experience, while also demonstrating what tools they use to…
Millroy, Wendy Lesley
The researcher conducted a six-month ethnographic study as an apprentice carpenter in Cape Town, South Africa, to document the valid mathematical ideas that are embedded in the everyday woodworking activities of a group of carpenters. A secondary objective was to examine and to give a firsthand account of the teaching and learning of mathematical…
Lawrence, Barbara Kent
This report overviews the rationale for conducting an ethnographic study of cultural factors that influence student aspiration in Tremont, a small rural community on Mount Desert Island, Maine. Although Tremont is the poorest community on Mount Desert Island, Tremont students scored as well or better on the Maine Educational Assessment than did…
Hangartner, Judith; Svaton, Carla Jana
This article discusses insights from an ethnographic study of local governance practices in the Canton of Bern, Switzerland, under changing policy conditions. Recent reforms introduced and strengthened the position of head teachers, enhanced the responsibility of the municipalities and introduced new quality management procedures in local…
Jenlink, Patrick M.
The purpose of this critical ethnographic study was to examine the nature and meaning of cultural ecology in relation to preparing scholar-practitioner leaders. The ethnography focused on how the discourses and practices within the disciplinary setting of leadership preparation shape the identity of social scholar-practitioner leaders. The…
Educational research is increasingly turning to conceptual frameworks from a range of disciplines in order to enrich understandings of education, pedagogy and learning. This paper draws on the work of Henri Lefebvre, specifically rhythmanalysis, to explore the nature and the function of pedagogy. The context is an ethnographic study of parenting…
The qualitative ethnographic study involved exploring the educational, background, and professional experiences of senior-level African American administrators in higher education. The following research question guided the exploration of the experiences and perceptions of African American administrators in higher education from the Mid-Atlantic…
Yusop, Farrah Dina; Correia, Ana-Paula
This ethnographic study took place in a graduate course at a large research university in the Midwestern United States. It presents an in-depth examination of the experiences and challenges of a group of four students learning to be Instructional Design and Technology professionals who are concerned with the well-being of all members of a society,…
Campbell, Cheri Ellis
An ethnographic study examined instructor uses of control, immediacy, and affinity-seeking behaviors in a large college lecture class. A class of 140 college sophomores was observed for 10 weeks, in an attempt to understand in a situational and non-quantitative manner, what instructor behaviors motivate students toward cognitive and affective…
Hovde, Marjorie Rush
Examines computer documentation writers' tactics for conceiving of their audiences. Describes and evaluates technical communicators' tactics for understanding audiences, constrained and supported by their organizations based on two ethnographic case studies and insights from activity theory. Discusses the advantages and limitations of each tactic,…
The ethnographic research presented in this paper consists of two parts developed chronologically. The first part is based on a study (Corona, V., Nussbaum, L., & Unamuno, V. . The emergence of new linguistic repertoires among Barcelona's youth of Latin American origin. "International Journal of Bilingual Education and…
The study involved 16 American undergraduate students who used weekly blogs and conducted ethnographic interviews with native speakers to develop their intercultural competence over the course of one semester abroad. Selected blog entries, post-surveys, and final interviews were collected and analyzed to report the findings. The results show that…
Russell, Lisa; Simmons, Robin; Thompson, Ron
This paper discusses the findings from a one-year ethnographic study of young people attending Entry to Employment (E2E) programmes in two local authorities in the north of England. The paper locates E2E within the broader context of provision for low-achieving young people and of UK government policy on reducing the proportion of young people who…
An ethnographic study examined the role of language, discrimination, and aspirations in the school success of Latino students in a small rural town. The town, located about 1,000 miles from Mexico and about 200 miles from any sizeable Latino community, contains about 200 Latinos. Almost all are Mexicans or Mexican Americans and have come to work…
Martos-Garcia, Daniel; Devis-Devis, Jose; Sparkes, Andrew C.
Drawing on data generated by a two-year ethnographic study in a high security Spanish prison, this article explores the multiple meanings given to the social practices of sport and physical activity. We provide details of the following key themes that emerged from the analysis: (a) escaping time; (b) perceived therapeutic benefits; (c) social…
Lemes, Maria Madalena Del Duqui; Bastos, Marisa Antonini Ribeiro
This ethnographic study aimed to understand a nursing team's experience on the maintenance of potential organ donors. Data were collected through ethnographic interview, participative observation and documental analysis and analyzed in thematic, cultural domain and taxonomical terms. The research enabled us to identify the meaning of brain death, revealing the interrelation between the categories (units, nursing team and patient), which constituted this study main theme: "it is not a person". The transplant meaning held by the nursing team is marked by disbelief due to some previous experiences in the Intensive Therapy Unit. Thus, beliefs and values of this subculture interfere or determine a distancing from the patient with a consequent loss in the maintenance of the potential donor and quality of the organs donated.
Miller, Michelle A.
With the introduction of the Post-9/11 GI Bill, there is an influx of active-duty military and student veterans enrolling in postsecondary and graduate-level education. The role of an academic advisor increases significantly with this influx of enrollment. The purpose of this study was to determine how a graduate-level academic advisor perceives…
Chen, Angela Chuan-Ru; Rhoads, Robert A.
This article examines staff and faculty allies working to help meet the needs of undocumented students at a large research university in the western region of the U.S. Drawing on scholarly work rooted in critical race theory and ethnic studies, the authors highlight forms of transformative resistance. They focus on four key findings: (1) student…
O'Connor, Thomas St James; Meakes, Elizabeth
What are the sources and definitions of theological reflection developed by Canadian practitioners of pastoral care and counseling? This study is part of a larger qualitative research project on theological reflection. This research reviews the literature, describes the ethnographic method, and presents the findings with a sample of 75. Main sources are sacred texts, personal experience, experiences of clients, and traditions of faith group. Definitions are meaning making, discovering the divine and discipleship with recommendations for future research listed.
Mirhaghi, Amir; Heydari, Abbas; Ebrahimi, Mohsen; Noghani Dokht Bahmani, Mohsen
Background Triage in the interactive atmosphere of the emergency department (ED) has been described as complex and challenging. Nonemergent ED visits have been accompanied by ethical and legal conflicts. Objectives The aim of this study was to gain an understanding of ED nurses’ practice regarding triage of nonemergent patients. Patients and Methods Focused micro-ethnography based on Spradley’s developmental research sequence (DRS) was used. This study was conducted in an emergency department. Data was collected through complete participant observations along with formal and informal interviews, and then analyzed using DRS. Results Nine key informants were interviewed formally. Four main categories emerged from the nurses’ culture: nonemergent patient as an uninvited guest, nonemergent patient as an elephant in a dark room, nonemergent patient as an aggressive client, and being nonemergency unless at risk of death. Conclusions Providing care in the emergency department is significantly affected by nonemergent patients, as the emergency department is a place for critically ill patients thus awareness training program is recommended. PMID:28180119
Patahuddin, Sitti Maesuri
This paper is a reflection on a model for mathematics teacher professional development with respect to technology. The model was informed by three interrelated concepts: (1) a theory of teacher professional development from analysis of the field, (2) the zone theory of teacher professional learning, and (3) ethnography as a method. The model was applied in a study that focused on the uses of the Internet for primary mathematics teacher professional development, particularly to exploit the potential of the Internet for professional learning and to use it in professional work. This is illustrated through selected critical events over an eight-month ethnographic intervention in a primary mathematics classroom in Australia. Though the model is theoretically grounded, it opens up questions about the power, potential, and challenges as well as its feasibility, with respect to not only the teacher but also the ethnographer.
Lee, Steven J; Levounis, Petros
Gamma hydroxybutyrate (GHB) is a psychoactive substance with complex neurophysiological activity and significant potential for abuse, addiction, and dangerous toxicity. In this study, a semistructured interview was administered to 17 subjects to investigate GHB use, including: manner of use; setting; positive and negative consequences; other drug history; and sexual practices. Respondents were overwhelmingly male, but otherwise had a broad demographic background. Settings varied from nightclubs to private use at home. There was significant variability in the drug obtained, which subjects found problematic because of the narrow therapeutic window and ease of accidental overdose. Common positive experiences included increased sexual desire, decreased sexual inhibitions, and decreased anxiety. Common negative consequences included oversedation, loss of consciousness, motor incoordination, and mental confusion. Nine subjects reported that they would use GHB again, some despite severe negative consequences. Although most subjects reported negative experiences, only three felt their use was problematic, and none sought treatment for GHB abuse or addiction. Subjects were highly drug-experienced, most commonly using MDMA, ketamine, cocaine, alcohol, and methamphetamine. Some reported that GHB could cause poor decision making in sexual situations. This effect has significant ramifications for issues such as date rape and control of sexually transmitted diseases, such as HIV.
Lochmiller, Chad R.
This article presents results from a study of leadership coaches who worked with novice principals in a university-based induction program for a 3-year period. The qualitative case study describes how the support the coaches provided to the novice principals changed over time. The study reveals that coaches adapted their leadership coaching…
Razquin, Cristina; Sanchez-Tainta, Ana; Salas-Salvadó, Jordi; Buil-Cosiales, Pilar; Corella, Dolores; Fito, Montserrat; Ros, Emilio; Estruch, Ramón; Arós, Fernando; Gómez-Gracia, Enrique; Fiol, Miquel; Lapetra, José; Serra-Majem, Luis; Pinto, Xavier; Schröder, Helmut; Tur, Josep; Sorlí, José V; Lamuela-Raventós, Rosa M; Bulló, Mónica; Bes-Rastrollo, Maira; Martinez-Gonzalez, Miguel A
The association of dietary energy density (ED) and overweight is not clear in the literature. Our aim was to study in 4259 of the PREDIMED trial whether an increase in dietary ED based on a higher adherence to a Mediterranean dietary pattern was associated with 3-year weight gain. A validated 137-item food-frequency questionnaire was administered. Multivariable-adjusted models were used to analyze the association between 3-year ED change and the subsequent 3-year body weight change. The most important weight reduction after 3-year follow-up was observed in the two lowest quintiles and the highest quintile of ED change. The highest ED increase was characterized by an increased intake of extra virgin olive oil (EVOO) and nuts and a decreased intake of other oils, vegetable and fruit consumption (p < .001). In conclusion, increased 3-year ED in the PREDIMED study, associated with a higher EVOO and nuts consumption, was not associated with weight gain.
Wylie, Cathy; Smith, Lesley
This study organized in 2 sections examined the progress of 32 New Zealand children during their first 3 years at school. Their achievement levels in reading, mathematics, and writing were examined based on interviews with the children, their teachers, and their parents; school records; notes; and video recordings. Section 1 deals with perceptions…
Gottfredson, Denise C.; Kearley, Brook W.; Najaka, Stacy S.; Rocha, Carlos M.
This study reports results from interviews with 157 research participants who were interviewed 3 years after randomization into treatment and control conditions in the evaluation of the Baltimore City Drug Treatment Court. The interviews asked about crime, substance use, welfare, employment, education, mental and physical health, and family and…
Kyle, Fiona E.; Harris, Margaret
The development of reading ability in a group of deaf children was followed over a 3-year period. A total of 29 deaf children (7-8 years of age at the first assessment) participated in the study, and every 12 months they were given a battery of literacy, cognitive, and language tasks. Earlier vocabulary and speechreading skills predicted…
This longitudinal study tested the veracity of one candidate multiple-deficits account of autism by assessing 37 children with autism (M age = 67.9 months) and 31 typical children (M age = 65.2 months) on tasks tapping components of theory of mind (ToM), executive function (EF), and central coherence (CC) at intake and again 3 years later. As a…
Cornish, Kim; Cole, Victoria; Longhi, Elena; Karmiloff-Smith, Annette; Scerif, Gaia
Basic attentional processes and their impact on developmental trajectories in fragile X syndrome were assessed in a 3-year prospective study. Although fragile X syndrome is a monogenic X-linked disorder, there is striking variability in outcomes even in young boys with the condition. Attention is a key factor constraining interactions with the…
Ando, Ryoichi; Yama, Satomi; Ohnishi, Tsuyoshi; Iwamoto, Shunsuke; Kimura, Hitoshi; Chida, Yoshiko; Ishida, Yuji; Yamada, Kouei; Inagaki, Yuichiro; Takayama, Masanobu; Tachibana, Ken; Kikuchi, Kan; Inoue, Atsushi; Ohtsuka, Masakazu
We previously conducted a multicenter study enrolling 101 dialysis patients with hyperphosphatemia in which lanthanum carbonate (LC) was administered for 2 years. In this study, the administration has been continued for an additional year, and we have evaluated the long-term (a total of 3 years) effects of LC. The average serum phosphorus (P) level was 6.05 mg/dL at the start and decreased to 5.84 mg/dL after 3 years, but no significant differences were observed at both points. The average serum corrected calcium (Ca) level significantly reduced after 3 years (P < 0.001). As results of evaluating the achievement rates with the management target values of serum P, Ca and intact parathyroid hormone (PTH) stated in the Japanese guideline, the achievement rates increased after 3 years. From these results, LC is considered to be a useful P binder that can be used for long-term treatment of hyperphosphatemia, without causing a Ca load.
Morton, Christine H.; Hsu, Clarissa
In this article, we examine key dilemmas childbirth educators experienced as they made crucial decisions about the content and format of their classes in the current U.S. maternity-care context. This ethnographic study demonstrates that childbirth education is a cultural phenomenon with deeply embedded values regarding the nature and importance of information, scientific evidence, and consumer choice. Articulating how culture shapes the presentation, content, and format of childbirth classes is an important step in understanding and increasing the relevance of this experience for birthing women. PMID:18769518
Beach, Dennis; Player-Koro, Catarina
Two related ethnographic research projects on mathematics teacher education in Sweden are presented in this paper. They represent a response to recent policy developments that reaffirm the value of authoritative subject studies content as the central and most important component in the professional knowledge base of would-be teachers and…
Akhter, R; Morita, M; Esaki, M; Nakamura, K; Kanehira, T
The aims of this study were to examine the incidence of temporomandibular disorders (TMDs) over a 3-year period and to evaluate the risk of self-reported TMDs among university students in Japan. The study population comprised 2374 university students examined at the start of their undergraduate course and 492 students re-examined after 3 years using questionnaires on symptoms of TMD and experiences of jaw injury, stress, orthodontic treatment and parafunctional habits. Cumulative incidence (%) and relative risks were calculated overall. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to determine the degree of risks of these variables for symptoms of TMDs using logistic regression. Results of logistic regression analysis showed that male subjects with experience of jaw injury had a 3·54 (CI=1·45-8·68, P<0·01)-fold higher risk of temporomandibular joint (TMJ) pain than that for those who did not. Female subjects who reported experiencing stress and bruxism had 10·56 (CI=1·28-87·54, P<0·05)- and 5·00 (CI=1·21-20·71, P<0·05)-fold higher risks of TMJ sound, respectively, than the risk for female subjects who had not experienced stress or bruxism. The results indicated that experiences of jaw injury, stress and bruxism were significantly associated with increased risks of development of TMJ disorders in a 3-year cohort.
Yeh, Yueh-Chen; St John, Winsome; Venturato, Lorraine
Traditionally Chinese and Taiwanese postpartum women conducted postpartum ritual practices, called "doing the month," at home. Today, many Taiwanese women undertake this ritual in postpartum nursing centers. However, little is known about how the traditional practices are being transformed in relation to contemporary health care in Taiwan. In this ethnographic study observations were carried out in a large post-partum center attached to a major hospital in Taipei for nine months, and 27 postpartum women were interviewed. Data were analyzed using ethnographic approaches to extract codes and categories. Doing the month was reshaped by being relocated from the home to a healthcare setting. Midwives took on roles traditionally taken by family members, which had an impact on family roles and relationships. Some postpartum practices were maintained, based on traditional explanations. However, many were modified or challenged, based on explanations from contemporary scientific knowledge. Midwives need to be aware that there could be differences between their culture of care and the cultural values of the women they care for. This study informs culturally appropriate postpartum care and support for women with traditional and contemporary cultural beliefs and attitudes to doing the month in a range of healthcare contexts.
Löffler, Harald; Bruckner, Thomas; Diepgen, Thomas; Effendy, Isaak
Irritant contact dermatitis is a mayor problem in health care employees. Because educational programs have shown convincing success in certain occupations (e.g. in hairdressers), this study investigates the effect of a special training program in health care trainees. 521 trainees from 14 nursing schools in Central Germany were randomly divided in 2 groups, (i) an intervention group with a regular teaching protocol regarding all aspects of primary prevention and (ii) a control group without any further teaching. Morphological changes of the hands, use of hand care creams and knowledge regarding skin care were evaluated regularly during their 3 years lasting training period (1999-2002). In the intervention group, we found at the end of the 3-year training period a significant better skin condition of the hands than in the control group: a 3-year prevalence of morphological skin changes of 66.7% versus 89.3%. The unteached trainees (control group) had an odds ratio (OR) of 4.8 [95% confidential interval (CI): 2.9-7.8] for developing any skin changes on the hands after 3 years. Besides the effect of the teaching, the history of hand dermatitis before the study start was an independent risk factor for development of further hand dermatitis [OR 1.9, 95% CI: 1.0-3.6). Age and sex showed no influence on the skin condition. Atopic constitution had an influence on the development of skin changes only at the evaluation after 18 month. The observed effect in the intervention group may best be explained by different behaviour of the trainees, e.g. the amount of hand washing was reduced, while procedure of hand disinfection remained unchanged compared with the control group. However, the amount of used skin care cream did not differ between the both groups. This study shows that primary prevention of skin disease by regularly teaching during the training period of medical employees can effectively reduce the risk of development of irritant skin changes of the hands. Therefore
Smith, Valerie J
SCHOLARLY STUDIES OF REFUGEES and other vulnerable populations carry special ethical concerns. In this invited case study of Afghan refugees in Fremont, California, I provide illustrations and recommendations of ethical research methods with refugees. I also compare and contrast some ethical issues in the U.S. with issues in Thailand. The qualitative, ethnographic methods I report here demonstrate how to conduct culturally sensitive investigations by ethically approaching gatekeepers and other community members to preserve autonomy, ensure confidentiality, build trust, and improve the accuracy of interpretations and results. Six groups at risk for being marginalized in multiple ways within refugee populations are described. Ten best practices are recommended for ethically acquiring an in-depth understanding of the refugees, their community, and appropriate research methods.
This auto-ethnographic study describes the changes in the author's thinking and clinical work connected to her first-hand experience of Open Dialogue, which is an innovative, psychosocial approach to severe psychiatric crises developed in Tornio, Finland. In charting this trajectory, there is an emphasis on three interrelated themes: the micropolitics of U.S. managed mental health care; the practice of "dialogicality" in Open Dialogue; and the historical, cultural, and scientific shifts that are encouraging the adaptation of Open Dialogue in the United States. The work of Gregory Bateson provides a conceptual framework that makes sense of the author's experience and the larger trends. The study portrays and underscores how family and network practices are essential to responding to psychiatric crises and should not be abandoned in favor of a reductionist, biomedical model.
This paper presents a study of children's use of fingerspelling. It is part of a larger longitudinal ethnographic study of deaf children, who were 3-6 years old when the study started. They are early signers using Swedish Sign Language in communication with teachers and peers. The aim of this paper is to examine the different functions which…
Blakely, Gillian; Hennessy, Catherine; Chung, Man C.; Skirton, Heather
As part of an ethnographic study, the impact of foreign postings on spouses who accompany military personnel was explored. Individual interviews and focus groups with 34 British military spouses based in one location in southern Europe were conducted. Key findings suggested that reaction to a foreign posting was a reflection of personal attitudes, prior experiences, support, ability to adjust to change and strength of relationship with the serving spouse and community. For many the experience was positive due to the increased opportunity for family time, for others this helped to compensate for the difficulties experienced. Some military spouses experienced significant distress on the posting, particularly if the family was not well-supported. The potential implications of military spouses not adapting to foreign postings have significant implications for healthcare practice. Provision of more appropriate support resources before and during the posting would facilitate the transition for the military spouse and their family. PMID:26973933
Snape, D; Wang, W; Wu, J; Jacoby, A; Baker, G A
Epilepsy represents one of the major brain disorders worldwide. In China, research into how much people with epilepsy know about their condition appears limited. Drawing on data collected as part of a large ethnographic study, we present the experiences and views of Chinese people with epilepsy and their family members, to identify knowledge gaps and uncertainties about epilepsy within selected urban and rural communities. We also examine how respondents' demographic characteristics influence their knowledge, understanding, and beliefs about epilepsy. We found knowledge and understanding of epilepsy to be uneven and context specific. Hereditary factors were most frequently cited as a potential cause, although their impact remained unclear. Western medicalization of epilepsy appears less evident in the reports of rural informants, where traditional beliefs continue to shape definitions and treatment. Societal differences within these communities set boundaries on knowledge acquisition. Plotted against these differences, we suggest strategies for proposed educational/psychosocial intervention programs.
Blakely, Gillian; Hennessy, Catherine; Chung, Man C; Skirton, Heather
As part of an ethnographic study, the impact of foreign postings on spouses who accompany military personnel was explored. Individual interviews and focus groups with 34 British military spouses based in one location in southern Europe were conducted. Key findings suggested that reaction to a foreign posting was a reflection of personal attitudes, prior experiences, support, ability to adjust to change and strength of relationship with the serving spouse and community. For many the experience was positive due to the increased opportunity for family time, for others this helped to compensate for the difficulties experienced. Some military spouses experienced significant distress on the posting, particularly if the family was not well-supported. The potential implications of military spouses not adapting to foreign postings have significant implications for healthcare practice. Provision of more appropriate support resources before and during the posting would facilitate the transition for the military spouse and their family.
This ethnographic case study offers insight into religiously devout sexual minorities and the reasons behind their continued participation in an anti-gay religious institution, the Roman Catholic Church. I demonstrate how members of Dignity, an organization for gay, lesbian, bisexual, and transgender (LGBT) Catholics, strategically use their identity as gay Catholics to initiate action, to build community, and to destigmatize other religious sexual minorities. Members leverage this unique identity to push for change and equality within the Church. At the same time, this identity also allows members to see their continued participation in the anti-gay Roman Catholic Church as activism, a positive and affirming identity, thereby alleviating potential conflict and contradiction between their sexuality and their spirituality as Roman Catholics.
Dierschke, Nicole; Lowe, Diana; Plastino, Kristen
Objectives. To assess whether a sexual health education intervention reduces pregnancy rates in high school students. Methods. We performed a secondary analysis of a 3-year quasi-experimental study performed in South Texas from 2011 to 2015 in which 1437 students without a history of pregnancy at baseline were surveyed each fall and spring. Potentially confounding risk factors considered included sexual behaviors, intentions, and demographics. The outcome measure was self-reported pregnancy status for male and female students. We performed analyses for male and female students using separate discrete time-to-event models. Results. We found no difference in pregnancy rates between intervention and comparison students within the first 3 years of high school. Female and male students in the intervention groups had pregnancy hazard ratios of, respectively, 1.62 (95% CI = 0.9, 2.61; P = .1) and 0.78 (95% CI = 0.44, 1.48; P = .4) relative to the comparison groups. Conclusions. The educational intervention had no impact on the pregnancy rate. Social media tools in pregnancy prevention programs should be adaptive to new technologies and rapidly changing adolescent preferences for these services. PMID:27689503
The introduction of computers into general practice settings has profoundly changed the dynamics of the clinical consultation. Previous research exploring the impact of the computer (in what has been termed the 'triadic' consultation) has shown that computer use and communication between doctor and patient are intricately coordinated and inseparable. Swinglehurst et al. have recently been critical of the ongoing tendency within health communication research to focus on 'the computer' as a relatively simple 'black box', or as a material presence in the consultation. By re-focussing on the electronic patient record (EPR) and conceptualising this as a complex collection of silent but consequential voices, they have opened up new and more nuanced possibilities for analysis. This orientation makes visible a tension between the immediate contingencies of the interaction as it unfolds moment-by-moment and the more standardised, institutional demands which are embedded in the EPR ('dilemma of attention'). In this paper I extend this work, presenting an in-depth examination of how participants in the consultation manage this tension. I used linguistic ethnographic methods to study 54 video recorded consultations from a dataset collected between 2007 and 2008 in two UK general practices, combining microanalysis of the consultation with ethnographic attention to the wider organisational and institutional context. My analysis draws on the theoretical work of Erving Goffman and Mikhail Bakhtin, incorporating attention to the 'here and now' of the interaction as well as an appreciation of the 'distributed' nature of the EPR, its role in hosting and circulating new voices, and in mediating participants' talk and social practices. It reveals - in apparently fleeting moments of negotiation and contestation - the extent to which the EPR shapes the dynamic construction, display and circulation of authority in the contemporary consultation.
Ware, Norma C; Idoko, John; Kaaya, Sylvia; Biraro, Irene Andia; Wyatt, Monique A; Agbaji, Oche; Chalamilla, Guerino; Bangsberg, David R
Background Individuals living with HIV/AIDS in sub-Saharan Africa generally take more than 90% of prescribed doses of antiretroviral therapy (ART). This number exceeds the levels of adherence observed in North America and dispels early scale-up concerns that adherence would be inadequate in settings of extreme poverty. This paper offers an explanation and theoretical model of ART adherence success based on the results of an ethnographic study in three sub-Saharan African countries. Methods and Findings Determinants of ART adherence for HIV-infected persons in sub-Saharan Africa were examined with ethnographic research methods. 414 in-person interviews were carried out with 252 persons taking ART, their treatment partners, and health care professionals at HIV treatment sites in Jos, Nigeria; Dar es Salaam, Tanzania; and Mbarara, Uganda. 136 field observations of clinic activities were also conducted. Data were examined using category construction and interpretive approaches to analysis. Findings indicate that individuals taking ART routinely overcome economic obstacles to ART adherence through a number of deliberate strategies aimed at prioritizing adherence: borrowing and “begging” transport funds, making “impossible choices” to allocate resources in favor of treatment, and “doing without.” Prioritization of adherence is accomplished through resources and help made available by treatment partners, other family members and friends, and health care providers. Helpers expect adherence and make their expectations known, creating a responsibility on the part of patients to adhere. Patients adhere to promote good will on the part of helpers, thereby ensuring help will be available when future needs arise. Conclusion Adherence success in sub-Saharan Africa can be explained as a means of fulfilling social responsibilities and thus preserving social capital in essential relationships. PMID:19175285
Meier, Lori T.
This ethnographic case study investigated the science practices of teachers at one public elementary magnet school in light of how school culture influenced science curriculum design and instruction. The purpose of the study was to address how school culture impacted the school's overall treatment of science as a viable content area. Key informant…
Travers, Jeffrey; And Others
This report summarizes findings from an ethnographic study of the Child and Family Resource Program (CFRP), a Head Start demonstration program providing child development and family support services to low-income families with young children. Designed to describe program operations from the perspective of staff and client families, the study was…
Cornish, Kim; Cole, Victoria; Longhi, Elena; Karmiloff-Smith, Annette; Scerif, Gaia
Basic attentional processes and their impact on developmental trajectories in fragile X syndrome were assessed in a 3-year prospective study. Although fragile X syndrome is a monogenic X-linked disorder, there is striking variability in outcomes even in young boys with the condition. Attention is a key factor constraining interactions with the environment, so it is a perfect candidate to predict trajectories in cognitive and behavioral outcomes. In this study, 48 boys with fragile X syndrome were assessed 3 times over 24 months. Although nonverbal IQ declined, there were significant improvements in nonverbal growth scores and in cognitive attention. In contrast, behavioral difficulties (i.e., autistic symptomatology, hyperactivity-inattention) remained stable over this time frame. Attentional markers in the visual and auditory modalities predicted intellectual abilities and classroom behavior, whereas auditory markers alone predicted autistic symptomatology.
Sbordone, L; Ramaglia, L; Barone, A; Ciaglia, R N; Iacono, V J
This study examined for 3 years the changes in periodontal status and the possible correlations with selected subgingival microbiota and diabetic conditions in a group of 16 insulin-dependent diabetes mellitus (IDDM, JD) patients as compared with their 16 healthy cohabiting siblings (HS). JD patients were monitored every 3 months for levels of glycosylated hemoglobin (HbA1C). Clinical and microbiological parameters were measured 6 weeks before drawing blood to determine levels of HbA1C. Periodontal parameters were measured at baseline (TO), year 2 (T2), year 3 (T3) and included: probing depth (PD), attachment level (AL), sulcus bleeding index (SBI), and plaque index (PI). Two sites in each patient were selected for microbial samples: a mesio-facial aspect of the maxillary right first molar (defined as constant site, CS) and a site with the greatest probing depth (defined as deepest site, DS). Microbial samples were analyzed by culture techniques. No significant differences in clinical parameters were found between diabetics and healthy siblings at any examination. The SBI in the non-diabetic group at T2 and at T3 was significantly lower than at baseline. PD and AL of constant sites in the diabetic group at T3 were significantly higher than baseline. There was a significant increase in Prevotella intermedia at T3 as compared with baseline for deepest sites in the diabetic group. Cluster analysis revealed, in a former study, two clusters (IV and V) at baseline which were significantly different from the overall mean regarding composition of Porphyromonas gingivalis and Capnocytophaga spp. They were not significantly different for periodontal parameters from TO to T3. These data would suggest no significant differences in clinical parameters between the diabetics and non-diabetic siblings throughout this 3-year longitudinal study.
Scollon, Ron; Bhatia, Vijay; Li, David; Yung, Vicki
Five ethnographic studies located genres of public discourse most central to university students, thus enhancing understanding of those genres as a significant influence on students' use of language. The problem of divergence between school-based genres and genres of public discourse were addressed. Results highlighted are audience roles, sites of…
Nero, Shondel J.
Using Jamaica, a former British colony where Jamaican Creole (JC) is the mass vernacular but Standard Jamaican English is the official language, as an illustrative case, this critical ethnographic study in three Jamaican schools examines the theoretical and practical challenges of language education policy (LEP) development and implementation in…
Wiryo, Hananto; Hakimi, M.
Traditionally, mothers provide banana to their neonates as well as discharge their colostrum prior to breastfeeding, increasing the risk of perinatal morbidity and mortality. Health education modules, based on ethnographic study, to discourage these detrimental practices were developed for use by community leaders. Two thousand six hundred and…
The transition from high school to college represents a life turning point during which health behavior trajectories may be influenced. This study addresses the internal and external factors that guide students’ eating decisions as they are understood and relayed by students through ethnographic, qu...
Hessling O'Neil, Marcy
This dissertation examines the relationship between higher education and social mobility among students and their families in Benin, West Africa. In this study I draw on ethnographic research conducted at the public University of Abomey-Calavi in Cotonou, Benin in 2010. I utilize interviews, historical documents, and participant observation to…
Winblad, B; Wimo, A; Engedal, K; Soininen, H; Verhey, F; Waldemar, G; Wetterholm, A-L; Haglund, A; Zhang, R; Schindler, R
Delays in the diagnosis of Alzheimer's disease, and, therefore, delays in treatment, may have a detrimental effect on a patient's long-term well-being. This study assessed the effects of postponing donepezil treatment for 1 year by comparing patients treated continuously for 3 years with those who received placebo for 1 year followed by open-label donepezil for 2 years. Patients (n = 286) with possible or probable Alzheimer's disease (according to DSM-IV, NINCDS-ADRDA, and Mini-Mental State Examination criteria; see text) were randomized to receive donepezil (5 mg/day for 4 weeks, 10 mg/day thereafter) or placebo (delayed-start group) for 1 year. Of the 192 completers, 157 began a 2-year, open-label phase of donepezil treatment. Outcome measures were the Gottfries-Bråne-Steen scale, the Mini-Mental State Examination, the Global Deterioration Scale, the Progressive Deterioration Scale, the Neuropsychiatric Inventory, and safety (adverse events). Mixed regression analysis was used to compare changes between the groups over 3 years on the efficacy measures. There was a trend for patients receiving continuous therapy to have less global deterioration (Gottfries-Bråne-Steen scale) than those who had delayed treatment (p = 0.056). Small but statistically significant differences between the groups were observed for the secondary measures of cognitive function (Mini-Mental State Examination; p = 0.004) and cognitive and functional abilities (Global Deterioration Scale; p = 0.0231) in favor of continuous donepezil therapy. Over 90% of the patients in both cohorts experienced one treatment-emergent adverse event; most were considered mild or moderate. In conclusion, patients in whom the start of treatment is delayed may demonstrate slightly reduced benefits as compared with those seen in patients starting donepezil therapy early in the course of Alzheimer's disease. These data support the long-term efficacy and safety of donepezil.
Travers, Jeffrey, Ed.; and Others
This report, devoted to the ethnographic study component of the Child and Family Resource Program (CFRP) evaluation, consists of three major sections. The first section outlines the rationale for employing ethnographic research in evaluating the effects and effectiveness of CFRP and describes study methodology, including examinations of the…
The author of this article, a developmental anthropologist, illustrates how the instructor can use ethnographic films to enhance the study of anthropology and override notions about the scope and efficacy of Western intervention in the Third World, provided the instructor places such films in their proper historical and cultural context. He…
Background This paper is an attempt to estimate the percentage of erroneously identified taxa in ethnographic studies concerning the use of plants and to propose a code for recording credibility of identification in historical ethnobotany publications. Methods A sample of Polish-language ethnobotanical literature (45 published sources from 1874-2005) and four collections of voucher specimens (from 1894-1975) were analyzed. Errors were detected in the publications by comparing the data with existing knowledge on the distribution of plant names and species ranges. The voucher specimens were re-examined. A one-letter code was invented for quick identification of the credibility of data published in lists of species compiled from historical or ethnographic sources, according to the source of identification: voucher specimen, Latin binominal, botanical expert, obvious widespread name, folk name, mode of use, range, physical description or photograph. To test the use of the code an up-to-date list of wild food plants used in Poland was made. Results A significant difference between the ratio of mistakes in the voucher specimen collections and the ratio of detectable mistakes in the studies without herbarium documentation was found. At least 2.3% of taxa in the publications were identified erroneously (mean rate was 6.2% per publication), and in half of these mistakes even the genus was not correct. As many as 10.0% of voucher specimens (on average 9.2% per collection) were originally erroneously identified, but three quarters of the identification mistakes remained within-genus. The species of the genera Thymus, Rumex and Rubus were most often confused within the genus. Not all of the invented credibility codes were used in the list of wild food plants, but they may be useful for other researchers. The most often used codes were the ones signifying identification by: voucher specimen, botanical expert and by a common name used throughout the country. Conclusions The
Stange, Jonathan P; Hamilton, Jessica L; Burke, Taylor A; Kleiman, Evan M; O'Garro-Moore, Jared K; Seligman, Nicole D; Abramson, Lyn Y; Alloy, Lauren B
Rates of suicidal ideation and behavior are extremely high in bipolar spectrum disorders (BSDs). However, relatively little work has evaluated potentially synergistic relationships between cognitive and emotion-regulatory processes proposed by theoretical models of suicidality in BSDs. The present study evaluated whether negative cognitive style and subtypes of rumination would exacerbate the impact of self-criticism on suicidal ideation in a prospective study of individuals with BSDs. Seventy-two young adults with BSDs (bipolar II, bipolar NOS, or cyclothymia) completed diagnostic interviews and trait measures of self-criticism, negative cognitive style, and brooding and reflective rumination at a baseline assessment. The occurrence of suicidal ideation was assessed as part of diagnostic interviews completed every 4 months for an average of 3 years of follow-up. Negative cognitive style and reflective rumination strengthened the association between self-criticism and the prospective occurrence of suicidal ideation across follow-up. Individuals with high levels of self-criticism in conjunction with negative cognitive style or reflective rumination were most likely to experience the onset of suicidal ideation. Self-criticism may work synergistically with negative cognitive style and rumination to confer risk for suicidal ideation in bipolar spectrum disorders. These results support theoretical models of suicidality in BSDs and indicate that evaluating and understanding negative cognitive styles may help to identify individuals who are at risk of suicide.
SADEGHZADEH, Mansour; KHOSHNEVIS ASL, Parisa; MAHBOUBI, Esrafil
Objective Febrile seizure is one of the most common neurological conditions of childhood. Several theories, such as iron deficiency anemia have been proposed as the pathogenesis of this condition. The aim of this study was to find the association between iron deficiency anemia and febrile seizures in children aged 6 months to 3 years admitted in Valie Asr hospital in Zanjan. Materials &Methods Hemoglobin (Hb), mean corpuscular volume (MCV), serum iron (SI), total iron binding capacity (TIBC) and SI/TIBC ratio were assessed in one hundred children with febrile seizures and compared to the values of one hundred healthy children presenting in a heath care center in the same period as the control group. Results A total of 6% of cases had iron deficiency anemia which was similar to the control group. In the case group SI/TIBC ratio below 12% was seen in 58% of children which was significantly higher than that of the control group (29%). Conclusion The results of this study suggest that although anemia was not common among febrile seizure patients, iron deficiency was more frequent in these patients. PMID:24665277
Alves, Celia Coutinho; Correia, Andre Ricardo; Neves, Manuel
To avoid the necessity of a removable provisional prosthesis, and therefore preserve the patient's functional outcome, esthetics, and quality of life, a clinical protocol was developed to approach periodontally compromised patients presenting a full-arch irreversibly lost dentition: full-arch extraction and immediate replacement with a provisional acrylic resin implant-supported fixed partial denture (FPD). A total of 23 periodontally compromised patients (11 women, 12 men; 4 smokers, 4 controlled diabetics) were included in this study. Pretreatment casts were taken and vertical dimension of occlusion was determined. In most patients, 6 Straumann implants were distributed along the arch according to the surgical guide or bone availability, with the most distal ones in the maxilla slightly tilted so they could emerge more distally. A total of 168 implants (146 Straumann, 10 Nobel Biocare, 8 Biomet 3i, and 4 Lifecore) were placed (83 in the maxilla, 85 in the mandible). Of those in the maxilla, 74 were loaded immediately (implant stability quotient mentor [ISQm] > 70) and 9 placed with delayed loading (ISQm =/< 70). Of the 85 implants placed in the mandible, all were loaded immediately (ISQm > 70). If an FPD had not been fabricated already, impressions were taken during surgery to do so. The prosthesis was then adapted (cemented or screwed) to the 6 implants within the first 48 hours postsurgery. After 2 months, definitive impressions were taken, and a definitive porcelain-fused-to-metal implant-supported 12-element FPD was fabricated and cemented or screwed to all 6 implants. Of the 168 implants, 108 were immediate implants and 159 immediately loaded. Only 2 implants (1 in the mandible, 1 in the maxilla) did not osseointegrate. This yields a 3-year cumulative survival rate of 98.74% (98.65% in the maxilla, 98.82% in the mandible). From a total of 26 immediately loaded prostheses (12 in the maxilla, 14 in the mandible), 6 were cemented and 20 screw-retained. The 3
Palpable Pedagogy: Expressive Arts, Leadership, and Change in Social Justice Teacher Education (An Ethnographic/Auto-Ethnographic Study of the Classroom Culture of an Arts-Based Teacher Education Course)
Barbera, Lucy Elizabeth
"Palpable Pedagogy: Expressive Arts, Leadership, and Change in Social Justice Teacher Education" is an arts-informed ethnographic study of the pedagogy and culture engendered when the expressive arts are employed in social justice teacher education. "Palpable Pedagogy" is a qualitative study that examines the power of the expressive arts to…
Introduction Vital pulp therapy is a major contributor in the preservation of primary dentition after caries affliction. Introduction of mineral trioxide aggregate (MTA) has revolutionized such treatment. Aim The aim of our study was to evaluate and correlate the effects of MTA clinically and radiographically on pulpotomized primary molars till their exfoliation or extraction followed by histological evaluation. Study design This is an observational study. Materials and methods A total of 25 teeth were selected from 5- to 8-year-old children requiring pulp therapy on the basis of inclusion and exclusion criterion. The teeth were treated by conventional pulpotomy technique under aseptic conditions using MTA and were immediately restored with stainless steel crown. The teeth were assessed postoperatively till 36 months. The exfoliated or extracted teeth were examined histologically. Results The pulpotomized teeth were vital with no adverse clinical findings during the observation period. After 3 months, one tooth showed internal resorption, but the same was not observed after 12 months. Pulp canal obliteration was seen in three cases. At the end of the study, five teeth were exfoliated and one tooth was extracted for maintaining arch symmetry. The histological examination of extracted tooth revealed the presence of healthy pulp and the area of true calcification. Remaining exfoliated teeth presented dentin bridge formation. Statistics Frequencies and percentages were used for descriptive statistics. Fisher’s exact tests were used to see the difference between clinical and radiological findings. The probability value was fixed at 5% level of significance. Conclusion The response of pulp in primary teeth to MTA was favorable in all cases from clinical and radiographic perspective, and histological evaluation confirmed the observation. How to cite this article Godhi B, Tyagi R. Success Rate of MTA Pulpotomy on Vital Pulp of Primary Molars: A 3-Year Observational Study
Bockting, Walter; Rosenblum, Andrew; Hwahng, Sel; Mason, Mona; Macri, Monica; Becker, Jeffrey
Objectives. We examined the effects of gender abuse (enacted stigma), depressive symptoms, and demographic, economic, and lifestyle factors on substance use among transgender women. Methods. We conducted a 3-year prospective study (December 2004 to September 2007) of 230 transgender women aged 19 to 59 years from the New York Metropolitan Area. Statistical techniques included generalized estimating equations with logistic and linear regression links. Results. Six-month prevalence of any substance use at baseline was 76.2%. Across assessment points, gender abuse was associated with alcohol, cannabis, cocaine, or any substance use during the previous 6 months, the number of days these substances were used during the previous month, and the number of substances used. Additional modeling associated changes in gender abuse with changes in substance use across time. Associations of gender abuse and substance use were mediated 55% by depressive symptoms. Positive associations of employment income, sex work, transgender identity, and hormone therapy with substance use were mediated 19% to 42% by gender abuse. Conclusions. Gender abuse, in conjunction with depressive symptoms, is a pervasive and moderately strong risk factor for substance use among transgender women. Improved substance abuse treatment is sorely needed for this population. PMID:25211716
Burnard, P; Naiyapatana, W; Lloyd, G
This paper reports some of the findings of an ethnographic study carried out in Thailand over a 2-year period. Interviews were conducted with three clinical nurses, three student nurses, 14 nurse educators, one psychiatrist, one Buddhist monk and two lay people (n = 24) about their views of mental health and mental health care in Thailand. Data (comprising field notes and interview transcripts) were analysed with the aid of Atlas.ti. Data were also collected through observation and conversation. This paper reports only the findings from the interviews. Findings emerged under the following headings: Causes of mental illness; Status of the mentally ill; Karma; Merit making; Kwan; Treatment and care; Reasons for becoming a mental health nurse. A range of causes, including the effects of ghosts and spirits, were identified under the first heading. The stigma of mental illness was noted under the second. Karma and merit making are Buddhist concepts and were discussed by many respondents as was the animist concept of kwan. Treatment and care seemed to include both 'modern' and 'traditional' approaches. These findings are discussed and some tentative 'rules' that appear to exist within the culture are mooted. The study is descriptive in nature and the findings cannot be generalized; however, it is hoped that they go some way to illuminate aspects of Thai culture as they relate to the mental health and mental health nursing fields.
Dixon-Woods, Mary; Suokas, Anu; Pitchforth, Emma; Tarrant, Carolyn
An understanding of how staff identify, classify, narrativise and orient to patient safety risks is important in understanding responses to efforts to effect change. We report an ethnographic study of four medical wards in the UK, in hospitals that were participating in the Health Foundation's Safer Patients Initiative, an organisation-wide patient safety programme. Data analysis of observations and 49 interviews with staff was based on the constant comparative method. We found that staff engaged routinely in practices of determining what gets to count as a risk, how such risks should properly be managed, and how to account for what they do. Staff practices and reasoning in relation to risk emerged through their practical engagement in the everyday work of the wards, but were also shaped by social imperatives. Risks, in the environment we studied, were not simply risks to patient safety; when things went wrong, professional identity was at risk too. Staff oriented to risks in the context of busy and complex ward environments, which influenced how they accounted for risk. Reasoning about risk was influenced by judgements about which values should be promoted when caring for patients, by social norms, by risk-spreading logics, and by perceptions of the extent to which particular behaviours and actions were coupled to outcomes and were blameworthy. These ways of identifying, evaluating and addressing risks are likely to be highly influential in staff responses to efforts to effect change, and highlight the challenges in designing and implementing patient safety interventions.
Calvete, Esther; Orue, Izaskun; Gamez-Guadix, Manuel; Bushman, Brad J
Although we rarely hear about it, children sometimes aggress against their parents. This is a difficult topic to study because abused parents and abusive children are both reluctant to admit the occurrence of child-to-parent aggression. There are very few research studies on this topic, and even fewer theoretical explanations of why it occurs. We predicted that exposure to violence in the home (e.g., parents aggressing against each other) and ineffective parenting (i.e., parenting that is overly permissive or lacks warmth) influences cognitive schemas of how children perceive themselves and the world around them (i.e., whether aggression is normal, whether they develop grandiose self-views, and whether they feel disconnected and rejected), which, in turn, predicts child-to-parent aggression. In a 3-year longitudinal study of 591 adolescents and their parents, we found that exposure to violence in Year 1 predicted child-to-parent aggression in Year 3. In addition, parenting characterized by lack of warmth in Year 1 was related to narcissistic and entitled self-views and disconnection and rejection schemas in Year 2, which, in turn, predicted child-to-mother and child-to-father aggression in Year 3. Gender comparisons indicated that narcissism predicted child-to-parent aggression only in boys and that exposure to violence was a stronger predictor of child-to-father violence in boys. This longitudinal study increases our understanding of the understudied but important topic of child-to-parent aggression, and will hopefully stimulate future research.
The burns intensive care unit (BICU) staff observed an increasing number of pediatric scald burn admissions as a result of increase injuries associated with the scald burns. A retrospective study was conducted to identify scalds demographics, etiologies, and mortality risk factors. This descriptive study comprised a total of 166 patients aged 0-5 years, who were admitted to the BICU of the Reconstructive Plastic Surgery and Burns Unit (RPSBU) through the Accident and Emergency (A and E) Centre of the Komfo Anokye Teaching Hospital (KATH)from May 1(st) 2009 to April 30(th) 2012. Source of information was the BICU Computerized Database System. Data extracted included demographics as well as treatment methods and outcomes. The study population was 166; 92 (55.4%) males and 74 (44.6%) females. Scalds admissions were 141 (84.9%); 13 (9.2%) of them died, 83 (58.9%) discharged, and 45 (31.9%) transferred-out to another burn ward and pediatric surgery ward in the hospital. Scald patients' demographics included 78 males (55.3%) and 63 females (44.7%); mean age was 2.18 years. Mortality risk factors identified were age <3 years (P = 0.044); scalds from hot water (P = 0.033), total burns surface area >30% (P = 0.017), and multiple body parts affected (P = 0.049). The current study showed age, hot water, and Total Burns Surface Area (TBSA) as risk factors of early childhood scalds. Education on scalds prevention targeting mothers/caregivers is needed to create awareness of the frequency, severity, and danger associated with pediatric scalds.
Sterkers, Yvon; Yera, Hélène; Accoceberry, Isabelle; Menotti, Jean; Cassaing, Sophie; Brenier-Pinchart, Marie-Pierre; Hennequin, Christophe; Delhaes, Laurence; Bonhomme, Julie; Villena, Isabelle; Scherer, Emeline; Dalle, Frédéric; Touafek, Feriel; Filisetti, Denis; Varlet-Marie, Emmanuelle; Pelloux, Hervé; Bastien, Patrick
Toxoplasmosis is a life-threatening infection in immunocompromised patients (ICPs). The definitive diagnosis relies on parasite DNA detection, but little is known about the incidence and burden of disease in HIV-negative patients. A 3-year retrospective study was conducted in 15 reference laboratories from the network of the French National Reference Center for Toxoplasmosis, in order to record the frequency of Toxoplasma gondii DNA detection in ICPs and to review the molecular methods used for diagnosis and the prevention measures implemented in transplant patients. During the study period, of 31,640 PCRs performed on samples from ICPs, 610 were positive (323 patients). Blood (n = 337 samples), cerebrospinal fluid (n = 101 samples), and aqueous humor (n = 100 samples) were more frequently positive. Chemoprophylaxis schemes in transplant patients differed between centers. PCR follow-up of allogeneic hematopoietic stem cell transplant (allo-HSCT) patients was implemented in 8/15 centers. Data from 180 patients (13 centers) were further analyzed regarding clinical setting and outcome. Only 68/180 (38%) patients were HIV+; the remaining 62% consisted of 72 HSCT, 14 solid organ transplant, and 26 miscellaneous immunodeficiency patients. Cerebral toxoplasmosis and disseminated toxoplasmosis were most frequently observed in HIV and transplant patients, respectively. Of 72 allo-HSCT patients with a positive PCR result, 23 were asymptomatic; all were diagnosed in centers performing systematic blood PCR follow-up, and they received specific treatment. Overall survival of allo-HSCT patients at 2 months was better in centers with PCR follow-up than in other centers (P < 0.01). This study provides updated data on the frequency of toxoplasmosis in HIV-negative ICPs and suggests that regular PCR follow-up of allo-HSCT patients could guide preemptive treatment and improve outcome. PMID:25762774
Robert-Gangneux, Florence; Sterkers, Yvon; Yera, Hélène; Accoceberry, Isabelle; Menotti, Jean; Cassaing, Sophie; Brenier-Pinchart, Marie-Pierre; Hennequin, Christophe; Delhaes, Laurence; Bonhomme, Julie; Villena, Isabelle; Scherer, Emeline; Dalle, Frédéric; Touafek, Feriel; Filisetti, Denis; Varlet-Marie, Emmanuelle; Pelloux, Hervé; Bastien, Patrick
Toxoplasmosis is a life-threatening infection in immunocompromised patients (ICPs). The definitive diagnosis relies on parasite DNA detection, but little is known about the incidence and burden of disease in HIV-negative patients. A 3-year retrospective study was conducted in 15 reference laboratories from the network of the French National Reference Center for Toxoplasmosis, in order to record the frequency of Toxoplasma gondii DNA detection in ICPs and to review the molecular methods used for diagnosis and the prevention measures implemented in transplant patients. During the study period, of 31,640 PCRs performed on samples from ICPs, 610 were positive (323 patients). Blood (n = 337 samples), cerebrospinal fluid (n = 101 samples), and aqueous humor (n = 100 samples) were more frequently positive. Chemoprophylaxis schemes in transplant patients differed between centers. PCR follow-up of allogeneic hematopoietic stem cell transplant (allo-HSCT) patients was implemented in 8/15 centers. Data from 180 patients (13 centers) were further analyzed regarding clinical setting and outcome. Only 68/180 (38%) patients were HIV(+); the remaining 62% consisted of 72 HSCT, 14 solid organ transplant, and 26 miscellaneous immunodeficiency patients. Cerebral toxoplasmosis and disseminated toxoplasmosis were most frequently observed in HIV and transplant patients, respectively. Of 72 allo-HSCT patients with a positive PCR result, 23 were asymptomatic; all were diagnosed in centers performing systematic blood PCR follow-up, and they received specific treatment. Overall survival of allo-HSCT patients at 2 months was better in centers with PCR follow-up than in other centers (P < 0.01). This study provides updated data on the frequency of toxoplasmosis in HIV-negative ICPs and suggests that regular PCR follow-up of allo-HSCT patients could guide preemptive treatment and improve outcome.
Xyrichis, Andreas; Lowton, Karen; Rafferty, Anne Marie
This paper reports an ethnographic study examining health professional jurisdictions within three intensive care units (ICUs) in order to draw out the social processes through which ICU clinicians organised and delivered life-saving care to critically ill patients. Data collection consisted of 240 h observation of actual practice and 27 interviews with health professionals. The research was conducted against a backdrop of international political and public pressure for national healthcare systems to deliver safe, quality and efficient healthcare. As in many Western health systems, for the English Department of Health the key to containing these challenges was a reconfiguration of responsibilities for clinicians in order to break down professional boundaries and encourage greater interprofessional working under the guise of workforce modernisation. In this paper, through the analysis of health professional interaction, we examine the properties and conditions under which professional jurisdiction was negotiated and accomplished in day-to-day ICU practice. We discuss how staff seniority influenced the nature of professional interaction and how jurisdictional boundaries were reproduced and reconfigured under conditions of routine and urgent work. Consequently, we question theorisation that treats individual professions as homogenous groups and overlooks fluctuation in the flow and intensity of work; and conclude that in ICU, urgency and seniority have a part to play in shaping jurisdictional boundaries at the level of day-to-day practice.
González-Juárez, Liliana; Noreña-Peña, Ana Lucía
OBJECTIVE: to describe the experience of Latin American working women regarding immigration, taking into account the expectations and conditions in which this process takes place. METHOD: ethnographic qualitative study. Data collection was performed by means of semi-structured interviews with 24 Latin American immigrant women in Spain. The information collected was triangulated through two focal groups. RESULTS: the expectations of migrant women focus on improving family living conditions. Social support is essential for their settling and to perform daily life activities. They declare they have adapted to the settlement country, although they live with stress. They perceive they have greater sexual freedom and power with their partners but keep greater responsibility in childcare, combining that with the role of working woman. CONCLUSIONS: migrant women play a key role in the survival of households, they build and create new meanings about being a woman, their understanding of life, their social and couple relationships. Such importance is shaped by their expectations and the conditions in which the migration process takes place, as well as their work integration. PMID:25493683
Nuwayhid, Iman; Nabulsi, Mona; Muwakkit, Samar; Kouzi, Sarah; Salem, George; Mikati, Mohamed; Ariss, Majd
Background Childhood lead poisoning has not made the list of national public health priorities in Lebanon. This study aims at identifying the prevalence and risk factors for elevated blood lead concentrations (B-Pb ≥ 100 μg/L) among 1–3 year old children. It also examines the need for universal blood lead screening. Methods This is a cross-sectional study of 281 well children, presenting to the pediatric ambulatory services at the American University of Beirut Medical Center in 1997–98. Blood was drawn on participating children for lead analysis and a structured questionnaire was introduced to mothers asking about social, demographic, and residence characteristics, as well as potential risk factors for lead exposure. Children with B-Pb ≥ 100 μg/L were compared to those with B-Pb < 100 μg/L. Results Mean B-Pb was 66.0 μg/L (median 60.0; range 10–160; standard deviation 26.3) with 39 (14%) children with B-Pb ≥ 100 μg/L. Logistic regression analysis showed that elevated B-Pb was associated with paternal manual jobs (odds ratio [OR]: 4.74), residence being located in high traffic areas (OR: 4.59), summer season (OR: 4.39), using hot tap water for cooking (OR: 3.96), exposure to kohl (OR: 2.40), and living in older buildings (OR: 2.01). Conclusion Lead screening should be offered to high-risk children. With the recent ban of leaded gasoline in Lebanon, emphasis should shift to other sources of exposure in children. PMID:12780938
Gagne, Jeffrey R.; Saudino, Kimberly J.
Parent- and lab-based observer ratings were employed to examine genetic and environmental influences on continuity and change in inhibitory control (IC) in over 300 twin-pairs assessed longitudinally at 2 and 3 years of age. Genetic influences accounted for approximately 60% of the variance in parent-rated IC at both ages. Although many of the…
Mueller, Tara C; Siv, Sovannaroth; Khim, Nimol; Kim, Saorin; Fleischmann, Erna; Ariey, Frédéric; Buchy, Philippe; Guillard, Bertrand; González, Iveth J; Christophel, Eva-Maria; Abdur, Rashid; von Sonnenburg, Frank; Bell, David; Menard, Didier
In the past decade, malaria control has been successfully implemented in Cambodia, leading to a substantial decrease in reported cases. Wide-spread use of malaria rapid diagnostic tests (RDTs) has revealed a large burden of malaria-negative fever cases, for which no clinical management guidelines exist at peripheral level health facilities. As a first step towards developing such guidelines, a 3-year cross-sectional prospective observational study was designed to investigate the causes of acute malaria-negative febrile illness in Cambodia. From January 2008 to December 2010, 1193 febrile patients and 282 non-febrile individuals were recruited from three health centers in eastern and western Cambodia. Malaria RDTs and routine clinical examination were performed on site by health center staff. Venous samples and nasopharyngeal throat swabs were collected and analysed by molecular diagnostic tests. Blood cultures and blood smears were also taken from all febrile individuals. Molecular testing was applied for malaria parasites, Leptospira, Rickettsia, O. tsutsugamushi, Dengue- and Influenza virus. At least one pathogen was identified in 73.3% (874/1193) of febrile patient samples. Most frequent pathogens detected were P. vivax (33.4%), P. falciparum (26.5%), pathogenic Leptospira (9.4%), Influenza viruses (8.9%), Dengue viruses (6.3%), O. tsutsugamushi (3.9%), Rickettsia (0.2%), and P. knowlesi (0.1%). In the control group, a potential pathogen was identified in 40.4%, most commonly malaria parasites and Leptospira. Clinic-based diagnosis of malaria RDT-negative cases was poorly predictive for pathogen and appropriate treatment. Additional investigations are needed to understand their impact on clinical disease and epidemiology, and the possible role of therapies such as doxycycline, since many of these pathogens were seen in non-febrile subjects.
Mueller, Tara C.; Siv, Sovannaroth; Khim, Nimol; Kim, Saorin; Fleischmann, Erna; Ariey, Frédéric; Buchy, Philippe; Guillard, Bertrand; González, Iveth J.; Christophel, Eva-Maria; Abdur, Rashid; von Sonnenburg, Frank; Bell, David; Menard, Didier
In the past decade, malaria control has been successfully implemented in Cambodia, leading to a substantial decrease in reported cases. Wide-spread use of malaria rapid diagnostic tests (RDTs) has revealed a large burden of malaria-negative fever cases, for which no clinical management guidelines exist at peripheral level health facilities. As a first step towards developing such guidelines, a 3-year cross-sectional prospective observational study was designed to investigate the causes of acute malaria-negative febrile illness in Cambodia. From January 2008 to December 2010, 1193 febrile patients and 282 non-febrile individuals were recruited from three health centers in eastern and western Cambodia. Malaria RDTs and routine clinical examination were performed on site by health center staff. Venous samples and nasopharyngeal throat swabs were collected and analysed by molecular diagnostic tests. Blood cultures and blood smears were also taken from all febrile individuals. Molecular testing was applied for malaria parasites, Leptospira, Rickettsia, O. tsutsugamushi, Dengue- and Influenza virus. At least one pathogen was identified in 73.3% (874/1193) of febrile patient samples. Most frequent pathogens detected were P. vivax (33.4%), P. falciparum (26.5%), pathogenic Leptospira (9.4%), Influenza viruses (8.9%), Dengue viruses (6.3%), O. tsutsugamushi (3.9%), Rickettsia (0.2%), and P. knowlesi (0.1%). In the control group, a potential pathogen was identified in 40.4%, most commonly malaria parasites and Leptospira. Clinic-based diagnosis of malaria RDT-negative cases was poorly predictive for pathogen and appropriate treatment. Additional investigations are needed to understand their impact on clinical disease and epidemiology, and the possible role of therapies such as doxycycline, since many of these pathogens were seen in non-febrile subjects. PMID:24755844
Chandra, Sadanandavalli Retnaswami; Issac, Thomas Gregor; Deepak, Sai; Teja, Ravi; Kuruthukulangara, Seby
Introduction: Epilepsy accounts for 1% of the global disease burden and about 8–10 million epilepsy patients live in India. About 30–40% of these patients become drug-resistant and land up with palliative or disease-modifying surgeries. This is a situation causing great concern in view of the psychosocial and economic burden on the patient and the family apart from severe cognitive and motor consequences, especially in children. Therefore, it is mandatory to have an insight into the wide spectrum of causes with reference to refractoriness to antiepileptic medications in children with epilepsy. Patients and Methods: Children admitted under our team with refractory epilepsy as per the International League Against Epilepsy (ILAE) criteria in the last 3 years were included in the study. Results: Refractory epilepsy constituted 13.3% of inpatients in the pediatric group. Males dominated with 68.9% of these patients. Nearly 34.4% of these patients were found to suffer from various neurometabolic diseases. Almost 3.5% were due to pyridoxine-dependent convulsions. This group of patients showed an excellent response to dietary manipulation, disease-modifying treatment for the metabolic disorder, and supportive small-dose anticonvulsants. During follow-up, they showed very good response with reference to global development and seizure control. Conclusion: Pyridoxine-dependent convulsions are relatively rare forming about 3.5% of refractory epilepsies in this series. With initiation of appropriate therapy, results with reference to seizure control as well as neurodevelopment became evident within 2 weeks, and at 1-year follow-up, complete independence for majority of the needed activities is achieved with minimum cost, almost zero side effects, and absolute elimination of the need for palliative surgery. PMID:27857784
Burrows, Betsy Denton
What experiences does a teacher have when interpreting and enacting curriculum frameworks and national and state standards? What does a teacher think about as she moves between the text of the written curriculum framework, her own particular experiences, and the context of a classroom? What are the negotiations that a teacher makes as she adopts and adapts curriculum policy for her own classroom? The purpose of this ethnographic case study was to explore these questions in the context of an eighth-grade science class as the teacher interpreted and enacted a new inquiry-based, constructivist curriculum framework. This yearlong study employed qualitative methods of data collection including open-ended interviews, classroom observations, guiding conversations (Cole & Knowles, 2001) and cogenerative dialogues and reflections (Roth & Tobin, 2005) with the teacher, and analysis of classroom artifacts. Constant comparative analysis and narrative analysis were used to analyze data and produce a narrative truth that emphasized verisimilitude or truthlike observations in order to capture one teacher's classroom experiences and advance an empathic form of understanding so the reader could experience the teacher's world. Reflections upon the teacher's story at the conclusion of this study suggest the following educational policy changes and areas of further study: (1) the need for more professional learning experiences for both preservice and practicing teachers that help them construct an understanding of the theoretical frameworks that underlie the curriculum they are enacting, (2) the need for more research, particularly qualitative case studies, describing learning communities in schools and constructivist leaders who have successfully facilitated authentic professional development, (3) the need for curriculum developers to address the pressing issue of depth vs. breadth in curriculum reform, and (4) the need for more studies that show how teachers adapt and improvise
Although the mixed heritage population of the U.S. continues to grow, few (if any) attempts have been made to examine educational needs specific to this group of children, especially from the family's perspective. This article uses ethnographic data to examine the experiences of one mixed heritage family--with an African American father and a…
Dixon-Woods, Mary; Leslie, Myles; Bion, Julian; Tarrant, Carolyn
Context Performance measures are increasingly widely used in health care and have an important role in quality. However, field studies of what organizations are doing when they collect and report performance measures are rare. An opportunity for such a study was presented by a patient safety program requiring intensive care units (ICUs) in England to submit monthly data on central venous catheter bloodstream infections (CVC-BSIs). Methods We conducted an ethnographic study involving ∼855 hours of observational fieldwork and 93 interviews in 17 ICUs plus 29 telephone interviews. Findings Variability was evident within and between ICUs in how they applied inclusion and exclusion criteria for the program, the data collection systems they established, practices in sending blood samples for analysis, microbiological support and laboratory techniques, and procedures for collecting and compiling data on possible infections. Those making decisions about what to report were not making decisions about the same things, nor were they making decisions in the same way. Rather than providing objective and clear criteria, the definitions for classifying infections used were seen as subjective, messy, and admitting the possibility of unfairness. Reported infection rates reflected localized interpretations rather than a standardized dataset across all ICUs. Variability arose not because of wily workers deliberately concealing, obscuring, or deceiving but because counting was as much a social practice as a technical practice. Conclusions Rather than objective measures of incidence, differences in reported infection rates may reflect, at least to some extent, underlying social practices in data collection and reporting and variations in clinical practice. The variability we identified was largely artless rather than artful: currently dominant assumptions of gaming as responses to performance measures do not properly account for how categories and classifications operate in the
Beck, Susan L.; Maurer, Martha; Black, Fraser; Palat, Gayatri
Background. The world’s global cancer burden disproportionally affects lower income countries, where 80% of patients present with late-stage disease and have limited access to palliative care and effective pain-relieving medications, such as morphine. Consequently, millions die each year with unrelieved pain. Objective. The objective of this study was to examine barriers to opioid availability and cancer pain management in India, with an emphasis on the experiences of nurses, who are often the front-line providers of palliative care. Methods. Fifty-nine participants were recruited using a purposive, snowball sampling strategy. Ethnographic data collection included in-depth, semistructured interviews (n = 54), 400+ hours of participant observation, and review of documents over 9 months at a government cancer hospital in South India. Systematic qualitative analysis led to identification of key barriers that are exemplified by representative quotes. Results. Morphine is more available at this study site than in most of India, but access is limited to patients seen by the palliative care service, and significant gaps in supply still occur. Systems to measure and improve pain outcomes are largely absent. Key barriers related to pain management include the role of nursing, opioid misperceptions, bureaucratic hurdles, and sociocultural/infrastructure challenges. Implications. Interventions must streamline process details of morphine procurement, work within the existing sociocultural infrastructure to ensure opioids reach patients most in need, target unexpected audiences for symptom management education, and account for role expectations of health care providers. Conclusion. Macro- and micro-level policy and practice changes are needed to improve opioid availability and cancer pain management in India. PMID:24755460
Barker, Judith C.; Hoeft, Kristin S.
Compared to other population groups in the United States, caries (tooth decay) is a disproportionately prevalent disease among Latino populations, especially among low-income and rural sub-groups and children under five years of age. Fluoride is a primary preventive for caries. While water fluoridation is a major and effective public health means for delivering fluoride on a mass scale, it does not reach many rural areas or population groups such as Latinos who eschew drinking water from municipal sources. This study examines the acceptability to such groups of salt fluoridation, an alternate means of delivering fluoride long used on a global scale. An ethnographic study in California’s rural Central Valley was performed. Thirty individual interviews and 5 focus groups (N = 61) were conducted in Spanish to investigate low-income Latino migrant caregivers’ experiences, views and understandings of domestic salt, oral health, caries prevention and fluoride. Audio data were transcribed, translated, coded and thematically analyzed. Table salt was readily available and frequently consumed. Both adult and child daily sodium consumption was high. Despite a general feeling that it was good, and present in dentifrices or dietary supplements, most participants had little knowledge about fluoride. Concerns were raised about cardio-vascular and other possibly deleterious effects if an increase in salt consumption occurred because fluoridated salt was viewed as having ‘extra’ benefits. Once informed about fluoride’s safety and role in caries prevention, most participants expressed willingness to use fluoridated salt, especially if it benefitted children. Reassurance about its safety and benefits, and demonstration of its taste, were important aspects of acceptance. Taste was paramount. Participants would not consume more fluoridated salt than their current salt as that would result in unpleasant changes in food flavor and taste. While salt fluoridation is acceptable
Lebaron, Virginia; Beck, Susan L; Maurer, Martha; Black, Fraser; Palat, Gayatri
The world's global cancer burden disproportionally affects lower income countries, where 80% of patients present with late-stage disease and have limited access to palliative care and effective pain-relieving medications, such as morphine. Consequently, millions die each year with unrelieved pain. Objective. The objective of this study was to examine barriers to opioid availability and cancer pain management in India, with an emphasis on the experiences of nurses, who are often the front-line providers of palliative care. Methods. Fifty-nine participants were recruited using a purposive, snowball sampling strategy. Ethnographic data collection included in-depth, semistructured interviews (n = 54), 400+ hours of participant observation, and review of documents over 9 months at a government cancer hospital in South India. Systematic qualitative analysis led to identification of key barriers that are exemplified by representative quotes. Results. Morphine is more available at this study site than in most of India, but access is limited to patients seen by the palliative care service, and significant gaps in supply still occur. Systems to measure and improve pain outcomes are largely absent. Key barriers related to pain management include the role of nursing, opioid misperceptions, bureaucratic hurdles, and sociocultural/infrastructure challenges. Implications. Interventions must streamline process details of morphine procurement, work within the existing sociocultural infrastructure to ensure opioids reach patients most in need, target unexpected audiences for symptom management education, and account for role expectations of health care providers. Conclusion. Macro- and micro-level policy and practice changes are needed to improve opioid availability and cancer pain management in India.
Expertise in physics has been traditionally studied in cognitive science, where physics expertise is understood through the difference between novice and expert problem solving skills. The cognitive perspective of physics experts only create a partial model of physics expertise and does not take into account the development of physics experts in the natural context of research. This dissertation takes a social and cultural perspective of learning through apprenticeship to model the development of physics expertise of physics graduate students in a research group. I use a qualitative methodological approach of an ethnographic case study to observe and video record the common practices of graduate students in their biophysics weekly research group meetings. I recorded notes on observations and conduct interviews with all participants of the biophysics research group for a period of eight months. I apply the theoretical framework of Communities of Practice to distinguish the cultural norms of the group that cultivate physics expert practices. Results indicate that physics expertise is specific to a topic or subfield and it is established through effectively publishing research in the larger biophysics research community. The participant biophysics research group follows a learning trajectory for its students to contribute to research and learn to communicate their research in the larger biophysics community. In this learning trajectory students develop expert member competencies to learn to communicate their research and to learn the standards and trends of research in the larger research community. Findings from this dissertation expand the model of physics expertise beyond the cognitive realm and add the social and cultural nature of physics expertise development. This research also addresses ways to increase physics graduate student success towards their PhD. and decrease the 48% attrition rate of physics graduate students. Cultivating effective research
Phenomenography is a qualitative research approach developed within an educational framework, focusing on the qualitative experience of learning. It is also being used, to a lesser degree, in healthcare research. In the present study, we conducted a meta-ethnographic synthesis of phenomenographic studies on chronic illness, in order to give a broader perspective of how chronic illness can be experienced. Our aim was not to describe patients’ various individual experiences of illness, but instead to identify the different ways chronic illness can be experienced by patients. Our synthesis and phenomenographic interpretation of 12 selected articles found that patients’ experiences of chronic illness can be described in terms of a different lived body, a struggle with threat to identity and self-esteem, a diminished lifeworld, and a challenging reality. These experiences relate to each other in a process of recurring loops, where the different ways of experiencing continue to influence each other over time. According to these findings, the use of phenomenography as a research approach has the potential to add to the understanding of how chronic illness can be experienced. Patients may benefit from seeing that their illness can be experienced in many different ways and that it has many aspects, which then can lead to a better understanding and coping with their illness. We suggest that it may be worthwhile to expand the scope of phenomenography outside pedagogics. This presupposes a revision of the application to include a wider and more comprehensive description, for instance, of the different ways illness and healthcare phenomena can be experienced, and how these different ways are related to each other, with less focus on hierarchical relations. PMID:25690674
It is increasingly argued that social and economic inequities poorly affect overall health. One of the means through which these inequities are translated to the body is via negative emotions, which carry known psychological and physiological responses. This paper examines migration-related psychosocial stressors impacting first-generation Mexican immigrants in southern Arizona, and reports on the primary emotional experiences immigrants associate with these stressors. Data were drawn from a qualitative, ethnographic study conducted over the course of 14 months during 2013–2014 with first-generation Mexican immigrants (N = 40) residing in Tucson Arizona and service providers working directly in the immigrant community (N = 32). Results indicate that the primary structural vulnerabilities that cause emotional hardship among immigrants are pre-migration stressors and adversity, dangerous border crossings, detention and deportation, undocumented citizenship status, family separation, and extreme poverty. Many of these factors have intensified over the past decade due to increased border security and state level anti-immigrant legislation in Arizona. Immigrants connected these hardships to the emotions of trauma (50%), fear (65%), depression (75%), loneliness (75%), sadness (80%), and stress (85%), and most respondents reported suffering from three or more of these emotions. Given the heavy emotional toll of migration and the direct impact that regional legislation and border security had on well-being, this paper argues that emotion be considered an important mechanism for health declines in the immigrant community. In order to stem the frequency and intensity of emotional stress in the Mexican immigrant community in Tucson, it is imperative to support organizations and policies that promote community building and support networks and also expand access to and availability of mental health services for immigrants regardless of documentation status. PMID
The, Anne-Mei; Hak, Tony; Koëter, Gerard; van der Wal, Gerrit
Objective To discover and explore the factors that result in “false optimism about recovery” observed in patients with small cell lung cancer. Design A qualitative observational (ethnographic) study in two stages over four years. Setting Lung diseases ward and outpatient clinic in university hospital in the Netherlands. Participants 35 patients with small cell lung cancer. Results “False optimism about recovery” usually developed during the (first) course of chemotherapy and was most prevalent when the cancer could no longer be seen in the x ray pictures. This optimism tended to vanish when the tumour recurred, but it could develop again, though to a lesser extent, during further courses of chemotherapy. Patients gradually found out the facts about their poor prognosis, partly because of physical deterioration and partly through contact with fellow patients who were in a more advanced stage of the illness and were dying. “False optimism about recovery” was the result an association between doctors' activism and patients' adherence to the treatment calendar and to the “recovery plot,” which allowed them not to acknowledge explicitly what they should and could know. The doctor did and did not want to pronounce a “death sentence” and the patient did and did not want to hear it. Conclusion Solutions to the problem of collusion between doctor and patient require an active, patient oriented approach from the doctor. Perhaps solutions have to be found outside the doctor-patient relationship itself — for example, by involving “treatment brokers.” PMID:11099281
Jessri, Mahsa; Farmer, Anna P; Olson, Karin
The aim of this study was to explore from the Middle-Eastern mothers' perspective, the experience of breastfeeding and their perceptions of attributes of the health care system, community and society on their feeding decisions after migration to Canada. New immigrant mothers from the Middle East (n = 22) were recruited from community agencies in Edmonton, Canada. Qualitative data were collected through four focus groups using an ethnographic approach to guide concurrent data collection and analysis. Survey data were collected on socio-demographic characteristics via pre-tested questionnaires. All mothers, but one who was medically exempt, breastfed their infants from birth and intended to continue for at least 2 years. Through constant comparison of data, five layers of influence emerged which described mothers' process of decision making: culture/society, community, health care system, family/friends and mother-infant dyad. Religious belief was an umbrella theme that was woven throughout all discussions and it was the strongest determining factor for choosing to breastfeed. However, cultural practices promoted pre-lacteal feeding and hence, jeopardising breastfeeding exclusivity. Although contradicted in Islamic tradition, most mothers practised fasting during breastfeeding because of misbeliefs about interpretations regarding these rules. Despite high rates of breastfeeding, there is a concern of lack of breastfeeding exclusivity among Middle-Eastern settlers in Canada. To promote successful breastfeeding in Muslim migrant communities, interventions must occur at different levels of influence and should consider religious beliefs to ensure cultural acceptability. Practitioners may support exclusive breastfeeding through cultural competency, and respectfully acknowledging Islamic beliefs and cultural practices.
Background Self-management is rarely studied 'in the wild'. We sought to produce a richer understanding of how people live with diabetes and why self-management is challenging for some. Method Ethnographic study supplemented with background documents on social context. We studied a socio-economically and ethnically diverse UK population. We sampled 30 people with diabetes (15 type 1, 15 type 2) by snowballing from patient groups, community contacts and NHS clinics. Participants (aged 5-88, from a range of ethnic and socio-economic groups) were shadowed at home and in the community for 2-4 periods of several hours (total 88 visits, 230 hours); interviewed (sometimes with a family member or carer) about their self-management efforts and support needs; and taken out for a meal. Detailed field notes were made and annotated. Data analysis was informed by structuration theory, which assumes that individuals' actions and choices depend on their dispositions and capabilities, which in turn are shaped and constrained (though not entirely determined) by wider social structures. Results Self-management comprised both practical and cognitive tasks (e.g. self-monitoring, menu planning, medication adjustment) and socio-emotional ones (e.g. coping with illness, managing relatives' input, negotiating access to services or resources). Self-management was hard work, and was enabled or constrained by economic, material and socio-cultural conditions within the family, workplace and community. Some people managed their diabetes skilfully and flexibly, drawing on personal capabilities, family and social networks and the healthcare system. For others, capacity to self-manage (including overcoming economic and socio-cultural constraints) was limited by co-morbidity, cognitive ability, psychological factors (e.g. under-confidence, denial) and social capital. The consequences of self-management efforts strongly influenced people's capacity and motivation to continue them. Conclusion Self
Cui, Shihai; Chen, Yue; Li, Haiyan; Ruan, ShiJie
Traumatic brain injury caused by drop and traffic accidents is an important reason for children's death and disability. Recently, the computer finite element (FE) head model has been developed to investigate brain injury mechanism and biomechanical responses. Based on CT data of a healthy 3-year-old child head, the FE head model with detailed anatomical structure was developed. The deep brain structures such as white matter, gray matter, cerebral ventricle, hippocampus, were firstly created in this FE model. The FE model was validated by comparing the simulation results with that of cadaver experiments based on reconstructing the child and adult cadaver experiments. In addition, the effects of skull stiffness on the child head dynamic responses were further investigated. All the simulation results confirmed the good biofidelity of the FE model.
Gagne, Jeffrey R.; Saudino, Kimberly J.
Parent and lab-based observer ratings were employed to examine genetic and environmental influences on continuity and change in inhibitory control (IC) in over 300 twin-pairs assessed longitudinally at 2 and 3 years of age. Genetic influences accounted for approximately 60% of the variance in parent-rated IC at both ages. Although many of the same genetic effects on parent-rated IC were stable across age, there were also novel genetic effects that emerged at age 3 (i.e., genetic factors contributed to both continuity and change in parent ratings of IC). Observed IC displayed a different developmental pattern. Genetic influences were moderate at age 2 (38%) and nonsignificant at age 3 (6%). Change in observed IC across early childhood was due to shared and nonshared environmental factors. Findings indicate that it is important to consider the measurement of IC when interpreting developmental and etiological findings. PMID:26784384
Sohn, Lucinda N.
Historically, science education research has promoted that learning science occurs through direct physical experiences. In recent years, the need for best practices and student motivation have been highlighted in STEM research findings. In response to the instructional challenges in STEM education, the National Research Council has provided guidelines for improving STEM literacy through best practices in science and mathematics instruction. A baseline qualitative ethnographic case study of the effect of instructional practices on a science classroom was an opportunity to understand how a teacher and students work together to learn in an International Baccalaureate life science course. This study was approached through an interpretivist lens with the assumption that learning science is socially constructed. The following were the research questions: 1.) How does the teacher implement science instruction strategies in the classroom? 2.) In what ways are students engaged in the classroom? 3.) How are science concepts communicated in the classroom? The total 35 participants included a high school science teacher and two classes of 11th grade students in the International Baccalaureate program. Using exploratory qualitative methods of research, data was collected from field notes and transcripts from a series of classroom observations, a single one-on-one interview with the teacher and two focus groups with students from each of the two classes. Three themes emerged from text coded using initial and process coding with the computer assisted qualitative data analysis software, MAXQDA. The themes were: 1.) Physical Forms of Communication Play Key Role in Instructional Strategy, 2.) Science Learning Occurs in Casual Environment Full of Distractions, and 3.) Teacher Persona Plays Vital Role in Classroom Culture. The findings provided insight into the teacher's role on students' motivation to learn science. The recommendation for STEM programs and new curriculum is a
Black, Emma; Naidoo, Norell; Dahlen, Hannah G.; Liamputtong, Pranee
Aim To conduct a meta-ethnographic study of the experiences, meanings and ways of ‘dealing with’ symptoms or a diagnosis of postnatal depression amongst migrant women living in high income countries. Background Prevalence of postnatal depression is highest amongst women who are migrants. Yet many women do not seek help for their symptoms and health services do not always respond appropriately to migrant women’s needs. Studies have reported migrant women’s experiences of postnatal depression and it is timely to synthesise findings from these studies to understand how services can be improved. Design A meta-ethnographic synthesis of 12 studies reported in 15 papers Data sources Five databases were searched for papers published between January 1999 and February 2016 Review methods The quality of included studies was assessed using the Critical Appraisal Skills Program tool. The synthesis process was guided by the seven steps of meta-ethnography outlined by Noblit and Hare. Findings Four key metaphors were identified: “I am alone, worried and angry—this is not me!”; ‘Making sense of my feelings’ ‘Dealing with my feelings’ and ‘What I need to change the way I feel!’. Primarily women related their feelings to their position as a migrant and as women, often living in poor socio-economic circumstances and they were exhausted keeping up with expected commitments. Many women were resourceful, drawing on their personal strengths and family / community resources. All the studies reported that women experienced difficulties in accessing appropriate services. Conclusion The meta-ethnographic study demonstrates the impact of migration on perinatal mental health, particularly for women lacking family support, who have no employment, a precarious migration status and/or relationship conflict. Migrant women are resourceful and this requires support through appropriate services. Further research is needed to evaluate effective support strategies for migrant
Mayou, R A; Ehlers, A; Bryant, B
The paper presents a 3-year follow-up of a prospective longitudinal study of posttraumatic stress disorder (PTSD) after motor vehicle accidents (J. Abnormal Psychol., 107 (1998) 508). Participants were 546 patients who had been assessed when attending an emergency clinic shortly after a motor vehicle accident, and at 3 months and 1 year afterwards. The prevalence of posttraumatic stress disorder PTSD at 3 years was 11%. Maintaining psychological factors, i.e. negative interpretation of intrusions, rumination, thought suppression and anger cognitions, were important in predicting the persistence of PTSD at 3 years, as were persistent health and financial problems after the accident. Other predictors were female sex, hospital admission for injuries, perceived threat and dissociation during the accident, and litigation.
Belsky, Jay; Jaffee, Sara R.; Sligo, Judith; Woodward, Lianne; Silva, Phil A.
More than 200 New Zealand men and women studied repeatedly since age 3 were videotaped interacting with their own 3-year-old children to determine (a) whether childrearing and family climate experienced in 3 distinct developmental periods while growing up (i.e., early childhood, middle childhood, early adolescence) predicted parenting and (b)…
Hand, Brian; Norton-Meier, Lori A.; Gunel, Murat; Akkus, Recai
How can classrooms become communities of inquiry that connect intellectually challenging science content with language-based activities (opportunities to talk, listen, read, and write) especially in settings with diverse populations? This question guided a 3-year mixed-methods research study using the Science Writing Heuristic (SWH) approach in…
Pelto, Gretel H; Armar-Klemesu, Margaret
An ethnographic study was conducted in two areas in southern and western Kenya to identify potential interventions to improve the quality, availability and affordability of foods consumed by infants and young children. A cultural-ecological model of determinants of nutrition identified the sectors of information for data collection related to infant and young child (IYC) diet and feeding-related behaviours, and the focused ethnographic study manual was used to guide the research. The results provide qualitative evidence about facilitators and constraints to IYC nutrition in the two geographical areas and document their inter-connections. We conclude with suggestions to consider 13 potential nutrition-sensitive interventions. The studies provide empirical ethnographic support for arguments concerning the importance of combining nutrition-specific and nutrition-sensitive interventions through a multi-sectoral, integrated approach to improve the nutrition of infants and young children in low-income, resource-constrained populations. They also document the value of ethnography as a component of landscape analysis in nutrition programme and policy planning. Key messages In addition to constraints on infant and young child diet that originate in environmental and technological conditions in both agro-ecological zones, other factors that affect feeding practices include features of social organisation, household access to social support, caregivers income-earning activities and their own health. The results of the ethnographies, which highlight the importance of obtaining the knowledge and perspectives of caregivers of infants and young children, reveal the interactions of the multiple factors that affect child nutrition and the need for simultaneous nutrition-sensitive interventions to complement nutrition-specific intervention actions. Most caregivers in both areas not only understood the importance of diet and food quality for child survival, they also regarded it as
Bowen, Gervase Michael Reynolds
Current reform documents in education call for elementary and high school students to engage in "authentic" scientific practices. In the past several years a number of authors have suggested that science education research and curriculum development could benefit from insights gained by research in the social studies of science that documents and theorizes science as it is actually done. Yet, although practices of laboratory science are well understood and provide a foundation from which educational practices could be drawn, little is known about the practices of the science disciplines which deal with field research and how people are enculturated into those practices. This dissertation is constituted by a series of research papers on different (although inter-related) topics, in which I examine the enculturation into the practices of field ecology and the world-view that is associated with that enculturation. To better understand the practices of field ecology and how they develop, I conducted several projects: (i) a video ethnography of a second-year university ecology class and observations on research experiences undergraduates experience; (ii) ethnographic research with ecologists conducting field research; (iii) observations of graduate student and professional ecologists as they participated in conferences, engaged in interaction in their laboratory and social settings, and presented/discussed their findings in various settings; (iv) interviews with graduate student and professional ecologists discussing their field research experiences; (v) videotaped interviews with practicing researchers and under/graduate science and non-science students as they interpreted various ecology-related inscriptions; (vi) an analysis of the inscriptions and textual information present in the various texts (textbooks and journals) used to teach students about ecology; and, (vii) observations of elementary school students engaged in practices congruent with those of field
McNeil, Ryan; Kerr, Thomas; Lampkin, Hugh; Small, Will
Introduction Many cities around the globe have experienced substantial increases in crack cocaine use. Public health programmes have begun to address crack smoking, primarily through the distribution of safer crack use equipment, but their impacts have been limited. More comprehensive safer environmental interventions, specifically safer smoking rooms (SSR), have been implemented only in select European cities. However, none have been subjected to rigorous evaluation. This ethnographic study was undertaken at an ‘unsanctioned’ SSR operated by a drug user-led organization in Vancouver, Canada, to explore how this intervention shaped crack smoking practices, public crack smoking, and related harms. Methods Ethnographic fieldwork was undertaken at this SSR from September to December 2011, and included approximately 50 hours of ethnographic observation and 23 in-depth interviews with people who smoke crack. Data were analyzed by drawing on the ‘Risk Environment’ framework and concepts of ‘symbolic’, ‘everyday’, and ‘structural’ violence. Findings Our findings illustrate how a high demand for SSRs was driven by the need to minimize exposure to policing (structural violence), drug scene violence (everyday violence), and stigma (symbolic violence) that characterized unregulated drug use settings (e.g., public spaces). Although resource scarcity and social norms operating within the local drug scene (e.g., gendered power relations) perpetuated crack pipe-sharing within unregulated drug use settings, the SSR fostered harm reduction practices by reshaping the social-structural context of crack smoking and reduced the potential for health harms. Conclusion Given the significant potential of SSRs in reducing health and social harms, there is an urgent need to scale up these interventions. Integrating SSRs into public health systems, and supplementing these interventions with health and social supports, has potential to improve the health and safety of crack
Peters, Jane; Skirton, Heather
Social support has been associated with positive outcomes regarding the mothering experience, and professional interventions have therefore been developed in formal settings to promote this. An ethnographic approach was used to consider the subjective experiences of mothers attending a professionally-facilitated group for parents and children aged 0-4 years, focusing on relationships within the group and their importance within existing social networks. Qualitative data were collected from seven participants using interviews and participant observation. These were analyzed by the constant comparison method into codes, categories, and themes. Three themes emerged: past history, being a mother, and function of the group. To ensure mothers and children benefit from such groups, nurses who participate in developing and leading community interventions for mothers and their children need to be aware of the importance of maternal identity and the factors that can impact the relationships between mothers within group settings.
Legendre, Claire-Marie; Charpentier-Côté, Catherine; Drouin, Régen; Bouffard, Chantal
Background During informal interviews in the course of an ethnographic study on intergenerational dialogue between individuals with neurofibromatosis and their parents, many members of Canadian neurofibromatosis associations stated they continue to be told the condition that afflicts them or their children is the “elephant man's” disease. Today, even though well established clinical criteria make it possible to diagnose and differentiate the two diseases, the confusion between NF1 and the disease of Joseph Merrick, the “elephant man”, persists in both media representations and those of physicians. The objective of this article is to document the persistence of this confusion, to identify the factors that contribute to it, and to identify its impact on the well being of individuals with NF1. Methodology Preliminary stages of an ethnographic study. Principal Findings Our findings show that some reference sources, past medical training, and print and online news media have all contributed to the persistence of the association between NF1 and the disease of Joseph Merrick, the “elephant man”. Our observations suggest that this misconception can have negative medical, social, and psychological impacts on patients and their families and thus increase the burden of the disease. Conclusions Changes of attitude regarding medical teaching and the media could lead to definitively clearing up the confusion. PMID:21347399
Crosby, Susan Ann; Rasinski, Timothy; Padak, Nancy; Yildirim, Kasim
Although parental involvement in children's literacy development has been recognized for its potential in helping children develop early literacy achievement, studies of the effectiveness and sustainability of school-based parent involvement programs are not numerous. This study examines the effectiveness and durability of a school-based…
Calvete, Esther; Orue, Izaskun; Gamez-Guadix, Manuel; Bushman, Brad J.
Although we rarely hear about it, children sometimes aggress against their parents. This is a difficult topic to study because abused parents and abusive children are both reluctant to admit the occurrence of child-to-parent aggression. There are very few research studies on this topic, and even fewer theoretical explanations of why it occurs. We…
Cross Francis, Dionne I.
Researchers in the field of mathematics education have focused on beliefs as a significant area of study because of the influence of beliefs on what is taught and learned. Much of the research in this area speaks about inconsistency between teachers' beliefs about mathematics teaching and learning and their classroom practices. In this case study,…
Hermann, Joseph R; Fry, Alethea M; Siev, David; Slate, Dennis; Lewis, Charles; Gatewood, Donna M
Rabies is an incurable zoonotic disease caused by rabies virus, a member of the rhabdovirus family. It is transmitted through the bite of an infected animal. Control methods, including oral rabies vaccination (ORV) programs, have led to a reduction in the spread and prevalence of the disease in wildlife. This study evaluated the stability of RABORAL, a recombinant vaccinia virus vaccine that is used in oral rabies vaccination programs. The vaccine was studied in various field microenvironments in order to describe its viability and facilitate effective baiting strategies. Field microenvironments influenced the stability of this vaccine in this study. This study emphasizes the importance of understanding how vaccines perform under varying field conditions in order to plan effective baiting strategies.
Scher, Anat; Epstein, Rachel; Tirosh, Emmanuel
The goal of the study was to examine the developmental course of sleep consolidation from infancy to preschool. The sleep of 50 healthy infants aged 3 months was recorded, at home, with actigraphs (computerised activity monitors). Follow-up recordings were carried out at 6, 9, 12, 20, and 42 months (due to attrition and occasional technical…
Garcell, Humberto Guanche; Arias, Ariadna Villanueva; Sandoval, Cristobal A. Pancorbo; García, Elias Guilarte; Gamboa, Moraima E. Valle; Sado, Adam Bode; Serrano, Ramón N. Alfonso
Objectives Surgical site infections (SSIs) constitute a threat, especially in complicated appendicitis, and are commonly due to gram-negative organisms. We sought to describe the incidence of SSIs in appendectomies performed during a three-year period (January 2013 to December 2015) in a community hospital in Qatar, and compare this with external benchmarks. Methods We conducted a longitudinal study at The Cuban Hospital, Qatar. We used the standardized surveillance criteria to define SSI developed by the Centers for Disease Control. Information about age, sex, smoking habits, diabetes mellitus status, body mass index, and the result of bacteriologic studies were collected. Results Of a total 603 patients, 22 (3.6%) cases of SSI were reported, with an infection rate of 13.6%, 4.5%, and 1.0% in 2013, 2014, and 2015, respectively. SSIs were observed more frequently in patients with contaminated/dirty wounds (6.6%). About 65% of isolates from the surgical site were multidrug-resistant organisms (Escherichia coli and Klebsiella spp.). Conclusions This study describes the incidence of SSI in appendectomy, which could be used as a benchmark for the facility improvement program. The high frequency of multidrug-resistant organisms in SSIs requires additional studies focused on evaluating the effectiveness of the current preventive practices with a particular reference to antimicrobial prophylaxis. PMID:28042400
Ervin, Barbara; Wash, Pamela D.; Mecca, Marilyn E.
Albert Bandura, the leading pioneer in the study of self-regulation, has defined the term as the child's ability to self-educate, self-direct, regulate motivation, and learn to think about what she is learning (1994). Lev Vygotsky's theory that children can be taught to think independently about how to solve problems expands upon Bandura's work…
Pais, Diogo; Casal, Diogo; Mascarenhas-Lemos, Luís; Barata, Pedro; Moxham, Bernard J; Goyri-O'Neill, João
Teaching time dedicated to anatomy education has been reduced at many medical schools around the world, including Nova Medical School in Lisbon, Portugal. In order to minimize the effects of this reduction, the authors introduced two optional, semester-long cadaveric dissection courses for the first two years of the medical school curriculum. These courses were named Regional Anatomy I (RAI) and Regional Anatomy II (RAII). In RAI, students focus on dissecting the thorax, abdomen, pelvis, and perineum. In RAII, the focus shifts to the head, neck, back, and upper and lower limbs. This study prospectively analyzes students' academic achievement and perceptions within the context of these two, newly-introduced, cadaveric dissection courses. Students' satisfaction was assessed anonymously through a questionnaire that included items regarding students' perception of the usefulness of the courses for undergraduate teaching, as well as with regards to future professional activity. For each of the three academic years studied, the final score (1 to 20) in General Anatomy (GA), RAI, and RAII was on average 14.26 ± 1.89; 16.94 ± 1.02; 17.49 ± 1.01, respectively. The mean results were lower in GA than RAI or RAII (P < 0.001). Furthermore, students who undertook these courses ranked them highly with regards to consolidating their knowledge of anatomy, preparing for other undergraduate courses, and training for future clinical practice. These survey data, combined with data on participating students' academic achievement, lend strong support to the adoption of similar courses as complementary and compulsory disciplines in a modern medical curriculum. Anat Sci Educ 10: 127-136. © 2016 American Association of Anatomists.
Pontes-Neto, Octávio Marques; Mazin, Suleimy Cristina; dos Reis, Felipe Ibiapina
The decrease in stroke mortality will increase the burden of survivors with functional dependence (FD). The aim of this study was to evaluate how many patients become functionally dependent over 3 years after an incident event in Joinville, Brazil. The proportion of FD (defined as a modified Rankin score 3 to 5) among stroke survivors from the Joinville Stroke Registry was assessed using a validated telephone interview. Incidence of FD after stroke in Joinville in one year was 23.24 per 100,000 population. The overall proportion of FD among stroke survivors at discharge was 32.7%. Of 303 patients with first-ever ischaemic stroke (IS), one-third were FD at discharge, and 12%, 9% and 8%, respectively at 1, 2 and 3 years. Among 37 patients with haemorrhagic stroke (HS), 38% were dependent at discharge, 16% after 1 and 2 years and 14% after 3. Among 27 patients with subarachnoid haemorrhage (SAH), 19% were dependent at discharge and 4% from 1 to 3 years. Among IS subtypes, cardioembolic ones had the worst risk of FD. (RR 19.8; 95% CI: 2.2 to 175.9). Our results showed that one-third of stroke survivors have FD during the first year after stroke in Brazil. Therefore, a city with half a million people might expect 120 new stroke patients with FD each year. PMID:28107401
Aveling, Emma-Louise; Parker, Michael; Dixon-Woods, Mary
An enduring debate concerns how responsibility for patient safety should be distributed between organisational systems and individual professionals. Though rule-based, calculus-like approaches intended to support a 'just culture' have become popular, they perpetuate an asocial and atomised account. In this article, we use insights from practice theory--which sees organisational phenomena as accomplished in everyday actions, with individual agency and structural conditions as a mutually constitutive, dynamic duality--along with contributions from the political science and ethics literature as a starting point for analysis. Presenting ethnographic data from five hospitals, three in one high-income country and two in low-income countries, we offer an empirically informed, normative rethinking of the role of personal accountability, identifying the collective nature of the healthcare enterprise and the extent to which patient safety depends on contributions from many hands. We show that moral responsibility for actions and behaviours is an irreducible element of professional practice, but that individuals are not somehow 'outside' and separate from 'systems': they create, modify and are subject to the social forces that are an inescapable feature of any organisational system; each element acts on the other. Our work illustrates starkly the structuring effects of the broader institutional and socioeconomic context on opportunities to 'be good'. These findings imply that one of the key responsibilities of organisations and wider institutions in relation to patient safety is the fostering of the conditions of moral community.
Ellenbogen, Kirsten M.
What we know about learning in museums tends to come from studies of single museum visits evaluating success according to the museum's agenda, neglecting the impressive cooperative learning strategies and resources that families bring to their museum experiences. This is a report of an ethnographic case study of four families that visit science museums frequently. The study used ethnographic research and discourse analysis as combined methodological approaches, and was grounded in a sociocultural perspective that frames science as a socially and culturally constituted activity. Over eighteen months, data were collected during observations of the families in science museums, at home, and at other leisure sites. The study generated two types of findings. First, macroanalysis based on established frameworks for understanding learning in museums revealed differences in the orientation and extent of the museum visits. Additionally, a hierarchical framework for measuring science learning in museums proved insensitive. These findings underscore limitations of some of the traditional frameworks for understanding family learning in science museums. Second, microanalysis of interactions around science objects at home and in museums revealed that parents provided children with opportunities to understand the "middle ground" of science. Analysis also revealed that families adapted the science content of the museum to renegotiate family identities. Interestingly, the types of discourse most valued in science education were least important for establishing family identity. These frequent museumgoers eliminated the distance between them and science objects by transforming their meanings to establish family identity. This study demonstrates that the families' mediating strategies shape not just an understanding of science, but also a family identity that is constructed in and through interactions with science. The results of this study provide a foundation for examining how
Kim, Yeon-Pyo; Joh, Ju-Youn; Shin, Il-Seon
Marriages between Korean men and immigrant women from elsewhere in Asia have increased rapidly during recent years. The aim of this study was to analyze the relationship within families consisting of immigrant women and to identify the relevant factors. The study subjects were 62 Asian immigrant women married to South Korean men living in South Korea. In a baseline study in August 2008, the socioeconomic factors and family APGAR (adaptation, partnership, growth, affection, and resolve) scores were measured. Family APGAR has been widely used to study the relationship of family function and health problems in the busy clinician's office. A 3-year follow-up study was then conducted in August 2011, and the results were compared with the baseline study results. Family APGAR scores were higher at the 3-year follow-up than those at baseline. Changes in family APGAR scores were found to be influenced by the birthplace, reported subjective ability to read Korean, and Center for Epidemiologic Studies-Depression Scale score.
This article presents a micro-ethnographic study that took place during a summer research course for six undergraduate and four graduate students majoring in the disciplines of architecture, art education, geography, landscape architecture and an integrative arts program. The research sought to implement ethnographic, visual methods as a means to…
Látos, Melinda; Devecsery, Ágnes; Lázár, György; Horváth, Zoltán; Szederkényi, Edit; Szenohradszky, Pál; Csabai, Márta
The aim of this study was to explore the role of body image, posttraumatic growth, and emotional state in recovery after transplantation. A total of 53 kidney transplant patients were assessed using our Self-Test and Organ Drawing Test, the Spielberger Anxiety Inventory, the Beck Depression Inventory, and the Posttraumatic Growth Inventory in a 3-year follow-up. Logistic regression analysis showed that lower levels of integrity of the body image and posttraumatic growth, and higher pre-discharge serum creatinine levels were significant predictors of graft rejection. Our results suggest that the integrity of the body image and posttraumatic growth might contribute to better health outcomes in organ transplantation.
Mason, Bruce; Epiphaniou, Eleni; Nanton, Veronica; Donaldson, Anne; Shipman, Cathy; Daveson, Barbara A; Harding, Richard; Higginson, Irene; Munday, Dan; Barclay, Stephen; Boyd, Kirsty; Dale, Jeremy; Kendall, Marilyn; Worth, Allison; Murray, Scott A
Background Coordination of care for individuals with advanced progressive conditions is frequently poor. Aim To identify how care is coordinated in generalist settings for individuals with advanced progressive conditions in the last year of life. Design and setting A mixed methods study of three UK generalist clinical settings producing three parallel case studies: an acute admissions unit in a regional hospital, a large general practice, and a respiratory outpatient service. Method Ethnographic observations in each setting, followed by serial interviews of patients with advanced progressive conditions and their family carers in the community. A spectrum of clinicians and healthcare workers were also interviewed. Results Ethnographic observations were conducted for 22 weeks. A total of 56 patients, 25 family carers and 17 clinicians yielded 198 interviews. Very few participants had been identified for a palliative approach. Rapid throughput of hospital patients and time pressures in primary care hindered identification of palliative care needs. Lack of care coordination was evident during emergency admissions and discharges. Patient, families, and professionals identified multiple problems relating to lack of information, communication, and collaboration at care transitions. Family carers or specialist nurses, where present, usually acted as the main care coordinators. Conclusion Care is poorly coordinated in generalist settings for patients in the last year of life, although those with cancer have better coordinated care than other patients. A model to improve coordination of care for all individuals approaching the end of life must ensure that patients are identified in a timely way, so that they can be assessed and their care planned accordingly. PMID:23972199
Artun, J; Spadafora, A T; Shapiro, P A
The present study was performed to test the tendency for plaque and calculus build-up along the wire of different types of bonded orthodontic canine-to-canine retainers, whether the presence of such retainers causes any damage to the teeth involved, the failure rate of the retainers, and any changes in incisor alignment during a 3-year period of retention. The four test groups received either retainers made of thick plain wire bonded only to the canines (n = 11); thick spiral wire bonded only to the canines (n = 13); thin, flexible spiral wire bonded to each tooth (n = 11); or removable retainers (n = 14). Accumulation of plaque and calculus along the gingival margin, gingival inflammation and probing attachment level were scored in lingual areas from canine to canine at the time of fixed appliance removal and again 3 years after retainer insertion. Incisor irregularity was measured on plaster models made at the same time periods. Accumulation of plaque and calculus and development of caries along the wire were scored at follow-up. Retainer failures were recorded whenever they occurred. The results revealed no intergroup differences in changes between baseline and follow-up examinations or status along the retainer wire for any of the variables. Gingival inflammation and plaque accumulation were scored less frequently after 3 years in retention than at the time of debonding. No signs of caries were seen adjacent to the wire. Failures were observed of one, four and three of the fixed retainer types, respectively. These patients showed a greater increase in incisor irregularity than the other patients.
Peterson, David Kent
The following study is an extended ethnographic case study of a "black intellectual insurgency" within the predominantly white space of the U.S. intercollegiate policy debate activity. A growing number of black students are entering the debate activity and insisting that "whiteness" be confronted and interrogated and that…
Calovini, Theresa Ann
While the place of language in building the tasks and activities of the science classroom has received attention in the education literature, how students do the work of affiliation building through language remains poorly understood. This dissertation is based on ethnographic research in an apprenticeship learning situation at a biological field research station. I carried out this research with five undergraduates apprentices. I focus on how the language used in this apprenticeship situation positioned the apprentices with science. Issues of access and diversity in science education have motivated this research but this point can be missed because the five apprentices were all fairly successful in university science. They had all secured their job for the summer as paid research assistants. Yet, even with these successful students, science had a complicated place in their lives. I draw on Gee's (1999) notion of Discourse to understand this complexity. I focus on four Discourses--- Science, Knowing about the Animals, Senior Projects and RAships, and Relationships ---which were important in the apprentices' learning about and socialization with science. I try to understand the inter-workings of these four Discourses through a detailed analysis of three conversations involving one of the participants, Michelle. Michelle's use of narrative emerged as a linguistic resource which she used to explore dilemmas she experienced in the tensions between these four Discourses. Michelle was in many ways an ideal apprentice. She did her job well and she sought and received expert advice on her Senior project. Nonetheless, Michelle faced obstacles in her pursuit of a career in science and these obstacles related to language use and her use of narrative. I show how her use of narrative either facilitated or impeded her learning, depending on the context of the interaction. My analysis of Discourse points to important issues in language use by both students and teachers, with
Darke, Shane; Williamson, Anna; Ross, Joanne; Mills, Katherine L; Havard, Alys; Teesson, Maree
To determine annual patterns and correlates of nonfatal heroin overdose across 3 years, data were analyzed on 387 heroin users recruited for the Australian Treatment Outcome Study (ATOS), interviewed at 12, 24, and 36 months. A heroin overdose across follow-up was reported by 18.6%, and naloxone had been administered to 11.9%. Annual rates of overdose declined between baseline and 12 months and then remained stable. Previous overdose experience was strongly related to subsequent overdose. Those with a history of overdose before ATOS were significantly more likely to overdose during the study period. In particular, there was a strong association between overdose experience in any 1 year and increased overdose risk in the subsequent year. This is the first study to examine long-term annual trends in nonfatal heroin overdose. While overdose rates declined after extensive treatment, substantial proportions continued to overdose in each year, and this was strongly associated with overdose history.
Marshall, Ann; Burns, Vicki; Briden, Judi
In this article, the authors discuss how the University of Rochester's two-year ethnographic study reveals what students do on campus and how the library fits in. Under Nancy Fried Foster's guidance, teams of librarians and staff conducted a two-year investigation. The goal: to improve the libraries' reference services, facilities, and web pages…
Saudelli, Mary Gene; Ciampa, Katia
This ethnographic research study investigated three elementary teachers' perceived self-efficacy beliefs and their attitudes toward mobile technology-enhanced instruction. Using technological pedagogical content knowledge (TPACK) as a guiding theory, the authors sought to determine whether and how the three knowledge components that form the…
Carrasco, Robert L.
The case study of the use of a classroom observation technique to evaluate the abilities and performance of a bilingual kindergarten student previously assessed as a low achiever is described. There are three objectives: to show the validity of the ethnographic monitoring technique, to show the value of teachers as collaborating researchers, and…
Sokolovsky, Jay; Sokolovsky, Joan
A volume devoted to aging and the aged in Third World societies focuses on ethnographic case studies from Papua New Guinea, China, India, the Sudan, and Mexico. The first of five articles, "Sweeping Men and Harmless Women: Responsibility and Gender Identity in Later Life" (Dorothy Ayers Counts), examines the perception of gender over the…
Chou, Ping-Song; Lai, Chiou-Lian; Chou, Yii-Her; Chang, Wei-Pin
Purpose Sleep apnea (SA)-induced chronic intermittent hypoxia increases oxidative stress and inflammation, which may contribute to the pathophysiology of Parkinson’s disease (PD). This study evaluated the risk of PD following SA diagnosis. Patients and methods This was a 3-year nationwide population-based matched cohort study using claims data from the National Health Insurance Research Database (NHIRD), Taiwan. We analyzed 1,944 patients diagnosed as having SA between 1997 and 2005 and a matched cohort of 9,720 non-SA patients from the NHIRD. Patients with a history of PD were excluded. Each patient was followed up for 3 years to evaluate subsequent PD development. Results Of the 11,664 patients, 17 (0.9%) and 38 (0.4%) from the SA and matched non-SA cohorts, respectively, were subsequently diagnosed as having PD during follow-up. After adjustments for potential confounders, the SA cohort had a 1.85-fold higher risk of PD than the non-SA cohort (95% confidence interval [CI] =1.02–3.35; P=0.042). After age and sex stratification, PD development was independently associated with SA only in men (adjusted hazard ratio [HR], 2.26; 95% CI =1.11–4.63; P<0.05) and in patients aged ≥60 years (adjusted HR, 1.93; 95% CI =1.01–3.71; P<0.05). Conclusion Our study suggests that patients with SA are at an increased longitudinal risk of PD. Furthermore, age and male sex are independently associated with the risk of PD.
Devecsery, Ágnes; Lázár, György; Horváth, Zoltán; Szederkényi, Edit; Szenohradszky, Pál; Csabai, Márta
The aim of this study was to explore the role of body image, posttraumatic growth, and emotional state in recovery after transplantation. A total of 53 kidney transplant patients were assessed using our Self-Test and Organ Drawing Test, the Spielberger Anxiety Inventory, the Beck Depression Inventory, and the Posttraumatic Growth Inventory in a 3-year follow-up. Logistic regression analysis showed that lower levels of integrity of the body image and posttraumatic growth, and higher pre-discharge serum creatinine levels were significant predictors of graft rejection. Our results suggest that the integrity of the body image and posttraumatic growth might contribute to better health outcomes in organ transplantation. PMID:28070354
Pietrzak, Robert H; Scott, J Cobb; Neumeister, Alexander; Lim, Yen Ying; Ames, David; Ellis, Kathryn A; Harrington, Karra; Lautenschlager, Nicola T; Szoeke, Cassandra; Martins, Ralph N; Masters, Colin L; Villemagne, Victor L; Rowe, Christopher C; Maruff, Paul
Although beta-amyloid, anxiety and depression have linked cross-sectionally to reduced memory function in healthy older adults without dementia, prospective data evaluating these associations are lacking. Using data an observational cohort study of 178 healthy older adults without dementia followed for 3 years, we found that anxiety symptoms significantly moderated the relationship between beta-amyloid level and decline in verbal (Cohen's d = 0.65) and episodic (Cohen's d = 0.38) memory. Anxiety symptoms were additionally linked to greater decline in executive function, irrespective of beta-amyloid and other risk factors. These findings suggest that interventions to mitigate anxiety symptoms may help delay memory decline in otherwise healthy older adults with elevated beta-amyloid.
van der Leeuw, Christine; Peeters, Sanne; Domen, Patrick; van Kroonenburgh, Marinus; van Os, Jim; Marcelis, Machteld
Altered estrogen-induced neuroprotection has been implicated in the etiology of psychotic disorders. Using bone mineral density as a marker of lifetime estrogen exposure, a longitudinal family study was conducted to discriminate between etiological mechanisms and secondary effects of disease and treatment. Dual X-ray absorptiometry scans were acquired twice, with an interval of 3 years, in 30 patients with psychotic disorder (male (M)/female (F): 24/6, mean age of 32 years at second measurement), 44 non-psychotic siblings of patients with a psychotic disorder (M/F: 26/18, mean age 32) and 27 controls (M/F: 7/20, mean age 35). Total bone mineral density, Z-scores and T-scores were measured in the lumbar spine and proximal femur. Associations between group and bone mineral density changes were investigated with multilevel random regression analyses. The effect of prolactin-raising antipsychotic medication was evaluated. (Increased risk of) psychotic disorder was not associated with disproportionate bone mineral density loss over a three year period. Instead, femoral bone mineral density measures appeared to decrease less in the patient versus control comparison (total BMD: B = 0.026, 95% CI 0.002 to 0.050, p = 0.037; Z-score: B = 0.224, 95% CI 0.035 to 0.412, p = 0.020; and T-score: B = 0.193, 95% CI 0.003 to 0.382, p = 0.046). Current or past use of a prolactin-raising antipsychotic medication was not associated with bone mineral density changes. In this small longitudinal study, there was no evidence of ongoing estrogen deficiency in psychotic disorder as there was no excessive loss of bone mineral density over a 3-year period in patients using antipsychotic medication. PMID:26309037
Reichard, P; Britz, A; Carlsson, P; Cars, I; Lindblad, L; Nilsson, B Y; Rosenqvist, U
In a planned 5-year study, 97 patients with insulin dependent diabetes mellitus (IDDM), non-proliferative retinopathy and unsatisfactory blood glucose control were monitored for 3 years. The patients were randomized to an intensified conventional treatment (ICT, n = 44) or a regular treatment (RT, n = 53) group. HbA1c (normal range 3.9-5.7%) was reduced from 9.5 +/- 0.2 (mean value +/- SEM) to 7.4 +/- 0.1% in the ICT group (P = 0.0001), and from 9.5 +/- 0.2 to 9.0 +/- 0.2% in the RT group (P = 0.004). Nerve conduction velocities in the sural and peroneal nerves (P = 0.01-0.0001) were impaired in the RT group, but not in the ICT group. Retinopathy increased in both groups. The condition of 22 ICT patients (50%, 95% confidence interval 34-66%) and 37 RT patients (73%, 61-84%) deteriorated with regard to at least one microvascular complication (retinopathy, nephropathy, neuropathy) (P = 0.024). Lower HbA1c levels during the study significantly reduced the risk of deterioration (P = 0.01). In total, 57% of the ICT patients had at least one episode of serious hypoglycaemia, compared with 23% in the RT group (P = 0.001). The patients in the ICT group also gained weight (P = 0.0001). Improved blood glucose control slowed down the progression of microangiopathy during a 3-year period in patients with non-proliferative retinopathy, but at the price of an increased frequency of serious hypoglycaemic episodes, and some gain in body weight.
Leeson, Verity C; Sharma, Pranev; Harrison, Masuma; Ron, Maria A; Barnes, Thomas R E; Joyce, Eileen M
Comparison of current and estimated premorbid IQ in schizophrenia suggests that there are subgroups with low IQ, deteriorated IQ (DIQ), or preserved IQ and that this is established by psychosis onset. There are no controlled studies examining the trajectory of these IQ subgroups longitudinally or their relationship with clinical and social outcomes. Of 129 individuals with first-episode schizophrenia or schizoaffective disorder, 25% showed stable low IQ, 31% showed stable IQ in the average/high range, and 44% demonstrated intellectual deterioration by 10 points or more. Patients in the low and deteriorated groups were equally impaired on tests of memory and executive function compared with the preserved average/high-IQ group and controls and showed more negative and disorganization symptoms than the preserved average/high-IQ group. Sixty patients and 27 controls were assessed again 1 and 3 years later. There was no evidence that those with IQ deterioration at baseline continued on a declining cognitive trajectory or that those with preserved average/high IQ experienced subsequent IQ decline. The low IQ group showed no change in IQ, whereas both the DIQ and the preserved IQ groups improved. However, the rate of improvement of these 2 subgroups was no greater than that of the healthy controls, suggesting that this reflected practice effects. Both the low and the deteriorated groups had longer index admissions, more core negative symptoms, and worse occupational outcomes at 3 years. These data suggest that following psychosis onset, IQ is stable and that it is IQ at psychosis onset rather than premorbid IQ predicts a more severe illness.
Budde, K; Lehner, F; Sommerer, C; Arns, W; Reinke, P; Eisenberger, U; Wüthrich, R P; Scheidl, S; May, C; Paulus, E-M; Mühlfeld, A; Wolters, H H; Pressmar, K; Stahl, R; Witzke, O
The long-term effect of conversion from calcineurin inhibitor (CNI) therapy to an mTOR inhibitor requires clarification. Following completion of the 12-month, open-label, multicenter ZEUS study, in which 300 kidney transplant recipients were randomized to continue cyclosporine (CsA) or convert to everolimus at 4.5 months posttransplant, outcomes were assessed at month 36 (n = 284; 94.7%). CNI therapy was reintroduced in 28.4% of everolimus patients by month 36. The primary efficacy endpoint, estimated glomerular filtration rate (Nankivell, ANCOVA) was significantly higher with everolimus versus the CsA group at month 24 (7.6 mL/min/1.73 m(2) , 95%CI 4.3, 11.0 mL/min/1.73 m(2) ; p < 0.001) and month 36 (7.5 mL/min/1.73 m(2) , 95%CI 3.6, 11.4 mL/min/1.73 m(2) ; p < 0.001). The incidence of biopsy-proven acute rejection from randomization to month 36 was 13.0% in the everolimus arm and 4.8% in the CsA arm (p = 0.015). Patient and graft survival, as well as incidences of malignancy, severe infections and hospitalization, were similar between groups. Kidney transplant patients who are converted from CsA to everolimus at month 4.5 and who remain on everolimus thereafter may achieve a significant improvement in renal function that is maintained to 3 years. There was a significantly higher rate of rejection in the everolimus arm but this did not exert a deleterious effect by 3 years posttransplant.
Background Tandem mass spectrometry (MS/MS) has been available in China for 8 years. This technique makes it possible to screen for a wide range of previously unscreened inborn errors of metabolism (IEM) using a single test. This 3-year pilot study investigated the screening, diagnosis, treatment and outcomes of IEM in symptomatic infants and children. Methods All children encountered in the Newborn Screening Center of Zhejiang Province during a 3-year period with symptoms suspicious for IEM were screened for metabolic diseases. Dried blood spots were collected and analyzed by tandem mass spectrometry. The diagnoses were further confirmed by clinical symptoms and biochemical analysis. Neonatal intrahepatic cholestasis caused by citrin deficiency, ornithine transcarbamylase deficiency and primary carnitine deficiency were confirmed by DNA analysis. Results A total of 11,060 symptomatic patients (6,720 boys, 4,340 girls) with a median age of 28.8 months (range: 0.04-168.2 months) were screened. Among these, 62 were diagnosed with IEM, with a detection rate of 0.56%. Thirty-five were males and 27 females and the median age was 3.55 months (range 0.07-143.9 months). Of the 62 patients, 27 (43.5%) had aminoacidemias, 26 (41.9%) had organic acidemias and nine (14.5%) had fatty acid oxidation disorders. Conclusions Because most symptomatic patients are diagnosed at an older age, mental retardation and motor delay are difficult to reverse. Additionally, poor medication compliance reduces the efficacy of treatment. More extensive newborn screening is thus imperative for ensuring early diagnosis and enhancing the treatment efficacy of IEM. PMID:22364411
Background Unintentional poisoning in young children is an important public health issue. Age pattern studies have demonstrated that children aged 1–3 years have the highest levels of poisoning risk among children aged 0–4 years, yet little research has been conducted regarding risk factors specific to this three-year age group and the methodologies employed varied greatly. The purpose of the current study is to investigate a broad range of potential risk factors for unintentional poisoning in children aged 1–3 years using appropriate methodologies. Methods Four groups of children, one case group (children who had experienced a poisoning event) and three control groups (children who had been ‘injured’, ‘sick’ or who were ‘healthy’), and their mothers (mother-child dyads) were enrolled into a case–control study. All mother-child dyads participated in a 1.5-hour child developmental screening and observation, with mothers responding to a series of questionnaires at home. Data were analysed as three case–control pairs with multivariate analyses used to control for age and sex differences between child cases and controls. Results Five risk factors were included in the final multivariate models for one or more case–control pairs. All three models found that children whose mothers used more positive control in their interactions during a structured task had higher odds of poisoning. Two models showed that maternal psychiatric distress increased poisoning risk (poisoning-injury and poisoning-healthy). Individual models identified the following variables as risk factors: less proximal maternal supervision during risk taking activities (poisoning-injury), medicinal substances stored in more accessible locations in bathrooms (poisoning-sick) and lower total parenting stress (poisoning-healthy). Conclusions The findings of this study indicate that the nature of the caregiver-child relationship and caregiver attributes play an important role in
Sawford, Kate; Vollman, Ardene Robinson; Stephen, Craig
The global public health community is facing the challenge of emerging infectious diseases. Historically, the majority of these diseases have arisen from animal populations at lower latitudes where many nations experience marked resource constraints. In order to minimize the impact of future events, surveillance of animal populations will need to enable prompt event detection and response. Many surveillance systems targeting animals rely on veterinarians to submit cases to a diagnostic laboratory or input clinical case data. Therefore understanding veterinarians’ decision-making process that guides laboratory case submission and their perceptions of infectious disease surveillance is foundational to interpreting disease patterns reported by laboratories and engaging veterinarians in surveillance initiatives. A focused ethnographic study was conducted with twelve field veterinary surgeons that participated in a mobile phone-based surveillance pilot project in Sri Lanka. Each participant agreed to an individual in-depth interview that was recorded and later transcribed to enable thematic analysis of the interview content. Results found that field veterinarians in Sri Lanka infrequently submit cases to laboratories – so infrequently that common case selection principles could not be described. Field veterinarians in Sri Lanka have a diagnostic process that operates independently of laboratories. Participants indicated a willingness to take part in surveillance initiatives, though they highlighted a need for incentives that satisfy a range of motivations that vary among field veterinarians. This study has implications for the future of animal health surveillance, including interpretation of disease patterns reported, system design and implementation, and engagement of data providers. PMID:23133542
Garthwaite, K A; Collins, P J; Bambra, C
Emergency foodbanks have become an increasingly prominent and controversial feature of austerity in Europe and the USA. In the UK, foodbanks have been called a 'public health emergency'. Despite this, there has been no UK research examining the health of foodbank users. Through an ethnographic study, this paper is the first to explore the health and health perceptions of foodbank users via a case study of Stockton-on-Tees in the North East of England, UK during a period of welfare reform and austerity. Participant observation, field notes and interviews with foodbank users and volunteers were conducted over a seventeen month period (November 2013 to March 2015) inside a Trussell Trust foodbank. Foodbank users were almost exclusively of working age, both men and women, with and without dependent children. All were on very low incomes - from welfare benefits or insecure, poorly paid employment. Many had pre-existing health problems which were exacerbated by their poverty and food insecurity. The latter meant although foodbank users were well aware of the importance and constitution of a healthy diet, they were usually unable to achieve this for financial reasons - constantly having to negotiate their food insecurity. More typically they had to access poor quality, readily available, filling, processed foods. Foodbank users are facing the everyday reality of health inequalities at a time of ongoing austerity in the UK.
Linnard-Palmer, Luanne; Kools, Susan
Pediatric nurses working in acute care settings serving religious and culturally diverse families may encounter parents whose beliefs influence treatment decisions. Previous literature describes how these complex situations lead to emotional distress and strained relationships between health care provider and family members. An ethnographic study was conducted to investigate the impact of parental treatment refusal on the bedside interactions between pediatric nurses and parents. Twenty in-depth interviews with nurses were conducted, and extensive field notes were taken during data collection. Emotional feelings associated with possible loss of guardianship and subsequent mandated treatment, the impact of the situation on the nurses' health and stress levels, and functional status were all explored. Three themes were identified following interpretive narrative analysis of transcriptions and field notes: weathering the storm of moral conflict, closeness and involvement versus distance and retreat, and battles between the supportive and oppositional groups. The findings of the study lead to a deeper understanding of the complexities of the ethical dilemma surrounding treatment refusal in pediatrics.
Kaplan, Bonnie; Farzanfar, Ramesh; Friedman, Robert H
The burgeoning of consumer health informatics and virtual health care can help people improve their health. However, little is known about individuals' reactions to such systems. We conducted an evaluation of the telephone-linked care (TLC) system, a computer-based telecommunications system, that functions as an at home monitor, educator, and counselor for patients with chronic health conditions. Our multimethod assessment of individuals' reactions to using TLC included both quantitative and qualitative methods. Ethnographic in-depth open-ended interviews indicated more subtle and surprising reactions to TLC than the overall positive responses from surveys: individuals formed personal relationships with this technology. This relationship formation suggests that TLC designers may have been successful in their attempts to emulate a conversation with a human being. Our study adds to evidence that technology can serve as a projective device for peoples' values and psychological issues. Both designers and users project values and goals onto computer-based technologies and take on different identities through it. Different groups of users, therefore, may see the same technology differently. People also form relationships with technologies, as they did with TLC. These findings, as well as implications for system design and health outcomes, need to be explored in additional studies.
Brenman, Natassia F; Hiddinga, Anja; Wright, Barry
Autism assessments for children who are deaf are particularly complex for a number of reasons, including overlapping cultural and clinical factors. We capture this in an ethnographic study of National Health Service child and adolescent mental health services in the United Kingdom, drawing on theoretical perspectives from transcultural psychiatry, which help to understand these services as a cultural system. Our objective was to analyse how mental health services interact with Deaf culture, as a source of cultural-linguistic identity. We ground the study in the practices and perceptions of 16 professionals, who have conducted autism assessments for deaf children aged 0-18. We adopt a framework of intersectionality to capture the multiple, mutually enforcing factors involved in this diagnostic process. We observed that professionals working in specialist Deaf services, or with experience working with the Deaf community, had intersectional understandings of assessments: the ways in which cultural, linguistic, sensory, and social factors work together to produce diagnoses. Working with a diagnostic system that focuses heavily on 'norms' based on populations from a hearing culture was a key source of frustration for professionals. We conclude that recognising the intersectionality of mental health and Deaf culture helps professionals provide sensitive diagnoses that acknowledge the multiplicity of D/deaf experiences.
Forbes, Dorothy; Egan, Mary Y.; Elliott, Jacobi; Stolee, Paul; Chesworth, Bert M.
ABSTRACT Purpose: To examine information exchange by physiotherapists during care handoffs of patients with hip fracture in a rural health care setting. Methods: This qualitative ethnographic study used observation and interviews of 11 networks of patients with hip fracture (n=11), family caregivers (n=8), and health care providers (n=24). Patients were followed from acute care through each subsequent care setting. Data were supplemented by health care records and policy documents. Results: Findings revealed that handoffs were less successful when information transfer was untimely or incomplete. Family caregivers experienced challenges in obtaining information required to facilitate the handoff, especially when direct contact with physiotherapists was not possible as a result of distance or other factors. Physiotherapists had to navigate multiple data sources to retrieve important information, and managed information gaps in various ways. Information flow was often unidirectional and suggested no further clinical accountability for the discharging physiotherapist. Conclusions: Providing information in a structured and timely fashion facilitated physiotherapy handoffs. Inadequate handoffs compromised continuity of care, delayed progress in rehabilitation, and resulted in families' missing information of vital importance to their caregiving role. A multi-directional exchange of information is needed between patients, families, and health care providers across care settings. PMID:24403697
Armstrong, Natalie; Herbert, Georgia; Brewster, Liz
Background. Context is important in implementation—we know that what works in one setting may not work in the same way elsewhere. Primary care has been described as a unique context both in relation to the care delivered and efforts to carry out research and implementation of new evidence. Objective. To explore some of the distinctive features of the primary care environment that may influence implementation. Methods. We conducted an ethnographic study involving observations, interviews and documentary analysis of the ENABLE-CKD project, which involved general practices implementing a chronic kidney disease care bundle and offering self-management support tools to patients. Analysis was based on the constant comparative method. Results. Four elements of the primary care environment emerged as important influences on the extent to which implementation was successful. First, the nature of delivering care in this setting meant that prioritizing one condition over others was problematic. Second, the lack of alignment with financial and other incentives affected engagement. Third, the project team lacked mechanisms through which engagement could be mandated. Fourth, working relationships within practices impacted on engagement. Conclusions. Those seeking to implement interventions in primary care need to consider the particular context if they are to secure successful implementation. We suggest that there are particular kinds of interventions, which may be best suited to the primary care context. PMID:27297465
Bjerknes, Mari Skancke; Bjørk, Ida Torunn
The transition from student to working nurse has long been recognized as challenging. This paper presents the findings of research into the opportunities and limitations encountered by newly qualified nurses when taking on the nursing role. The study had an ethnographic design. Observation, interviews, and document analysis were used to gain insight into nurses' daily work from the perspective of recently graduated nurses. Thirteen nurses were monitored closely during their first year in a hospital setting in Norway. These new nurses generally entered the field with empathy for their patients, enthusiasm for the profession, and readiness to learn more about being a good nurse. However, their more experienced colleagues seemed to neither respect nor nurture this attitude. The new nurses experienced heavier responsibilities than expected, fragmentation of patient care, and stressful interactions with colleagues. The lack of a supportive work environment and role models increased the new nurses' experience of overwhelming responsibility in their daily work situations. The nurses learned to cope the hard way, despite the organizational culture, not because of it. Adjusting the profession's expectations of new nurses, and offering good role models and more comprehensive support programmes, would markedly ease the transition for new nurses. PMID:23050136
Stack, Emma; King, Rachel; Janko, Balazs; Burnett, Malcolm; Hammersley, Nicola; Agarwal, Veena; Hannuna, Sion; Burrows, Alison; Ashburn, Ann
Self-report underpins our understanding of falls among people with Parkinson's (PwP) as they largely happen unwitnessed at home. In this qualitative study, we used an ethnographic approach to investigate which in-home sensors, in which locations, could gather useful data about fall risk. Over six weeks, we observed five independently mobile PwP at high risk of falling, at home. We made field notes about falls (prior events and concerns) and recorded movement with video, Kinect, and wearable sensors. The three women and two men (aged 71 to 79 years) having moderate or severe Parkinson's were dependent on others and highly sedentary. We most commonly noted balance protection, loss, and restoration during chair transfers, walks across open spaces and through gaps, turns, steps up and down, and tasks in standing (all evident walking between chair and stairs, e.g.). Our unobtrusive sensors were acceptable to participants: they could detect instability during everyday activity at home and potentially guide intervention. Monitoring the route between chair and stairs is likely to give information without invading the privacy of people at high risk of falling, with very limited mobility, who spend most of the day in their sitting rooms.
Stack, Emma; King, Rachel; Janko, Balazs; Burnett, Malcolm; Hammersley, Nicola; Agarwal, Veena; Hannuna, Sion; Burrows, Alison; Ashburn, Ann
Self-report underpins our understanding of falls among people with Parkinson's (PwP) as they largely happen unwitnessed at home. In this qualitative study, we used an ethnographic approach to investigate which in-home sensors, in which locations, could gather useful data about fall risk. Over six weeks, we observed five independently mobile PwP at high risk of falling, at home. We made field notes about falls (prior events and concerns) and recorded movement with video, Kinect, and wearable sensors. The three women and two men (aged 71 to 79 years) having moderate or severe Parkinson's were dependent on others and highly sedentary. We most commonly noted balance protection, loss, and restoration during chair transfers, walks across open spaces and through gaps, turns, steps up and down, and tasks in standing (all evident walking between chair and stairs, e.g.). Our unobtrusive sensors were acceptable to participants: they could detect instability during everyday activity at home and potentially guide intervention. Monitoring the route between chair and stairs is likely to give information without invading the privacy of people at high risk of falling, with very limited mobility, who spend most of the day in their sitting rooms. PMID:26981528
Mangano, Francesco; Luongo, Fabrizia; Shibli, Jamil Awad; Anil, Sukumaran; Mangano, Carlo
Purpose. Nowadays, the advancements in direct metal laser sintering (DMLS) technology allow the fabrication of titanium dental implants. The aim of this study was to evaluate implant survival, complications, and peri-implant marginal bone loss of DMLS implants used to support bar-retained maxillary overdentures. Materials and Methods. Over a 2-year period, 120 implants were placed in the maxilla of 30 patients (18 males, 12 females) to support bar-retained maxillary overdentures (ODs). Each OD was supported by 4 implants splinted by a rigid cobalt-chrome bar. At each annual follow-up session, clinical and radiographic parameters were assessed. The outcome measures were implant failure, biological and prosthetic complications, and peri-implant marginal bone loss (distance between the implant shoulder and the first visible bone-to-implant contact, DIB). Results. The 3-year implant survival rate was 97.4% (implant-based) and 92.9% (patient-based). Three implants failed. The incidence of biological complication was 3.5% (implant-based) and 7.1% (patient-based). The incidence of prosthetic complication was 17.8% (patient-based). No detrimental effects on marginal bone level were evidenced. Conclusions. The use of 4 DMLS titanium implants to support bar-retained maxillary ODs seems to represent a safe and successful procedure. Long-term clinical studies on a larger sample of patients are needed to confirm these results.
Nardis, Amanda da Costa; Costa, Sabrina Araújo Pinho; da Silva, Rogério Almeida; Kaba, Shajadi Carlos Pardo
The objective of this study is to analyze patterns of facial fractures in children treated at the Service of Oral and Maxillofacial Surgery of the Vila Penteado General Hospital (HGVP), in São Paulo, Brazil, in a period of 3 years. Between May 2008 and April 2011 the authors reviewed 110 records of patients under 12 years old with facial fractures. The following parameters were evaluated: age and sex distribution, aetiology of trauma, incidence and type of fractures, monthly distribution and treatment modality. Male-to-female ratio was 1.8:1, and the mean age was 8.13. The majority of the involved patients were aged between 6 and 12 years. The most prevalent cause was fall (58%) and nasal fractures were the most common type of fracture (69%). Monthly distribution was similar in all seasons. Of 110 patients, 69 (62%) were treated conservatively. The incidence of facial fractures in the area of study is high. The high incidence of nasal fractures should be a warning to maxillofacial surgeons, so that they are not overlooked. Safety programs should be installed in Brazil to increase public awareness and to decrease morbidity resulting from paediatric trauma.
Mangano, Francesco; Shibli, Jamil Awad; Anil, Sukumaran
Purpose. Nowadays, the advancements in direct metal laser sintering (DMLS) technology allow the fabrication of titanium dental implants. The aim of this study was to evaluate implant survival, complications, and peri-implant marginal bone loss of DMLS implants used to support bar-retained maxillary overdentures. Materials and Methods. Over a 2-year period, 120 implants were placed in the maxilla of 30 patients (18 males, 12 females) to support bar-retained maxillary overdentures (ODs). Each OD was supported by 4 implants splinted by a rigid cobalt-chrome bar. At each annual follow-up session, clinical and radiographic parameters were assessed. The outcome measures were implant failure, biological and prosthetic complications, and peri-implant marginal bone loss (distance between the implant shoulder and the first visible bone-to-implant contact, DIB). Results. The 3-year implant survival rate was 97.4% (implant-based) and 92.9% (patient-based). Three implants failed. The incidence of biological complication was 3.5% (implant-based) and 7.1% (patient-based). The incidence of prosthetic complication was 17.8% (patient-based). No detrimental effects on marginal bone level were evidenced. Conclusions. The use of 4 DMLS titanium implants to support bar-retained maxillary ODs seems to represent a safe and successful procedure. Long-term clinical studies on a larger sample of patients are needed to confirm these results. PMID:25580124
Baek, Jong Ha; Jin, Sang-Man; Bae, Ji Cheol; Jee, Jae Hwan; Yu, Tae Yang; Kim, Soo Kyoung; Hur, Kyu Yeon; Lee, Moon-Kyu
Background An association between serum calcium level and risk of metabolic syndrome (MetS) has been suggested in cross-sectional studies. This study aimed to evaluate the association between baseline serum calcium level and risk of incident MetS in a longitudinal study. Methods We conducted a retrospective longitudinal study of 12,706 participants without MetS who participated in a health screening program, had normal range serum calcium level at baseline (mean age, 51 years), and were followed up for 4.3 years (18,925 person-years). The risk of developing MetS was analyzed according to the baseline serum calcium levels. Results A total of 3,448 incident cases (27.1%) of MetS developed during the follow-up period. The hazard ratio (HR) for incident MetS did not increase with increasing tertile of serum calcium level in an age- and sex-matched model (P for trend=0.915). The HRs (95% confidence interval [CI]) for incident MetS comparing the second and the third tertiles to the first tertile of baseline serum calcium level were 0.91 (95% CI, 0.84 to 0.99) and 0.85 (95% CI, 0.78 to 0.92) in a fully adjusted model, respectively (P for trend=0.001). A decreased risk of incident MetS in higher tertiles of serum calcium level was observed in subjects with central obesity and/or a metabolically unhealthy state at baseline. Conclusion There was no positive correlation between baseline serum calcium levels and incident risk of MetS in this longitudinal study. There was an association between higher serum calcium levels and decreased incident MetS in individuals with central obesity or two components of MetS at baseline. PMID:28029017
Bodri, Daniel; Kawachiya, Satoshi; De Brucker, Michaël; Tournaye, Herman; Kondo, Masae; Kato, Ryutaro; Matsumoto, Tsunekazu
A 3-year, retrospective, single-centre cohort study was conducted in a private infertility centre to determine cumulative live birth rates (LBR) per scheduled oocyte retrieval following minimal ovarian stimulation/natural-cycle IVF in unselected infertile patients. A total of 727 consecutive infertile patients were analysed who underwent 2876 (median 4) cycles with scheduled oocyte retrieval from November 2008 to December 2011. Natural-cycle IVF or clomiphene-based minimal ovarian stimulation was coupled with single-embryo transfer and increased use of delayed vitrified-warmed blastocyst transfer. Main outcome measures were crude and expected age-specific cumulative LBR per scheduled oocyte retrieval. Crude cumulative LBR were 65%, 60%, 39%, 15% and 5% in patients aged 26-34, 35-37, 38-40, 41-42 and 43-44 years, respectively. No live births occurred in patients aged ⩾ 45 years. Dropout rates per cycle were 13-25%. Success rates gradually reached a plateau, with few additional live births after six cycles. Most of the expected success rate was reached within 6 months with almost maximal rates within 15 months of the first oocyte retrieval. Acceptable cumulative LBR are reached with an exclusive minimal ovarian stimulation/single-embryo transfer policy especially in patients aged <38 years but also in intermediate aged patients (38-40 years).
Rolon-Arroyo, Benjamin; Arnold, David H.; Harvey, Elizabeth A.
Conduct disorder (CD) symptoms often emerge during the preschool years, but it is not clear whether they predict later symptoms. The present study examined whether age 3 CD symptoms predict age 6 CD symptoms beyond oppositional defiant disorder (ODD) and attention-deficit/hyperactivity disorder—hyperactive/impulsive (ADHD HI) symptoms. Participants were 216 preschool children (MAge = 44.19 months), including an externalizing sample (n = 161) and a comparison group (n = 55). Parents were administered a diagnostic interview when children were 3 years old and again three years later. The externalizing sample exhibited more CD symptoms than the comparison sample. In the externalizing sample, initial CD symptoms predicted later CD symptoms above and beyond ODD and ADHD HI symptoms; this relation was stronger for boys than girls. Stealing, property destruction, and fighting independently predicted later CD symptoms. CD symptoms also predicted subsequent ADHD HI symptoms and predicted ODD symptoms at level that approached significance. Results support the predictive validity of CD symptoms in preschool. PMID:23979222
Although the school constitutes a key cultural arena for the production and reproduction of gender identities, few studies have addressed gender discourse in educational institutions in developing societies. Such studies are especially sparse in Arab society in Israel. This study goes some way to addressing what is often absent from many…
Negis-Isik, Ayse; Gursel, Musa
Even though they are perceived similar from outside, all schools have distinct characteristics and a culture that differ them from other schools. School culture, is one of the important factors that play role in school efficiency and success. The purpose of this study was to examine the culture of a successful school profoundly. This study was a…
South Korean society in the late 1990s was confronted with socio-economic setbacks and discursive turbulence concerning the quality of education being provided. It was at such a particular historical juncture of South Korean society that I conducted ethnographic research on homeschooling families. Based on field data collected from four…
Sullivan, Mercer L.
Ethnographic interviews and observations were conducted with a group of teenage males from one inner-city neighborhood who were biological and/or social fathers, i.e., males who were fulfilling fathering roles toward the children of their girlfriends. Some of the respondents were not supporting their children, but most were contributing partial…
Chaffee, Rachel L.
This dissertation study contributes to the research on filmmaking and identity development by exploring the ways that film production provided unique opportunities for a team of four girls to engage in science, to develop identities in science, and to see and understand science differently. Using social practice, identity, and feminist theory and New Literacies Studies as a theoretical lens and grounded theory and multimodality as analytic frameworks, I present findings that suggest that girls in this study authored identities and communicated and represented science in and through film in ways that drew on their social, cultural, and embodied resources and the material resources of the after-school science club. Findings from this study highlight the affordances of filmmaking as a venue for engaging in the disciplinary practices of science and for accessing and authoring identities in science.
Andrews, Gavin J; Sudwell, Mark I; Sparkes, Andrew C
During recent years, research in health geography has engaged with peoples' health as well as diseases, an interest reflected by therapeutic geographies and geographies of public health. At the same time, studies have focused on micro-contexts such as the body, reflected in geographies of diseased and disadvantaged bodies. However, little research has combined elements of the two approaches and engaged in research on active healthy bodies and fitness. Equally the sub-discipline of sports geography provides little insight into fitness activities because this research has tended to focus on elite sports, their fans and facilities. Given these contexts, a detailed case study is presented to demonstrate the potential for geographical research on fitness. Through an observational study of a specialist gym facility, the study investigates how bodybuilding culture and place are co-produced. Indeed, the gym provides a narrative resource and a crucial setting for individual body projects and collective body culture which involve social conflicts, cohesions and hierarchies, illegal and potentially health harming activities, as well as personal comfort and therapeutic attachments. It is argued that beyond this case study, many activities crosscut health maintenance, or conversely risks to health, and the enjoyment of sports and fitness. A greater emphasis therefore at the sub-disciplinary interface of sports and health geography on hybrid 'fitness geographies' may help researchers towards a more comprehensive understanding, and coverage, of health issues in society.
Hägg-Martinell, A; Hult, H; Henriksson, P; Kiessling, A
Objectives To optimise medical students’ early clerkship is a complex task since it is conducted in a context primarily organised to take care of patients. Previous studies have explored medical students’ perceptions of facilitation and hindrance of learning. However, the opportunities for medical student to learn within the culture of acute medicine care have not been fully investigated. This study aimed to explore how medical students approach, interact and socialise in an acute internal medicine ward context, and how spaces for learning are created and used in such a culture. Design and setting Ethnographic observations were performed of medical students' interactions and learning during early clerkship at an acute internal medicine care ward. Field notes were taken, transcribed and analysed qualitatively. Data analysis was guided by Wenger's theory of communities of practice. Participants 21 medical students and 30 supervisors participated. Results Two themes were identified: Nervousness and curiosity—students acted nervously and stressed, especially when they could not answer questions. Over time curiosity could evolve. Unexplored opportunities to support students in developing competence to judge and approach more complex patient-related problems were identified. Invited and involved—students were exposed to a huge variation of opportunities to learn, and to interact and to be involved. Short placements seemed to disrupt the learning process. If and how students became involved also depended on supervisors' activities and students' initiatives. Conclusions This study shed light on how an acute internal medicine ward culture can facilitate medical students' possibilities to participate and learn. Medical students' learning situations were characterised by questions and answers rather than challenging dialogues related to the complexity of presented patient cases. Further, students experienced continuous transfers between learning situations where the
Gaztambide-Fernandez, Ruben A.; Howard, Adam
In this article, we use our experiences to demonstrate the limits of the "studying up" metaphor to capture the complexity of the dynamics involved in doing research on groups that occupy positions of power within social hierarchies. The article focuses on different facets of the research process, alternating between our individual narratives and a…
After reviewing previous research on speech acts, this article describes a study that analyzed the behavior of speakers of standard Italian in refusing an offer of food. The importance of "face" is explained, and the refusal strategies are classified into four categories: explicit, tactical, decisive, and conclusive. (CFM)
Miller, Erin T.
In blatant, but nuanced and often invisible ways, racism continues to exist globally, nationally and locally, implicating us all. The insidious nature of racism is deeply rooted in the lives of young children. In order to interrupt and reverse those practices, we must know how race is constructed during the early years. This study looked closely…
In the last thirty years, the improvement of biomedical acculturate had influenced the medical tradition of Nauha, in souther-eastern Mexico. The study analyses how the constituent elements of biomedical tradition are incorporated into new rhetorical, diagnostic and therapeutic strategies, mixed with languages and symbols typical of local tradition.
Chaffee, Rachel L.
This dissertation study contributes to the research on filmmaking and identity development by exploring the ways that film production provided unique opportunities for a team of four girls to engage in science, to develop identities in science, and to see and understand science differently. Using social practice, identity, and feminist theory and…
Dobbs, Debra; Eckert, J. Kevin; Rubinstein, Bob; Keimig, Lynn; Clark, Leanne; Frankowski, Ann Christine; Zimmerman, Sheryl
Purpose: This study explored aspects of stigmatization for older adults who live in residential care or assisted living (RC-AL) communities and what these settings have done to address stigma. Design and Methods: We used ethnography and other qualitative data-gathering and analytic techniques to gather data from 309 participants (residents, family…
The most innovative reading practices currently rely on the paradigm of dialogic reading. Book clubs, literary gatherings and study circles are emerging in different social spaces to promote reading and literary discussion amongst adults, and libraries, bookshops, cultural centres, etc. are increasingly developing strategies in this direction.…
Instrument-making is a powerful way to teach and learn music, especially world music. This case study looks at adult music learners whose engagement in music involves instrument-making and the long lasting practice of music. A case in point is Japanese and North American practitioners of Japanese bamboo flutes, especially the end-blown…
Giuriceo, Carol M.
This study focuses on the experiences and perspectives of sixth grade girls in a moderately-sized East Coast city as they construct meaning through active engagement in a science classroom and analyzes the ways in which girls change roles and incorporate social interaction during science activities to create their own unique engagement in science.…
Noga, Michael A.
Using meta-ethnography as a research method, this study identified, organized, and synthesized efforts to implement learning communities at the 19 American colleges and universities that prepared written reports at the conclusion of the 1996-1999 National Learning Communities Dissemination Project (FIPSE). The researcher used 10 research questions…
Winchell, Dick G.
Humanistic geography is similar to ethnography in that both are concerned with describing actions and events in terms of their meaning to those experiencing them; humanistic geography is particularly concerned with understanding subjective social space: space as perceived by members of particular human groups. A humanistic geography case study,…
Paradis, Elise; Leslie, Myles; Gropper, Michael A.
Morning interprofessional rounds (MIRs) are used in critical care medicine to improve team-based care and patient outcomes. Given existing evidence of conflict between and dissatisfaction among rounds participants, this study sought to better understand how the operational realities of care delivery in the intensive care unit (ICU) impact the…
Jones, Aled; Jones, Delyth
This study explored the perceptions of staff in an interprofessional team based on a medical rehabilitation ward for older people, following the introduction of a service improvement programme designed to promote better teamworking. The study aimed to address a lack of in-depth qualitative research that could explain the day-to-day realities of interprofessional teamworking in healthcare. All members of the team participated, (e.g. nurses, doctors, physiotherapists, social worker, occupational therapists), and findings suggest that interprofessional teamworking improved over the 12-month period. Four themes emerged from the data offering insights into the development and effects of better interprofessional teamworking: the emergence of collegial trust within the team, the importance of team meetings and participative safety, the role of shared objectives in conflict management and the value of autonomy within the team. Reductions in staff sickness/absence levels and catastrophic/major patient safety incidents were also detected following the introduction of the service improvement programme.
Holmes, Seth M
Background Migrant workers in the United States have extremely poor health. This paper aims to identify ways in which the social context of migrant farm workers affects their health and health care. Methods and Findings This qualitative study employs participant observation and interviews on farms and in clinics throughout 15 months of migration with a group of indigenous Triqui Mexicans in the western US and Mexico. Study participants include more than 130 farm workers and 30 clinicians. Data are analyzed utilizing grounded theory, accompanied by theories of structural violence, symbolic violence, and the clinical gaze. The study reveals that farm working and housing conditions are organized according to ethnicity and citizenship. This hierarchy determines health disparities, with undocumented indigenous Mexicans having the worst health. Yet, each group is understood to deserve its place in the hierarchy, migrant farm workers often being blamed for their own sicknesses. Conclusions Structural racism and anti-immigrant practices determine the poor working conditions, living conditions, and health of migrant workers. Subtle racism serves to reduce awareness of this social context for all involved, including clinicians. The paper concludes with strategies toward improving migrant health in four areas: health disparities research, clinical interactions with migrant laborers, medical education, and policy making. PMID:17076567
Asan, Onur; Chiou, Erin; Montague, Enid
This study explores the relationship between primary care physicians' interactions with health information technology and primary care workflow. Clinical encounters were recorded with high-resolution video cameras to capture physicians' workflow and interaction with two objects of interest, the electronic health record (EHR) system, and their patient. To analyze the data, a coding scheme was developed based on a validated list of primary care tasks to define the presence or absence of a task, the time spent on each task, and the sequence of tasks. Results revealed divergent workflows and significant differences between physicians' EHR use surrounding common workflow tasks: gathering information, documenting information, and recommend/discuss treatment options. These differences suggest impacts of EHR use on primary care workflow, and capture types of workflows that can be used to inform future studies with larger sample sizes for more effective designs of EHR systems in primary care clinics. Future research on this topic and design strategies for effective health information technology in primary care are discussed.
Asan, Onur; Chiou, Erin; Montague, Enid
This study explores the relationship between primary care physicians’ interactions with health information technology and primary care workflow. Clinical encounters were recorded with high-resolution video cameras to capture physicians’ workflow and interaction with two objects of interest, the electronic health record (EHR) system, and their patient. To analyze the data, a coding scheme was developed based on a validated list of primary care tasks to define the presence or absence of a task, the time spent on each task, and the sequence of tasks. Results revealed divergent workflows and significant differences between physicians’ EHR use surrounding common workflow tasks: gathering information, documenting information, and recommend/discuss treatment options. These differences suggest impacts of EHR use on primary care workflow, and capture types of workflows that can be used to inform future studies with larger sample sizes for more effective designs of EHR systems in primary care clinics. Future research on this topic and design strategies for effective health information technology in primary care are discussed. PMID:26279597
Shefer, Guy; Griffin, Simon; Ogilvie, David
Objective To describe and explore perceptions, practices and motivations for active living in later life. Design Qualitative study with semistructured interviews and ‘semistructured’ participant observations of participant-selected activities, such as exercise classes, private or organised walks, shopping and gardening. Participants 27 participants (65–80 years) from the European Prospective Investigation into Cancer Norfolk study, purposefully selected by gender, age, occupational class, living status and residential location; 19 of the participants agreed to be accompanied for observed activities. Setting Participants’ homes, neighbourhoods, places of leisure activities and workplaces in Norfolk, England. Results All participants regarded a positive attitude as important for healthy ageing; this included staying active, both physically and mentally through sedentary activities such as reading and crosswords. ‘Getting out of the house’, being busy, or following a variety of interests were regarded as both important motivators and descriptions of their ‘activeness’. Purposeful activities formed an important part of this, for example, still being engaged in paid or voluntary work, having caring responsibilities, or smaller incidental activities such as helping neighbours or walking for transport. Many also reported adapting previous, often lifelong, activity preferences and habits to their ageing body, or replacing them altogether with lower impact activities such as walking. This included adapting to the physical limitations of partners and friends which dictated the intensity and frequency of shared activities. The social context of activities could thus form a barrier to active living, but could also encourage it through companionship, social responsibilities and social pressures. Conclusions Promoting and maintaining physical activity among older people may require more attention to activeness as an attitude and way of life as well as to its
Kim, Beom-Jun; Ahn, Seong Hee; Bae, Sung Jin; Kim, Eun Hee; Lee, Seung-Hun; Kim, Hong-Kyu; Choe, Jae Won; Koh, Jung-Min; Kim, Ghi Su
Despite extensive experimental and animal evidence about the detrimental effects of iron and its overload on bone metabolism, there have been no clinical studies relating iron stores to bone loss, especially in nonpathologic conditions. In the present study, we performed a large longitudinal study to evaluate serum ferritin concentrations in relation to annualized changes in bone mineral density (BMD) in healthy Koreans. A total of 1729 subjects (940 postmenopausal women and 789 middle-aged men) aged 40 years or older who had undergone comprehensive routine health examinations with an average 3 years of follow-up were enrolled. BMD in proximal femur sites (ie, the total femur, femur neck, and trochanter) was measured with dual-energy X-ray absorptiometry using the same equipment at baseline and follow-up. The mean age of women and men in this study was 55.8 ± 6.0 years and 55.5 ± 7.8 years, respectively, and serum ferritin levels were significantly higher in men than in women (p < 0.001). The overall mean annualized rates of bone loss in the total femur, femur neck, and trochanter were -1.14%/year, -1.17%/year, and -1.51%/year, respectively, in women, and -0.27%/year, -0.34%/year, and -0.41%/year, respectively, in men. After adjustment for potential confounders, the rates of bone loss in all proximal femur sites in both genders were significantly accelerated in a dose-response fashion across increasing ferritin quartile categories (p for trend = 0.043 to <0.001). Consistently, compared with subjects in the lowest ferritin quartile category, those in the third and/or highest ferritin quartile category showed significantly faster bone loss in the total femur and femur neck in both genders (p = 0.023 to <0.001). In conclusion, these data provide the first clinical evidence that increased total body iron stores could be an independent risk factor for accelerated bone loss, even in healthy populations.
Dobbs, Debra; Eckert, J. Kevin; Rubinstein, Bob; Keimig, Lynn; Clark, Leanne; Frankowski, Ann Christine; Zimmerman, Sheryl
Purpose This study explored aspects of stigmatization for older adults who live in residential care or assisted living (RC–AL) communities and what these settings have done to address stigma. Design and recognition of resident preferences and strengths, rather than their limitations. Methods We used ethnography and other qualitative data-gathering and analytic techniques to gather data from 309 participants (residents, family and staff) from six RC–AL settings in Maryland. We entered the transcript data into Atlas.ti 5.0. We analyzed the data by using grounded theory techniques for emergent themes. Results Four themes emerged that relate to stigma in RC–AL: (a) ageism in long-term care; (b) stigma as related to disease and illness; (c) sociocultural aspects of stigma; and (d) RC–AL as a stigmatizing setting. Some strategies used in RC–AL settings to combat stigma include family member advocacy on behalf of stigmatized residents, assertion of resident autonomy, and administrator awareness of potential stigmatization. Implications: Findings suggest that changes could be made to the structure as well as the process of care delivery to minimize the occurrence of stigma in RC–AL settings. Structural changes include an examination of how best, given the resident case mix, to accommodate care for persons with dementia (e.g., separate units or integrated care); processes of care include staff PMID:18728301
Deutschman, Marian T
The current system of delivery of nursing home care is costly both in dollars and in human terms. Culture change may provide solutions to both issues. Culture change has a different meaning for different organizations depending on where they are in the continuum of change. Detailed observation of staff members "in action" in three long-term care facilities over a period of several months was supplemented by formal and informal interviews of organization members to gain an understanding of the culture of the nursing home organization. Four three-hour observations in each of three facilities, representing privately-held and not-for-profit organizations in urban, suburban, and rural locations yielded insights into the routine, recruitment, training, teamwork, activities, leadership, role-modeling, mentoring, staff and resident satisfaction, weekend staffing and activities, bureaucratic structure, and sharing of best practices. Discussion of each of these issues may provide a starting point for all those facilities that are contemplating significant culture change. If the objective is to have facilities truly embrace a new set of values, then the change begins with the owners and administrators of nursing homes who need to focus on building new relationships with all the stakeholders. In-depth interviews of organization members and six chief executive officers in long-term care in the Western New York area culminated the study with the development of a fifty-question survey for decision makers.
Sawford, Kate; Vollman, Ardene Robinson; Stephen, Craig
The animal and public health communities need to address the challenge posed by zoonotic emerging infectious diseases. To minimize the impacts of future events, animal disease surveillance will need to enable prompt event detection and response. Diagnostic laboratory-based surveillance systems targeting domestic animals depend in large part on private veterinarians to submit samples from cases to a laboratory. In contexts where pre-diagnostic laboratory surveillance systems have been implemented, this group of veterinarians is often asked to input data. This scenario holds true in Alberta where private cattle veterinarians have been asked to participate in the Alberta Veterinary Surveillance Network-Veterinary Practice Surveillance, a platform to which pre-diagnostic disease and non-disease case data are submitted. Consequently, understanding the factors that influence these veterinarians to submit cases to a laboratory and the complex of factors that affect their participation in surveillance programs is foundational to interpreting disease patterns reported by laboratories and engaging veterinarians in surveillance. A focused ethnographic study was conducted with ten cattle veterinarians in Alberta. Individual in-depth interviews with participants were recorded and transcribed to enable thematic analysis. Laboratory submissions were biased toward outbreaks of unknown cause, cases with unusual mortality rates, and issues with potential herd-level implications. Decreasing cattle value and government support for laboratory testing have contributed to fewer submissions over time. Participants were willing participants in surveillance, though government support and collaboration were necessary. Changes in the beef industry and veterinary profession, as well as cattle producers themselves, present both challenges and opportunities in surveillance. PMID:23741397
Aggarwal, Ajay; Batura, Rekha; Sullivan, Richard
The media plays a vital role in informing the public about new developments in cancer research and influencing cancer policy. This is no easy task, in view of the myriad of trials and wonder drugs that purport to be the 'magic bullet'. However, misrepresentation can have profound consequences. In this qualitative study, we sought to understand the interaction between the media and cancer through the perspective of European science journalists by defining their attitudes towards current cancer research and challenges faced when reporting science news. A total of 67 respondents took part in this online survey, which was distributed by the European CanCer Organisation (ECCO) to all its media contacts between June and September 2013. Fifty-three per cent had over 20 years experience in reporting science news stories. The respondents utilised a number of media formats, including newsprint, online services, and radio. Fifty per cent ranked public interest as the greatest influence on their selection of cancer research topics, followed by topicality. Respondents were conscious of being fed ambiguous and exaggerated results from trials by the research community. Sixty-five per cent of respondents would appreciate access to a forum of experts willing to provide comment on new research findings. Seventy per cent highlighted the importance of prompt responses from scientists and researchers during correspondence, and the need to have advance warning of new developments (49%). To conclude - coverage of cancer related issues and scientific advances require greater collaboration between the press and cancer healthcare community to provide both credibility and accountability for the health information disseminated. Key areas include a more precise definition of the research context and differentiation of absolute and relative risks, as well as individual and population risks and an informed discussion about the realities and limitations of cancer care and research.
Simmonds, Rosemary; Glogowska, Margaret; McLachlan, Sarah; Cramer, Helen; Sanders, Tom; Johnson, Rachel; Kadam, Umesh; Lasserson, Daniel; Purdy, Sarah
Objectives Heart failure is a common cause of unplanned hospital admissions but there is little evidence on why, despite evidence-based interventions, admissions occur. This study aimed to identify critical points on patient pathways where risk of admission is increased and identify barriers to the implementation of evidence-based interventions. Design Multicentre, longitudinal, patient-led ethnography. Setting National Health Service settings across primary, community and secondary care in three geographical locations in England, UK. Participants 31 patients with severe or difficult to manage heart failure followed for up to 11 months; 9 carers; 55 healthcare professionals. Results Fragmentation of healthcare, inequitable provision of services and poor continuity of care presented barriers to interventions for heart failure. Critical points where a reduction in the risk of current or future admission occurred throughout the pathway. At the beginning some patients did not receive a formal clinical diagnosis, in addition patients lacked information about heart failure, self-care and knowing when to seek help. Some clinicians lacked knowledge about diagnosis and management. Misdiagnoses of symptoms and discontinuity of care resulted in unplanned admissions. Approaching end of life, patients were admitted to hospital when other options including palliative care could have been appropriate. Conclusions Findings illustrate the complexity involved in caring for people with heart failure. Fragmented healthcare and discontinuity of care added complexity and increased the likelihood of suboptimal management and unplanned admissions. Diagnosis and disclosure is a vital first step for the patient in a journey of acceptance and learning to self-care/monitor. The need for clinician education about heart failure and specialist services was acknowledged. Patient education should be seen as an ongoing ‘conversation’ with trusted clinicians and end-of-life planning should be
Zhao, Xin; Xiao, Jianping; Liao, Xiangpeng; Cai, Liyi; Xu, Fei; Chen, Daozhen; Xiang, Jingying; Fang, Rui
Background The increasingly recognized importance of vitamin D has been discussed and vitamin D status among young children has attracted widespread attention in recent years. However, study on vitamin D status in young children aged 1–3 y is limited in China. Objective To evaluate the nutritional vitamin D status of young children aged 1–3 y in Wuxi, southeastern China. Methods A large cohort of 5,571 young children aged 1–3 y were recruited in this study who visited the child health clinics at the Wuxi Maternity and Child Health Hospital (latitude 31.57°N) during January 2014 to January 2015. Wuxi was located in southeastern China at a latitude of 31.57°N. Finger-stick blood sampling was conducted in all the subjects and serum 25-Hydroxyvitamin D (25(OH)D) levels were measured to evaluate their vitamin D status. Results In this study, serum 25(OH)D levels of young children at the age of 1–3 years ranged from 20.6–132.9 nmol/L (Median: 71.5 nmol/L). 16.1% of the population had vitamin D deficiency (<50 nmol/L), while 38.8% of the subjects had a sufficient (50–74.9 nmol/L) vitamin D level. An optimal vitamin D status (≥75 nmol/L) was found in 45.1% of the young children. The prevalence of vitamin D deficiency was higher in autumn (19.5%) than in summer (12.1%). There was no significant difference in vitamin D status between genders. The binary logistic regression analysis revealed that child age was strongly associated with vitamin D deficiency (adjusted OR: 1.173; 95%CI: 1.053–1.308; P = 0.004). Conclusions The prevalence of vitamin D deficiency was 16.1% among young children aged 1–3 y in Wuxi. Season and child age were associated with their vitamin D status. It is implied that young children should receive adequate amounts of vitamin D supplementation and spend more time outdoors to prolong the sunlight exposure when they grow older. PMID:26505743
Kurita, Noriaki; Akizawa, Tadao; Fukagawa, Masafumi; Onishi, Yoshihiro; Kurokawa, Kiyoshi; Fukuhara, Shunichi
Background The extent of contribution of disturbed magnesium balance to mortality remains unclear among hemodialysis patients. Methods This was a cohort study involving 3276 patients on maintenance hemodialysis at 86 facilities in Japan from 2008 to 2010 who had secondary hyperparathyroidism (SHPT). Baseline serum magnesium (sMg) values were categorized into quintiles (≤2.3, >2.3–2.5, >2.5–2.7, >2.7–3.0 and >3.0 mg/dL), and the middle quintile was set as the reference. Outcome was all-cause death. Independent contribution to all-cause death was assessed via Cox regression to generate population-attributable fractions (PAFs). Results A total of 2165 patients from 68 facilities were analyzed. The lowest quintile of sMg was positively associated with lower serum potassium and albumin levels, higher C-reactive protein (CRP) levels and prevalence of atrial fibrillation and cerebrovascular disease than the other quintiles. The highest sMg quintile was positively associated with higher potassium levels, and negatively associated with lower serum albumin levels and higher intact parathyroid hormone and CRP levels and prevalence of cerebrovascular disease than the other quintiles. During a median follow-up of 3 years, the lowest and the second lowest quintiles of sMg were associated with all-cause death [adjusted hazard ratio (HR) 1.737, 95% confidence interval (95% CI) 1.200–2.512 and HR 1.675, 95% CI 1.254–2.238, respectively). Point estimates of adjusted HRs of the highest and the second highest sMg quintiles were higher than those of the middle quintile for all-cause death. Adjusted PAFs of lower sMg and of higher and lower sMg for all-cause death were 24.0% (95% CI 13.0–35.0%) and 30.7% (95% CI 14.5–46.8%), respectively. Conclusion In hemodialysis patients with SHPT, dysregulated sMg is an important contributor to all-cause death. Further studies are warranted to examine whether or not correction of sMg improves survival. PMID:26613035
Soleyman-Jahi, Saeed; Abdirad, Afshin; Fallah, Amir Afraz; Ghasemi, Sevil; Sadeghi, Fatemeh; Heidari, Reza; Mahmoodzadeh, Habibollah; Zendehdel, Kazem
OBJECTIVES: We aimed to investigate prognostic effects of plasma levels of ghrelin before and after gastrectomy in gastric cancer (GC). METHODS: We followed 81 GC patients up to 3 years in this study. They were candidates for curative gastrectomy with or without neoadjuvant chemotherapy. Plasma levels of total and active ghrelins before and after the operation were assessed. Association of plasma levels of ghrelin with survival were assessed and adjusted for other potential prognostic factors using Cox regression analyses. RESULTS: Both total and active ghrelins dropped after gastrectomy (P<0.001 for both). Multiple Cox models revealed worse survival for patients with postoperative total ghrelins below median (hazards ratio (HR)=2.33, 95% confidence interval (CI): 1.01–5.41) or 25th percentile (HR=4.29, 95% CI: 1.48–12.44) compared with patients with higher ghrelin levels. In case of preoperative total ghrelin, patients with either second or third quartiles of plasma ghrelin showed worse survival compared with patients with the lowest quartile (HR=2.67, 95% CI: 1.11–6.38 for second quartile, and HR=2.32, 95% CI: 1.01–5.35 for third quartile vs. the lowest quartile). However, there was no difference between patients with the highest and lowest quartiles (HR=0.78, 95% CI: 0.22–2.73). Similar pattern was observed for preoperative active ghrelin (HR=4.92, 95% CI: 1.80–13.54 for second quartile, and HR=2.87, 95% CI: 1.11–7.38 for third quartile vs. the lowest quartile). Advanced TNM stage (HR=4.88, 95% CI: 1.10–21.77), cachexia (HR=2.99, 95% CI: 1.35–6.63), and receiving no neoadjuvant chemotherapy (HR=2.02, 95% CI: 1.04–3.92) were other poor prognostic factors. CONCLUSIONS: Preoperative and postoperative plasma levels of ghrelin could predict survival of GC patients with different patterns. This prognostic effect was independent of stage and cachexia. Measurement of plasma ghrelin in GC patients could complement conventional staging for more precise
Lehmann, Harold P.; Freedman, Joan A.; Massad, John; Dintzis, Renee Z.
Objective: To evaluate the use and effect of a computer-based histology atlas during required laboratory sessions in a medical school histology course. Design: Ethnographic observation of students' interactions in a factorial, controlled setting. Measurements: Ethnographer's observations; student and instructor self-report survey after each laboratory session with items rated from 1 (least) to 7 (best); microscope practicum scores at the end of the course. Results: Between groups assigned the atlas and those not, the ethnographer found qualitative differences in the semantic categories used by students in communicating with each other and with the faculty. Differences were also found in the quality of the interactions and in the learning styles used with and without the computer present in the laboratory. The most interactive learning style was achieved when a pair of students shared a computer and a microscope. Practicum grades did not change with respect to historical controls. Students assigned the atlas, compared with those not assigned, reported higher overall satisfaction (a difference in score of 0.1, P = 0.003) and perceived their fellow students to be more helpful (a difference of 0.11, P = 0.035). They rated the usefulness of the microscope lower (a difference of 0.23, P < 0.001). Conclusion: A computer-based histology atlas induces qualitative changes in the histology laboratory environment. Most students and faculty reacted positively. The authors did not measure the impact on learning, but they found that there are aspects of using the atlas that instructors must manipulate to make learning optimal. Ethnographic techniques can be helpful in delineating the context and defining what the interventions might be. PMID:9925227
Sena, Nuno Afonso De Freitas Lopes De
An interactional ethnographic study informed by a sociocultural perspective was conducted to examine how a professor and students discursively and interactionally shaped the basis for engaging in the work of a community of geologists. Specifically, the study examined the role the Question of the Day, an interactive writing activity in the lecture, in affording students opportunities for learning the literate practices of science and how to incorporate them in thinking critically. A writing-intensive, introductory oceanography course given in the Geological Sciences Department was chosen because the professor designed it to emphasize writing in the discipline and science literacy within a science inquiry framework. The study was conducted in two phases: a pilot in 2002 and the current study in the Spring Quarter of 2003. Grounded in the view that members in a classroom construct a culture, this study explored the daily construction of the literate practices of science and writing. This view of classrooms was informed by four bodies of research: interactional ethnography, sociolinguistics sociology of science and Writing In the Disciplines. Through participant observation, data were collected in the lecture and laboratory settings in the form of field notes, video, interviews, and artifacts to explore issues of science literacy in discourse, social action, and writing. Examination of participation in the Question of the Day interactive writing activity revealed that it played a key role in initiating and supporting a view of science and inquiry. As the activity permitted collaboration, it encouraged students to engage in the social process to critically explore a discourse of science and key practices with and through their writing. In daily interaction, participants were shown to take up social positions as scientist and engage in science inquiry to explore theory, examine data, and articulately reformulate knowledge in making oral and written scientific arguments
Background Information and communication technologies (ICTs) are often proposed as ‘technological fixes’ for problems facing healthcare. They promise to deliver services more quickly and cheaply. Yet research on the implementation of ICTs reveals a litany of delays, compromises and failures. Case studies have established that these technologies are difficult to embed in everyday healthcare. Methods We undertook an ethnographic comparative analysis of a single computer decision support system in three different settings to understand the implementation and everyday use of this technology which is designed to deal with calls to emergency and urgent care services. We examined the deployment of this technology in an established 999 ambulance call-handling service, a new single point of access for urgent care and an established general practice out-of-hours service. We used Normalization Process Theory as a framework to enable systematic cross-case analysis. Results Our data comprise nearly 500 hours of observation, interviews with 64 call-handlers, and stakeholders and documents about the technology and settings. The technology has been implemented and is used distinctively in each setting reflecting important differences between work and contexts. Using Normalisation Process Theory we show how the work (collective action) of implementing the system and maintaining its routine use was enabled by a range of actors who established coherence for the technology, secured buy-in (cognitive participation) and engaged in on-going appraisal and adjustment (reflexive monitoring). Conclusions Huge effort was expended and continues to be required to implement and keep this technology in use. This innovation must be understood both as a computer technology and as a set of practices related to that technology, kept in place by a network of actors in particular contexts. While technologies can be ‘made to work’ in different settings, successful implementation has been
Barker, Judith C; Horton, Sarah B
Background Latino children experience a higher prevalence of caries than do children in any other racial/ethnic group in the US. This paper examines the intersections among four societal sectors or contexts of care which contribute to oral health disparities for low-income, preschool Latino1 children in rural California. Methods Findings are reported from an ethnographic investigation, conducted in 2005–2006, of family, community, professional/dental and policy/regulatory sectors or contexts of care that play central roles in creating or sustaining low income, rural children's poor oral health status. The study community of around 9,000 people, predominantly of Mexican-American origin, was located in California's agricultural Central Valley. Observations in homes, community facilities, and dental offices within the region were supplemented by in-depth interviews with 30 key informants (such as dental professionals, health educators, child welfare agents, clinic administrators and regulatory agents) and 47 primary caregivers (mothers) of children at least one of whom was under 6 years of age. Results Caregivers did not always recognize visible signs of caries among their children, nor respond quickly unless children also complained of pain. Fluctuating seasonal eligibility for public health insurance intersected with limited community infrastructure and civic amenities, including lack of public transportation, to create difficulties in access to care. The non-fluoridated municipal water supply is not widely consumed because of fears about pesticide pollution. If the dentist brought children into the clinic for multiple visits, this caused the accompanying parent hardship and occasionally resulted in the loss of his or her job. Few general dentists had received specific training in how to handle young patients. Children's dental fear and poor provider-parent communication were exacerbated by a scarcity of dentists willing to serve rural low-income populations
Tunchel, Samy; Blay, Alberto; Kolerman, Roni; Mijiritsky, Eitan; Shibli, Jamil Awad
This prospective 3-year follow-up clinical study evaluated the survival and success rates of 3DP/AM titanium dental implants to support single implant-supported restorations. After 3 years of loading, clinical, radiographic, and prosthetic parameters were assessed; the implant survival and the implant-crown success were evaluated. Eighty-two patients (44 males, 38 females; age range 26-67 years) were enrolled in the present study. A total of 110 3DP/AM titanium dental implants (65 maxilla, 45 mandible) were installed: 75 in healed alveolar ridges and 35 in postextraction sockets. The prosthetic restorations included 110 single crowns (SCs). After 3 years of loading, six implants failed, for an overall implant survival rate of 94.5%; among the 104 surviving implant-supported restorations, 6 showed complications and were therefore considered unsuccessful, for an implant-crown success of 94.3%. The mean distance between the implant shoulder and the first visible bone-implant contact was 0.75 mm (±0.32) and 0.89 (±0.45) after 1 and 3 years of loading, respectively. 3DP/AM titanium dental implants seem to represent a successful clinical option for the rehabilitation of single-tooth gaps in both jaws, at least until 3-year period. Further, long-term clinical studies are needed to confirm the present results.
This prospective 3-year follow-up clinical study evaluated the survival and success rates of 3DP/AM titanium dental implants to support single implant-supported restorations. After 3 years of loading, clinical, radiographic, and prosthetic parameters were assessed; the implant survival and the implant-crown success were evaluated. Eighty-two patients (44 males, 38 females; age range 26–67 years) were enrolled in the present study. A total of 110 3DP/AM titanium dental implants (65 maxilla, 45 mandible) were installed: 75 in healed alveolar ridges and 35 in postextraction sockets. The prosthetic restorations included 110 single crowns (SCs). After 3 years of loading, six implants failed, for an overall implant survival rate of 94.5%; among the 104 surviving implant-supported restorations, 6 showed complications and were therefore considered unsuccessful, for an implant-crown success of 94.3%. The mean distance between the implant shoulder and the first visible bone-implant contact was 0.75 mm (±0.32) and 0.89 (±0.45) after 1 and 3 years of loading, respectively. 3DP/AM titanium dental implants seem to represent a successful clinical option for the rehabilitation of single-tooth gaps in both jaws, at least until 3-year period. Further, long-term clinical studies are needed to confirm the present results. PMID:27313616
Audran, M; Jakob, F J; Palacios, S; Brandi, M-L; Bröll, H; Hamdy, N A T; McCloskey, E V
Strontium ranelate has been available as an osteoporosis treatment in Europe since 2004. This article describes a large European observational survey of the use of strontium ranelate in clinical daily practice. A retrospective observational registry included 32,446 women consulting for postmenopausal osteoporosis in seven countries. Within the registry, 12,046 women were receiving strontium ranelate and were followed up over 3 years. The baseline characteristics of the follow-up cohort were similar to those of the whole registry cohort (age, 68.9 ± 10.3 years; body mass index, 25.6 ± 4.3 kg/m(2); lumbar spine T-score, -2.57 ± 0.85 SD; femoral neck T-score, -2.11 ± 0.86 SD). At baseline, 77 % of patients had at least one risk factor for osteoporosis, and 46 % had a previous history of osteoporotic fracture. Mean duration of follow-up was 32.0 ± 9.7 months, and treatment duration was 25.2 ± 13.7 months (24,956 patient-years of treatment). Persistence with strontium ranelate was 80 % at 1 year, 68 % at 2 years, and 64 % at 32 months; most patients (about 80 %) reported rarely omitting a dose. At least one emergent adverse event was reported in 2,674 (22 %) patients, most frequently gastrointestinal side effects. The crude incidence of venous thromboembolic events was 2.1/1,000 patient-years. No cases of hypersensitivity reactions, such as drug rash with eosinophilia and systemic symptoms (DRESS), Steven-Johnson syndrome, or toxic epidermal necrolysis, were reported. During follow-up, a fracture occurred in 890 patients (7 %); 429 of the fractures were nonvertebral fractures. Our observational survey over 32 months indicated good rates of adherence with strontium ranelate and confirmed its good safety profile in the management of postmenopausal osteoporosis.
... years; Growth milestones for children - 3 years; Childhood growth milestones - 3 years; Well child - 3 years ... activities related to your child's interests. Encourage your child to use words to express feelings (rather than acting out).
Matsudaira, Ko; Hara, Nobuhiro; Oka, Hiroyuki; Kunogi, Junichi; Yamazaki, Takashi; Takeshita, Katsushi; Atsushi, Seichi; Tanaka, Sakae
Objective To assess the predictive factors for subjective improvement with nonsurgical treatment in consecutive patients with lumbar spinal stenosis (LSS). Materials and Methods Patients with LSS were enrolled from 17 medical centres in Japan. We followed up 274 patients (151 men; mean age, 71 ± 7.4 years) for 3 years. A multivariable logistic regression model was used to assess the predictive factors for subjective symptom improvement with nonsurgical treatment. Results In 30% of patients, conservative treatment led to a subjective improvement in the symptoms; in 70% of patients, the symptoms remained unchanged, worsened, or required surgical treatment. The multivariable analysis of predictive factors for subjective improvement with nonsurgical treatment showed that the absence of cauda equina symptoms (only radicular symptoms) had an odds ratio (OR) of 3.31 (95% confidence interval [CI]: 1.50–7.31); absence of degenerative spondylolisthesis/scoliosis had an OR of 2.53 (95% CI: 1.13–5.65); <1-year duration of illness had an OR of 3.81 (95% CI: 1.46–9.98); and hypertension had an OR of 2.09 (95% CI: 0.92–4.78). Conclusions The predictive factors for subjective symptom improvement with nonsurgical treatment in LSS patients were the presence of only radicular symptoms, absence of degenerative spondylolisthesis/scoliosis, and an illness duration of <1 year. PMID:26863214
Hamer, Mark; von Känel, Roland; Reimann, Manja; Malan, Nico T.; Schutte, Alta E.; Huisman, Hugo W.; Malan, Leone
Recent work identified a high prevalence of modifiable risk factors for cardiovascular disease (CVD) among urban black South Africans. The aim was to track the progression of CVD risk factors in a multi-ethnic sample of South Africans. Participants were 173 black (aged 47.5 ± 7.8 yrs) and 186 white teachers (aged 49.6 ± 9.9 yrs) that were examined at baseline and 3 years follow-up. Blacks demonstrated a substantially higher prevalence of composite CVD burden (defined as history of physician diagnosed heart disease, use of anti-hypertensives, anti-diabetic, or statin medications at either time point) compared to whites (49.1 vs. 32.0%, p = 0.012) respectively. After controlling for baseline, the black participants demonstrated greater increases in 24 h systolic and diastolic blood pressure, total cholesterol, fasting glucose, fibrinogen, D-dimer, and waist circumference in comparison with whites. In summary, an adverse progression of CVD risk factors was observed in the whole sample, although to a larger degree in black participants. Aggressive treatment strategies for controlling risk factors in black Africans are needed to reduce the increasing burden of CVD in South Africa. PMID:25437890
Measuring the seasonal variability of fatty acids (FAs) in milk improves our understanding of the nutritional and health values of milk. In collaboration with the Rodale Institute, Kutztown, PA, a 3-year study evaluated the seasonal variation of FA profiles of milk obtained from two farms adjacent t...
Transformative learning is a most important issue in medical education. Ethnographic edutainment is a concept that consists of reward, competition, and motivation strategies, which are more effective in engaging with learners. First-year medical students (N = 321) were included in this study during the Doctor and Society course at Chulalongkorn University in 2011. Four preset learning objectives were set and participants assigned a term group project with clouding technologies. The deliverables and the attitude toward this method were evaluated. Nineteen of 20 (95%) groups achieved all objectives. Females rated higher scores for this activity than males (P < 0.001). Statistically significant differences were found between lecture-based sessions and field visit sessions as well as ethnographic edutainment activity sessions and other types (P < 0.01). The results were consistent in both male and female groups. Ethnographic edutainment can be well-accepted with higher satisfaction than some other types of teaching.
Andersen, Rikke Sand; Vedsted, Peter
This article explores the mutually constituting relationship between healthcare seeking practices and the socio-political context of clinical encounters. On the basis of ethnographic fieldwork carried out in the context of Danish primary care (general practice) and inspired by recent writings on institutional logics, we illustrate how a logic of efficiency organise and give shape to healthcare seeking practices as they manifest in local clinical settings. Overall, patient concerns are reconfigured to fit the local clinical setting and healthcare professionals and patients are required to juggle efficiency in order to deal with uncertainties and meet more complex or unpredictable needs. Lastly, building on the empirical case of cancer diagnostics, we discuss the implications of the pervasiveness of the logic of efficiency in the clinical setting and argue that provision of medical care in today's primary care settings requires careful balancing of increasing demands of efficiency, greater complexity of biomedical knowledge and consideration for individual patient needs.
Padilla, Mark B
This article draws on ethnographic research among two categories of male sex workers in the Dominican Republic in order to describe the relationships between gay male tourists and the Dominican men they hire on their trips to the Caribbean. Drawing on both qualitative interview data and quantitative surveys, the discussion examines the usefulness of theories of 'authenticity,' as they have been applied in the analysis of tourist practices more generally, in accounting for the behaviors and practices of male sex workers and their foreign gay clients. While the flow of international remittances from 'Western Union daddies' to their Dominican 'boys' creates a continuous reminder of the utilitarian nature of the exchange, both sex workers and clients are motivated to camouflage this instrumentality in their construction of a more 'authentic,' fulfilling relationship. The article examines the consequences of this ambivalent negotiation for the emotional and economic organization of gay male sex tourism in the Caribbean.
Christensen, Lois McFadyen
The structures of meaning preservice teachers perceived and interpreted as a result of field placements in a methods course and through the use of ethnographic tools were studied in an ethnographic design. The study involved 11 preservice teachers. It described how they shaped each other's thinking about teaching and it examined how ethnographic…
Peterli, Ralph; Wölnerhanssen, Bettina Karin; Vetter, Diana; Nett, Philipp; Gass, Markus; Borbély, Yves; Peters, Thomas; Schiesser, Marc; Schultes, Bernd; Beglinger, Christoph; Drewe, Juergen; Bueter, Marco
Objective: Laparoscopic sleeve gastrectomy (LSG) is performed almost as often in Europe as laparoscopic Roux-Y-Gastric Bypass (LRYGB). We present the 3-year interim results of the 5-year prospective, randomized trial comparing the 2 procedures (Swiss Multicentre Bypass Or Sleeve Study; SM-BOSS). Methods: Initially, 217 patients (LSG, n = 107; LRYGB, n = 110) were randomized to receive either LSG or LRYGB at 4 bariatric centers in Switzerland. Mean body mass index of all patients was 44 ± 11 kg/m2, mean age was 43 ± 5.3 years, and 72% of patients were female. Minimal follow-up was 3 years with a rate of 97%. Both groups were compared for weight loss, comorbidities, quality of life, and complications. Results: Excessive body mass index loss was similar between LSG and LRYGB at each time point (1 year: 72.3 ± 21.9% vs. 76.6 ± 20.9%, P = 0.139; 2 years: 74.7 ± 29.8% vs. 77.7 ± 30%, P = 0.513; 3 years: 70.9 ± 23.8% vs. 73.8 ± 23.3%, P = 0.316). At this interim 3-year time point, comorbidities were significantly reduced and comparable after both procedures except for gastro-esophageal reflux disease and dyslipidemia, which were more successfully treated by LRYGB. Quality of life increased significantly in both groups after 1, 2, and 3 years postsurgery. There was no statistically significant difference in number of complications treated by reoperation (LSG, n = 9; LRYGB, n = 16, P = 0.15) or number of complications treated conservatively. Conclusions: In this trial, LSG and LRYGB are equally efficient regarding weight loss, quality of life, and complications up to 3 years postsurgery. Improvement of comorbidities is similar except for gastro-esophageal reflux disease and dyslipidemia that appear to be more successfully treated by LRYGB. PMID:28170356
Adair, Jennifer Keys
The policy brief "Ethnographic Knowledge for Early Childhood" details the contributions of current ethnographic research in the area of early childhood education. The brief's main purpose is to demonstrate how ethnography (as a methodology) helps us better understand the context of early childhood programs, the types of settings and…
Chowdhury, Arabinda N.; Mondal, Ranajit; Brahma, Arabinda; Biswas, Mrinal K.
AIMS Human–tiger conflict (HTC) is a serious public health issue in Sundarban Reserve Forest, India. HTC is a continued concern for the significant mortality and morbidity of both human and tiger population. This is the first comprehensive report on Sundarban tiger–human conflicts and its impact on widows whose husbands were killed by tigers. The study attempts to explore the situation analysis of HTC and the aftermath of the incident including bereavement and coping, the cultural stigma related to being killed by a tiger and the consequent discrimination, deprivation, and social rejection, and the impact on the mental health of the tiger-widows. METHODS This is a three-phase ethnographic research with a mix of quantitative and qualitative methods. In the first phase, a door-to-door village survey (3,084 households) was carried out in two villages of Sundarban, which are adjacent to the Reserve Forest, in which the incidents of human–animal conflicts and the 65 tiger-widows identified were documented. In the second phase, the 65 tiger-widows were studied to explore the ecodemography of tiger attacks and tiger-widows alongside the stigma issue by using a stigma questionnaire (n = 49). The stigma burden was compared with normal widows (n = 21) and snake-bite widows (n = 18). In the third phase, the psychosocial and cultural dimensions related to tiger attacks were studied by using in-depth interviews (IDI) of the tiger-widows, focus-group discussions (FGD), and participatory mapping in the community. Clinical examinations of the mental health of the widows were also carried out in this phase. RESULTS The mean age of the 65 widows was 43.49 ± 9.58 years. Of this, 12.3% of the widows had remarried and only 4.6% of the widows were literate. In all, 67.2% of all tiger attacks occurred as a result of illegal forest entry. The main livelihood of the former husbands of the widows were 43.8% wood cutting, 28.1% fishing, 10.9% crab catching, 9.4% tiger prawn seed
Watson-Gegeo, Karen Ann; Ulichny, Polly
A discussion of ethnographic research methods in language learning research focuses on what is involved in good descriptive and analytic ethnographic research and the value of the approach in the study of English as a second language (ESL). A basic definition of ethnography is offered, some key research principles are identified, and the…
Muraki, Shigeyuki; Akune, Toru; Nagata, Keiji; Ishimoto, Yuyu; Yoshida, Munehito; Tokimura, Fumiaki; Tanaka, Sakae; Kawaguchi, Hiroshi; Nakamura, Kozo; Oka, Hiroyuki; Yoshimura, Noriko
The objective of the present longitudinal study was to clarify whether osteophytosis and joint space narrowing predict quality of life (QOL) decline using a longitudinal population-based cohort of the Research on Osteoarthritis/osteoporosis Against Disability (ROAD) study. The present study analyzed 1,525 participants who completed the radiographic examination at baseline and questionnaires regarding QOL at a 3-year follow-up (546 men and 979 women; mean age, 67.0 ± 11.0 years). This study examined the associations of osteophyte area (OPA) and minimum joint space width (mJSW) in the medial compartment of the knee at baseline with pain and physical functional disability measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). OPA and mJSW in the medial compartment of the knee were measured using a knee osteoarthritis (OA) computer-aided diagnosis system. Overall, OPA independently predicted physical functional disability after 3 years of follow-up. When analyzed in men and women separately, OPA, rather than mJSW, was an independent predictor for pain and physical functional disability after 3 years of follow-up in men. OPA, rather than mJSW, also predicted worsening of pain in men during the 3-year follow-up, whereas in women, mJSW, rather than OPA, predicted worsening of pain. In conclusion, the present longitudinal study using a large-scale population from the ROAD study found gender differences in the association of osteophytosis and joint space narrowing with pain and physical functional disability.
Lung, For-Wey; Chiang, Tung-Liang; Lin, Shio-Jean; Shu, Bih-Ching
To increase public awareness and sensitivity, a two-stage screening with a community-based approach is proposed, with the use of the broadband Taiwan Birth Cohort Study (TBCS) developmental instrument in the first stage and the narrowband Modified Checklist of Autism in Toddlers (M-CHAT) in the second stage. Thus, the purpose of this study was to…
Nelson, Geoffrey; Ochocka, Joanna; Janzen, Rich; Trainor, John; Goering, Paula; Lomotey, Jonathan
The objective of this study was to evaluate the impacts of participation in mental health Consumer/Survivor Initiatives (CSIs), organizations run by and for people with mental illness. A nonequivalent comparison group design was used to compare three groups of participants: (a) those who were continually active in CSIs over a 36-month period (n =…
Retelsdorf, Jan; Becker, Michael; Koller, Olaf; Moller, Jens
Background: Assigning students to different school tracks on the basis of their achievement levels is a widely used strategy that aims at giving students the best possible learning opportunity. There is, however, a growing body of literature that questions such positive effects of tracking. Aims: This study compared the developmental trajectories…
Bernhardt, Barbara; Major, Eva
Background: Three years before the present study, 19 preschool children participated in a phonological and metaphonological intervention programme. The phonological intervention programme was based on non-linear phonological analyses. The metaphonological intervention programme included both rhyming and alliteration tasks and was directly targeted…
The emphasis on socio-cultural theories of learning has required the understanding of multi-dimensional, dynamic and social nature of acquiring the scientific knowledge and practices. Recent policy documents suggest a focus on formative and dynamic assessment practices that will help understand and improve the complex nature of scientific learning in classrooms. This study focuses on teachers' use of "Informal Formative Assessments (IFA)" aimed at improving students' learning and teachers' frequent recognition of students' learning process. The study was designed as an ethnographic case study of four middle school teachers and their students at a local charter school. The data of the study included (a) teachers' responses to history of teaching questionnaire (b) video and audio records of teachers' assessment practices during two different scientific projects (c) video and audio records of ethnographic interviews with teachers during their reflections on their practices, and (d) field notes taken by the researcher to understand the assessment culture of the school. The analytical tools from sociolinguistics (e.g., transcripts and event maps) were prepared and discourse analysis based in an ethnographic perspective was used to analyze the data. Moreover, Cultural-Historical Activity Theory (CHAT) was also introduced as an alternative data analysis framework for understanding the role of division of labor among the elements of the community on the challenges and the outcomes of IFA practices. The findings from the analysis of the classroom discourse showed three different types of IFA cycles: connected, non-connected, and repeating. The analysis of the teachers' reflections showed that the effectiveness of these cycles did not only depend on whether the cycles were connected, but also on other variables such as the phase of the lessons and student's identities and abilities. Teachers' reflections during researcher-teacher meetings on the concept and the aims of IFA
ABSTRACT Herpes Zoster (HZ) and its main complication, post-herpetic neuralgia (PHN), represent important public health issues because of their relevant burden among older adults. However, data on the epidemiology of HZ and PHN in Italy are very limited. A population-based study was performed by seeking for cases of HZ and PHN, occurred in the period 2013-2015, in the clinical charts of 56 General Practitioners working in 4 Italian Regions (Liguria, Puglia, Toscana and Veneto). The main objective of the study was to estimate the incidence of HZ and the proportion of PHN (at 1 and 3 mo from the onset of HZ; PHN1 and PHN3) among people aged ≥ 50 y. Overall, 598 cases of HZ were identified over 93,146 person-years of observation, thus corresponding to an overall incidence of 6.42 (IC95%: 5.93 – 6.95) HZ cases per 1,000 person-years. The incidence of HZ increased with age and was higher in female than in male. In total, 22.7%, 12.7%, and 2.4% of HZ cases suffered PHN at 1 and 3 mo and 1 y from the onset of acute episode. The proportions of these complications significantly increased with age, with the peak occurring in people aged ≥ 85 y. Four per cent of patients suffered ophthalmic zoster. The study provided an update of the epidemiological burden of HZ and PHN in Italy, confirming the relevant burden of the disease in the elderly population. The study was funded by the Italian Ministry of Health, Center for Disease Prevention and Control (CCM) in 2013. PMID:27925843
Saeki, Urara; Nasermoaddeli, Ali; Sekine, Michikazu; Kagamimori, Sadanobu
We conducted this longitudinal study to evaluate the relationships of positive and negative affectivity (Affect Balance Scale) to sleep quality among civil servants. For this study we evaluated 827 civil servants of T city in Toyama prefecture in the springs of 2001 (Baseline) and 2004 with complete information in both phases of the study. Based on the median score at each phase, we divided Affect Balance Scale (ABS) scores into high and low groups. We conducted logistic regression analysis to determine the odds ratios (OR) of 3-yr follow-up sleep quality by baseline and follow-up ABS scores. After adjusting for baseline sleep quality scores, age, sex, employment, job strain, and exercise habits, participants who had high ABS scores were more likely (OR: 3.13, 95% confidence interval (CI): 1.78-5.53) to have better sleep quality than those with low ABS scores at both phases. In addition, participants with low ABS scores at baseline and high ABS scores 3 yr later had better sleep quality (OR: 1.81, 95%CI: 1.02-3.20) than those with low ABS scores at both phases. These findings substantiate the relationships of positive and negative affectivity to sleep quality. Improving the affect balance condition as well as maintaining good affect balance condition may be important determinants of sleep quality in civil servants.
Carrasco-Labra, Alonso; Sung-Hsieh, Hsiao H.; Cortés-Araya, Juan
Objectives: To describe the epidemiology of facial trauma injuries in a group of Chilean children aged 15 years or less. Study Design: Retrospective study of case series. Between 2006 and 2009, clinical records of 293,090 patients were reviewed. Data of patients with trauma injuries to the face were collected and evaluated for: age, sex, day and month of hospital admission, cause of injury, anatomical location, type of injury and presence of associated injuries. Results: A total of 7,617 patients with 8,944 injuries were found. Boy to girl ratio was 1,7:1. Preschool age children were most frequently affected. Main cause of injury were falls, soft tissue injuries the most common type of injury. Associated injuries occurred in 11% of cases. Conclusions: Facial trauma presents a significant frequency in the group of Chilean children studied. Preeschool age boys were prone to present facial trauma of mild severity associated to falls. Key words:Facial trauma, pediatric trauma, epidemiology, pediatrics. PMID:23986019
Li, Haochu; Holroyd, Eleanor; Lau, Joseph
Background Unprotected anal intercourse (UAI) is a major pathway towards secondary HIV transmission among men who have sex with men (MSM). We explored the socio-cultural environment and individual beliefs and experiences conducive to UAI in the context of Southern China. Methods We employed an ethnographic approach utilizing a socio-ecological framework to conduct repeated in-depth interviews with thirty one newly diagnosed HIV positive MSM as well as participant observations in Shenzhen based healthcare settings, MSM venues and NGO offices. Results Some men (6/31) reported continuing to practice UAI after an initial diagnosis of being HIV positive. For MSM who had existing lovers or stable partners, the fear of losing partners in a context of non-serostatus disclosure was testified to be a major concern. MSM with casual partners reported that anonymous sexual encounters and moral judgments played a significant role in their sexual risk behaviors. Simultaneously, self-reported negative emotional and psychological status, perception and idiosyncratic risk interpretation, as well as substance abuse informed the intrapersonal context for UAI. Conclusion UAI among these HIV positive MSM was embedded in an intrapersonal context, related to partner type, shaped by anonymous sexual encounters, psychological status, and moral judgments. It is important that prevention and intervention for secondary HIV transmission among newly diagnosed HIV positive MSM in China take into account these contextual factors. PMID:26461258
de Campora, Gaia; Larciprete, Giovanni; Delogu, Anna Maria; Meldolesi, Cristina; Giromini, Luciano
Some recent findings indicate that maternal sensitivity and emotional regulation may play a key role in predicting the risk for obesity of the child in early ages. The current article describes a longitudinal study encompassing more than 50 women, across a time-span that currently goes from pregnancy (n = 65) to three years of age of the baby (n = 53). In a previous report on our ongoing research project, we showed that emotional regulation during pregnancy and pre-pregnancy BMI significantly predicted the quality of the early, dyadic feeding interactions, at 7 months of age of the baby. The current study confirmed and extended those findings, by showing that maternal emotional dysregulation (r = .355, p = .009) and pre-pregnancy BMI (r = .389, p = .004) predicted the BMI of the child at three years of age too, with a medium to large effect size. However, neither maternal emotional regulation nor pre-pregnancy BMI significantly predicted infant attachment at one year of age.
Frimat, L; Cassuto-Viguier, E; Provôt, F; Rostaing, L; Charpentier, B; Akposso, K; Moal, M C; Lang, P; Glotz, D; Caillard, S; Ducloux, D; Pouteil-Noble, C; Girardot-Seguin, S; Kessler, M
Calcineurin inhibitor (CNI) toxicity contributes to chronic allograft nephropathy (CAN). In the 2-year, randomized, study, we showed that 50% cyclosporin (CsA) reduction in combination with mycophenolate mofetil (MMF) treatment improves kidney function without increasing the risk for graft rejection/loss. To investigate the long-term effect of this regimen, we conducted a follow up study in 70 kidney transplant patients until 5 years after REFERENCE initiation. The improvement of kidney function was confirmed in the MMF group but not in the control group (CsA group). Four graft losses occurred, 2 in each group (graft survival in the MMF group 95.8% and 90.9% in control group). One death occurred in the control group. There was no statistically significant difference in the occurrence of serious adverse events or acute graft rejections. A limitation is the weak proportion of patient still remaining within the control group. On the other hand, REFERENCE focuses on the CsA regimen while opinions about the tacrolimus ones are still debated. In conclusion, CsA reduction in the presence of MMF treatment seems to maintain kidney function and is well tolerated in the long term.
Buser, D; Weber, H P; Bragger, U; Balsiger, C
This study examined the tissue integration of one-stage, nonsubmerged ITI implants over a period of 3 years. Fifty-four implants were placed in 38 partially edentulous patients. Following healing (at least 3 months), all 54 implants were free of peri-implant infections and revealed no detectable mobility. Radiographs showed no signs of peri-implant radiolucencies, and the implants were in favorable positions for prosthetic restoration. Following incorporation of fixed partial dentures, patients were enrolled in a hygiene recall program with 3-month intervals and were examined once a year. Based on predefined criteria, each implant was classified as successful or failing. After the 3-year observation period, 51 of 53 implants (96.2%) were considered successfully integrated. (One patient with one implant dropped out of the study.) Two implants exhibited recurrent peri-implant infections and were classified as late failures. These results indicate that one-stage ITI implants can achieve successful tissue integration on a predictable basis and that it can be maintained over a period of at least 3 years.
Patricelli, B.; González, M. M.; Fraija, N.; Marinelli, A.
The Milagro experiment was a TeV gamma-ray observatory designed to continuously monitor the overhead sky in the 0.1-100 TeV energy range. It operated from 2000 and 2008 and was characterized by a large field of view (˜ 2 sr) and a high duty cycle (≥ 90%). Here we report on the long-term monitoring of the blazar Mrk 421 with Milagro over the period from September 21, 2005 to March 15, 2008. We present a study of the TeV variability of the source and provide upper limits for the measured flux for different time scales, ranging from one week up to one year.
Carpentier, Patrick; Gressin, Virginie; Diot, Elisabeth; Allanore, Yannick; Sibilia, Jean; Launay, David; Mouthon, Luc; Jego, Patrick; Cabane, Jean; de Groote, Pascal; Chabrol, Amélie; Lazareth, Isabelle; Guillevin, Loïc; Clerson, Pierre; Humbert, Marc
Objectives. This longitudinal study investigated survival, risk factors and causes of death in the multicentre ItinérAIR-Sclérodermie cohort of patients with SSc without severe pulmonary fibrosis or severe left heart disease at baseline. Methods. At 3-year follow-up, vital status was obtained from investigators or French national death records. Causes of death were classified as SSc-related or otherwise. Data were censored at 37 months, time of death or loss to follow-up, whichever was earlier. Survival was estimated using the Kaplan–Meier method. Multivariate survival analyses were conducted using the Cox model. Results. In total, 546 patients were followed for a median duration of 37 months, representing 1547 patient-years. At baseline, the majority of patients were female, with lcSSc, mean age 54.9 ± 13.0 years and mean duration of SSc of 8.8 ± 8.1 years. In total, 47 patients died, giving a 3-year survival of 91.1% and cumulative mortality of 3.04 deaths per 100 patient-years; 17 deaths (32.2%) resulted from pulmonary arterial hypertension (PAH) and eight (17.1%) from cancer. Of the 47 patients with PAH at baseline, 20 died during follow-up, giving a 3-year survival of 56.3%. In a multivariate analysis, PAH [hazard ratio (HR) 7.246], age at first symptom (HR 1.052), duration of SSc (HR 1.047 per year) and Rodnan skin score (per one point) (HR 1.045) were associated with increased mortality. Conclusion. This 3-year study observed survival and mortality estimates that were comparable with previous reports. PAH increased the HR for mortality in patients with SSc, justifying yearly echocardiographic screening. PMID:19174571
Garg, Kavita Nitish; Raj, Vineet; Chandra, Shaleen
Background: Oral cancer is one of the most debilitating and disfiguring of all malignancies; it is one of the most frequently occurring cancers in the body. The high incidence of oral cancer in India has been attributed to widespread tobacco usage among the population either in chewable or smoked form. Aim: In the current study, we retrospectively analyzed 191 cases (2007-2009) of potentially malignant oral lesions, which had been biopsied in our hospital, in order to assess their relationship with tobacco usage. Materials and Methods: Based on the histopathology, these lesions were classified as high-risk lesions (HRL), low-risk lesions, and questionable risk lesions. The data obtained were then analyzed to find out the correlation between the occurrence of risk level with various demographic parameters such as age and gender as well as with type, frequency, and duration of tobacco habit. Results: Out of 191 cases, 122 patients reported with tobacco habit (chewers, smokers, and both) and frequency (<5 and >5 packets/day) were seen in 109 cases and duration (<5 and >5 years) seen in 99 cases. These parameters were correlated with histopathological diagnosis and results showed that both the groups came under the high-risk category. Further analysis of decategorized group (age and gender) was also done. Conclusion: Analysis showed that overall histopathologically diagnosed HRLs were seen more in males and smokers compared to female and chewers, respectively. PMID:24250079
Kdous, Moez; Zhioua, Fethi
Objectives To evaluate the long-term efficacy and safety of transobturator four-arm mesh for treating cystoceles. Patients and methods In this prospective study, 105 patients had a cystocele corrected between January 2004 and December 2008. All patients had a symptomatic cystocele of stage ⩾2 according to the Baden–Walker halfway stratification. We used only the transobturator four-arm mesh kit (Surgimesh®, Aspide Medical, France). All surgical procedures were carried out by the same experienced surgeon. The patients’ characteristics and surgical variables were recorded prospectively. The anatomical outcome, as measured by a physical examination and postoperative stratification of prolapse, and functional outcome, as assessed by a questionnaire derived from the French equivalents of the Pelvic Floor Distress Inventory, Pelvic Floor Impact Questionnaire and the Pelvic Organ Prolapse–Urinary Incontinence-Sexual Questionnaire, were considered as the primary outcome measures. Peri- and postoperative complications constituted the secondary outcome measures. Results At 36 months after surgery the anatomical success rate (stage 0 or 1) was 93%. On a functional level, all the scores of quality of life and sexuality were improved. The overall satisfaction score (visual analogue scale) was 71.4%. There were no perioperative adverse events. Mesh erosion was reported in 7.6% and mesh retraction in 5.7% of the patients. Conclusions If the guidelines and precautions are followed, vaginal prosthetic surgery for genitourinary prolapse has shown long-term benefits. It provides excellent results both anatomically and functionally. However, complications are not negligible and some are specific to prosthetic surgery. PMID:26019962
Fujihara, Masahiko; Higashimori, Akihiro; Kato, Yoshihiro; Taniguchi, Hiromasa; Iwasaki, Yusuke; Amano, Tomonori; Sumiyoshi, Akinori; Nishiya, Daisuke; Yokoi, Yoshiaki
The clinical outcomes of nitinol stents for femoropopliteal arterial (FP) disease in patients on hemodialysis were assessed. Endovascular therapy (EVT) is accepted for symptomatic FP disease. However, the clinical outcomes of patients on dialysis are not well known. A multicenter retrospective study was conducted with data between November 2010 and August 2013. A total of 484 consecutive patients who successfully underwent EVT for FP disease with nitinol stents were recruited and analyzed. Patients were categorized into the hemodialysis group (N = 161) and non-hemodialysis group (N = 323). The primary measure was primary patency verified by duplex ultrasound at a rest peak systolic velocity (PSVR) of >2.5, and secondary measures were freedom from target lesion revascularization (TLR) and major amputation-free survival (AFS). Average follow-up duration was 19.5 ± 13.5 months. The primary patency rate at 3 years was significantly lower in the hemodialysis group than the non-hemodialysis group (33.8 vs. 43.7 %; p = 0.036). Freedom from TLR at 3 years was 55.0 % in the hemodialysis group and 66.1 % in the non-hemodialysis group (p = 0.032). The hemodialysis group showed a significantly lower AFS rate at 3 years than the non-hemodialysis group (86.4 vs. 58.2 %; p < 0.001). In hemodialysis patients, nitinol stent use resulted in a lower patency rate, higher TLR rate, and lower AFS rate compared to non-hemodialysis patients. These data suggest that nitinol stent implantation for FP arteries in hemodialysis patient needs to be reconsidered.
This study, part of a larger linguistic ethnographic enquiry carried out in two primary school classrooms in Flanders and the Netherlands, sheds light on the perils faced by the ethnographer caught between pupils' inventiveness and his own ethnographic naivety when dealing with these pupils' ethnolinguistic identity construction. The study first…
Tuquero, Jean Marie
This qualitative study utilized a meta-ethnographic approach to synthesize findings of five dissertations that focused on distance learning support services. The history of ethnographical studies stemmed from an anthropological background. Researchers have applied ethnographical approaches to examine and document various phenomena. This…
Seki, N; Matsumoto, T; Fukazawa, M
The aim of the study was to examine the relationship between the brain natriuretic peptide (BNP) level and progression or remission of diabetic nephropathy with microalbuminuria for 3 years. The subjects were 100 Japanese type 2 diabetes mellitus outpatients with microalbuminuria. Associations between metabolic parameters at baseline [HbA1c, systolic blood pressure (SBP), urine albumin-creatinine ratio (ACR), estimated glomerular filtration rate (eGFR), and BNP] and the progression or remission of diabetic nephropathy were examined for 3 years. A total of 83 patients were examined at the end of the 3-year period, including 17 with remission to normoalbuminuria, 47 with continuing microalbuminuria, and 19 with progression to macroalbuminuria. HbA1c, ACR, and BNP differed significantly among the 3 groups (p=0.024, p<0.001, p=0.002, respectively). Among baseline factors, HbA1c and BNP were significant predictors of the percentage increase in ACR for 3 years in multiple linear regression analysis (β=0.259, p=0.02; β=0.299, p=0.007, respectively). In multivariate logistic regression analysis, HbA1c and ACR were independently associated with progression of diabetic nephropathy (p=0.008, p=0.023, respectively), and ACR and BNP were independently associated with remission of diabetic nephropathy (p=0.029, p=0.012, respectively). ROC curve analysis gave a cutoff value for BNP of 14.9 pg/ml for prediction of remission of diabetic nephropathy (p=0.016). The BNP level has a relationship with diabetic nephropathy and a low BNP level predicts remission of diabetic nephropathy. Therefore, monitoring of BNP can play an important role in management of diabetic nephropathy.
Zakerihamidi, Maryam; Latifnejad Roudsari, Robab; Merghati Khoei, Effat
Background: Cesarean section (C-section) in the North of Iran accounts for 70% of childbirths, which is higher than the national average of 55%. Understanding women’s perceptions towards modes of delivery in different cultures can pave the way for promoting programs and policies in support of vaginal delivery. We aimed to investigate women’s perceptions towards modes of delivery in the North of Iran. Methods: Using a focused ethnographic approach and purposive sampling, 12 pregnant women, 10 women with childbirth experience, nine non-pregnant women, seven midwives, and seven gynecologists were selected from hospitals, healthcare centers, and clinics of Tonekabon and Chaloos, Mazandaran, Iran, during 2012-2014. Data were collected through in-depth interviews and participant observation. Data analysis was performed using thematic analysis using MAXqda software. Results: Two major themes emerged from the data including: “vaginal delivery, a facilitator of women’s physical and mental health promotion”, and “C-section, a surgical intervention associated with decreased labor pain”. Six sub-themes subsumed within these major themes were: vaginal delivery as a safe mode of delivery, fullfilment of maternal instinct, a natural process with a pleasant ending, and C-section as a procedure associated with future complications, a surgical intervention and sometimes a life saving procedure, and a painless mode of delivery. Conclusion: In the North of Iran, women’s justified cultural beliefs overshadow their micsconceptions, so it is hopped that through implementing appropriate training programs for raising awarness and correcting miscomceptions, vaginal delivery could be promoted even in regions with high rates of cesarean section. PMID:25553333
V Lloyd, Joanne; Schneider, Justine; Scales, Kezia; Bailey, Simon; Jones, Rob
Rising dementia incidence is likely to increase pressures on healthcare services, making effective well coordinated care imperative. Yet, barriers to this care approach exist which, we argue, might be understood by focussing on identity dynamics at the frontlines of care. In this article, we draw upon findings from an ethnographic study of healthcare assistants (HCAs) from three dementia wards across one National Health Service mental health trust. Data revealed that the HCAs are a close-knit 'in-group' who share low group status and norms and, often highlight their own expertise in order to promote self worth. HCAs' social identity is considered as a barrier to effective teamwork with strong ingroup behaviour suggested as a consequence of their marginalisation. We explore these findings with reference to social identity theory (Tajfel, 1974; Turner, 1978 ) and discuss implications for delivering multiprofessional and interprofessional care.
Zraly, Maggie; Nyirazinyoye, Laetitia
Rape has been used in contemporary armed conflicts to inflict physical, psychological, cultural and social damage. In endeavoring to address the psychological damage of collective violence, some researchers and global health practitioners are turning toward post-conflict mental health promotion approaches that centrally feature resilience. Though previous findings from resilience and coping research are robust, few studies have actually investigated resilience among genocide-rape survivors in cultural context in non-Western settings. This paper presents ethnographic data gathered over 14 months (September 2005 to November 2006) in southern Rwanda on resilience among genocide-rape survivors who were members of two women's genocide survivor associations. Study methods included a content analysis of a stratified purposive sample of 44 semi-structured interviews, as well as participant-, and non-participant-observation. Resilience among genocide-rape survivors in this context was found to be shaped by the cultural-linguistic specific concepts of kwihangana (withstanding), kwongera kubaho (living again), and gukomeza ubuzima (continuing life/health), and comprised of multiple sociocultural processes that enabled ongoing social connection with like others in order to make meaning, establish normalcy, and endure suffering in daily life. The results of this research show that the process of resilience among genocide-rape survivors was the same regardless of whether genocide survivor association membership was organized around the identity of genocide-rape survivorship or the identity of widowhood. However, the genocide-rape survivors' association members were more involved with directing resilience specifically toward addressing problems associated with genocide-rape compared to the members of the genocide widows' association. The findings from this research suggest that ethnographic methods can be employed to support resilience-based post-conflict mental health promotion
Matinga, Margaret Njirambo; Annegarn, Harold J; Clancy, Joy S
Policymakers at global level recognise that household biomass use in developing countries has significant health consequences. However, it is unclear how local-level health professionals perceive and respond to such health effects. This paper which is derived from the findings of a larger study on perceptions and responses to the harmful health effects of carrying heavy firewood loads and to smoke from cooking fires is based on a study conducted in South Africa among managers of health programmes and community nurses of Qaukeni and Mhlontlo municipalities in rural Eastern Cape. Interviews and participant observations were conducted in 2009 using ethnographic grounded theory approaches. In addition to a 10-month period of ethnographic fieldwork, ten programme managers and nurses in two villages were interviewed about health patterns in the villages that they serve, their perceptions of, and responses to the health effects of carrying heavy firewood loads, and inhalation of smoke from wood and dung cooking fires, their professional qualifications and experience, their own household energy use; and observations made as they served clinic clients. Results show that these programme managers and nurses perceive the health effects of carrying heavy loads of firewood and of cooking smoke as minor. Sometimes, nurses give women symptomatic relief for musculoskeletal pain resulting from carrying heavy loads. We posit that their perceptions are derived from customary neglect of work-related health and non-communicable diseases, cultural interpretations of womanhood, limited access to relevant information, and limited interactions between health and energy sector professionals. We conclude that culturally and gender-sensitive awareness programmes are needed for local-level health professionals to effectively address health effects of biomass collection and use. This paper provides new insights into overlooked differences between globally-driven initiatives to address health
Tuquero, Jean M.
This qualitative research study utilized Noblit and Hare's (1988) meta-ethnographic approach to synthesize findings of five dissertations that focused on distance learning support services for adult learners. Noblit and Hare's (1988) meta-ethnographic approach consists of seven phases. Each meta-ethnographic phase guided the identification process…
Eisenberg, Sarita L.; Guo, Ling-Yu; Germezia, Mor
Purpose: This study investigated the level of grammatical accuracy in typically developing 3-year-olds and the types of errors they produce. Method: Twenty-two 3-year-olds participated in a picture description task. The percentage of grammatical utterances was computed and error types were analyzed. Results: The mean level of grammatical accuracy…
Background Parkinson’s disease affects facial, vocal and trunk muscles. As symptoms progress, facial expression becomes masked, limiting the person’s ability to communicate emotions and intentions to others. As people with the disease live and reside in their homes longer, the burden of caregiving is unmitigated by social and emotional rewards provided by an expressive individual. Little is known about how adults living with Parkinson’s disease manage their social lives and how an inability to be emotionally expressive can affect social connections and health. Because social networks have been shown to be crucial to the overall well-being of people living with chronic diseases, research is needed on how expressive capacity affects life trajectories and health. Methods/Design The overall objective is to understand the emergence and evolution of the trajectories of the self-management of the social lives of people living with Parkinson’s disease. The central hypothesis is that expressive capacity predicts systematic change in the pattern of social self-management and quality of life outcomes. The specific aims of this 3-year longitudinal study of 120 people with the disease and a maximum of 120 care partners are: 1) characterize social self-management trajectories over a 3-year period; 2) estimate the degree to which expressive nonverbal capacity predicts the trajectory; and 3) determine the moderating effect of gender on the association between expressive capacity and change in social self-management. Each participant will be assessed 14 times to detect rapid and non-linear changes in social participation and management of social activities; social network; and social comfort, general health and well-being. Discussion This project will provide evidence to guide the development of interventions for supporting social integration of those living with Parkinson’s disease, thus leading to improved overall health. It focuses on the novel construct of social self
Prati, C; Chersoni, S; Cretti, L; Montanari, G
The aim of this clinical study was to evaluate class V and class III cavities restored with a polyacid-modified resin composite (compomer) restorative material in association with two different dentin-enamel bonding systems: Dyract-PSA (Primer Sealer Adhesive-DentSply, Germany) and Prime & Bond 2.0 (DentSply, Germany). The control group was a hybrid composite used with ProBond bonding system (DentSply, Germany). A total of 116 restorations (79 class V, 37 class III) were made and reevaluated after 1, 2 and 3 years in 55 patients in two private practices and in a university department. Class V nonretentive cavities were located at the CEJ level and class III at interproximal level close to CEJ. Each cavity was prepared using a water-cooled, high-speed handpiece with a fine diamond burr. A small bevel was prepared along enamel margin. Cavity dimensions were no more than 3.5 x 3.5 mm (using burr as reference point). Each restoration was finished immediately with fine diamond burrs and Sof-Lex disks (3 M, USA). The criteria that were evaluated by the USPHS method included: retention, color match, marginal integrity, marginal discoloration, and secondary caries. Results indicated that all compomer restorations were fully retained at 3 years, and that no secondary caries detected. Seven composite restorations were lost during the 3-year study. No statistical differences were observed between class III and class V or among other conditions (e.g., upper-lower arc, sex, age). This study demonstrates that compomers are suitable restorative materials for class III-V restorations. They may represent a clinical alternative to composites in class V and III restorations.
Nagata, Keiji; Yoshida, Munehito; Ishimoto, Yuyu; Hashizume, Hiroshi; Yamada, Hiroshi; Yoshimura, Noriko
Although bone loss contributes to osteoporosis (OP) in the elderly, little is known about changes in bone mineral density (BMD) in young adults that lead to bone loss. Here, we evaluated the rate of bone change and risk factors for bone loss in young men and women using data from a 3-year prospective study of Japanese medical students. The study included a self-administrated questionnaire survey, anthropometric measurements, and BMD measurements of the spine (L2-L4) and femoral neck (FN). After 3 years, the BMD of the participants was again measured at the same sites. In all, 458 students (95.4 %; 298 men and 160 women; age range, 18-29 years; mean age, 20.2 years) completed both the baseline and follow-up surveys. The mean L2-L4 BMD value at baseline increased significantly within 3 years. This tendency was also observed for the FN in men but not in women. The annual changes at L2-L4 were 1.78 % in men and 0.97 % in women per year; those for FN were 1.08 % in men and 0.08 % in women per year. However, 20.3 % and 38.5 % of the total freshmen lost BMD in the lumbar spine and FN, respectively. After adjustment for age and body mass index, logistic regression analysis revealed that bone loss in men at L2-L4 at the baseline was affected by skipping breakfast. In contrast, exercise (>2 h/week) increased lumbar spine BMD in both genders. These findings indicate that breakfast and exercise are important for maintaining BMD in young men and women.
Quah, Phaik Ling; Cheung, Yin Bun; Pang, Wei Wei; Toh, Jia Ying; Saw, Seang-Mei; Godfrey, Keith M; Yap, Fabian; Chong, Yap Seng; Mary, Chong Foong-Fong
The Children's Eating Behaviour Questionnaire (CEBQ) was developed to measure eating behaviors related to obesity risk in children. However, this questionnaire has not been validated for use in South East Asia, where parenting practices are different from those in western countries and child obesity rates are increasing. The aim of this study was to examine the validity of the CEBQ administered to mothers of children aged 3 years in Singapore. Confirmatory factor analysis (CFA) was used to examine if the original 35-item, 8-factor model was supported in our cohort. Participants were 636 mother-child dyads (mean (SD) child age = 36.7 (1.6) months), from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort in which the mothers were characterized in pregnancy and children were followed up to age 3 years. The CFA showed a poor model fit; RMSEA = 0.072 (PCLOSE<0.001), SRMR = 0.094, CFI = 0.826, and TLI = 0.805. Exploratory factor analysis revealed a 35 item, 7-factor structure (factor loadings ≥ 0.35): enjoyment of food, food fussiness, emotional overeating, desire to drink, emotional under eating, satiety responsiveness and slowness in eating. Cronbach's alpha estimates ranged from 0.70 to 0.88 for the 7 subscales. Convergent validity tests via correlation analysis revealed that emotional under eating (r = -0.14), slowness in eating (r = -0.16) and satiety responsiveness (r = -0.11) were negatively correlated with BMI z-score at 3 years, while enjoyment of food (r = 0.12) was positively correlated, p < 0.05. In conclusion, we found a revised 7-factor structure of the CEBQ more appropriate for examining eating behavior in 3 year old children in the Singapore setting. Further replication studies in a separate cohort study are warranted before further use of these factor structures generated.
... Feeding Your 1- to 2-Year-Old Your Child’s Development: 3 Years KidsHealth > For Parents > Your Child’s Development: 3 Years A A A Kids this age ... but certain signs could indicate a delay in development. Talk to your doctor if your child: doesn't speak, or can't speak in ...
... Feeding Your 1- to 2-Year-Old Your Child’s Development: 3 Years KidsHealth > For Parents > Your Child’s Development: 3 Years Print A A A en español ... but certain signs could indicate a delay in development. Talk to your doctor if your child: doesn't speak, or can't speak in ...
Background Seniors need sufficient balance and strength to manage in daily life, and sufficient physical activity is required to achieve and maintain these abilities. This can be a challenge, but fun and motivational exergames can be of help. However, most commercial games are not suited for this age group for several reasons. Many usability studies and user-centered design (UCD) protocols have been developed and applied, but to the best of our knowledge none of them are focusing on seniors’ use of games for physical activity. In GameUp, a European cofunded project, some prototype Kinect exergames to enhance the mobility of seniors were developed in a user-centered approach. Objective In this paper we aim to record lessons learned in 3 years of experience with exergames for seniors, considering both the needs of older adults regarding user-centered development of exergames and participation in UCD. We also provide a UCD protocol for exergames tailored to senior needs. Methods An initial UCD protocol was formed based on literature of previous research outcomes. Senior users participated in UCD following the initial protocol. The users formed a steady group that met every second week for 3 years to play exergames and participate in the UCD during the 4 phases of the protocol. Several methods were applied in the 4 different phases of the UCD protocol; the most important methods were structured and semistructured interviews, observations, and group discussions. Results A total of 16 seniors with an average age above 80 years participated for 3 years in UCD in order to develop the GameUp exergames. As a result of the lessons learned by applying the different methodologies of the UCD protocol, we propose an adjusted UCD protocol providing explanations on how it should be applied for seniors as users. Questionnaires should be turned into semistructured and structured interviews while user consultation sessions should be repeated with the same theme to ensure that the
Moledina, Dennis G.; Parikh, Chirag R.; Garg, Amit X.; Thiessen-Philbrook, Heather; Koyner, Jay L.; Patel, Uptal D.; Devarajan, Prasad; Shlipak, Michael G.; Coca, Steven G.
Background Higher levels of plasma neutrophil gelatinase-associated lipocalin (pNGAL) are an early marker of acute kidney injury and are associated with increased risk of short-term adverse outcomes. The independent association between pNGAL and long-term mortality is unknown. Methods In this prospective observational cohort study, we studied 1191 adults who underwent cardiac surgery between 2007 and 2009 at 6 centers in the TRIBE-AKI cohort. We measured the pNGAL on the pre-operative and first 3 post-operative days and assessed the relationship of peri-operative pNGAL concentrations with all-cause mortality. Results During a median follow-up of 3.0 years, 139 participants died (50/1000 person-years). Pre-operative levels of pNGAL were associated with 3-year mortality (unadjusted HR 1.96, 95% CI 1.34,2.85) and the association persisted after adjustment for pre-operative variables including estimated glomerular filtration rate (adjusted HR 1.48, 95% CI 1.04–2.12). After adjustment for pre- and intra-operative variables, including pre-operative NGAL levels, the highest tertiles of first post-operative and peak post-operative pNGAL were also independently associated with 3-year mortality risk (adjusted HR 1.31, 95% CI 1.0–1.7 and adjusted HR 1.78, 95% CI 1.2–2.7, respectively). However, after adjustment for peri-operative changes in serum creatinine, there was no longer an independent association between the first post-operative and peak post-operative pNGAL and long-term mortality (adjusted HR 0.98,95% CI 0.79–1.2 for first pNGAL and adjusted HR 1.19, 95% CI 0.87–1.61 for peak pNGAL). Conclusions Pre-operative pNGAL levels were independently associated with 3-year mortality after cardiac surgery. While post-operative pNGAL levels were also associated with 3-year mortality, this relationship was not independent of changes in serum creatinine. These findings suggest that while pre-operative pNGAL adds prognostic value for mortality beyond routinely available
Santorelli, Gillian; Fairley, Lesley; Petherick, Emily S; Cabieses, Baltica; Sahota, Pinki
The present study aimed to explore previously unreported ethnic differences in infant feeding practices during the introduction of solid foods, accounting for maternal and birth factors, and to determine whether these feeding patterns are associated with BMI at 3 years of age. An observational study using Poisson regression was carried out to investigate the relationship between ethnicity and infant feeding practices and linear regression was used to investigate the relationship between feeding practices and BMI at 3 years of age in a subsample of 1327 infants in Bradford. It was found that compared with White British mothers, mothers of Other ethnicities were less likely to replace breast milk with formula milk before introducing solid foods (adjusted relative risk (RR) - Pakistani: 0·76 (95 % CI 0·64, 0·91), Other South Asian: 0·58 (95 % CI 0·39, 0·86), and Other ethnicities: 0·50 (95 % CI 0·34, 0·73)). Pakistani and Other South Asian mothers were less likely to introduce solid foods early ( < 17 weeks) (adjusted RR - Pakistani: 0·92 (95 % CI 0·87, 0·96) and Other South Asian: 0·87 (95 % CI 0·81, 0·93)). Other South Asian mothers and mothers of Other ethnicities were more likely to continue breast-feeding after introducing solid foods (adjusted RR - 1·72 (95 % CI 1·29, 2·29) and 2·12 (95 % CI 1·60, 2·81), respectively). Pakistani and Other South Asian infants were more likely to be fed sweetened foods (adjusted RR - 1·18 (95 % CI 1·13, 1·23) and 1·19 (95 % CI 1·10, 1·28), respectively) and Pakistani infants were more likely to consume sweetened drinks (adjusted RR 1·72 (95 % CI 1·15, 2·57)). No association between infant feeding practices and BMI at 3 years was observed. Although ethnic differences in infant feeding practices were found, there was no association with BMI at 3 years of age. Interventions targeting infant feeding practices need to consider ethnicity to identify which populations are failing to follow
The prevalence of posterior crossbite among pacifier-sucking girls in Falköping, Sweden, was previously found to be 26%. The aim of this investigation was to follow the development of crossbites in pacifier suckers and to determinate the possibility of reducing the prevalence of crossbite by informing and instructing the parents about sucking habits and reducing the time the child has the pacifier in the mouth. Parents of 60 consecutively born girls belonging to St Olof's health district, Falköping, Sweden, were invited to take part in the study. All parents agreed to participate. Five interviews or examinations of each girl took place from birth until 3 years of age. Fifty-four (90%) of the 60 girls were breast-fed. The mean duration of breast-feeding was 8 months, and 67% of the girls were breast-fed for half a year or more. Forty-three children (72%) developed a pacifier-sucking habit, 6 (10%), a digit-sucking habit, and 11 (18%), no sucking habits. The mean duration of breast-feeding was longer for the nonsuckers (11 months) than for the pacifier- and digit-sucking children (5 months). Of the 39 girls who still had the pacifier habit at 3 years of age, 2 had developed a posterior crossbite. Another girl stopped the habit when a crossbite was registered at the 2 1/2-year examination. At the next appointment, the crossbite had corrected itself spontaneously. One of the 2 girls with crossbite at 3 years of age developed a prenormal occlusion with both anterior and posterior crossbites. For 12 more pacifier suckers, an interfering contact was noted with a forced guidance of the mandible and a midline shift. In all 12 cases, the interfering teeth were primary canines. We conclude that parents should be instructed to reduce the "in the mouth time" of the pacifier. The transverse occlusal relationship in pacifier-sucking children should be evaluated between 2 and 3 years of age. If interfering contacts of the primary canines exist, the parents should be instructed
Sakallioglu, Umur; Yavuz, Umit; Lütfioglu, Müge; Keskiner, Ilker; Açikgöz, Gökhan
In this controlled clinical trial, initial and long-term treatment outcomes of guided tissue regeneration (GTR) were investigated for a synthetic absorbable membrane (Atrisorb) in intrabony defects. Eighteen defects in 16 patients received GTR with Atrisorb (test), with the membrane applied by an indirect method, and 15 defects in 15 patients were treated with open flap debridement (control). Probing pocket depth (PPD), gingival recession (GR), clinical attachment level (CAL), and linear alveolar bone level (ABL) were recorded at baseline and at 1 and 3 years following the treatment procedures and were assessed as the therapeutic outcome parameters. Both groups demonstrated significant PPD reduction and CAL and ABL gain after 1 year. Among these parameters, alterations in PPD and CAL were statistically significantly greater in the test group than the control group 1 year postsurgery. No significant changes were noted in the parameters of the first year between and within the study groups after 3 years. The results suggest that GTR performed with Atrisorb membrane via an indirect application method may provide favorable clinical outcomes for intrabony defects, and these outcomes may be maintained at least as well as open flap debridement over an extended period.
Braithwaite, Ronald L.; And Others
A case study of the use of ethnographic approaches in community organization and development demonstrates their utility in achieving health empowerment among communities of color. The importance of citizen participation in community-based health initiatives is stressed. (SK)
Immonen, J; Meklin, T; Taskinen, T; Nevalainen, A; Korppi, M
Dampness and moisture problems in a building may cause growth of moulds, leading to sensitization and symptoms in the inhabitants. The mechanism by which sensitization to moulds takes place has remained obscure; in particular, the role of atopy is not clear. In 1996, 622 pupils (7-13 years of age) attending a school with a moisture problem (index school; 414 pupils) and a control school (208 pupils) were screened using a questionnaire. Two-hundred and twelve children had doctor-diagnosed asthma, parental-reported wheezing or prolonged cough, and they participated in a clinical study, which included skin prick tests (SPT) to 12 moulds. An identical, follow-up study was performed 3 years later in 1999. In the follow-up study, 144 of the original 212 students participated. They were now attending four different schools: the index primary school had been renovated and the control school remained unchanged, but the two secondary schools had moisture and mould problems. The purpose of the study was to evaluate the occurrence of mould allergy in children of school age and to compare sensitization to moulds in relation to age, exposure, asthma, and atopy. In 1999, SPT responses to moulds were demonstrated in 17 (12%) of the 144 children. Six children had SPT reactions > or = 3 mm and all but one were older than 14 years. During the 3-year follow-up period, mould allergy developed in five children and disappeared in two children. Five of the six children with reactions > or = 3 mm to moulds had positive responses to other allergens, five had clinical atopy but only two had asthma. Likewise, all six children had been exposed to moisture and dampness in the school buildings. In conclusion, mould allergy diagnosed by SPTs was rare in students. Most reactions to moulds were in students older than 14 years with multiple SPT reactions to common allergens, and there was no significant association with asthma.
Background In 2007, the Tanzanian government called for improvements in its primary health care services. Part of this initiative was to accelerate the training rate for nurses qualified to work in rural areas. The aim of this study was to reflect on the issues experienced whilst establishing and implementing a faith-based organisation (FBO) nursing school and make recommendations for other similar initiatives. Design This paper describes an auto-ethnographic case study design to identify the key difficulties involved with establishing and implementing a new nursing school, and which factors helped the project achieve its goals. Results Six themes emerged from the experiences that shaped the course of the project: 1) Motivation can be sustained if the rationale of the project is in line with its aims. Indeed, the project's primary health care focus was to strengthen the nursing workforce and build a public-private partnership with an FBO. All these were strengths, which helped in the midst of all the uncertainties. 2) Communication was an important and often underrated factor for all types of development projects. 3) Managing the unknown and 4) managing expectations characterised the project inception. Almost all themes had to do with 5) handling conflicts. With so many participants having their own agendas, tensions were unavoidable. A final theme was 6) the need to adjust to ever-changing targets. Conclusions This retrospective auto-ethnographic manuscript serves as a small-scale case study, to illustrate how issues that can be generalised to other settings can be deconstructed to demonstrate how they influence health development projects in developing countries. From this narrative of experiences, key recommendations include the following: 1) Find the right ratio of stakeholders, participants, and agendas, and do not overload the project; 2) Be alert and communicate as much as possible with staff and do not ignore issues hoping they will solve themselves; 3
Background In 2007, the Tanzanian government called for improvements in its primary health care services. Part of this initiative was to accelerate the training rate for nurses qualified to work in rural areas. The aim of this study was to reflect on the issues experienced whilst establishing and implementing a faith-based organisation (FBO) nursing school and make recommendations for other similar initiatives. Design This paper describes an auto-ethnographic case study design to identify the key difficulties involved with establishing and implementing a new nursing school, and which factors helped the project achieve its goals. Results Six themes emerged from the experiences that shaped the course of the project: 1) Motivation can be sustained if the rationale of the project is in line with its aims. Indeed, the project's primary health care focus was to strengthen the nursing workforce and build a public–private partnership with an FBO. All these were strengths, which helped in the midst of all the uncertainties. 2) Communication was an important and often underrated factor for all types of development projects. 3) Managing the unknown and 4) managing expectations characterised the project inception. Almost all themes had to do with 5) handling conflicts. With so many participants having their own agendas, tensions were unavoidable. A final theme was 6) the need to adjust to ever-changing targets. Conclusions This retrospective auto-ethnographic manuscript serves as a small-scale case study, to illustrate how issues that can be generalised to other settings can be deconstructed to demonstrate how they influence health development projects in developing countries. From this narrative of experiences, key recommendations include the following: 1) Find the right ratio of stakeholders, participants, and agendas, and do not overload the project; 2) Be alert and communicate as much as possible with staff and do not ignore issues hoping they will solve themselves; 3
Claus, John F.
An ethnographic, case-study complement to a statewide survey in New York State attempted to shed light on the interwoven personal, social, economic, and program factors underlying secondary vocational education students' reports of improved attitudes. The survey assessed whether the state's two-year, half-day, separate-facility vocational programs…
Ayanore, Martin Amogre; Pavlova, Milena; Biesma, Regien; Groot, Wim
Access to skilled provider and emergency obstetric care is not universal across all districts in Ghana. The lived experiences of 3 stakeholder groups on maternity care shortcomings in 3 rural Ghanaian districts are examined in this study. We applied an ethnographic study approach where field data were collected between March to May 2015 in 3 rural districts of northern Ghana. Data were collected among women with recent births experiences (n = 90), health care providers (n = 16), and policy actors (n = 6). Transcripts were read through to identify similar and divergent stakeholders' views. Significant expressions and experiences of stakeholders on maternity care shortcomings were extracted and evaluated to define key themes. Four themes emerged: social/community factors, payments for health care, facility level factors, and policy level factors. The results show that traditional women's roles divest time for maternity care. Poor transport arrangements, insufficient health workforce, health funding gaps, insurance reimbursements delays, and catastrophic health expenditures on travel and drugs are attested as major barriers across all stakeholder groups in all districts studied. The discussion of the study findings suggests it is important to ascertain the scale of informal payments and their impacts on health access. Investments in health workforce and reliable ambulatory service systems could help address poor referral difficulties in rural areas of the country. Social support for community initiatives that pool funds could provide extra resources and relieve cost access-related challenges for using maternity care in rural settings in Ghana.
Hashimoto, K; Bruno, D; Nierenberg, J; Marmar, C R; Zetterberg, H; Blennow, K; Pomara, N
Major depressive disorder (MDD), common in the elderly, is a risk factor for dementia. Abnormalities in glutamatergic neurotransmission via the N-methyl-d-aspartate receptor (NMDA-R) have a key role in the pathophysiology of depression. This study examined whether depression was associated with cerebrospinal fluid (CSF) levels of NMDA-R neurotransmission-associated amino acids in cognitively intact elderly individuals with MDD and age- and gender-matched healthy controls. CSF was obtained from 47 volunteers (MDD group, N=28; age- and gender-matched comparison group, N=19) at baseline and 3-year follow-up (MDD group, N=19; comparison group, N=17). CSF levels of glutamine, glutamate, glycine, l-serine and d-serine were measured by high-performance liquid chromatography. CSF levels of amino acids did not differ across MDD and comparison groups. However, the ratio of glutamine to glutamate was significantly higher at baseline in subjects with MDD than in controls. The ratio decreased in individuals with MDD over the 3-year follow-up, and this decrease correlated with a decrease in the severity of depression. No correlations between absolute amino-acid levels and clinical variables were observed, nor were correlations between amino acids and other biomarkers (for example, amyloid-β42, amyloid-β40, and total and phosphorylated tau protein) detected. These results suggest that abnormalities in the glutamine–glutamate cycle in the communication between glia and neurons may have a role in the pathophysiology of depression in the elderly. Furthermore, the glutamine/glutamate ratio in CSF may be a state biomarker for depression. PMID:26926880
A recent survey has shown that Nepali drug users in Hong Kong tend to have a low rate of usage of day-care and residential rehabilitation services, but a high rate of usage of methadone services. Little is known about the reasons behind such a pattern. Therefore, in this study, a 12-month ethnographic examination has been implemented in three sites, including a day-care center, residential rehabilitation center, and methadone clinic, to explore the experiences of 20 Nepali drug users in their use of drug-related services in Hong Kong and to examine the relationship between ethnicity and the use of drug-related services. The result shows that the reason for this pattern of service use is related to the approach of the services and the cultural perception of the service providers about the service users. The day-care and residential rehabilitation services emphasize an integrated approach, but the staff tend to overlook the heterogeneity of their clients, for example, the differences in caste and sex, and fail to provide suitable services to them, whereas the methadone service follows a biomedical model, which seldom addresses the social characteristics of the service users, which in turn minimizes the opportunity for misunderstandings between the staff and the clients. This research shows that ethnicity is a significant factor in drug treatment and that culture-specific treatment that takes into consideration the treatment approach and the heterogeneity of the clients is strongly needed. PMID:25114609
Goonan, Sarah; Mirosa, Miranda; Spence, Heather
Foodservice organizations, particularly those in hospitals, are large producers of food waste. To date, research on waste in hospitals has focused primarily on plate waste and the affect of food waste on patient nutrition outcomes. Less focus has been placed on waste generation at the kitchen end of the hospital food system. We used a novel approach to understand reasons for hospital food waste before consumption and offer recommendations on waste minimization within foodservices. A mixed methods ethnographic research approach was adopted. Three New Zealand hospital foodservices were selected as research sites, all of which were contracted to an external foodservice provider. Data collection techniques included document analyses, observations, focus groups with kitchen staff, and one-on-one interviews with managers. Thematic analysis was conducted to generate common themes. Most food waste occurred during service and as a result of overproduction. Attitudes and habits of foodservice personnel were considered influential factors of waste generation. Implications of food waste were perceived differently by different levels of staff. Whereas managers raised discussion from a financial perspective, kitchen staff drew upon social implications. Organizational plans, controls, and use of pre-prepared ingredients assisted in waste minimization. An array of factors influenced waste generation in hospital foodservices. Exploring attitudes and practices of foodservice personnel allowed an understanding of reasons behind hospital food waste and ways in which it could be minimized. This study provides a foundation for further research on sustainable behavior within the wider foodservice sector and dietetics practice.
Kuuppelomäki, Merja; Utriainen, Pekka
The purpose of the study was to describe the sense of coherence (SOC) of three groups of Finnish polytechnic students (n=287) at the beginning of their studies and to follow it during a period of 3 year amongst the health care students (n=63) of this group. The associations between SOC and smoking, drinking and physical exercise were also studied. The data were collected with a questionnaire which included Antonovsky's (Adv. Nurs. Sci. 1(1983)37) SOC scale. Data analysis was with SPSS statistical software. The students showed a strong sense of coherence at the beginning of their studies. Physical activity was related to the strength of SOC, but no association was found with smoking and drinking. Health care students showed a stronger SOC at the beginning of their studies than the two other groups. During the follow-up focused on the health care students, SOC weakened in 6%, remained unchanged in 65% and strengthened in 32% of the participants. Smoking, drinking and physical exercise showed no association with these changes. Future research should be focused on identifying factors that are related to SOC during education.
This paper intends to problematise understandings of the ethnographer's presence in investigating contemporary forms of technologised learning. The ubiquity of new educational technologies raises questions concerning the spaces of education and learning, and challenges, at the same time, the sense of "being there" in terms of the face-to-face…
The purpose of this paper is to describe the process of conducting ethnographic research. Methodology definition and key characteristics are given. The stages of the research process are described including preparation, data gathering and recording, and analysis. Important issues such as reliability and validity are also discussed.
Hough, David A.
This paper describes a technique for English-as-a-Second-Language teaching that has students and teachers sharing personal narratives, developed using ethnographic research techniques, as a classroom exercise. The technique, used in a higher education institution in Japan, is presented as a work-in-progress to those who are interested in…
Stein, Howard F.
An ethnographic approach based on in-depth interviewing, naturalistic and participant observation, narrative description, and contextual interpretation is proposed as a tool for family health care research. The multiple meanings of family, both for research clinicians and for society, are considered. The problem of how a family orientation is incorporated into biomedical' health care is discussed. PMID:21229058
Arias-Martín, María; García, Matías; Castañera, Pedro; Ortego, Félix; Farinós, Gema P
The cultivation of Cry1Ab-expressing genetically modified MON810 (Bt maize) has led to public concern in Europe, regarding its impact on nontarget arthropods (NTAs). We have assessed the potential effects of DKC 6451 YG (MON810) maize on canopy NTAs in a farm-scale study performed in Central Spain during 3 years. The study focused on hemipteran herbivores (leafhoppers and planthoppers) and hymenopteran parasitic wasps (mymarids) collected by yellow sticky traps, which accounted for 72% of the total number of insects studied. The dynamics and abundance of these groups varied among years, but no significant differences were found between Bt and non-Bt maize, indicating that Bt maize had no negative effect on these taxa. Nonetheless, the Cry1Ab toxin was detected in 2 different arthropods collected from Bt maize foliage, the cicadellids Zyginidia scutellaris and Empoasca spp. A retrospective power analysis on the arthropod abundance data for our field trials has determined that Z. scutellaris and the family Mymaridae have high capacity to detect differences between the Bt maize and its isogenic counterpart. The use of these canopy NTAs as surrogates for assessing environmental impacts of Bt maize is discussed.
Roeder, Peter Martin
Reviews three qualitative case studies on the educational systems of Japan, the United States, and Germany, conducted as a component of the Third International Mathematics and Science Study (TIMSS). States that the studies provide a basis for understanding the differences in mathematics and science achievement among Japan, Germany, and the United…
This paper applies Dennis' [(2009). "What does it Mean when an Ethnographer Intervenes?" "Ethnography and Education" 4 (2): 131-146] modes of ethnographic intervention to a fieldwork experience of an observed secondary school lesson in England. Ethnographic research raises numerous ethical dilemmas, in the face of which…
Ayesa-Arriola, Rosa; Setién-Suero, Esther; Neergaard, Karl D.; Ferro, Adele; Fatjó-Vilas, Mar; Ríos-Lago, Marcos; Otero, Soraya; Rodríguez-Sánchez, Jose M.; Crespo-Facorro, Benedicto
This study aimed to confirm whether first-episode psychosis patients present a stable trait impairment in theory of mind (ToM) and to examine the potential relationship between ToM and clinical symptomatology and neurocognition. Patients with a first episode of psychosis (N = 160) and healthy controls (N = 159) were assessed with an extensive neuropsychological test battery, which included a mental state decoding task known as “The Reading the Mind in the Eyes” (Eyes test), at baseline and reassessed after 1 and 3 years. The clinical group performed below healthy controls on the Eyes test while not showing test-retest differences between baseline and follow-up administrations. Analyses revealed age, education and premorbid IQ as potential moderators. Poorer performance on the Eyes test was not linked to clinical symptomatology but was associated with greater neurocognitive deficit, particularly related to processing speed. The persistence of ToM deficits in patients suggests that there are trait related metalizing impairments in first episode psychosis. This study shows the influence of processing speed and moderator variables on efficient ToM. PMID:27199826
Tuomainen, M; Tuomainen, A; Liesivuori, J; Pasanen, A-L
Indoor climate of two new blocks of flats was investigated. The case building was built for people with respiratory diseases by following the instructions of the Finnish Classification of Indoor Climate, Construction and Finishing Materials, while the control building was built using conventional building technology. The main indoor air parameters (temperature, relative humidity and levels of CO, CO2, ammonia, total volatile organic compounds, total suspended particles, fungal spores, bacteria and cat, dog and house dust mite allergens) were measured in six apartments of both the buildings on five occasions during the 3-year occupancy. In addition, a questionnaire to evaluate symptoms of the occupants and their satisfaction with their home environment was conducted in connection with indoor air quality (IAQ) measurements. The levels of indoor air pollutants in the case building were, in general, lower than those in the control building. In addition, the asthmatic occupants informed that their symptoms had decreased during the occupancy in the case building. This case study showed that high IAQ is possible to reach by careful design, proper materials and equipment and on high-quality construction with reasonable additional costs. In addition, the study indicated that good IAQ can also be maintained during the occupancy, if sufficient information on factors affecting IAQ and guidance on proper use and care of equipment are available for occupants.
Arcelus, Victor J.
This study investigates the cultures of the academic and student affairs divisions within one selective residential liberal arts institution. Specifically, the study investigates how faculty and student affairs personnel perceive their own and each other's roles as educators on the campus and how these perceptions influence the potential for…
Alarming statistics reveal that African American male students are encountering long-standing challenges in K-12 mathematics. However, few studies have explored the phenomena associated with African American males and K-12 mathematics education, particularly at the middle school level in the context of an Algebra 1 course of study. The purpose of…
Jennings, Louise B.
This classroom ethnography examines the engagement of fifth-grade children in a year-long study of rights, respect, and responsibility, which culminated in a focused study of tolerance and intolerance organized around literature regarding the Holocaust. A close examination of one teacher's approach to teaching about the Holocaust, the study…
Hung, Chia Yuan
Despite the growing number of studies on video games, there are still gaps in video game research, especially when it comes to describing the situated (in situ) actions of gameplay. The study explores the locally-produced meaning-making practices of video game players, and analyzes gameplay as it occurs, not as a post hoc, reconstructed event, but…
Hung, Tsung-Hsing; Lay, Chorng-Jang; Tseng, Chih-Wei; Tsai, Chih-Chun; Tsai, Chen-Chi
Renal function impairment (RFI) contributes to poor prognosis in cirrhotic patients. However, there have been no studies that seek to identify the effect of different types of RFI on the mortality of cirrhotic patients. We used the National Health Insurance Database, derived from the Taiwan National Health Insurance Program, to identify 44365 cirrhotic patients between January 1, 2007 and December 31, 2007. RFI was identified in 2832 cirrhotic patients, including 1075 with acute renal failure (ARF) (169 with hepatorenal syndrome, HRS; 906 with non-hepatorenal syndrome, NHRS), 705 with chronic kidney disease (CKD), and 1052 with end stage renal disease (ESRD). After Cox proportional hazard regression analysis adjusted by gender, age, and comorbid disorders, the 30-day, 30 to 90-day, 90-day to 1-year, and 1 to 3-year mortality hazard ratios (HR) compared to the non-RFI group were: (ARF) 5.19 (4.70–5.74), 3.23 (2.76–3.77), 1.51 (1.26–1.81), and 1.35 (1.13–1.61), respectively; (CKD) 2.70 (2.30–3.18), 2.03 (1.66–2.49), 1.60 (1.34–1.90), and 1.26 (1.06–1.49), respectively; and (ESRD) 1.42 (1.17–1.72), 1.62 (1.35–1.94), 1.90 (1.68–2.15), and 1.67 (1.48–1.89), respectively. Compared to NHRS, the 30-day, 30 to 90-day, 90-day to 1-year, and 1 to 3-year mortality HRs of HRS were 1.03 (0.80–1.32), 2.13 (1.46–3.11), 1.58 (0.90–2.75), and 2.51 (1.41–4.48), respectively, in cirrhotic patients with ARF. These results indicate the effects of CKD and ESRD on the mortality of cirrhotic patients are distributed equally in every survival stage, whereas the effect of ARF appears only in the early stage. Compared to NHRS, HRS contributes to a higher mortality risk at the late survival stage. PMID:27631098
Johansen, Merete Selsbakk; Normann-Eide, Tone; Egeland, Jens
Personality disorders (PDs) are highly prevalent in patients receiving psychiatric services, and are associated with significant personal and social costs. Over the past two decades, an increasing number of treatment studies have documented the effectiveness of treatment for patients with PDs, especially when it comes to reduction of symptom distress, risk taking behavior, self-harm, or suicide attempts. However, less is known about the more complex aims of improving the personality structure itself, such as identity- and interpersonal disturbances. Emotional dysfunction is closely associated with PD pathology. The present study investigated changes in affect consciousness (AC) in patients with avoidant or borderline PD, and how these changes were associated with clinical status after 3 years of follow-up. The study included 52 individuals; 79 percent were females, and mean age was 30 years. The evaluations included the Affect Consciousness Interview, Symptom Checklist-90-R, Circumplex of Interpersonal Problems, the Index of Self-Esteem, and three domains (Identity Integration, Relational Capacities, and Self-Control) of the Severity Indices of Personality Problems (SIPP-118). There was a significant increase in the Global AC and AC scores for most of the specific affects from baseline to follow-up. As the present study did not include a control group, it cannot be concluded that changes in AC are effects of psychotherapy, and the possibility of age-related maturation processes cannot be excluded. The change in Global AC contributed significantly to explained variance in the follow-up levels of Circumplex of Interpersonal Problems, and the two SIPP-118 domains Relational Capacities and Identity Integration. Improved AC was not associated with change in the Self-Control domain or the Global Severity Index of Symptom Checklist-90-R. The results suggest that AC may be altered for patients with borderline and avoidant PDs, and this is the first study to report that
Kabat-Ryan, Katalin Judith
This dissertation examines the spatio-temporal practices of a distance learning class in a graduate institution in the Northeast United States. Guided by a multispatial and temporal perspective, the case study builds on Hine's (2003) and Leander and McKim's (2003) connective ethnography of offline and online research sites, and frames the research…
McCarthy, Lucille Parkinson
To discover how one student learned to produce writing in different academic contexts, a study documented a Loyola College (Maryland) student's experiences with writing for a poetry class and a biology class during his sophomore year. The subject was interviewed several times, observed, and his voice taped during "writing aloud" sessions…
Yan, Chunmei; He, Chuanjun
This article reports on a study of secondary English teachers' perceptions of and implementation of the New English Curriculum Reform in China initiated in 2009. Ethnography and triangulated data collection methods were employed to gather information about three senior secondary English teachers' interpretations of the New Curriculum and their…
The purpose of this dissertation is to investigate the discursive process of the negotiation and construction of teacher identity in a US-based Master of Arts for Teachers of English to Speakers of Other Languages (MATESOL) program. This study explores how both native-English-speaking (NES) and non-native-English-speaking (NNES) student teachers'…
The purpose of this study was to examine the potential of a High School Health Science Career Academy to support African American students' science career trajectories. I used three key theoretical tools---critical science agency (Basu, 2007; Calabrese Barton & Tan, 2008), power (Nespor, 1994), and cultural production (Carlone, 2004; Eisenhart &…
Madrey, Francine Giles
The effects of the graduate experience on the intra- and inter-family relationships among married doctoral student couples were studied. Full-time students 35 years old or less enrolled at Ohio State University in 1982 and their nonenrolled spouses made up the sample. The ways that these students coped with the dual student-spouse role and made…
O'Hern, Darren M.
In Kenya, indigenous knowledges related to the natural sciences are not considered in the formal science education of secondary students. Despite the prevalence of studies that examine indigenous knowledges in Kenyan school and community contexts, the perspectives of students and teachers concerning indigenous natural science knowledges and their…
The purpose of this study was to examine the potential of a High School Health Science Career Academy to support African American students' science career trajectories. I used three key theoretical tools---critical science agency (Basu, 2007; Calabrese Barton & Tan, 2008), power (Nespor, 1994), and cultural production (Carlone, 2004; Eisenhart & Finkel, 1998) to highlight the intersections between the career trajectory implied by the Academy (its curriculum, classroom activities, and clinical experiences) and the students' pursued career trajectories. Data was collected over five months and included individual student interviews, group interviews, parent and administrator interviews, field notes from a culminating medical course and clinical internship, and Academy recruitment documents. The results of this study suggest that participants pursued a health science career for altruistic purposes and the Academy was a resource they drew upon to do so. However, the meanings of science and science person implied by the Academy hindered the possibility for many participants' to advance their science career trajectories. While the Academy promised to expose students to a variety of high-status health care roles, they were funneled into feminine, entry-level positions. This study adds to previous underrepresentation literature by contextualizing how identity-related factors influence African American students' career attainment.
Dixon-Woods, Mary; Redwood, Sabi; Leslie, Myles; Minion, Joel; Martin, Graham P; Coleman, Jamie J
Context “Meaningful use” of electronic health records to improve quality of care has remained understudied. We evaluated an approach to improving patients’ safety and quality of care involving the secondary use of data from a hospital electronic prescribing and decision support system (ePDSS). Methods We conducted a case study of a large English acute care hospital with a well-established ePDSS. Our study was based on ethnographic observations of clinical settings (162 hours) and meetings (28 hours), informal conversations with clinical staff, semistructured interviews with ten senior executives, and the collection of relevant documents. Our data analysis was based on the constant comparative method. Findings This hospital's approach to quality and safety could be characterized as “technovigilance.” It involved treating the ePDSS as a warehouse of data on clinical activity and performance. The hospital converted the secondary data into intelligence about the performance of individuals, teams, and clinical services and used this as the basis of action for improvement. Through a combination of rapid audit, feedback to clinical teams, detailed and critical review of apparent omissions in executive-led meetings, a focus on personal professional responsibility for patients’ safety and quality care, and the correction of organizational or systems defects, technovigilance was—based on the hospital's own evidence—highly effective in improving specific indicators. Measures such as the rate of omitted doses of medication showed marked improvement. As do most interventions, however, technovigilance also had unintended consequences. These included the risk of focusing attention on aspects of patient safety made visible by the system at the expense of other, less measurable but nonetheless important, concerns. Conclusions The secondary use of electronic data can be effective for improving specific indicators of care if accompanied by a range of interventions to
Campanha, Mariele B; Awan, Almas Taj; de Sousa, Diana N R; Grosseli, Guilherme M; Mozeto, Antonio A; Fadini, Pedro S
This manuscript reports a 3-year study on occurrence of pharmaceuticals, hormones, and triclosan in surface waters of a central urban region of São Paulo State of Southeast Brazil (the Monjolinho River in São Carlos). Water samples collected once at every 2 months were pre-concentrated by solid-phase extraction (SPE) and analyzed by liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). The most frequently detected compounds in higher concentrations were caffeine, paracetamol, and atenolol (maximum concentrations 129,585, 30,421, and 8199 ng L(-1), respectively), while hormones estrone and 17-β-estradiol were the least detected, in levels up to 14.8 ng L(-1). There was an increasing trend in concentrations of most of the compounds along the river course, especially downstream of the river where there is discharge of both wastewater treatment plant effluent and raw sewage from a particular region of São Carlos city. Concentrations of contaminants were higher during dry periods as a result of decline in the water levels. Decrease in concentrations near the river mouth occurred to different extents for each compound. It was high for caffeine and atenolol, but was very low for carbamazepine and diclofenac. The present study reports the first data about the occurrence of some major emerging contaminants in the Monjolinho River. Besides its regional significance, this work may assist in composing a dataset for water contamination diagnosis focusing on emerging contaminants, both in the Brazilian as well as in the Global studies related to aquatic ecosystems. Such datasets can be helpful for making future public policies on water quality, since these compounds are not yet legally regulated.
Chung, Shiu-Dong; Weng, Sung-Shun; Huang, Chao-Yuan; Lin, Herng-Ching; Kao, Li-Ting
To date, the relationship between antimuscarinics for overactive bladder (OAB) syndrome and depressive disorder still remains unclear. Therefore, this retrospective cohort study examined the association between antimuscarinic use and the subsequent risk of depressive disorder using a population-based data set. This study used data from the Taiwan Longitudinal Health Insurance Database 2005. We selected 1952 OAB women who received antimuscarinics as the study cohort and 9760 OAB women who did not receive antimuscarinics as the comparison cohort. Each subject was tracked for 3 years from her index date to determine all those who were subsequently diagnosed with depressive disorder. Results indicated that the adjusted hazard ratio (HR) for depressive disorder in OAB women who received antimuscarinics was 1.38 (95% confidence interval [CI], 1.15-1.64) compared with those OAB women who did not receive antimuscarinics. In addition, the adjusted HRs for subsequent depressive disorder for OAB women aged 18-39, 40-59, and ≥60 years who received antimuscarinics were 1.83 (95%CI, 1.27-2.64), 1.36 (95%CI, 1.03-1.81), and 1.16 (95%CI, 0.86-1.56), respectively, compared with those OAB women who did not receive antimuscarinics. We concluded that women with OAB who received antimuscarinics had a significantly higher risk of subsequent depressive disorder compared with those OAB women who did not receive antimuscarinics. Accordingly, clinicians should be alert to the relationship between antimuscarinics usage and depressive disorder in OAB women and provide appropriate instructions for these patients.
Kumar, Neeraj; Malhotra, Hardeep Singh; Gupta, Rakesh Kumar; Verma, Rajesh; Sharma, Praveen Kumar
Objective To evaluate the role of advanced magnetic resonance (MR) sequences (fast imaging employing steady-state acquisition (FIESTA), T2 star-weighted angiography (SWAN) and spoiled gradient recalled echo (SPGR)) in patients with single small enhancing computed tomography lesions and scolex demonstration in typical and atypical parenchymal neurocysticercosis. Methods In this study, 59 patients of new-onset seizures with single small enhancing computed tomography lesions of the brain were included. Along with routine MR sequences, advanced MR sequences, like SWAN, FIESTA, and pre and post-contrast SPGR, were performed. Follow-up MR studies focussing on the morphology of the lesions and demonstration of scolex were performed 6 monthly for 3 years. Results The majority of patients (62.7%) were men with partial seizure as the most common manifestation. On SPGR, contrast lesions were identified as either ‘typical’ (42, 71.2%) or ‘atypical’ (17, 28.8%). In the typical lesion group, SWAN and FIESTA sequences detected scolex in 30 (71.4%) and 32 (76.2%), respectively. The combination of SPGR-contrast, FIESTA and SWAN sequences detected scolex in 35 (83.3%) patients compared to 19 (45.2%) by routine sequences (P < 0.001). In the atypical lesion group, SWAN and FIESTA sequences detected scolex in 15 (88.2%) and 16 (94.1%) patients, respectively. The combination of SPGR-contrast, FIESTA and SWAN sequences detected scolex in 16 (94.1%) patients compared to 10 (58.8%) by routine sequences (P < 0.001). Follow-up showed greater resolution with lesser calcification in the typical group compared to the atypical group. Conclusion This study provides an insight into the natural course of typical and atypical solitary cysticercus granuloma lesions, and the utility of SPGR-contrast, FIESTA and SWAN MR sequences in scolex demonstration and identification of atypical lesions. PMID:26659345
Akay, Hatice Kubra; Bahar Tokman, Hrisi; Hatipoglu, Nevin; Hatipoglu, Huseyin; Siraneci, Rengin; Demirci, Mehmet; Borsa, Baris Ata; Yuksel, Pelin; Karakullukcu, Asiye; Kangaba, Achille Aime; Sirekbasan, Serhat; Aka, Sibel; Mamal Torun, Muzeyyen; Kocazeybek, Bekir S
Bifidobacteria are beneficial bacteria for humans. These bacteria are particularly effective at protecting against infectious diseases and modulating the immune response. It was shown that in newborns, the fecal distribution of the colonizing Bifidobacterium species influences the prevalence of allergic diseases. This study aimed to compare the faecal Bifidobacterium species of allergic children to those of healthy children to detect species level differences in faecal distribution. Stool samples were obtained from 99 children between 0 and 3 years of age whose clinical symptoms and laboratory reports were compatible with atopic dermatitis and allergic asthma. Samples were also obtained from 102 healthy children who were similar to the case group with respect to age and sex. Bifidobacteria were isolated by culture and identified at the genus level by API 20 A. In addition, 7 unique species-specific primers were used for the molecular characterization of bifidobacteria. The McNemar test was used for statistical analyses, and p < 0.05 was accepted as significant. Bifidobacterium longum was detected in 11 (11.1%) of the allergic children and in 31 (30.3%) of the healthy children. Statistical analysis revealed a significant difference in the prevalence of B. longum between these two groups (X(2): 11.2, p < 0.001). However, no significant differences in the prevalence of other Bifidobacterium species were found between faecal samples from healthy and allergic children. (p > 0.05). The significant difference in the isolation of B. longum from our study groups suggests that this species favors the host by preventing the development of asthma and allergic dermatitis. Based on these results, we propose that the production of probiotics in accordance with country-specific Bifidobacterium species densities would improve public health. Thus, country-specific prospective case-control studies that collect broad data sets are needed.
Background Uptake of HIV testing by men remains low in high prevalence settings in many parts of Africa. By focusing on masculinity, this study explores the social context and relations that shape men’s access to HIV testing in Mam-Kiror, Busia district, rural eastern Uganda. Methods From 2009–2010 in-depth interviews were undertaken with 26 men: nine being treated for HIV, eight who had tested but dropped out of treatment, six not tested but who suspected HIV infection and three with other health problems unrelated to HIV. These data were complemented by participant observation. Thematic analysis was undertaken. Results There were two main categories of masculinity in Mam-Kiror, one based on ‘reputation’ and the other on ‘respectability’, although some of their ideals overlapped. The different forms of masculine esteem led to different motives for HIV testing. Men positioned HIV testing as a social process understood within the social context and relationships men engaged in rather than an entirely self-determined enterprise. Wives’ inferior power meant that they had less influence on men’s testing compared to friends and work colleagues who discussed frankly HIV risk and testing. Couple testing exposed men’s extra-marital relationships, threatening masculine esteem. The fear to undermine opportunities for sex in the context of competition for partners was a barrier to testing by men. The construction of men as resilient meant that they delayed to admit to problems and seek testing. However, the respectable masculine ideal to fulfil responsibilities and obligations to family was a strong motivator to seeking an HIV test and treatment by men. Conclusion The two main forms of masculine ideals prevailing in Mam-Kiror in Busia led men to have different motives for HIV testing. Reputational masculinity was largely inconsistent with the requirements of couple testing, community outreach testing and the organisation of testing services, discouraging men
Quintana-Duque, M A; Rondon-Herrera, F; Mantilla, R D; Calvo-Paramo, E; Yunis, J J; Varela-Nariño, A; Restrepo, J F; Iglesias-Gamarra, A
The objective of the study is to find predictors of remission, radiographic progression (RP), and erosive disease in a cohort of patients with early onset rheumatoid arthritis (EORA) that followed a therapeutic protocol aiming at remission, in a real world tight-control setting. EORA patients were enrolled in a 3-year follow-up study. Clinical, biological, immunogenetic, and radiographical data were analyzed. Radiographs were scored according to Sharp-van der Heijde (SvdH) method. RP was defined by an increase of 3 units in 36 months. Remission was defined as DAS28 <2.6. A stepwise multiple logistic regression model was used to identify independent predictors of the three target outcomes. One hundred twenty-nine patients were included. Baseline disease activity was high. Significant overall improvement was observed, but only 33.3 % achieved remission. At 36 month, 50.4 % (65) of patients showed erosions. RP was observed in 62.7 % (81) of cases. Statistical analysis showed that baseline SvdH score was the only predictive factor associated with the three outcomes evaluated. Lower HAQ-DI and absence of autoantibodies were predictive of remission. Higher levels of ESR and presence of erosions at entry were predictive of RP. Independent baseline predictors of incident erosive disease were anti-CCP and RF positivity, symptom duration at baseline >3 months, and presence of HLA-DRB1 shared epitope. Radiographic damage at baseline was the main predictor of outcomes. Autoantibodies, HAQ and ESR at baseline, symptom duration before diagnosis, and HLA-DRB1 status had influence on clinical course and development of structural joint damage in Colombian RA patients.
Yu, Lu-Lu; Guo, Hui-Qin; Lei, Xiao-Qin; Qin, Yu; Wu, Ze-Ni; Kang, Le-Ni; Zhang, Xun; Qiao, You-Lin; Chen, Wen
Purpose To evaluate the association of p16/Ki-67 co-expression and persistence of high-risk human papillomavirus (HR-HPV) infection as well as cervical abnormalities. Methods We performed a 3-year cohort study among which 2498 Chinese women aged 25 to 65 years were screened by different HPV tests in 2011. 690 women who were positive at any of the tests and a random sample of 164 women with all negative results received colposcopy, cervical specimens for cobas HPV test (Roche diagnostics) were collected before colposcopy; of this group, 737 cervical specimens were collected to perform cobas, Liquid-based cytology, HPV E6 test (Arbor Vita Corporation) and p16/Ki-67 dual staining (Roche diagnostics) in 2014. Colposcopy and biopsies was performed on women with any abnormal result. Results Compared to women without HR-HPV persistent infection, women in the HR-HPV persistence group had a higher risk of p16/Ki-67 positive, with an adjusted Odds Ratio(OR) and 95% confidence interval (CI) of 6.29 (4.07-9.72); moreover, adjusted odds ratio for women who had HPV16/18 persistent infection was nearly 4-folder higher than women with other 12 HR-HPV persistent infection (adjusted OR = 17.15, 95% CI: 7.11-41.33 vs adjusted OR = 4.68, 95% CI: 2.89-7.58). Additionally, p16/Ki-67 positivity rate significantly increased with the severity of the cytological and histological abnormalities, and resulted strongly associated with a CIN2+ diagnosis (OR = 16.03, 95% CI: 4.46-57.59). Conclusions p16/Ki-67 co-expressions associated strongly with HR-HPV persistence, especially with HPV16/18, and the presence of a CIN2+ lesion. Therefore, p16/Ki-67 could be considered as a suitable biomarker for cervical cancer screening, particularly in HPV-based screening programs. PMID:27588487
Ozay, Guner; Seyhan, Ferda; Pembeci, Ceyda; Saklar, Sena; Yilmaz, Aysun
The levels aflatoxins in Turkish hazelnuts have been monitored over a 3-years period (2002-2004). Periodical sampling was made in 72 different orchards at different locations representative of the hazelnut-growing areas and post-harvest applications. Various parameters (aflatoxins, water activity, moulds) were analysed and environmental conditions (temperature and relative humidity) recorded during growing and at different stages of harvest and post-harvest processing, involving three different harvesting methods (collection in nets, from the ground, etc.) and four drying techniques (traditional sun-drying, mechanical drying, etc.). Fungal and aflatoxin analyses (HPLC) showed no significant difference except between samples which had been in contact with the ground and those which had not (at 95% confidence level). Aflatoxins levels from the orchard recorded a maximum of 0.77+/-0.08 ng g(-1) from a total of 1624 samples. Regarding harvesting and post-harvest processes, the only application where aflatoxins were detected was in samples which had been in direct contact with the ground (max. 3.18+/-0.03 ng g(-1)). Aflatoxin formation was low during storage (max. 0.34+/-0.003 ng g(-1)). As a result of mycological studies, a total of 5546 Aspergillus flavus (89%) and A. parasiticus (11%) species were isolated and identified from samples. The results indicated that harvesting hazelnuts into a canvas by shaking the trees, manual harvesting of mature hazelnuts where possible, use of jute instead of nylon sacks and mechanical drying technique would minimize aflatoxin levels in hazelnuts. These recommendations have been implemented and about 4000 people in the hazelnut industry have been trained in these practices.
Nouri Saeidlou, Sakineh; Rezaiegoyjeloo, Fatemeh; Ayremlou, Parvin; Babaie, Fariba
Background: Obesity and overweight among children is a major public health problem in developed and developing countries and has important health and economic implications. This longitudinal study aimed to assessing the prevalence trend of overweight and obesity in West Azerbaijan in North West of Iran. Methods: This study was a longitudinal follow-up study and was conducted in school children at 2009–2011 year. The subjects were all school children (12 years of age) that were recruited from rural and urban schools in West Azerbaijan. Overall, 22,820 girls and 28,763 boys were enrolled in 2009 and were followed for 3 years. A body mass index (BMI) 85th–95th percentile was classified as overweight and a BMI >95th percentile was classified as obese. All statistical analyses were performed using the Excel Software. Descriptive statistics were used to characterize the sample in different time periods. The prevalence was calculated as the ratio of number of present cases to a given population number in a given subgroup at a given time. Results: In urban schools, the prevalence of overweight among girls and boys was 118.26 and 103.9 per 1000 persons in 2009 year, respectively, and this trend was increased in both girls (152.90 per 1000 persons) and boys (125.72 per 1000 persons) in 2011. The obesity trend was increased among both girls and boys (22.26 and 26.52 among girls and boys in 2009 to 24.66 and 28.65 per 1000 persons in 2011), respectively. In rural schools, the prevalence of overweight among girls was increased from 84.5 in 2009 to 108.89 per 1000 persons in 2011, but this trend was decreased among boys (from 95.49 in 2009 to 43.9 per 1000 persons in 2011), and the prevalence of obesity among boys was increased at the end of follow-up, but this trend was decreased among girls. Conclusions: Overweight and obesity in children has increased. Further studies are necessary to evaluate the relationship between obesity and overweight and risk factors such as
Shin, Joon-Shik; Lee, Jinho; Kim, Me-riong; Shin, Byung-Cheul; Lee, Myeong Soo; Ha, In-Hyuk
Objectives This study aimed to assess the efficacy and safety of an integrative complementary and alternative medicine (CAM) approach in the management of lumbar herniated disc (LHD) with sciatic pain and investigate pain relapse, use of medical care and surgery rates in patients who actively chose non-surgical CAM treatment for LHD. Study design/Setting This prospective observational study was undertaken at a Korean medicine hospital outpatient setting in Korea. Participants A total of 128 consecutive patients with LHD with a numeric rating scale for leg pain of ≥5 completed 6 months of CAM treatment after recruitment from November 2006, and 73/128 participants (57%) attended follow-up 3 years later. Interventions 6 months of CAM treatment (herbal medicine, acupuncture, bee venom pharmacopuncture, and Chuna manipulation). Primary outcome measures Visual analogue scale (VAS) for low back and leg pain, Oswestry Disability Index (ODI), and Short Form (SF)-36 Health Survey. Secondary outcome measures Neurological impairment (muscular weakness, sensory loss, Straight Leg Raise test), MRIs, recurrence of low back pain and/or radiating pain, and use of medical care. Results 92 patients could be assessed for surgical state, of whom 4 replied that they had received surgery. 73 patients attended the 3-year follow-up. The baseline VAS of back pain (4.37±2.70) decreased after treatment (0.90±1.01; p<0.001) and was maintained at 3 years (1.12±1.64; p=0.19). The baseline VAS of leg pain (7.57±1.40) also decreased on treatment (0.82±1.18; p<0.001) and was sustained at 3 years (0.99±1.58; p=0.34). ODI scores declined from 40.74±16.15 to 9.84±9.67 (p<0.001), then decreased further to 6.30±7.19 (p<0.01). SF-36 scores increased from 34.96±13.30 to 69.20±14.96 (p<0.001), reaching 76.19±14.45 (p<0.001) at 3 years. 37 patients reported recurrence of pain and most chose CAM treatment for management of relapse symptoms. Conclusions Although the absence of a
Miller, Dana L.; Creswell, John W.; Olander, Lisa
An ethnographic study narrated three tales about a soup kitchen for the homeless and the near-homeless. To provide a cultural, ethnographic analysis, and share fieldwork experiences the study began with realist and confessional tales. These two tales emerged from the initial writing and presenting of the soup kitchen ethnography to qualitative…
This paper explores the challenges and dilemmas of conducting ethnographic race research in the context of the South African situation, forming part of my ethnographic race research PhD project, conducted in two historically white, single-sex schools in South Africa. First, it critically examines the theoretical dilemmas on crucial issues of…
Sajan, K. S.; Sindhu, M.
Ethnographic research is an emerging research technique in the field of education. Ethnographic research was a procedure usually used in anthropology but now it is getting popular in educational field. This kind of research relies on qualitative data, its perspective is holistic and its procedures of data analysis involve contextualization. Data…
Wong, Andrew D.; Wu, Lan
Despite an increasing demand for marketing researchers familiar with ethnographic methods, ethnographic consumer research has received little coverage in current marketing curricula. The innovation discussed in the present paper addresses this problem: it introduces the notion of "cultural relativism" and gives students hands-on experience in…
Ethnographic study describes the professional development of seven unlicensed or nonqualified teachers involved in a community teacher education project in two informal settlement community schools near Johannesburg, South Africa. Data from observations and interviews highlight the teachers' initiative in pursuing their own professional…
Jacobsen, Alice Juel
This article explores challenges of applying an ethnographic approach, combining participant observation and interviews, to a study of organizational change. The exploration is connected to reform changes, as they are constructed in the interaction between managers and teachers, in a Danish Upper Secondary High School. The data material is…
Long, David E.
Evolution education in the US is conducted unevenly, or in cases is absent. Showing the strength of ethnography as a means of deeper explication in science education, this article explores the interactions of policy and practice in evolution education. Discussing vignettes from a larger ethnographic study, Creationist rationales and practices…
Cohen, Rosetta Marantz
This paper offers a synopsis of the findings of a full-length ethnographic study which dealt with the phenomenon of the strong, veteran teacher who has succeeded in remaining enthusiastic over the course of a 30-year career. Subjects were five secondary school teachers of varied ethnic backgrounds representing a range of disciplines and teaching…
Shows how archaeological interpretation based strictly on the evidence of architectural remains may lead to inaccurate conclusions about social patterns in extinct societies. An ethnographic study of an Iranian Kurdish village is used to illustrate the possible variations of residential social relationships within buildings with similar…
Asahina, Roberta R.
A study explored whether ethnographic research is appropriate and feasible for Hispanic consumer research. Subjects, 41 Hispanic advertising executives (out of an original group of 80) in advertising agencies listed in the Standard Directory of Advertising Agencies from New York, Los Angeles, Chicago, Miami, and San Antonio, answered a 23-item…
Artists and novelists have rarely been considered as ethnographers in the medical social sciences. This article pursues the idea that ethnographically informed artistic works can be viewed as critical cultural texts alongside sociological and anthropological studies of surgery. It is proposed that art provides fresh perspectives on topics of interest in health sociology and medical anthropology while simultaneously expanding our engagement with ethnographic representation. Discussion revolves around a video installation incorporating images of heart surgery by contemporary artist Bill Viola and a recent novel by Ian McEwan detailing the day-in-the-life of a neurosurgeon. Considering an emerging re-engagement, particularly in contemporary art that artists are having with medical themes, and a concurrent ;ethnographic turn' in art practice, it seems timely to recognize the potentially critical contribution of non-social scientist ethnographers to our understanding of a rapidly changing medical culture.
This chapter outlines a typology of genres of ethnographic research with regard to virtual worlds, informed by extensive research the author has completed both in Second Life and in Indonesia. It begins by identifying four confusions about virtual worlds: they are not games, they need not be graphical or even visual, they are not mass media, and they need not be defined in terms of escapist role-playing. A three-part typology of methods for ethnographic research in virtual worlds focuses on the relationship between research design and ethnographic scale. One class of methods for researching virtual worlds with regard to ethnographic scale explores interfaces between virtual worlds and the actual world, whereas a second examines interfaces between two or more virtual worlds. The third class involves studying a single virtual world in its own terms. Recognizing that all three approaches have merit for particular research purposes, ethnography of virtual worlds can be a vibrant field of research, contributing to central debates about human selfhood and sociality.
Puillat, I.; Taupier-Letage, I.; Millot, C.
The Algerian Current (AC) is unstable and generates mesoscale meanders and eddies. Only anticyclonic eddies can develop and reach diameters over 200 km with vertical extents down to the bottom (˜3000 m). Algerian Eddies (AEs) first propagate eastward along the Algerian slope at few kilometers per day. In the vicinity of the Channel of Sardinia, a few AEs detach from the Algerian slope and propagate along the Sardinian one. It was hypothesized that AEs then followed a counter-clockwise circuit in the eastern part of the basin. Maximum recorded lifetimes were known to exceed 9 months. Within the framework of the 1-year Eddies and Leddies Interdisciplinary Study off Algeria (ELISA) experiment (1997-1998), we exhaustively tracked two AEs, using mainly an ˜3-year time series of NOAA/AVHRR satellite images. We show that AEs lifetimes can near 3 years, exceeding 33 months at least. We also confirm the long-lived AEs preferential circuit in the eastern part of the Algerian Basin, and specify that it may include several loops (at least three).
The report presents the results of the data analyses of the DIRBE-COBE data set to study the structure of the zodiacal cloud in the near-infrared wavebands at 1.2, 2.2, and 3.4 microns. The cloud has been divided into two components which have been analyzed and studied separately. The annual variation of the flux in the smooth or low frequency component has been measured in all three bands and the presence of any asymmetries due to the Earth's resonant ring have been studied. The high frequency component which primarily consisted of the asteroidal dust bands. Extensive and careful co-addition was done to extract the central bands in all three wavebands. The ten-degree bands are present in the 1.2 and 2.2 microns but not in the 3.4 micron waveband.
Leong, Dara; NicAogáin, Kerrie; Luque-Sastre, Laura; McManamon, Oisin; Hunt, Karen; Alvarez-Ordóñez, Avelino; Scollard, Johann; Schmalenberger, Achim; Fanning, Séamus; O'Byrne, Conor; Jordan, Kieran
The problem of assessing the occurrence of the food-borne pathogen Listeria monocytogenes in the food chain, and therefore the risk of exposure of the human population, is often challenging because of the limited scope of some studies. In this study the occurrence of L. monocytogenes in food from four major food groups, dairy products, meats, seafood and vegetables, and associated food processing environments in Ireland was studied over a three-year period. Fifty-four small food businesses participated in the study and sent both food and environmental samples every 2months between 2013 and 2015. L. monocytogenes was isolated using the ISO11290 standard method. Confirmation of L. monocytogenes and identification of serogroups were achieved using a multiplex PCR assay, and for some isolates serotype was determined using commercial antisera. Pulsed- field gel electrophoresis (PFGE) analysis was performed on all isolates allowing the relatedness of isolates from different food businesses to be compared nationwide. In total, 86 distinct pulsotypes were identified. The overall occurrence of L. monocytogenes in food samples was 4.2%, while in environmental samples it was 3.8%. In general, the occurrence of L. monocytogenes in food businesses decreased over the course of the study, presumably reflecting increased awareness and vigilance. The majority of the pulsotypes detected were unique to a particular food group (63/86), while only three pulsotypes were found in all four food groups investigated. The highest occurrence in food was found in the meat category (7.5%) while seafood had the lowest rate of occurrence (1.8%). Seventeen of the pulsotypes detected in the study were persistent, where persistence was defined as repeated isolation from a single facility with a minimum time interval of 6months. Using PFGE, 11 of the pulsotypes identified in this study were indistinguishable from those of 11 clinical isolates obtained from patients in Ireland over the last 4years
Paunio, P; Rautava, P; Helenius, H; Alanen, P; Sillanpää, M
The aim of this study was to examine how dental health related habits, infectious diseases and long-term illness are associated with dental health at the age of 3 in first-born children resident in a Finnish province. The study was designed as a survey using stratified randomised cluster sampling, confidential questionnaires and clinical dental examinations. The results were analysed using polytomous logistic models. In the stepwise analysis the only statistically significant explanatory factors were the use of juice at night and dental cleanliness. Antibiotic treatment or long-term illness was not significantly associated with dental health.
Drake, David; Dawson, Deborah; Kramer, Katherine; Schumacher, Amy; Warren, John; Marshall, Teresa; Starr, Delores; Phipps, Kathy
Severe Early Childhood Caries (S-ECC) is a terribly aggressive and devastating disease that is all too common in lower socio-economic children, but none more so that what is encountered in American Indian Tribes. Nationwide, approximately 27% of 2–5 year olds have decay while 62% percent of American Indian/Alaska Native children in the same age group have a history of decay (IHS 2010, NHANES 1999–2002). We have conducted a study of children from birth to 36 months of age on Pine Reservation to gain a better understanding of the variables that come into play in the development of this disease, from transmission and acquisition of Streptococcus mutans genotypes from mother to child to multiple dietary and behavioral components. This article describes how we established a direct partnership with the Tribe and the many opportunities and challenges we faced in performing this 5-year field study. PMID:27668133
Bajoub, Aadil; Hurtado-Fernández, Elena; Ajal, El Amine; Ouazzani, Noureddine; Fernández-Gutiérrez, Alberto; Carrasco-Pancorbo, Alegría
The phenolic fraction of monovarietal virgin olive oils (VOOs) from the main Moroccan cultivar Picholine marocaine (142 samples from three different subareas of the Meknès region) was studied over three consecutive crop seasons (2011, 2012, and 2013) using a powerful LC-MS methodology. First, LC-ESI-TOF MS was used to get a comprehensive characterization of the phenolic fraction; afterward, LC-ESI-IT MS was utilized for further identification (MS/MS experiments) and quantitation purposes. A total of 28 phenolic compounds (and quinic acid) were determined, revealing the complex profile of Meknès VOO, composed, in order of abundance, by secoiridoids, phenolic alcohols, lignans, flavonoids, and phenolic acids. Tukey's test was applied to ascertain possible significant intraregional and/or interannual variations of the phenolic content of the Meknès VOOs under study. Results showed that the content of phenolic compounds was mainly related to the crop season.
Hannula, Silja Emilia; de Boer, Wietse; van Veen, Johannes
In this three year field study the impact of different potato (Solanum tuberosum L.) cultivars including a genetically modified (GM) amylopectin-accumulating potato line on rhizosphere fungal communities are investigated using molecular microbiological methods. The effects of growth stage of a plant, soil type and year on the rhizosphere fungi were included in this study. To compare the effects, one GM cultivar, the parental isoline, and four non-related cultivars were planted in the fields and analysed using T-RFLP on the basis of fungal phylum specific primers combined with multivariate statistical methods. Additionally, fungal biomass and some extracellular fungal enzymes (laccases, Mn-peroxidases and cellulases) were quantified in order to gain insight into the function of the fungal communities. Plant growth stage and year (and agricultural management) had the strongest effect on both diversity and function of the fungal communities while the GM-trait studied was the least explanatory factor. The impact of cultivar and soil type was intermediate. Occasional differences between cultivars, the amylopectin-accumulating potato line, and its parental variety were detected, but these differences were mostly transient in nature and detected either only in one soil, one growth stage or one year.
Hannula, Silja Emilia; de Boer, Wietse; van Veen, Johannes
In this three year field study the impact of different potato (Solanum tuberosum L.) cultivars including a genetically modified (GM) amylopectin-accumulating potato line on rhizosphere fungal communities are investigated using molecular microbiological methods. The effects of growth stage of a plant, soil type and year on the rhizosphere fungi were included in this study. To compare the effects, one GM cultivar, the parental isoline, and four non-related cultivars were planted in the fields and analysed using T-RFLP on the basis of fungal phylum specific primers combined with multivariate statistical methods. Additionally, fungal biomass and some extracellular fungal enzymes (laccases, Mn-peroxidases and cellulases) were quantified in order to gain insight into the function of the fungal communities. Plant growth stage and year (and agricultural management) had the strongest effect on both diversity and function of the fungal communities while the GM-trait studied was the least explanatory factor. The impact of cultivar and soil type was intermediate. Occasional differences between cultivars, the amylopectin-accumulating potato line, and its parental variety were detected, but these differences were mostly transient in nature and detected either only in one soil, one growth stage or one year. PMID:22529898
Messac, Luke; Ciccarone, Dan; Draine, Jeffrey; Bourgois, Philippe
The apolitical legitimacy of "evidence-based medicine" offers a practical means for ethnography and critical social-science-and-humanities-of-health theory to transfer survival resources to structurally vulnerable populations and to engage policy and services audiences with urgent political problems imposed on the urban poor in the United States that harm health: most notably, homelessness, hyperincarceration, social service cut-backs and the War on Drugs. We present four examples of collaborations between ethnography and clinical research projects that demonstrate the potentials and limits of promoting institutional reform, political debate and action through distinct strategies of cross-methodological dialogue with epidemiological and clinical services research. Ethnographic methods alone, however, are simply a technocratic add-on. They must be informed by critical theory to contribute effectively and transformatively to applied health initiatives. Ironically, technocratic, neoliberal logics of cost-effectiveness can sometimes render radical service and policy reform initiatives institutionally credible, fundable and capable of generating wider political support, even though the rhetoric of economic efficacy is a double-edged sword. To extend the impact of ethnography and interdisciplinary theories of political-economic, cultural and disciplinary power relations into applied clinical and public health research, anthropologists--and their fellow travelers--have to be able to strategically, but respectfully learn to see through the positivist logics of clinical services research as well as epidemiological epistemology in order to help clinicians achieve--and extend--their applied priorities. In retrospect, these four very differently-structured collaborations suggest the potential for "good-enough” humble scientific and political strategies to work for, and with, structurally vulnerable populations in a punitive neoliberal era of rising social inequality
Messac, Luke; Ciccarone, Dan; Draine, Jeffrey; Bourgois, Philippe
The apolitical legitimacy of "evidence-based medicine" offers a practical means for ethnography and critical social-science-and-humanities-of-health theory to transfer survival resources to structurally vulnerable populations and to engage policy and services audiences with urgent political problems imposed on the urban poor in the United States that harm health: most notably, homelessness, hyperincarceration, social service cut-backs and the War on Drugs. We present four examples of collaborations between ethnography and clinical research projects that demonstrate the potentials and limits of promoting institutional reform, political debate and action through distinct strategies of cross-methodological dialog with epidemiological and clinical services research. Ethnographic methods alone, however, are simply a technocratic add-on. They must be informed by critical theory to contribute effectively and transformatively to applied health initiatives. Ironically, technocratic, neoliberal logics of cost-effectiveness can sometimes render radical service and policy reform initiatives institutionally credible, fundable and capable of generating wider political support, even though the rhetoric of economic efficacy is a double-edged sword. To extend the impact of ethnography and interdisciplinary theories of political-economic, cultural and disciplinary power relations into applied clinical and public health research, anthropologists - and their fellow travelers - have to be able to strategically, but respectfully learn to see through the positivist logics of clinical services research as well as epidemiological epistemology in order to help clinicians achieve - and extend - their applied priorities. In retrospect, these four very differently-structured collaborations suggest the potential for "good-enough" humble scientific and political strategies to work for, and with, structurally vulnerable populations in a punitive neoliberal era of rising social inequality
Tartaglia, Gianluca M.; Sidoti, Ernesto; Sforza, Chiarella
OBJECTIVES: Zirconia-based prostheses are commonly used for aesthetic crown and fixed restorations, although follow-up data are limited, especially for implant-supported crowns. The aim of this study was to evaluate the three-year clinical results of the installation of 463 zirconia core crowns by a general dental private practice. METHODS: This study followed 142 patients (69 men and 73 women; aged 28-82 years) who had received 248 single crowns (202 tooth-supported, 36 implant-supported) and 225 multiple units of up to six elements (81 tooth-supported, 144 implant-supported). Clinical events, including fracture and loss of retention, secondary caries, and marginal integrity, were recorded. The overall failure rate was computed for the fractured and lost prostheses. Aesthetic, functional, and biological properties were rated, and patient satisfaction was investigated. RESULTS: During the three-year follow-up period, four patients were lost from the study (18 crowns, 4% of the total crowns). Three of the zirconia prostheses suffered fractures in more than three units (11 crowns; one- vs. three-year follow-up, p<0.05, Wilcoxon signed-rank test), and the cumulative prosthesis survival rate was 98.2%. Twelve units lost retention and were re-cemented, and no secondary caries of the abutment teeth were reported. The aesthetic, functional, and biological properties were generally well-rated, and there were no differences between tooth- and implant-supported crowns. The lowest scores were given regarding the anatomical form of the crowns, as some minor chipping was reported. Relatively low scores were also given for the periodontal response and the adjacent mucosa. Overall, patient satisfaction was high. CONCLUSIONS: At the three-year follow-up, the zirconia-core crowns appeared to be an effective clinical solution as they had favorable aesthetic and functional properties. Only the marginal fit of the prostheses should be improved upon. PMID:22189731
Yonezu, Takuro; Yakushiji, Masashi
The purpose of the present study was to investigate the relationship between infant sucking habits and the prevalence of caries in Japanese preschool children.The study was designed as a prospective, longitudinal study starting with 592 children aged 18 months. Information on sucking habits and patterns of feeding was collected from parents in the form of a questionnaire. Children who continued breastor bottle-feeding at 18 months of age were eliminated prior to the evaluations. The children were divided into 3 groups according to their sucking habits at 18 months of age: Group 1: children with a finger-sucking habit (n=151); Group 2: children who used a pacifier (n=45) and Group 3: children with no oral habit (n=205). Clinical examinations were carried out by one of the authors.Mean dft and prevalence of caries were not statistically significant among the 3 groups at 18 months of age. However, only 10.6% of the children in Group 1 exhibited caries at 36 months of age, compared with 17.1% in Group 3 and 24.4% in Group 2. Group 1 children showed the smallest mean dft at 0.30 among the 3 groups at 36 months of age, and those in Group 2 showed 1.18; the difference was statistically significant (p<0.01).The results suggest that children with a finger-sucking habit are more likely to be free of caries by the age of 3. However, use of pacifier at 18 months of age is a potential risk factor for the development of dental caries in children.
Issa, Abdoulkarim Ibrahim; Duprez, Jean-Noël; Bada-Alambedji, Rianatou; Djika, Mamane; Mainil, Jacques Georges; Bardiau, Marjorie
Staphylococcus (S.) aureus is one of the most important pathogens causing bovine mastitis. The aim of the present work was to follow in three herds and during the 3 years the clonality of S. aureus isolated from California Mastitis Test (CMT)-positive cows at the experimental station of Toukounous (Niger) by (i) comparing their pulsed field gel electrophoresis (PFGE) fingerprints, (ii) identifying their virulotypes by PCR amplification and (iii) assessing the production of capsule and the formation of biofilm. The 88 S. aureus isolates belonged to 14 different pulsotypes, 3 of them being predominant: A (30 %), D (27 %), B (15 %). A and B pulsotypes had the highest profile similarity coefficient (94 %), while others had similarity coefficients under 60 %. Seventy-five S. aureus isolates were further studied for their virulotypes, capsular antigens and biofilm production. Most surface factor-, leukocidin- and haemolysin-, but not the enterotoxin-encoding genes were detected in the majority (>75 %) of the isolates and were evenly distributed between the A, B and D pulsotype isolates. The majority of the 72 S. aureus positive with the cap5H or cap8H PCR produced the CP5 (82 %) or the CP8 (88 %) capsular antigen, respectively. Biofilm production by the 57 icaA-positive isolates was strong for 8 isolates, moderate for 31 isolates but weak for 18 isolates, implying that the icaA gene may not be expressed in vitro by one third of the positive isolates. Similar to other studies, those results confirm that a restricted number of S. aureus clones circulate within the three herds at Toukounous and that their specific virulence-associated properties must still be further studied.
Kodama, Naoki; Takeuchi, Hiroshi
We assessed relationships between six texture features and changes in atrophy of the cerebral parenchyma, the hippocampus, and the parahippocampal gyrus in the Alzheimer-type dementia (ATD) brain to determine whether or not the features reflect cerebral atrophy in ATD patients. The subjects of this study were 10 ATD patients, and underwent an magnetic resonanse imaging test of the head annually for at least 3 consecutive years. They consisted of three men and seven women, with a mean age of 71.4 ± 6.7 years. The results of study, the mean run length nonuniformity (RLN), angular second moment (ASM), and contrast (CON) increased with time, whereas the mean gray level nonuniformity (GLN), run percentage (RPC), and entropy (ENT) decreased with time. There was a statistically significant correlation between brain-intracranial area ratio (BIR) and GLN (p = 0.039), between BIR and ASM (p = 0.011), and between BIR and ENT (p = 0.023) as well as between parahippocampal-intracranial area ratio and GLN (p = 0.049). These results indicate that the six texture features were shown to reflect gray matter atrophy associated with ATD and to change with the progress of the disease. Although the course of ATD can be followed up by measuring a hippocampal area or volume and determining a decrease in the area or volume, texture features should be a more effective instrument for identifying the progress of ATD.
Introduction The use of urinary output and vital signs to guide initial burn resuscitation may lead to suboptimal resuscitation. Invasive hemodynamic monitoring may result in over-resuscitation. This study aimed to evaluate the results of a goal-directed burn resuscitation protocol that used standard measures of mean arterial pressure (MAP) and urine output, plus transpulmonary thermodilution (TPTD) and lactate levels to adjust fluid therapy to achieve a minimum level of preload to allow for sufficient vital organ perfusion. Methods We conducted a three-year prospective cohort study of 132 consecutive critically burned patients. These patients underwent resuscitation guided by MAP (>65 mmHg), urinary output (0.5 to 1 ml/kg), TPTD and lactate levels. Fluid therapy was adjusted to achieve a cardiac index (CI) >2.5 L/minute/m2 and an intrathoracic blood volume index (ITBVI) >600 ml/m2, and to optimize lactate levels. Statistical analysis was performed using mixed models. We also used Pearson or Spearman methods and the Mann-Whitney U-test. Results A total of 98 men and 34 women (mean age, 48 ± 18 years) was studied. The mean total body surface area (TBSA) burned was 35% ± 22%. During the early resuscitation phase, lactate levels were elevated (2.58 ± 2.05 mmol/L) and TPTD showed initial hypovolemia by the CI (2.68 ± 1.06 L/minute/m2) and the ITBVI (709 ± 254 mL/m2). At 24 to 32 hours, the CI and lactic levels were normalized, although the ITBVI remained below the normal range (744 ± 276 ml/m2). The mean fluid rate required to achieve protocol targets in the first 8 hours was 4.05 ml/kg/TBSA burned, which slightly increased in the next 16 hours. Patients with a urine output greater than or less than 0.5 ml/kg/hour did not show differences in heart rate, mean arterial pressure, CI, ITBVI or lactate levels. Conclusions Initial hypovolemia may be detected by TPTD monitoring during the early resuscitation phase. This hypovolemia might not be reflected by blood
Yeh, Ming-Lun; Huang, Ching-I; Hsieh, Ming-Yen; Huang, Chung-Feng; Hsieh, Meng-Hsuan; Huang, Jee-Fu; Dai, Chia-Yen; Lin, Zu-Yau; Chen, Shinn-Chern; Yu, Ming-Lung; Chuang, Wan-Long
The subsequent maintenance therapy in chronic hepatitis B (CHB) patients after long-term viral replication suppression is still uncertain. We aim to evaluate the efficacy of lamivudine (LAM) maintenance therapy in CHB patients achieving undetectable hepatitis B virus (HBV) DNA after 3 years of entecavir (ETV) therapy. Consecutive CHB patients who received at least 3 years of ETV and achieved HBV DNA negativity were allocated either LAM switch therapy or stopped ETV therapy in a prospective, open-label study. Another group of sex- and age-matched patients with continuous ETV therapy for at least 4 years served as historical control group. The primary outcome measurement of the study was relapse of HBV DNA (defined as serum HBV DNA level ≥ 2000 IU/mL). A total of 74 patients, including 42 of LAM switch and 32 of the nonswitch group, were enrolled. There were no significant differences in demographics, except a higher proportion of patients with positive hepatitis B envelope antigen in the nonswitch group at the initiation of ETV therapy. The LAM switch group had significantly lower 1-year relapse rate of HBV within 1 year compared to the nonswitch group (14.3% vs. 75%, p<0.001). However, none of the 48 historical control patients developed relapse of HBV, which was significantly lower than the rate in LAM switch group (p < 0.001). LAM switch was the only factor associated with HBV DNA relapse. In conclusion, continuous long-term potent nucleot(s)ide analogue therapy is mandatory for prevention of viral relapse in CHB patients.
DA, Edelstein; I, Florescu
The objective of this study was to determine the compared results of both the reconstruction surgery and the amputation in severe crushing of the foot, which led to open fractures. The type of study. Prospective. Background. Two major trauma hospitals (Floreasca Clinical Emergency Hospital and "Bagdasar Arseni" Clinical Emergency Hospital) from the university center in Bucharest. Patients. 21 patients, who sustained crushing of the foot with resulting Gustilo type III open fractures, were involved. The exclusion criteria were represented by open fractures that had very gross destructions of the neurovascular bundle, for which the amputation was the only solution, with no modality to reconstruct whatsoever. Treatment. An immediate amputation (at 24, 48 hours after a thorough debridement, proper patient resuscitation, and detailed imaging investigation - the technique of delayed emergency) and reconstruction surgery were performed. Methods of evaluation. Three variables were used: the Sickness Impact Profile (SIP) score, the Visual Analogue Scale (VAS) for the residual pain and the number of rehospitalizations for secondary surgical procedures. Results. When comparing the two lots of patients, first in which the amputation patients were included and second in which the reconstruction patients were included, it was noticed that there was a less favorable prognostic in the second lot for a three-year follow up period. Conclusions. The patients with a mangled foot, in which reconstruction surgery of the bone and soft tissue envelope was performed, had a worse prognostic than those who had an amputation as a first intention. Abbreviations: SIP = Sickness Impact Profile, VAS = Visual Analogue Scale, MVA = Motor Vehicle Accident, STSG = Split Thickness Skin Graft.
Holman, E Alison; Silver, Roxane Cohen
The September 11, 2001 terrorist attacks (9/11) presented a unique opportunity to assess the physical health impact of collective stress in the United States. This study prospectively examined rates of physical ailments and predictors of health care utilization in a U.S. nationally representative sample over three years following the attacks. A sample of adults (N = 2592) completed a survey before 9/11/01 that assessed MD-diagnosed physical and mental health ailments. Follow-up surveys were administered at one (N = 1923), two (N = 1576), and three (N = 1950) years post-9/11 to assess MD-diagnosed physical health ailments (e.g., cardiovascular, endocrine) and health care utilization. Reports of physical ailments increased 18% over three years following 9/11. 9/11-related exposure, lifetime and post-9/11 stress, MD-diagnosed depression/anxiety, smoking status, age, and female gender predicted increased incidence of post-9/11 ailments, after controlling for pre-9/11 health. After adjusting for covariates (demographics, somatization, smoking status, pre-9/11 mental and physical health, lifetime and post-9/11 stress, and degree of 9/11-related exposure), increases in MD-diagnosed cardiovascular, endocrine, gastrointestinal, and hematology-oncology ailments predicted greater utilization of health care services over two years. After the collective stress of 9/11, rates of physical ailments increased and predicted greater health care utilization in a U.S. national sample.
Background Type 2 diabetes mellitus and depression are highly prevalent diseases that are associated with an increased risk of cardiovascular disease and mortality. There is evidence about a bidirectional association between depressive symptoms and type 2 diabetes mellitus. However, prognostic implications of the joint effects of these two diseases on cardiovascular morbidity and mortality are not well-known. Method/design A three-year, observational, prospective, cohort study, carried out in Primary Health Care Centres in Madrid (Spain). The project aims to analyze the effect of depression on cardiovascular events, all-cause and cardiovascular mortality in patients with type 2 diabetes mellitus, and to estimate a clinical predictive model of depression in these patients. The number of patients required is 3255, all them with type 2 diabetes mellitus, older than 18 years, who regularly visit their Primary Health Care Centres and agree to participate. They are chosen by simple random sampling from the list of patients with type 2 diabetes mellitus of each general practitioner. The main outcome measures are all-cause and cardiovascular mortality and cardiovascular morbidity; and exposure variable is the major depressive disorder. There will be a comparison between depressed and not depressed patients in all-cause mortality, cardiovascular mortality, coronary artery disease and stroke using the Chi-squared test. Logistic regression with random effects will be used to adjust for prognostic factors. Confounding factors that might alter the effect recorded will be taken into account in this analysis. To assess the effect of depression on the mortality, a survival analysis will be used comparing the two groups using the log-rank test. The control of potential confounding variables will be performed by the construction of a Cox regression model. Discussion Our study’s main contribution is to evaluate the increase in the risk of cardiovascular morbidity and mortality
Changes in magnetic resonance imaging disease measures over 3 years in mildly disabled patients with relapsing-remitting multiple sclerosis receiving interferon β-1a in the COGnitive Impairment in MUltiple Sclerosis (COGIMUS) study
Background Conventional magnetic resonance imaging (MRI) has improved the diagnosis and monitoring of multiple sclerosis (MS). In clinical trials, MRI has been found to detect treatment effects with greater sensitivity than clinical measures; however, clinical and MRI outcomes tend to correlate poorly. Methods In this observational study, patients (n = 550; 18-50 years; relapsing-remitting MS [Expanded Disability Status Scale score ≤4.0]) receiving interferon (IFN) β-1a therapy (44 or 22 µg subcutaneously [sc] three times weekly [tiw]) underwent standardized MRI, neuropsychological and quality-of-life (QoL) assessments over 3 years. In this post hoc analysis, MRI outcomes and correlations between MRI parameters and clinical and functional outcomes were analysed. Results MRI data over 3 years were available for 164 patients. T2 lesion and T1 gadolinium-enhancing (Gd+) lesion volumes, but not black hole (BH) volumes, decreased significantly from baseline to Year 3 (P < 0.0001). Percentage decreases (baseline to Year 3) were greater with the 44 μg dose than with the 22 μg dose for T2 lesion volume (-10.2% vs -4.5%, P = 0.025) and T1 BH volumes (-7.8% vs +10.3%, P = 0.002). A decrease in T2 lesion volume over 3 years predicted stable QoL over the same time period. Treatment with IFN β-1a, 44 μg sc tiw, predicted an absence of cognitive impairment at Year 3. Conclusion Subcutaneous IFN β-1a significantly decreased MRI measures of disease, with a significant benefit shown for the 44 µg over the 22 µg dose; higher-dose treatment also predicted better cognitive outcomes over 3 years. PMID:21999142
This article reports new ethnographic research exploring community-based, participatory arts practice in Northern England and Mexico City. Noting the value of an ethnographic approach, the study investigated whether commonalities discovered in practitioners’ approaches are significant enough to constitute a generalisable participatory arts methodology, transcending significant contextual differences, and recognisable across national boundaries. Shared characteristics emerged in practitioners’ modes of engagement with groups, and strategies for catalysing change; clear convergences from which a core methodology in community-based participatory arts for change is distilled. It suggests the opening of liminal spaces in which participants can reflect, rehearsing fresh ways of engaging in transformative dialogues in relation to the world in which they live. This article presents the study findings as a grounded characterisation of ‘participatory arts practice’: a complex but potentially powerful mechanism, in use within numerous community health projects, and evident in diverse settings, despite little or no exchange of ideas between practitioners. PMID:26045637
Paunio, P; Rautava, P; Sillanpää, M
Sucking habits and their connection with family background was investigated in 3-year-old Finnish children. The association between sucking habits and malocclusion was also studied. The study was based on a survey with stratified randomized cluster sampling, confidential questionnaires, and clinical dental examinations. Dummy (pacifier) use was often associated with a negligent attitude towards the child's toothbrushing. This may imply that these parents need more support, encouragement, and counseling from the well-baby clinic than others. Sucking habits were strongly associated with malocclusion.
Stewart, Abigail J.
Suggests the value of ethnographically informed methods in the psychology of women, emphasizing the role of generation in psychology. Examines evidence from an ongoing, ethnographically informed study of high school graduates in the mid-1950s and late-1960s. The two generations of graduates have distinctive accounts of their experiences, with the…
Smith, Laura J.
Naturalistic inquiry (based on the ethnographic research paradigm) has the potential to supplement, or possibly to replace, quantitative experimental research in education. For years most reading researchers have used the experimental research design. This design fails to tap self-concept, value systems, purpose of and attitude toward reading,…
A 3-year physical activity intervention program increases the gain in bone mineral and bone width in prepubertal girls but not boys: the prospective copenhagen school child interventions study (CoSCIS).
Hasselstrøm, H A; Karlsson, M K; Hansen, S E; Grønfeldt, V; Froberg, K; Andersen, L B
The aim of this study was to evaluate the effect of increasing the amount of time spent in physical education classes on bone mineral accrual and gain in bone size in prepubertal Danish children. A total of 135 boys and 108 girls, aged 6-8 years, were included in a school-based curriculum intervention program where the usual time spent in physical education classes was doubled to four classes (180 min) per week. The control group comprised age-matched children (62 boys and 76 girls) recruited from a separate community who completed the usual Danish school curriculum of physical activity (90 min/week). Dual-energy X-ray absorptiometry was used to evaluate bone mineral content (BMC; g), bone mineral density (g/cm(2)), and bone width at the calcaneus and distal forearm before and after 3 years of intervention. Anthropometrics and Tanner stages were evaluated on the same occasions. General physical activity was measured with an accelerometer worn for 4 days. In girls, the intervention group had a 12.5% increase (P = 0.04) in distal forearm BMC and a 13.2% increase (P = 0.005) in distal forearm scanned area compared with girls in the control group. No differences were found between the intervention and control groups in boys. Increasing the frequency of physical education classes for prepubertal children is associated with a higher accrual of bone mineral and higher gain in bone size after 3 years in girls but not in boys.
Pelto, Gretel H; Armar-Klemesu, Margaret; Siekmann, Jonathan; Schofield, Dominic
The concept of a focused ethnographic study (FES) emerged as a new methodology to answer specific sets of questions that are required by agencies, policymakers, programme planners or by project implementation teams in order to make decisions about future actions with respect to social, public health or nutrition interventions, and for public-private partnership activities. This paper describes the FES on complementary feeding that was commissioned by the Global Alliance for Improved Nutrition and highlights findings from studies conducted in three very different country contexts (Ghana, South Africa and Afghanistan) burdened by high levels of malnutrition in older infants and young children (IYC). The findings are analysed from the perspective of decision-making for future interventions. In Ghana, a primary finding was that in urban areas the fortified, but not instant cereal, which was being proposed, would not be an appropriate intervention, given the complex balancing of time, costs and health concerns of caregivers. In both urban and rural South Africa, home fortification products such as micronutrient powders and small quantity, lipid-based nutrient supplements (LNS) are potentially feasible interventions, and would require thoughtful behaviour change communication programmes to support their adoption. Among the important results for future decision-making for interventions in Afghanistan are the findings that there is little cultural recognition of the concept of special foods for infants, and that within households food procurement for IYC are in the hands of men, whereas food preparation and feeding are women's responsibilities.
Nishijo, Muneko; Tai, Pham The; Anh, Nguyen Thi Nguyet; Nghi, Tran Ngoc; Nakagawa, Hideaki; Van Luong, Hoang; Anh, Tran Hai; Morikawa, Yuko; Waseda, Tomoo; Kido, Teruhiko; Nishijo, Hisao
In our previous study of 3-year-old children in a dioxin contamination hot spot in Vietnam, the high total dioxin toxic equivalent (TEQ-PCDDs/Fs)-exposed group during the perinatal period displayed lower Bayley III neurodevelopmental scores, whereas the high 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)-exposed group displayed increased autistic traits. In autistic children, urinary amino acid profiles have revealed metabolic alterations in the amino acids that serve as neurotransmitters in the developing brain. Therefore, our present study aimed to investigate the use of alterations in urinary amino acid excretion as biomarkers of dioxin exposure-induced neurodevelopmental deficits in highly exposed 3-year-old children in Vietnam. A nested case-control study of urinary analyses was performed for 26 children who were selected from 111 3-year-old children whose perinatal dioxin exposure levels and neurodevelopmental status were examined in follow-up surveys conducted in a dioxin contaminated hot spot. We compared urinary amino acid levels between the following 4 groups: (1) a high TEQ-PCDDs/Fs and high TCDD-exposed group; (2) a high TEQ-PCDDs/Fs but low TCDD-exposed group; (3) a low TEQ-PCDDs/Fs exposed and poorly developed group; and (4) a low TEQ-PCDDs/Fs exposed and well-developed group. Urinary levels of histidine and tryptophan were significantly decreased in the high TEQ-PCDDs/Fs and high TCDD group, as well as in the high TEQ-PCDDs/Fs but low TCDD group, compared with the low TEQ-PCDDs/Fs and well-developed group. However, the ratio of histidine to glycine was significantly lower only in the high TEQ-PCDDs/Fs and high TCDD group. Furthermore, urinary histidine levels and the ratio of histidine to glycine were significantly correlated with neurodevelopmental scores, particularly for language and fine motor skills. These results indicate that urinary histidine is specifically associated with dioxin exposure-induced neurodevelopmental deficits, suggesting that
Nishijo, Muneko; Tai, Pham The; Anh, Nguyen Thi Nguyet; Nghi, Tran Ngoc; Nakagawa, Hideaki; Van Luong, Hoang; Anh, Tran Hai; Morikawa, Yuko; Waseda, Tomoo; Kido, Teruhiko; Nishijo, Hisao
In our previous study of 3-year-old children in a dioxin contamination hot spot in Vietnam, the high total dioxin toxic equivalent (TEQ-PCDDs/Fs)-exposed group during the perinatal period displayed lower Bayley III neurodevelopmental scores, whereas the high 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)-exposed group displayed increased autistic traits. In autistic children, urinary amino acid profiles have revealed metabolic alterations in the amino acids that serve as neurotransmitters in the developing brain. Therefore, our present study aimed to investigate the use of alterations in urinary amino acid excretion as biomarkers of dioxin exposure-induced neurodevelopmental deficits in highly exposed 3-year-old children in Vietnam. A nested case-control study of urinary analyses was performed for 26 children who were selected from 111 3-year-old children whose perinatal dioxin exposure levels and neurodevelopmental status were examined in follow-up surveys conducted in a dioxin contaminated hot spot. We compared urinary amino acid levels between the following 4 groups: (1) a high TEQ-PCDDs/Fs and high TCDD-exposed group; (2) a high TEQ-PCDDs/Fs but low TCDD-exposed group; (3) a low TEQ-PCDDs/Fs exposed and poorly developed group; and (4) a low TEQ-PCDDs/Fs exposed and well-developed group. Urinary levels of histidine and tryptophan were significantly decreased in the high TEQ-PCDDs/Fs and high TCDD group, as well as in the high TEQ-PCDDs/Fs but low TCDD group, compared with the low TEQ-PCDDs/Fs and well-developed group. However, the ratio of histidine to glycine was significantly lower only in the high TEQ-PCDDs/Fs and high TCDD group. Furthermore, urinary histidine levels and the ratio of histidine to glycine were significantly correlated with neurodevelopmental scores, particularly for language and fine motor skills. These results indicate that urinary histidine is specifically associated with dioxin exposure-induced neurodevelopmental deficits, suggesting that
Suurküla, M; Agewall, S; Fagerberg, B; Wendelhag, I; Wikstrand, J
than we observed is needed to favorably affect intima-media thickness during an observation period of around 3 years in high-risk hypertensive patients.
Brown, Candice Michelle
This research project involves the investigation of the opportunities to learn science and about science through an extended year-long weather project in two middle school science classrooms. The theoretical framework draws together two compatible but as yet unconnected bodies of literature. From studies of scientific practices, the importance of the ways science is learned through practice in authentic settings are considered. Studies of situated cognition are examined as well to discern how students learn in context-specific ways. This empirical research is unique in three important ways. First, the research took place in two different middle school classrooms and utilized extensive participant observation over the course of the entire academic year and focus group interviews with students. One of the classes was mostly Hispanic students of lower socioeconomic status. The other class was primarily Caucasian students of middle socioeconomic status. Second, the teachers in the study participated in a multi-year service program coordinated by the local university. The teachers worked with their students to complete a year-long weather project that involves data collection, representation, analysis, and interpretation. Third, the project involves long-term study of weather data. As a result, students participating in the research over the year began to challenge the claims of their peers. Few classroom studies of earth science have been conducted and published and even fewer involved student managed school science research projects. The findings from this study can be used as a model for how long-term research projects in science can be incorporated into middle school science classes. This project is thus very important in the field of science education for understanding ways to make science accessible and appealing to a variety of students.
Syvertsen, Jennifer L.; Ohaga, Spala; Agot, Kawango; Dimova, Margarita; Guise, Andy; Rhodes, Tim; Wagner, Karla D.
Background Illegal drug markets are shaped by multiple forces, including local actors and broader economic, political, social, and criminal justice systems that intertwine to impact health and social wellbeing. Ethnographic analyses that interrogate multiple dimensions of drug markets may offer both applied and theoretical insights into drug use, particularly in developing nations where new markets and local patterns of use traditionally have not been well understood. This paper explores the emergent drug market in Kisumu, western Kenya, where our research team recently documented evidence of injection drug use. Methods Our exploratory study of injection drug use was conducted in Kisumu from 2013-2014. We draw on 151 surveys, 29 in-depth interviews, and 8 months of ethnographic fieldwork to describe the drug market from the perspective of injectors, focusing on their perceptions of the market and reports of drug use therein. Results Injectors described a dynamic market in which the availability of drugs and proliferation of injection drug use have taken on growing importance in Kisumu. In addition to reports of white and brown forms of heroin and concerns about drug adulteration in the market, we unexpectedly documented widespread perceptions of cocaine availability and injection in Kisumu. Examining price data and socio-pharmacological experiences of cocaine injection left us with unconfirmed evidence of its existence, but opened further possibilities about how the chaos of new drug markets and diffusion of injection-related beliefs and practices may lend insight into the sociopolitical context of western Kenya. Conclusions We suggest a need for expanded drug surveillance, education and programming responsive to local conditions, and further ethnographic inquiry into the social meanings of emergent drug markets in Kenya and across sub-Saharan Africa. PMID:26838470
Very few Latinos earn doctorates in anthropology, and the number enrolling in undergraduate programs is also not encouraging. This paper addresses the low and stagnant number of "new" Latino doctorates in anthropology, discusses reasons for this poor showing, and presents a possible solution--an approach to the study of anthropology that…
Petersen, Christie M.
This qualitative study was designed to gain an in-depth understanding of the role of the principal in successfully improving English Language Learner (ELL) educational outcomes in high poverty schools based on interviews with five elementary principals who were employed by Hillsboro School District during the SET-R grant from school years…
The US Agency for International Development (USAID) has awarded a 3-year US$593,036 grant to the Los Angeles firm of Juarez and Associates, Inc. to help implement a contraceptive social marketing project in Guatemala. The firm will provide marketing assistance to the for-profit organization. Importadora de Productos Farmaceuticos (PROFA), an offshoot of the nonprofit International Planned Parenthood Federation affiliate, Asociacion Pro-Bienestar de la Familia de Guatemala (APROFAM), created specifically to conduct the social marketing project. Juarez and Associates has previous market research experience in family planning in Guatemala. Contraceptive social marketing sales are projected to begin in early 1985.
Fawcett, Christine A.; Markson, Lori
Two studies examined the influence of similarity on 3-year-old children's initial liking of their peers. Children were presented with pairs of childlike puppets who were either similar or dissimilar to them on a specified dimension and then were asked to choose one of the puppets to play with as a measure of liking. Children selected the puppet…
Abramson, Corey M; Dohan, Daniel
Recent methodological debates in sociology have focused on how data and analyses might be made more open and accessible, how the process of theorizing and knowledge production might be made more explicit, and how developing means of visualization can help address these issues. In ethnography, where scholars from various traditions do not necessarily share basic epistemological assumptions about the research enterprise with either their quantitative colleagues or one another, these issues are particularly complex. Nevertheless, ethnographers working within the field of sociology face a set of common pragmatic challenges related to managing, analyzing, and presenting the rich context-dependent data generated during fieldwork. Inspired by both ongoing discussions about how sociological research might be made more transparent, as well as innovations in other data-centered fields, the authors developed an interactive visual approach that provides tools for addressing these shared pragmatic challenges. They label the approach "ethnoarray" analysis. This article introduces this approach and explains how it can help scholars address widely shared logistical and technical complexities, while remaining sensitive to both ethnography's epistemic diversity and its practitioners shared commitment to depth, context, and interpretation. The authors use data from an ethnographic study of serious illness to construct a model of an ethnoarray and explain how such an array might be linked to data repositories to facilitate new forms of analysis, interpretation, and sharing within scholarly and lay communities. They conclude by discussing some potential implications of the ethnoarray and related approaches for the scope, practice, and forms of ethnography.
Collin, Gilles; Ichou, Houria; Charpentier, Charlotte; Bendhafer, Samia; Dumitrescu, Madalina; Allal, Lahcene; Cojocaru, Bogdan; Desfrère, Luc; Descamps, Diane; Mandelbrot, Laurent; Houhou-Fidouh, Nadhira
Background To date, only influenza and RSV testing are recommended for respiratory viruses’ detection in paediatric units. In this study, we described, according to seasons, ages and clinical units, the results obtained in children (<15 years old) by multiplex-PCR (mPCR) tests allowing a quick and wide range detection of all respiratory viruses. These results were also compared with RSV specific detection. Methods All nasopharyngeal mPCR and RSV tests requested by clinicians in our French teaching hospitals group between 2011 and 2014 were retrospectively included. All repeated samples for the same children in the same month were discarded. Results Of the 381 mPCR tests (344 children) performed, 51.4% were positive. Positivity and viral co-infection rates were higher in the 6–36 months old strata (81% and 25%, p<0.0001 and p = 0.04, respectively). Viral distribution showed strong variations across ages. During specific influenza epidemic periods, only 1/39 (2.5%) mPCR tests were positive for influenza and 19/39 (48.7%) for other viruses. During specific RSV epidemic periods, only 8/46 (17.4%) mPCR tests were positive for RSV and 14/46 (30.4%) for other viruses. 477/1529 (31.2%) of RSV immunochromatography-tests were positive. Among the negatives immunochromatography-test also explored by mPCR, 28/62 (31%) were positive for other respiratory viruses. Conclusion This study provides a wide description of respiratory viruses’ distribution among children in hospital settings using mPCR over 3 years. It emphasizes the number of undiagnosed respiratory viruses according to the current diagnosis practice in France and gives a better picture of respiratory viruses identified in hospital settings by mPCR all over the year in France. PMID:28235002
Fabbri, Giacomo; Zarone, Fernando; Dellificorelli, Gianluca; Cannistraro, Giorgio; De Lorenzi, Marco; Mosca, Alberto; Sorrentino, Roberto
This study aimed to assess the clinical performance of lithium disilicate restorations supported by natural teeth or implants. Eight hundred sixty lithium disilicate adhesive restorations, including crowns on natural teeth and implant abutments, veneers, and onlays, were made in 312 patients. Parafunctional patients were included, but subjects with uncontrolled periodontitis and gingival inflammation were excluded. Veneers up to 0.5 mm thick were luted with flowable composite resin or light curing cements, while dual-curing composite systems were used with veneers up to 0.8 mm thick. Onlays up to 2 mm in thickness were luted with flowable composite resins or dual-curing composite cements. Crowns up to 1 mm in thickness were cemented with self-adhesive or dual-curing resin cements. The observational period ranged from 12 to 72 months, with a mean follow-up of 3 years. The mechanical and esthetic outcomes of the restorations were evaluated according to the modified California Dental Association (CDA) criteria. Data were analyzed with descriptive statistics. Twenty-six mechanical complications were observed: 17 porcelain chippings, 5 fractures, and 4 losses of retention. Structural drawbacks occurred mainly in posterior segments, and monolithic restorations showed the lowest number of mechanical complications. The clinical ratings of the successful restorations, both monolithic and layered, were satisfactory according to the modified CDA criteria for color match, porcelain surface, and marginal integrity. The cumulative survival rates of lithium disilicate restorations ranged from 95.46% to 100%, while cumulative success rates ranged from 95.39% to 100%. All restorations recorded very high survival and success rates. The use of lithium disilicate restorations in fixed prosthodontics proved to be effective and reliable in the short- and medium-term.
A composition scholar conducted a study of peer response groups in a freshmen composition course to determine what leads to conflict among students in these groups. In the course of her study, however, she found herself deeply perplexed by conflicting roles she had to play as a participant/observer. The ethnographer as a participant/observer is,…
The apparent simplicity of ethnographic methods--studying people in their normal life setting, going beyond what might be said in surveys and interviews to observe everyday practices--is deceptive. Anthropological knowledge is gained through fieldwork and through pursuing a reflexive flexible approach. This study carried out in a non-government…
Kunanbayeva, Sholpan B.; Ibrayeva, Akmaral G.; Abzhanov, Hangeldy M.; Sadykov, Tlegen S.; Seitkazina, Kuralay O.
The paper analyzes the collections of the Peter the Great Museum of Anthropology and Ethnography (MAE RAS) and the Russian Ethnographic Museum (REM) (St. Petersburg, Russian Federation). Their study is of great importance both in the scientific-theoretical and practical aspects. In theory, their study is of particular interest, since at the turn…
Herring, Chris; Rosaldo, Manuel; Seim, Josh; Shestakofsky, Benjamin
This article details the principles and practices animating an "ethnographic" method of teaching social theory. As opposed to the traditional "survey" approach that aims to introduce students to the historical breadth of social thought, the primary objective of teaching ethnographically is to cultivate students as participant…
This study explored how the learners-as-ethnographers (LAE) approach facilitated intercultural learning among American students learning Chinese as a foreign language. Two research questions addressed the effectiveness of the LAE approach and students' learning experiences in a non-immersion context. I designed six ethnographic tasks for the…
Merrill, Elizabeth J. Bryant
Macrocosmic and microcosmic perspectives are employed in this ethnographic study of a La Leche League mothering/breastfeeding group in Buffalo, New York, in order to place the group in its historical perspective and cultural context and to describe its structure as a small cultural system. The first section provides an historical overview of…
Vinnikov, Y R
This is the second part of an article in which the author examines trends in population growth and development among the national and ethnographic groups of the republics of Central Asia. The historical process of ethnic group consolidation is studied, with a focus on the roles of bilingualism, cross-national marriage, and socioeconomic development in inter-ethnic integration
Researchers' "reflexivity" about how they shape the phenomena that they study within the data collection process is often presented as a crucial component of ethnographic research methodology. Nevertheless, academic literature about ethnography is mostly silent around whether researchers' dreams are relevant to the research process and…
Mortimer, Katherine S.
Ethnographic and discursive approaches to educational language policy (ELP) that explore how policy is appropriated in context are important for understanding policy success/failure in meeting goals of educational equity for language-minoritized students. This study describes how Paraguayan national policy for universal bilingual education…
Sanchez-Valero, Joan-Anton; Padilla-Petry, Paulo
This article presents partial results of a multi-sited ethnographic study about the role of multiple literacies in young people's learning in and outside school. In one of the five participant secondary schools, fourth grade students were segregated in groups according to their special needs. We start with a critical review on segregated and…
Sayago, Sergio; Forbes, Paula; Blat, Josep
A growing ageing population and an increasing reliance on information and communication technologies (ICT) to conduct activities associated with daily living means that addressing how older people learn to use ICT is timely and important. By drawing on a four-year ethnographical study with 420 older people in two different environments, this paper…
Everhart, Nancy; Johnston, Melissa P.
This paper uses a meta-ethnographic approach to examine a core body of research conducted primarily by one iSchool research center that has bolstered its curriculum in support of school librarian leadership in the past decade. Substantive studies, conducted by faculty and doctoral students, have focused on various phases of leadership from…
This ethnographic study focuses on a community college VESL program in the Pacific Northwest that attempts to address the critical employment needs of a growing number of English language learners (ELLs). Immigrants are routinely barred from mainstream career and technical programs because content is linguistically inaccessible. This college VESL…
Adu-Gyamfi, Kenneth; Ampiah, Joseph Ghartey
Science education at the Basic School (Primary and Junior High School) serves as the foundation upon which higher levels of science education are pivoted. This ethnographic study sought to investigate the teaching of Integrated Science at the Junior High School (JHS) level in the classrooms of two science teachers in two schools of differing…
Davenport, Rick D.; Mann, William; Lutz, Barbara
Comparatively little research has been conducted regarding the smart technology needs of the older adult population despite the proliferation of smart technology prototypes. The purpose of this study was to explore the perceived smart technology needs of older adults with mobility impairments while using an ethnographic research approach to…
Patahuddin, Sitti Maesuri
This paper is aimed to describe an ethnographic intervention study of supporting a Low Use Internet (LUI) teacher to use the Internet for his professional development. Five characteristics of effective professional development were identified and applied. This description is followed by a reflection on the process to get a deeper insight about…
Abramson, Corey M.; Dohan, Daniel
Recent methodological debates in sociology have focused on how data and analyses might be made more open and accessible, how the process of theorizing and knowledge production might be made more explicit, and how developing means of visualization can help address these issues. In ethnography, where scholars from various traditions do not necessarily share basic epistemological assumptions about the research enterprise with either their quantitative colleagues or one another, these issues are particularly complex. Nevertheless, ethnographers working within the field of sociology face a set of common pragmatic challenges related to managing, analyzing, and presenting the rich context-dependent data generated during fieldwork. Inspired by both ongoing discussions about how sociological research might be made more transparent, as well as innovations in other data-centered fields, the authors developed an interactive visual approach that provides tools for addressing these shared pragmatic challenges. They label the approach “ethnoarray” analysis. This article introduces this approach and explains how it can help scholars address widely shared logistical and technical complexities, while remaining sensitive to both ethnography’s epistemic diversity and its practitioners shared commitment to depth, context, and interpretation. The authors use data from an ethnographic study of serious illness to construct a model of an ethnoarray and explain how such an array might be linked to data repositories to facilitate new forms of analysis, interpretation, and sharing within scholarly and lay communities. They conclude by discussing some potential implications of the ethnoarray and related approaches for the scope, practice, and forms of ethnography. PMID:26834296
Ethnographic interviewing is an under-utilized tool in climate change evaluation research, even though it has the potential to serve as a powerful method of data collection. The utility of the ethnographic interview lies in its ability to elicit responses from program participants describing what a program is in practice, shedding light on both intended and unintended program impacts. Drawing on evaluation work involving a federally-funded climate change grant at the University of California, Riverside, I will discuss how to design an ethnographic interview protocol in an effort to share "best practices" with other climate change evaluators. Particular attention will be given to applying ethnographic approaches to various program types, even those differing from the one discussed. I will share some of the concrete findings from my work on this grant, to serve as examples of the kinds of data evaluators can collect when employing an ethnographic approach to interviewing. UC Riverside's climate change grant is multi-faceted, however the component studied ethnographically was a science fair mentoring program. About twenty K-12 students from high poverty, ethnically diverse schools who expressed an interest in participating in science fair were paired up with graduate student mentors to simultaneously research climate change and design authentic science fair projects to compete at various levels. Since one of the stated goals of the grant is to "stimulate…students to consider climate science as a career track through experiential education activities" I was particularly interested in how student experiences with the project might differ from school science which has historically "pushed out" ethnically diverse students like those in many of Riverside's schools. (In the program students are able to interact one-on-one with a mentor and in school settings there is typically one teacher for more than thirty students). I also sought to understand student perceptions of
McNeil, Ryan; Small, Will; Lampkin, Hugh; Shannon, Kate; Kerr, Thomas
People who require help injecting are disproportionately vulnerable to drug-related harm, including HIV transmission. North America’s only sanctioned SIF operates in Vancouver, Canada under an exemption to federal drug laws, which imposes operating regulations prohibiting assisted injections. In response, the Vancouver Area Network of Drug Users (VANDU) launched a peer-run unsanctioned SIF in which trained peer volunteers provide assisted injections to increase the coverage of supervised injection services and minimize drug-related harm. We undertook qualitative interviews (n=23) and ethnographic observation (50 hours) to explore how this facility shaped assisted injection practices. Findings indicated that VANDU reshaped the social, structural, and spatial contexts of assisted injection practices in a manner that minimized HIV and other health risks, while allowing people who require help injecting to escape drug scene violence. Findings underscore the need for changes to regulatory frameworks governing SIFs to ensure that they accommodate people who require help injecting. PMID:23797831
Pilot Study of Intensive Chemotherapy with Peripheral Hematopoietic Cell Support for Children Less than 3 Years of Age with Malignant Brain Tumors, The CCG-99703 Phase I/II Study. A Report from the Children’s Oncology Group
Cohen, Bruce H.; Geyer, J. Russell; Miller, Douglas C.; Curran, John G.; Zhou, Tianni; Holmes, Emi; Ingles, Sue Ann; Dunkel, Ira J.; Hilden, Joanne; Packer, Roger J.; Pollack, Ian F.; Gajjar, Amar; Finlay, Jonathan L.
Background The primary goals of the CCG-99703 study were to assess the feasibility and tolerability of, as well as the response rate to, a novel dose-intensive chemotherapy regimen. Methods Between March 1998 and October 2004, 92 eligible patients were enrolled. Following biopsy/resection, patients received three identical cycles of Induction chemotherapy (vincristine, cyclophosphamide, etoposide and cisplatin) administered every 21–28 days. Patients without tumor progression then received three Consolidation cycles of marrow-ablative chemotherapy (thiotepa and carboplatin) followed by autologous hematopoietic cell rescue. Results The Maximum Tolerated Dose (MTD) of thiotepa was 10mg/kg/day x 2 days per cycle. The toxic mortality rate was zero during Induction and 2.6% during Consolidation. Centrally evaluated response rates to Induction and Consolidation in evaluable patients with residual tumor were 73.3% and 66.7% respectively. Disease progression rates on Induction and Consolidation were 4%. Five-year EFS and OS were 43.9±5.2% and 63.6±5% respectively. Gross total resection (GTR) versus
Ethnographic auditing is the application of ethnographic or anthropological concepts and methods to the appraisal of administrative controls over resources. Ethnographic auditing highlights the role of culture, subculture, values, rituals and physical environment in management in higher education. The ethnographic auditor measures the fiscal and…
Mohamed, Wessam; Elbert, Thomas; Landerl, Karin
In a cross-sectional study, we investigated the development of fluent reading and spelling in the first 3 years of learning Arabic. The goals of our study were to: (1) validate suitable measures for fluent reading and spelling in the first 3 years of learning Arabic; (2) trace the developmental course of the relationship between fluent reading and…
Guerrero, M. L.; Morrow, R. C.; Calva, J. J.; Ortega-Gallegos, H.; Weller, S. C.; Ruiz-Palacios, G. M.; Morrow, A. L.
Before carrying out a breastfeeding promotion programme in a periurban area of Mexico City, we conducted a rapid ethnographic study to determine the factors associated with absence of exclusive breastfeeding. The responses to pilot interviews were used to develop a standardized questionnaire regarding reasons for infant feeding choice, sources of advice, and barriers to breastfeeding. We interviewed a random sample of 150 mothers with a child < 5 years of age; 136 (91%) of them had initiated breastfeeding; but only 2% exclusively breastfed up to 4 months. The mothers consistently stated that the child's nutrition, health, growth, and hygiene were the main reasons for the type of feeding selected; cost, comfort, and the husband's opinion were less important. Physicians were ranked as the most important source of advice. Reduction or cessation of breastfeeding occurred on the doctor's advice (68%); or when the mothers encountered local folk illnesses such as "coraje" (52%) or "susto" (54%), which are associated with anger or fright; or had "not enough milk" (62%) or "bad milk" (56%); or because of illness of the mother (56%) or child (43%). During childhood illnesses and conditions, breastfeeding was reduced and the use of supplementary foods was increased. This study emphasizes the importance of cultural values in infant feeding choices, defines specific barriers to breastfeeding, and provides a basis for interventions to promote exclusive breastfeeding in the study population. PMID:10327711
Conover, S.; Berkman, A.; Gheith, A.; Jahiel, R.; Stanley, D.; Geller, P. A.; Valencia, E.; Susser, E.
Public health is paying increasing attention to elusive urban populations such as the homeless, street drug users, and illegal immigrants. Yet, valid data on the health of these populations remain scarce; longitudinal research, in particular, has been hampered by poor follow-up rates. This paper reports on the follow-up methods used in two randomized clinical trials among one such population, namely, homeless men with mental illness. Each of the two trials achieved virtually complete follow-up over 18 months. The authors describe the ethnographic approach to follow-up used in these trials and elaborate its application to four components of the follow-up: training interviewers, tracking participants, administering the research office, and conducting assessments. The ethnographic follow-up method is adaptable to other studies and other settings, and may provide a replicable model for achieving high follow-up rates in urban epidemiologic studies. PMID:9211004
Czarniecka, Renata; Milde, Katarzyna; Tomaszewski, Pawel
Study aim: To evaluate changes in strength abilities of adolescent girls that underwent a 3-year physical education curriculum. Material and methods: The research participants comprised 141 girls aged 13.3 plus or minus 0.35 years who participated in a 3-year physical education curriculum (PEC). Evaluation was based on the following EUROFIT…
Synoptic life history accounts and case studies of people with leprosy have tended to follow conventionalised narrative forms, with the onset of leprosy causing a violent rupture in otherwise positively construed life courses. Many of those I worked with in India, well-versed in relating their stories to donor agencies, were also aware of the power of such narratives to access funding. While case studies can be informative about the politics of representation, then, they often obscure as much as they reveal about the lives of those described within them, emphasising leprosy-related stigma at the expense of other forms or drivers of social exclusion. Drawing upon a series of interviews with a leprosy affected man I have known and worked with for 25 years, this paper demonstrates how more nuanced--and, from a policy perspective, more useful--accounts might be achieved through intensive biographical interviews carried out over time. In particular, analysis of such biographies, set against the wider backdrop of ethnographic research, allows for a more subtle reading of leprosy-related stigma, contextualised in relation to a range of intersecting socio-political, cultural and economic concerns.
Ulber, Julia; Hamann, Katharina; Tomasello, Michael
Two studies investigated the influence of external rewards and social praise in young children's fairness-related behavior. The motivation of ninety-six 3-year-olds' to equalize unfair resource allocations was measured in three scenarios (collaboration, windfall, and dictator game) following three different treatments (material reward, verbal praise, and neutral response). In all scenarios, children's willingness to engage in costly sharing was negatively influenced when they had received a reward for equal sharing during treatment than when they had received praise or no reward. The negative effect of material rewards was not due to subjects responding in kind to their partner's termination of rewards. These results provide new evidence for the intrinsic motivation of prosociality-in this case, costly sharing behavior-in preschool children.
... 1- to 2-Year-Old Growth and Your 2- to 3-Year-Old KidsHealth > For Parents > Growth and Your 2- to 3-Year-Old Print A A A ... 4 pounds (1.8 kilograms) and grow about 2 to 3 inches (5 to 8 centimeters). They' ...
... 1- to 2-Year-Old Fitness and Your 2- to 3-Year-Old KidsHealth > For Parents > Fitness and Your 2- to 3-Year-Old A A A Kids ... skills are appropriate for this age. By age 2, toddlers should be able to walk and run ...
Extends the methods of using film as a tool to teach content analysis and examines the use of feature films in teaching ethnographic methods. Explores how feature films are a valuable pedagogical tool in qualitative methods instruction by drawing from an assignment developed for a course on youth subcultures. (DSK)
Smith, Louis M.
A number of methodological and substantive issues were raised by the ethnographic research for the book (coauthored by the author of this paper), "Teaching Tales and Theories: A Story and A Commentary on a Science Classroom" (1981). First, the origin of the "problem" came not only from earlier research but also from a serendipitous meeting with…
This paper focuses on the ethical position of the ethnographer when encountering unethical activities. Ethnography affords a rich insight into cultures, often behind previously secure doors but it is also a demanding science. Our gatekeepers control our access and our relationships with them can determine our destiny. This paper offers an exchange…
This article gives Michael Agar's email responses to two questions put by Gavin Melles: "What are your thoughts on the advantages and dangers of developments in applied anthropology for ethnographic and anthropology practice?" and "What are your impressions of the potential and actual use of ethnography in design?" The…
Chung, Rita Chi-Ying; Bemak, Fred
Ethnographic fiction is a technique for educating counseling students about the relationship of social justice to counseling practice. Preliminary data indicate it is an effective tool, with counseling students (N = 48) reporting an increased understanding and appreciation of clients' life experiences from a holistic perspective. Furthermore,…
Ethnographic research projects have surged in recent years and are well represented in Research in the Teaching of English (RTE) bibliographies. However, methods texts were written for social scientists and anthropologists, not for writing researchers. Methods texts and rhetoric programs' general grounding in positivistic research imply that…
Howe, Edward R.
Cross-cultural teaching and research in Canada and Japan is reported. Ethnographic narrative methods were used to examine Japan's teacher acculturation. Canada's teachers are largely required to work in isolation, to learn their practice through trial and error. There is little provision for mentorship and insufficient time to reflect. In…
Beach, Dennis; Lunneblad, Johannes
In this article we aim to present an overview of some of the ways in which issues of race and ethnicity are represented and researched in educational ethnography in Scandinavia. Several things are suggested. Amongst them is that educational ethnographers in Scandinavia rarely use the concept of race. The term (im)migrant(s) is used instead and the…
This paper explores what it means to engage as an ethical researcher in the conduct of critical ethnography. During the years in which this critical ethnography of new language learners in a midwestern high school, the ethnographer actively participated in the life of the site. This paper poses the question of what such active involvement means…
Bélanger, Emmanuelle; Rodríguez, Charo; Groleau, Danielle; Légaré, France; MacDonald, Mary Ellen; Marchand, Robert
The participation of patients in making decisions about their care is especially important towards the end of life because palliative care decisions involve extensive uncertainty and are heavily influenced by personal values. Yet, there is a scarcity of studies directly observing clinical interactions between palliative patients and their health care providers. In this study, we aimed to understand how patient participation in palliative care decisions is constructed through discourse in a community hospital-based palliative care team. This qualitative study combined ethnographic observations of a palliative care team with discourse analysis. Eighteen palliative care patients with cancer diagnoses, six family physicians, and two nurses were involved in the study. Multiple interactions were observed between each patient and health care providers over the course of 1 year, for a total of 101 consultations, 24 of which were audio-recorded. The analysis consisted in looking for the interpretive repertoires (i.e., familiar lines of argument used to justify actions) that were used to justify patient participation in decision-making during clinical interactions, as well as exploring their implications for decision roles and end-of-life care. Patients and their health care providers seldom addressed their decision-making roles explicitly. Rather, they constructed patient participation in palliative care decisions in a covert manner. Four interpretive repertoires were used to justify patient participation: (1) exposing uncertainty, (2) co-constructing patient preferences, (3) affirming patient autonomy, and finally (4) upholding the authority of health care providers. The results demonstrate how patients and health care providers used these arguments to negotiate their respective roles in decision-making. In conclusion, patients and health care providers used a variety of interpretive repertoires to covertly negotiate their roles in decision-making, and to legitimize
Bélanger, Emmanuelle; Rodríguez, Charo; Groleau, Danielle; Légaré, France; MacDonald, Mary Ellen; Marchand, Robert
The participation of patients in making decisions about their care is especially important towards the end of life because palliative care decisions involve extensive uncertainty and are heavily influenced by personal values. Yet, there is a scarcity of studies directly observing clinical interactions between palliative patients and their health care providers. In this study, we aimed to understand how patient participation in palliative care decisions is constructed through discourse in a community hospital-based palliative care team. This qualitative study combined ethnographic observations of a palliative care team with discourse analysis. Eighteen palliative care patients with cancer diagnoses, six family physicians, and two nurses were involved in the study. Multiple interactions were observed between each patient and health care providers over the course of 1 year, for a total of 101 consultations, 24 of which were audio-recorded. The analysis consisted in looking for the interpretive repertoires (i.e., familiar lines of argument used to justify actions) that were used to justify patient participation in decision-making during clinical interactions, as well as exploring their implications for decision roles and end-of-life care. Patients and their health care providers seldom addressed their decision-making roles explicitly. Rather, they constructed patient participation in palliative care decisions in a covert manner. Four interpretive repertoires were used to justify patient participation: (1) exposing uncertainty, (2) co-constructing patient preferences, (3) affirming patient autonomy, and finally (4) upholding the authority of health care providers. The results demonstrate how patients and health care providers used these arguments to negotiate their respective roles in decision-making. In conclusion, patients and health care providers used a variety of interpretive repertoires to covertly negotiate their roles in decision-making, and to legitimize
Exploring the Impact of Phonological Awareness, Visual-Spatial Working Memory, and Preschool Quantity--Number Competencies on Mathematics Achievement in Elementary School: Findings from a 3-year Longitudinal Study
Krajewski, Kristin; Schneider, Wolfgang
This longitudinal study explored the importance of kindergarten measures of phonological awareness, working memory, and quantity-number competencies (QNC) for predicting mathematical school achievement in third graders (mean age 8 years 8 months). It was found that the impact of phonological awareness and visual-spatial working memory, assessed at…
... effective in significantly increasing their final adult height. Constitutional growth delay (delayed puberty). Although they are usually ... about age 2 or 3 years, kids with constitutional growth delay will grow at a normal childhood ...
The article critically interrogates contemporary discourses and practices around "anorexia nervosa" through an ethnographic study that moves between two sites: an online pro-anorexia (pro-ana) community, and a Local Authority-funded eating disorder prevention project located in schools and youth centres in the north of England. The…
Bair, David E.; Bair, Mary Antony
Although many states mandate college preparatory curricula for all high school students, there is no conclusive evidence regarding the benefits of this effort. Furthermore, we know little about how schools interpret and implement such policies. This extended ethnographic case study included a 4 year examination of 1 Michigan high school's response…
Exploring the impact of phonological awareness, visual-spatial working memory, and preschool quantity-number competencies on mathematics achievement in elementary school: findings from a 3-year longitudinal study.
Krajewski, Kristin; Schneider, Wolfgang
This longitudinal study explored the importance of kindergarten measures of phonological awareness, working memory, and quantity-number competencies (QNC) for predicting mathematical school achievement in third graders (mean age 8 years 8 months). It was found that the impact of phonological awareness and visual-spatial working memory, assessed at 5 years of age, was mediated by early QNC, which predicted math achievement in third grade. Importantly, and confirming our isolated number words hypothesis, phonological awareness had no impact on higher numerical competencies (i.e., when number words needed to be linked with quantities [QNC Level II and above]) but predicted basic numerical competencies (i.e., when number words were isolated from quantities [QNC Level I]), explaining the moderate relationship between early literacy development and the development of mathematical competencies.
Govindarajulu, Srinivas; Isaakidis, Petros; Shewade, Hemant Deepak; Rokade, Vasudev; Singh, Rajbir; Kamble, Sanjeev
Background Worldwide, leprosy is one of the major causes of preventable disability. India contributes to 60% of global leprosy burden. With increasing numbers of leprosy with grade 2 disability (visible disability) at diagnosis, we aimed to determine risk factors associated with grade 2 disability among new cases and explore patients and providers’ perspectives into reasons for late presentation. Methodology/Principal Findings This was an explanatory mixed-methods study where the quantitative component, a matched case-control design, was followed by a qualitative component. A total of 70 cases (grade 2 disability) and 140 controls (grade 0) matched for age and sex were randomly sampled from new patients registered between January 2013-January 2015 in three districts of Maharashtra (Mumbai, Thane and Amaravati) and interviewed using a structured close ended questionnaire. Eight public health care providers involved in leprosy care and 7 leprosy patients were purposively selected (maximum variation sampling) and interviewed using a structured open-ended interview schedule. Among cases, overall median (IQR) diagnosis delay in months was 17.9(7–30); patient and health system delay was 7(4–16.5) and 5.5(0.9–12.5) respectively; this was significantly higher than the delay in controls. Reasons for delayed presentation identified by the quantitative and qualitative data were: poor awareness of leprosy symptoms, first health care provider visited being private practitioners who were not aware about provision of free leprosy treatment at public health care facilities, reduced engagement and capacity of the general health care system in leprosy control. Conclusions Raising awareness in communities and health care providers regarding early leprosy symptoms, engagement of private health care provider in early leprosy diagnosis and increasing capacity of general health system staff, especially targeting high endemic areas that are hotspots for leprosy transmission may
Bianciotto, O A; Pinedo, L B; San Roman, N A; Blessio, A Y; Collantes, M B
The Antarctic ozone hole and a general depletion of the stratospheric ozone layer cause increased levels of ultraviolet-B solar radiation (UV-B) over Tierra del Fuego, the southernmost tip of South America. For three consecutive growing seasons (1997-2000), we studied the biological impacts (morphology, physiology, demography and phenology) of natural UV-B radiation on a perennial Salicornia ambigua Michx. community in San Sebastian Bay (53 degrees S and 68 degrees W), Tierra del Fuego, Argentina. This is the first UV-B screening experiment on a subantarctic halophytic community. The shortwave UV-B spectrum (280 to 320 nm) was excluded by covering plots with UV-B blocking film (Mylar). These plots were compared to controls covered with UV-B transparent (Aclar) plastic screens, and unscreened plots. Shoot length in Salicornia was not affected by UV-B. Exposure to natural UV-B reduced biomass and density (by 17% and 38%, respectively). Concentration of UV-shielding pigments and cuticle thickness were both significantly higher (25-48% and 21-40%, respectively) in plants receiving ambient UV-B. The increase in cuticle thickness persisted throughout the growing season, whereas pigment concentration was higher at the beginning of the growing season. Also, the number of dead shoots was higher in plants exposed to UV-B. At the end of the growing season (March) shoot mortality was higher in plants exposed to ambient UV-B, and post-flowering senescence was 30 days earlier. Slight changes in the relative composition of Salicornia to Puccinellia were seen. The reduction observed in Salicornia shoot density under ambient UV-B was cumulative over time; 23% in the first growing-season, rising to 38% by the third growing-season. A similar incremental increase in pigment absorption at 305 nm was seen; 25% in the first and 48% in the third growing season.
Martin-Neira, Manuel; Corbella, Ignasi; Torres, Francesc; Kainulainen, Juha; Oliva, Roger; Closa, Josep; Cabot, François; Castro, Rita; Barbosa, Jose; Gutierrez, Antonio; Anterrieu, Eric; Tenerelli, Joe; Martin-Porqueras, Fernando; Buenadicha, Guillermo; Delwart, Steven; Crapolicchio, Raffaele; Suess, Martin
such well known target and suffer from residual undulations in the brightness temperature signatures along incidence angle. In addition, brightness temperatures tend to be negatively bias in the region around nadir, an artifact dependent of the processing technique and which is likely to be corrected in future processor versions. The 3 year long data set has enabled the computation of the drift of the instrument, at orbital, seasonal and yearly scales. Orbital and seasonal drifts are dominating the stability of the brightness temperature images while the yearly drift is lower but clearly measurable. An important question about these drifts, still under study, is how much of them is coming from the instrument itself and how much is due to other effects influencing the metrics, like the Sun tails or the reflected galaxy. The most recent efforts have therefore focused in the correction of the Sun tails from the images by acquiring the Sun response in orbit through external calibration maneuvers. In parallel new calibration techniques to reduce further any instrumental variation are being investigated as an improved thermal model for the NIR receivers of MIRAS or the so called ALL-LICEF mode. An overview of the good progress achieved in both calibration and image reconstruction issues in SMOS after these first 3 years in orbit, as described above, shall be presented in this contribution.
Walker, Jean F.; Archibald, Lisa M. D.
Background: Speaking rate has implications for both clinical practice and an understanding of normal and disordered communication processes. Fundamental information on speaking rate is required by the clinician for the appropriate management of those disorders with disturbances of rate or those in which rate modification strategies are applied.…
Gopinath, N.; Chadha, S. L.; Shekhawat, S.; Tandon, R.
A follow-up study of hypertension was carried out among adults in Delhi 3 years after an initial community-based epidemiological survey of the same population. The treatment and the severity status of 1115 out of 1749 individuals with hypertension detected in the initial survey were compared with those observed in the follow-up. The proportion of treated cases with controlled blood pressure rose from 10.8% to 60.8%. Among the cohort of 3611 subjects aged 25-64 years who were normotensive in the initial survey, 132 new cases of hypertension, were detected. The annual incidence of hypertension was the same in men and women (12.2 per 1000). Diabetes and regular alcohol consumption were significant risk factors for hypertension, being present in 13 and 7 cases, respectively. Electrocardiograms (ECGs) were recorded for 871 of the 1115 cases of hypertension. Abnormal ECGs were exhibited by 307 cases (35.2%), of which 24 (2.7%) had had myocardial infarction, 133 (15.3%) had ischaemic ST-T changes, 54 (6.2%) had left ventricular hypertrophy, and 96 (11.0%) had conduction defects and arrhythmias. PMID:7955019
Most qualitative studies in international education take place in a single site in a single nation. When studies are of more than one country, they most often use more quantitative than qualitative approaches. Beatrice and John Whiting conducted the most systematic of comparative cross-cultural studies of child rearing in their "Six…
Ethnographic analogy, the use of comparative data from anthropology to inform reconstructions of past human societies, has a troubled history. Archaeologists often express concern about, or outright reject, the practice--and sometimes do so in problematically general terms. This is odd, as (or so I argue) the use of comparative data in archaeology is the same pattern of reasoning as the 'comparative method' in biology, which is a well-developed and robust set of inferences which play a central role in discovering the biological past. In pointing out this continuity, I argue that there is no 'special pleading' on the part of archaeologists in this regard: biologists must overcome analogous epistemic difficulties in their use of comparative data. I then go on to emphasize the local, empirically tractable ways in which particular ethnographic analogies may be licensed.
Braithwaite, R L; Bianchi, C; Taylor, S E
The purpose of this article is to address pertinent issues relative to the association between community organization and health empowerment methods in ethnic communities of colour. It seeks to address these issues by utilizing ethnographic procedures for documenting community health concerns and by advocating for empowerment for people of colour and their participation in coalition partnerships. Increasingly the importance of citizen participation in the planning, assessment, and implementation of community-based health initiatives has been identified as essential for effective health promotion and disease prevention programs. This article argues for the utility of a community organization approach for achieving health empowerment, and subsequently decreasing the excess deaths in communities of colour. The interface of ethnographic procedures, community organization, and development of community-owned action plans for programming health interventions is discussed.
Pierce, T G
Through ethnographic research with injection drugs users (IDUs), the author presents a discussion on the network dynamics of young White heroin users from the Washington, DC, metropolitan area. An analysis of who the users are, how their networks form, how they change over time, and how they dissolve are presented in comparison the the dynamics of an older Black IDU network from the same area. Significant differences between these two types of networks shed light on important issues surrounding drug use and HIV risk, and aid in directing future research efforts in this field of study.
Hashidate, Hiroyuki; Kamimura, Mikio; Ikegami, Shota; Mukaiyama, Keijiro; Uchiyama, Shigeharu; Nakamura, Yukio; Kato, Hiroyuki
The present study measured changes in plasma pentosidine and bone turnover markers in elderly patients with osteoporosis treated using bisphosphonate. The relationship between pentosidine and bone turnover markers and bone mineral density (BMD) was investigated. This study consisted of post-menopausal osteoporotic women who could be treated using bisphosphonate for 3 years were included in the present analysis. The study population consisted of 58 cases, all women, ranging in age from 53 to 86 years (mean, 67.1 years). Bisphosphonate treatment significantly increased BMD of the lumbar spine to 0.914 ± 0.141 g/cm(2) and BMD of the femoral neck to 0.708 ± 0.086 g/cm(2) after 3 years (p < 0.001 versus baseline). The mean BAP level was 27.3 ± 8.3 U/L in patients at baseline. After bisphosphonate treatment, BAP significantly decreased to 18.1 ± 7.2 U/L at 3 years (p < 0.001). Urinary NTX also decreased after bisphosphonate treatment. After 3 years of treatment, urinary NTX significantly decreased from 50.0 ± 19.0 nmol BCE/mmol Cr to 24.6 ± 10.2 nmol BCE/mmol Cr at 3 years (p < 0.001). Serum pentosidine levels were 0.0413 ± 0.0094 μg/mL at baseline and 0.0413 ± 0.0122 μg/mL after 3 years. They were not significantly changed by bisphosphonate treatment. Serum pentosidine levels were not changed by treatment with bisphosphonates. Thus, serum pentosidine may not be suitable as a marker of bone quality after 3 years of bisphosphonate treatment.
Molina, Pablo; Cerverón, M. Jesús; Vila, Rocío; Bover, Jordi; Nieto, Javier; Barril, Guillermina; Martínez-Castelao, Alberto; Fernández, Elvira; Escudero, Verónica; Piñera, Celestino; Adragao, Teresa; Navarro-Gonzalez, Juan F.; Molinero, Luis M.; Castro-Alonso, Cristina; Pallardó, Luis M.; Jamal, Sophie A.
Background and objectives Vascular calcification (VC) is common in CKD, but little is known about its prognostic effect on patients with nondialysis CKD. The prevalence of VC and its ability to predict death, time to hospitalization, and renal progression were assessed. Design, setting, participants, & measurements The Study of Mineral and Bone Disorders in CKD in Spain is a prospective, observational, 3-year follow-up study of 742 patients with nondialysis CKD stages 3–5 from 39 centers in Spain from April to May 2009. VC was assessed using Adragao (AS; x-ray pelvis and hands) and Kauppila (KS; x-ray lateral lumbar spine) scores from 572 and 568 patients, respectively. The primary end point was death. Secondary outcomes were hospital admissions and appearance of a combined renal end point (beginning of dialysis or drop >30% in eGFR). Factors related to VC were assessed by logistic regression analysis. Survival analysis was assessed by Cox proportional models. Results VC was present in 79% of patients and prominent in 47% (AS≥3 or KS>6). Age (odds ratio [OR], 1.05; 95% confidence interval [95% CI], 1.02 to 1.07; P<0.001), phosphorous (OR, 1.68; 95% CI, 1.28 to 2.20; P<0.001), and diabetes (OR, 2.11; 95% CI, 1.32 to 3.35; P=0.002) were independently related to AS≥3. After a median follow-up of 35 months (interquartile range=17–36), there were 70 deaths (10%). After multivariate adjustment for age, smoking, diabetes, comorbidity, renal function, and level of phosphorous, AS≥3 but not KS>6 was independently associated with all-cause (hazard ratio [HR], 2.07; 95% CI, 1.07 to 4.01; P=0.03) and cardiovascular (HR, 3.46; 95% CI, 1.27 to 9.45; P=0.02) mortality as well as a shorter hospitalization event–free period (HR, 1.14; 95% CI, 1.06 to 1.22; P<0.001). VC did not predict renal progression. Conclusions VC is highly prevalent in patients with CKD. VC assessment using AS independently predicts death and time to hospitalization. Therefore, it could be a useful
Wiebe, Sandra A; Sheffield, Tiffany; Nelson, Jennifer Mize; Clark, Caron A C; Chevalier, Nicolas; Espy, Kimberly Andrews
Although the structure of executive function (EF) during adulthood is characterized by both unity and diversity, recent evidence suggests that preschool EF may be best described by a single factor. The latent structure of EF was examined in 228 3-year-olds using confirmatory factor analysis. Children completed a battery of executive tasks that differed in format and response requirements and in putative working memory and inhibitory control demands. Tasks appeared to be age appropriate, with adequate sensitivity across the range of performance and without floor or ceiling effects. Tests of the relative fit of several alternative models supported a single latent EF construct. Measurement invariance testing revealed less proficient EF in children at higher sociodemographic risk relative to those at lower risk and no differences between boys and girls. At 3years of age, when EF skills are emerging, EF appears to be a unitary, more domain-general process.
Meissner, M; Kippenberger, S; Valesky, E M; Kaufmann, R
In the context of increasing travel to the tropics, outpatient services are more frequently confronted with non-domestic diseases in Europe. A 3-year old child presented with a painful tumor of the scalp. After incision of the furuncle-like lesion, we extracted a larva of the botfly Dermatobia hominis. Botflies are mainly encountered in Central and South America; they should be considered if patients demonstrate a furuncle-like lesion and have returned from a holiday in these endemic regions.
Alcorn, Ted E.; Opryszko, Melissa C.; Schwab, Kellogg J.
The accessibility of potable water is fundamental to public health. A private for-profit company is installing kiosk-based drinking-water systems in rural and peri-urban villages in Ghana, and we evaluated their performance. Preceding an observational study to measure the effect of these kiosks on the incidence of water-related disease in recipient communities, we conducted ethnographic research to assess local water-related practices and the ways these practices would affect adoption of the new technology. We conducted fieldwork in two communities in Ghana and interviewed stakeholders throughout the water sector. Our findings illustrate the complexity of water-related behaviors and indicate several factors that may sustain disease transmission despite the presence of the new technology. This formative ethnographic research also improved the precision of our subsequent evaluation of the intervention by providing a site-specific, culturally-appropriate knowledge base. This study demonstrates the value of incorporating qualitative research techniques into evaluations of water-related projects. PMID:21540392
Lee, Shawna J.; Perron, Brian E.; Taylor, Catherine A.; Guterman, Neil B.
This study uses data from 2,309 biological fathers who participated in the Fragile Families and Child Well-Being Study (FFCWS) to examine associations between psychosocial characteristics and levels of corporal punishment (CP) toward their 3-year-old children over the past month. Results indicate that 61% of the fathers reported no CP over the…
Jaswal, Vikram K.; Malone, Lauren S.
Under most circumstances, children (and adults) can safely assume that the testimony they hear is true. In two studies, we investigated whether 3-year-olds (N = 100) would continue to hold this assumption even if the person who provided the testimony behaved in an uncertain, ignorant, and/or distracted manner. In Study 1, children were less likely…
Schulze, Cornelia; Grassmann, Susanne; Tomasello, Michael
Three studies investigated 3-year-old children's ability to determine a speaker's communicative intent when the speaker's overt utterance related to that intent only indirectly. Studies 1 and 2 examined children's comprehension of indirectly stated requests (e.g., "I find Xs good" can imply, in context, a request for…
Moll, Henrike; Carpenter, Malinda; Tomasello, Michael
Recent studies have established that even infants can determine what others know based on previous visual experience. In the current study, we investigated whether 2-and 3-year-olds know what others know based on previous auditory experience. A child and an adult heard the sound of one object together, but only the child heard the sound of another…
Walczak, Monika; Esbjørn, Barbara H; Breinholst, Sonja; Reinholdt-Dunne, Marie Louise
Parental factors have been linked to childhood anxiety, hence, parental involvement in cognitive behavioral therapy (CBT) for anxious children has been examined. However, findings do not consistently show added effects of parent-enhanced CBT, longitudinal investigations are scarce and long-term effects unclear. In the present study, 40 out of 54 families who, 3 years previously, completed one of two types of CBT treatment: with limited or active parental involvement, were assessed using semi-structured diagnostic interviews. Diagnostic status at 3-years follow-up was compared between groups. Changes in diagnostic status across assessment points: posttreatment, 6-month and 3-year follow-up were analyzed within groups. Diagnostic change from 6-month to 3-year follow-up was compared between groups. Intent-to-treat analyses revealed no significant difference in diagnostic status between groups at 3-year follow-up. Nonetheless, children whose parents actively participated in treatment showed significantly more remission from 6-month to 3-year follow-up than children with limited parental participation.
Pluijmers, Britt I.; Koudstaal, Maarten J.; Paridaens, Dion; van der Wal, Karel G.H.
A 3-year-old patient was referred to the oral and maxillofacial department with a fracture of the orbital floor. Due to the lack of clinical symptoms, a conservative approach was chosen. After 3 weeks, an enophthalmos developed. The orbital floor reconstruction was successfully performed through a transconjunctival approach. This case highlights the rarity of pure blowout fractures in young children. The specific presentation and diagnostics of orbital floor fractures in children and the related surgical planning and intervention are discussed. PMID:24436749
Holdaway, M. D.; Kennedy, J.; Ashcroft, T.; Kay-Butler, J. J.
Until 1960, 179 cases of infection with Nocardia asteroides had been described in the world literature. Seventeen cases in children were reported by 1963. The organism is a common saprophyte in nature with probably a world-wide distribution. Infection can be primary but is more common in patients with underlying malignancy, auto-immune disease or preceding tuberculosis. Sulphonamides, particularly sulphadiazine, are the drugs of choice in treatment; the value of antibiotics is less clearly established. The indications for surgical treatment have not yet been defined. We record a further case of primary pulmonary nocardiosis in a 3-year-old child. Images PMID:6035802
Narasimhan, T. N.
Josh Trapani's emerging experience as an AGU Congressional Fellow (Eos, 87(7), 76, 2006) is educational. Spectacular developments in the physical sciences tempt us to believe that finer and finer dissection of matter and sophisticated manipulation of molecules will soon enable us to control nature at will. Increasing knowledge, though, about the Earth and its interconnected biological systems makes us skeptical about the enthusiastic vision of physical sciences. Living things, unlike the nonliving things that are the concern of physical sciences, possess the attribute of `behavior,' associated with `mind' and `instinct.'. Trapani's ethnographic extravaganza is merely a subset of behavior, which lies beyond the scope of relativity, quantum mechanics, or thermodynamics. Rationally, one would expect that with its fine program of liberal education, congressional fellowships, and prestigious academies of sciences, the United States will enjoy a most harmonious interrelationship between science and national policies. Such rational thinking, a reflection of our training in the physical sciences, is valid in the case of inanimate things that are faithfully subject to physical laws. When on occasion we feel dismayed at a lack of harmony between what science tells us and how national policies take shape, we would do well to be reminded by Trapani's ethnographic extravaganza that `behavior' of even the most technologically advanced living things transcends the rationality of the physical sciences.
Novais, Gabriel; Câmara, Volney de Magalhães
This study used ethnographic methods to examine the perception of mercury contamination by adolescents in the mining community of Poconé, Mato Grosso, Brazil. In Phase I, 53 students aged 13 to 16 years in six schools presented theatrical sketches about community health risks to generate key terms for a pile sorting activity in Phase II. Mercury was reported by four of the 15 groups (26%). In Phase II, researchers conducted semi-structured interviews and pile sorts with 31 students to assess adolescent attitudes about mercury and to generate an ethnomedical model of mercury perception. The lack of consensus evident in the model reveals that while students view mercury as an overall threat, many of them do not understand how its presence can harm human health. Few adolescents felt confident about their knowledge (3%) or could accurately explain how it was used (9%), even though many of them had relatives working as miners (55%). Further analysis of pile sort data suggests that mercury may not belong in a 'typical risks' domain. The authors argue that ethnographic methods are a useful tool for public health research, and hope that these findings can contribute to health education interventions in the field.
Perone, Sammy; Molitor, Stephen J.; Buss, Aaron T.; Spencer, John P.; Samuelson, Larissa K.
Executive functions enable flexible thinking, something young children are notoriously bad at. For instance, in the dimensional change card sort (DCCS) task, 3-year-olds can sort cards by one dimension (shape), but continue to sort by this dimension when asked to switch (to color). This study tests a prediction of a dynamic neural field model that…
Soini, Anne; Villberg, Jari; Sääkslahti, Arja; Gubbels, Jessica; Mehtälä, Anette; Kettunen, Tarja; Poskiparta, Marita
The main purpose of the study was to determine 3-year-olds' physical activity levels and how these vary across season, gender, time of day, location, and the physical and social environment in childcare settings in Finland. A modified version of the Observational System for Recording Physical Activity in Children-Preschool (OSRAC-P) was used to…
Ezpeleta, Lourdes; Granero, Roser; de la Osa, Nuria; Penelo, Eva; Domenech, Josep M.
Background: To test the factor structure of oppositional defiant disorder (ODD) symptoms and to study the relationships between the proposed dimensions and external variables in a community sample of preschool children. Method: A sample of 1,341 3-year-old preschoolers was randomly selected and screened for a double-phase design. In total, 622…
Gati, Itamar; Asulin-Peretz, Lisa; Fisher, Ahinoam
This study tests the temporal stability and the concurrent and predictive validity of the Emotional and Personality-related Career decision-making Difficulties (EPCD) model and questionnaire. Five hundred forty-three participants filled out the EPCD twice, 3 years apart. The Anxiety cluster was the most stable of the three, followed by the…
This article considers the impact of the increasing use of the visual mode in texts found in urban landscapes on two 3-year-olds' understanding of communication practices. The data discussed are taken from a study into a group of 3- to 6-year-olds' interaction with and emerging comprehension of the visual mode and its connection to writing in…
Kim, Hyoun K.; Pears, Katherine C.; Fisher, Philip A.; Connelly, Cynthia D.; Landsverk, John A.
Objective: Despite the high prevalence rates of harsh parenting, the nature of developmental change in this domain early in life and the factors that contribute to changes in harsh parenting over time are not well understood. The present study examined developmental patterns in maternal harsh parenting behavior from birth to age 3 years and their…
Bannard, Colin; Klinger, Jörn; Tomasello, Michael
In 3 studies we explored when 3-year-olds would imitate novel words in utterances produced by adult speakers. Child and experimenter took turns in requesting objects from a game master. The experimenter always went first and always preceded the object's familiar name with a novel adjective (e.g., "the dilsige duck"). In the first 2…
Windham, Amy M.; Rosenberg, Leon; Fuddy, Loretta; McFarlane, Elizabeth; Sia, Calvin; Duggan, Anne K
Objective: The purpose of this research was to investigate, within an at-risk population, parent and child characteristics associated with a mother's self-reports of severe physical assault and assault on the self-esteem of the child in the first 3 years of life. Design: The study population consisted of a community-based sample of mothers of…
van der Horst, A J; Kamble, A; Wijers, R A M J; Resmi, L; Bhattacharya, D; Rol, E; Strom, R; Kouveliotou, C; Oosterloo, T; Ishwara-Chandra, C H
Radio observations of gamma-ray burst (GRB) afterglows are essential for our understanding of the physics of relativistic blast waves, as they enable us to follow the evolution of GRB explosions much longer than the afterglows in any other wave band. We have performed a 3-year monitoring campaign of GRB 030329 with the Westerbork Synthesis Radio Telescopes and the Giant Metrewave Radio Telescope. Our observations, combined with observations at other wavelengths, have allowed us to determine the GRB blast wave physical parameters, such as the total burst energy and the ambient medium density, as well as to investigate the jet nature of the relativistic outflow. Further, by modelling the late-time radio light curve of GRB 030329, we predict that the Low-Frequency Array (30-240 MHz) will be able to observe afterglows of similar GRBs, and constrain the physics of the blast wave during its non-relativistic phase.
Shkedi, Brienne; Thompson, Dean
The International Space Station (ISS) Environmental Control and Life Support System (ECLSS) is designed to be maintainable. During the 3 years since the ISS US Lab became operational, there have been numerous ECLSS Orbital Replacement Units (ORUs) launched and returned to Maintain the ECLSS operation in the US segments. The maintenance logistics have provided tools for maintenance, replaced limited life ORUs and failed ORUs, upgraded ECLSS hardware to improve reliability and placed critical spares onboard prior to need. In most cases, the removed ORUs have been returned for either failure analysis and repair or refurbishment. This paper describes the ECLSS manifesting history and maintenance events and quantifies the numbers of ECLSS items, weights, and volumes.
Hornberger, Nancy H.; Johnson, David Cassels
In this article, we take up the call for more multilayered and ethnographic approaches to language policy and planning (LPP) research by sharing two examples of how ethnography can illuminate local interpretation and implementation. We offer ethnographic data collected in two very different institutions--the School District of Philadelphia and the…
This article proposes a three-part conceptualisation of the use of Facebook in ethnographic research: as a tool, as data and as context. Longitudinal research with young adults at a time of significant change provides many challenges for the ethnographic researcher, such as maintaining channels of communication and high rates of participant…
Kaplan, Michael H., Ed.; And Others
Three hundred and twenty-seven citations from 1937-1980 are listed in this selective annotated bibliography on ethnographic and qualitative research techniques. It is intended for the novice ethnographer. Listed publications consist of papers, books, journal articles, reports, and workshop notes. The volume is arranged in six parts. Part one…
This paper explores the auto/biographicity of ethnographic research, describing the way in which our research pursuits can be seen as the replaying of past agendas. It looks specifically at the auto/biographic interview as part of the ethnographic data collected, positing it as the site of co-construction of new memory, and the re-enactment of…
Campbell, Elizabeth A.
This dissertation uses theoretical explorations and participant conversations to consider the constitutive possibilities of ethnographic writing that works between students, faculty, and communities and uses those possibilities to describe the philosophy and key elements of an ethnographic composition pedagogy. The project begins with an…
Magnier, Kirsty M; Wang, Ruolan; Dale, Vicki H M; Pead, Matthew J
This study aimed to explore the complex role of the clinical teacher in the workplace, with a view to identifying effective teaching practices. An ethnographic case-study approach was taken, including participant observations and semi-structured interviews with three participants that were selected from two participating veterinary institutions. The clinical teacher has several responsibilities, such as establishing a rapport with learners and maximizing the use of case-based learning opportunities to provide instruction and support to individual learners in a safe but challenging environment. Associated difficulties include balancing the competing demands of students' learning needs and patients' welfare, as well as maximizing the learning opportunities within available case material. Participants in this study demonstrated a reflective approach, adjusting their teaching approach "in action" and "on action" as appropriate.
Lee, Jeffrey; Sparks, Paul
While advances have made it possible for the average Nepali to access mobile phones, computers, and digital cameras, barriers continue to impede access. Like other governments, Nepal responded in 2004 by creating about 80 telecenters to push sustainable technology to its people. Five years later, most telecenters struggle with sustainability. This…
This qualitative research investigates the meaning of "keitai" (mobile phones) for older Japanese adults between the ages of 59 and 79. Participants' emails from keitai, handwritten daily logs, and audio and video recordings from meetings and interviews were collected during my stay of nearly seven months in one of the largest cities in…
Dimberg, Lillemor; Bondemark, Lars; Söderfeldt, Björn; Lennartsson, Bertil
The aim of the present study was to evaluate the prevalence of malocclusion traits and sucking habits among 3-year-old children. A sample of 457 3-year-old children (234 girls and 223 boys) was obtained from three Public Dental Health clinics in Orebro County Council, Sweden. Data from clinical examination and a questionnaire were used to determine malocclusion traits, sucking habits, snoring and breathing pattern including nocturnal breathing disturbances. The results showed that 70% had one or more malocclusion traits at 3 years of age. The most common malocclusion traits were anterior open bite (50%), Class II occlusion (26%), increased overjet (23%) and posterior crossbite (19%). The prevalence of sucking habit was 66% and dummy sucking was dominating and in connection with more malocclusion traits than finger/thumb sucking. A significant association was found between the sucking habits and the most prevalent malocclusions, anterior open bite, Class II occlusion, increased overjet and posterior crossbite. In conclusion, the prevalence of malocclusion traits in 3-year-old children was high. Sucking habits was highly prevalent and dummy sucking resulted in more malocclusion traits than finger/thumb sucking did.
Cummings, Jo Ann F
In this ethnographic study, the author explores the pediatric procedural pain management practice of healthcare providers in a non-pediatric emergency department. Data were collected for 5 months with over 100 hours of observation. Six key informants were interviewed, and 44 pediatric procedural interactions with 27 healthcare providers during the treatment of children two to eight years of age undergoing procedures were observed. Other information gathered included documents from the institution, and pain related information from the patient’s medical record. Two major themes with categories are discussed, the treatment of pain, and procedural pain. The findings of this study provide insight to the everyday practice of emergency department healthcare providers for pediatric pain in a non-pediatric setting, and identify practice issues that may adversely affect the management of pediatric procedural pain, notably the non-use of pharmacological techniques for simple needle procedures and the common use of physical restraint during painful procedures. PMID:26025793
Cantlon, Jessica F; Safford, Kelley E; Brannon, Elizabeth M
When enumerating small sets of elements nonverbally, human infants often show a set-size limitation whereby they are unable to represent sets larger than three elements. This finding has been interpreted as evidence that infants spontaneously represent small numbers with an object-file system instead of an analog magnitude system (Feigenson, Dehaene & Spelke, 2004). In contrast, non-human animals and adult humans have been shown to rely on analog magnitudes for representing both small and large numbers (Brannon & Terrace, 1998; Cantlon & Brannon, 2007; Cordes, Gelman, Gallistel & Whalen, 2001). Here we demonstrate that, like adults and non-human animals, children as young as 3 years of age spontaneously employ analog magnitude representations to enumerate both small and large sets. Moreover, we show that children spontaneously attend to numerical value in lieu of cumulative surface area. These findings provide evidence of young children's greater sensitivity to number relative to other quantities and demonstrate continuity in the process they spontaneously recruit to judge small and large values.
Gallagher, Kathleen; Fusco, Caroline
This paper explores spatial theory, and particularly a Foucauldian analysis of space, power, and the subject, as a frame within which to examine moves toward security in North American urban schools. We bring into play empirical data from an ethnographic study of New York City and Toronto schools where policies and technologies of record-keeping,…
Teacher Implementation of Mathematics Curriculum Initiatives in a Test-Driven Accountability Environment: An Ethnographic Investigation into Leadership; School Culture; and Teacher's Attitudes, Beliefs, and Concerns
McGee, Robert M., III
This ethnographic study investigated the implementation process of mathematics curriculum initiatives designed to improve student achievement in a test-driven accountability environment. The research focused on complex factors within the school contextual environment influencing implementation and student achievement specifically, leadership;…
Thomas, Kristopher J.
This study is an ethnographic exploration of organizational culture, work-life balance, and the use of information and communication technology ("ICT") in the work and home settings. The researcher was embedded for nine weeks within the Information Technology ("IT") department at the corporate headquarters of a mid-sized…
Doherty, Martin J.; Anderson, James R.; Howieson, Lynne
Two studies examined development of the ability to judge what another person is looking at. In Study 1, 54 2- to 4-year-olds judged where someone was looking in real-life, photograph, and drawing formats. A minority of 2-year-olds, but a majority of older children, passed all tasks, suggesting that the ability arises at around 3 years of age.…
Drew, Elaine M.; Schoenberg, Nancy E.
Researchers have long held that fatalism (the belief in a lack of personal power or control over destiny or fate) constitutes a major barrier to participation in positive health behaviors and, subsequently, adversely affects health outcomes. In this paper, we present two in-depth, ethnographic studies of rural women's health decisions surrounding cancer treatments to illustrate the complexity and contestability of the long-established fatalism construct. Narrative analyses suggest that for these women, numerous and complex factors—including inadequate access to health services, a legacy of self-reliance, insufficient privacy, combined with a culturally acceptable idiom of fatalism—foster the use of, but not necessarily a rigid conviction in, the notion of fatalism. PMID:21834356
Klossek, Ulrike M H; Dickinson, Anthony
Previous studies failed to find evidence for rational action selection in children under 2 years of age. The current study investigated whether younger children required more training to encode the relevant causal relationships. Children between 1½ and 3 years of age were trained over two sessions to perform actions on a touch-sensitive screen to obtain video clips as outcomes. Subsequently, a visual habituation procedure was employed to devalue one of the training outcomes. As in previous studies, 2- and 3-year-olds chose actions associated with an expected valued outcome significantly more often during a subsequent choice test. Moreover, analysis of children's first responses in the post-devaluation test revealed evidence of rational action selection even in the youngest age group (18-23 months). Consistent with dual-process accounts of action control, the findings support the view that the ability to make rational action choices develops gradually.
Ficheux, A S; Dornic, N; Bernard, A; Chevillotte, G; Roudot, A C
Very few exposure data are available for children in Europe and worldwide. The aim of this study was to assess the exposure to cosmetic products used on children aged 0-3 years using recent consumption data generated for the French population. Exposure was assessed using a probabilistic method for 24 products including cleanser, skin care, fragrance, solar and bottom products. The exposure data obtained in this study for children aged 0-3 years were higher than the values fixed by the SCCS for all common products: liquid shampoo, face moisturizer cream, toothpaste, shower gel and body moisturizer cream. Exposure was assessed for the first time for many products such as sunscreens, Eau de toilette and massage products. These new French exposure values will be useful for safety assessors and for safety agencies.
Campbell, Thomas F.; Kurs-Lasky, Marcia; Rockette, Howard E.; Dale, Philip S.; Colborn, D. Kathleen; Paradise, Jack L.
The MacArthur–Bates Communicative Development Inventories (CDI; Dale, 1996; Fenson et al., 1994), parent reports about language skills, are being used increasingly in studies of theoretical and public health importance. This study (N = 113) correlated scores on the CDI at ages 2 and 3 years with scores at age 3 years on tests of cognition and receptive language and measures from parent–child conversation. Associations indicated reasonable concurrent and predictive validity. The findings suggest that satisfactory vocabulary scores at age 2 are likely to predict normal language skills at age 3, although some children with limited skills at age 3 will have had satisfactory scores at age 2. Many children with poor vocabulary scores at 2 will have normal skills at 3. PMID:16026501
Peykarjou, Stefanie; Westerlund, Alissa; Cassia, Viola Macchi; Kuefner, Dana; Nelson, Charles A.
The current study examines the processing of upright and inverted faces in 3-year-old children (n = 35). Event-related potentials (ERPs) were recorded during a passive looking paradigm including adult and newborn face stimuli. We observed three face-sensitive components, the P1, the N170 and the P400. Inverted faces elicited shorter P1 latency and…
Sovey, James S.; Patterson, Michael J.; Rawlin, Vincent K.; Hamley, John A.
A xenon ion engine and power processor system, which was developed by the NASA Glenn Research Center in partnership with the Jet Propulsion Laboratory and Boeing Electron Dynamic Devices, completed nearly 3 years of operation aboard the Deep Space 1 spacecraft. The 2.3-kW ion engine, which provided primary propulsion and two-axis attitude control, thrusted for more than 16,000 hr and consumed more than 70 kg of xenon propellant. The Deep Space 1 spacecraft was launched on October 24, 1998, to validate 12 futuristic technologies, including the ion-propulsion system. After the technology validation process was successfully completed, the Deep Space 1 spacecraft flew by the small asteroid Braille on July 29, 1999. The final objective of this mission was to encounter the active comet Borrelly, which is about 6 miles long. The ion engine was on a thrusting schedule to navigate the Deep Space 1 spacecraft to within 1400 miles of the comet. Since the hydrazine used for spacecraft attitude control was in short supply, the ion engine also provided two-axis attitude control to conserve the hydrazine supply for the Borrelly encounter. The comet encounter took place on September 22, 2001. Dr. Marc Rayman, project manager of Deep Space 1 at the Jet Propulsion Laboratory said, "Deep Space 1 plunged into the heart of the comet Borrelly and has lived to tell every detail of its spinetingling adventure! The images are even better than the impressive images of comet Halley taken by Europe's Giotto spacecraft in 1986." The Deep Space 1 mission, which successfully tested the 12 high-risk, advanced technologies and captured the best images ever taken of a comet, was voluntarily terminated on December 18, 2001. The successful demonstration of the 2-kW-class ion propulsion system technology is now providing mission planners with off-the-shelf flight hardware. Higher power, next generation ion propulsion systems are being developed for large flagship missions, such as outer planet
BALDINI, N.; DE SANCTIS, M.; CAGIDIACO, M.C.; BALLERI, P.; VIGNOLETTI, F.; GORACCI, C.; FERRARI, M.
SUMMARY Aim. In this preliminary study, the 3-year radiological outcomes of Osseospeed implant-supported fixed complete or partial prostheses made with two different laboratory protocols were compared. Methods. A convenience sample of 34 patients, who were either partially or completely edentulous in either jaw, were randomly assigned to two groups, of 17 patients each, using either a traditional laboratory protocol (control group) or the Cresco one (test group). The study’s objective was an assessment of marginal bone loss around implants, measured on intraoral radiographs at 3-year follow-up. Results. None of the implants inserted was lost during the study and radiological measurements of marginal bone level changes revealed that the mean marginal bone loss was respectively 0,73±0,33mm for test group and 0,88±1,13mm for control group. The differences between test and control groups were not statistically significant. Conclusion. This preliminary study did not demonstrate statistically significant differences in marginal bone loss around implant-prostheses prepared with the two different laboratory protocols, over the 3-year observational period. PMID:25694796
Becske, Tibor; Potts, Matthew B; Shapiro, Maksim; Kallmes, David F; Brinjikji, Waleed; Saatci, Isil; McDougall, Cameron G; Szikora, István; Lanzino, Giuseppe; Moran, Christopher J; Woo, Henry H; Lopes, Demetrius K; Berez, Aaron L; Cher, Daniel J; Siddiqui, Adnan H; Levy, Elad I; Albuquerque, Felipe C; Fiorella, David J; Berentei, Zsolt; Marosföi, Miklós; Cekirge, Saruhan H; Nelson, Peter K
OBJECTIVE The long-term effectiveness of endovascular treatment of large and giant wide-neck aneurysms using traditional endovascular techniques has been disappointing, with high recanalization and re-treatment rates. Flow diversion with the Pipeline Embolization Device (PED) has been recently used as a stand-alone therapy for complex aneurysms, showing significant improvement in effectiveness while demonstrating a similar safety profile to stent-supported coil treatment. However, relatively little is known about its long-term safety and effectiveness. Here the authors report on the 3-year safety and effectiveness of flow diversion with the PED in a prospective cohort of patients with large and giant internal carotid artery aneurysms enrolled in the Pipeline for Uncoilable or Failed Aneurysms (PUFS) trial. METHODS The PUFS trial is a prospective study of 107 patients with 109 aneurysms treated with the PED. Primary effectiveness and safety end points were demonstrated based on independently monitored 180-day clinical and angiographic data. Patients were enrolled in a long-term follow-up protocol including 1-, 3-, and 5-year clinical and imaging follow-up. In this paper, the authors report the midstudy (3-year) effectiveness and safety data. RESULTS At 3 years posttreatment, 74 subjects with 76 aneurysms underwent catheter angiography as required per protocol. Overall, complete angiographic aneurysm occlusion was observed in 71 of these 76 aneurysms (93.4% cure rate). Five aneurysms were re-treated, using either coils or additional PEDs, for failure to occlude, and 3 of these 5 were cured by the 3-year follow-up. Angiographic cure with one or two treatments of Pipeline embolization alone was therefore achieved in 92.1%. No recanalization of a previously completely occluded aneurysm was noted on the 3-year angiograms. There were 3 (2.6%) delayed device- or aneurysm-related serious adverse events, none of which led to permanent neurological sequelae. No major or minor
Villamor, Eduardo; Rifas-Shiman, Sheryl L; Gillman, Matthew W; Oken, Emily
Methyl-donor nutrients are substrates for methylation reactions involved in neurodevelopment processes. The role of maternal intake of these nutrients on cognitive performance of the offspring is poorly understood. We examined the associations of maternal intake of folate, vitamin B12, choline, betaine and methionine during the first and second trimesters of pregnancy, with tests of cognitive performance in the offspring at 3 years of age using data from 1210 participants in Project Viva, a prospective pre-birth cohort study in Massachusetts. We assessed nutrient intake with the use of food frequency questionnaires. Children's cognition at age 3 years was evaluated with the Peabody Picture Vocabulary Test III (PPVT-III) and visual-motor skills with the Wide Range Assessment of Visual Motor Abilities test. In multivariable models adjusting for potential sociobehavioural and nutritional confounders, for each 600 µg/day increment in total folate intake during the first trimester, PPVT-III score at age 3 years was 1.6 points [95% confidence interval (CI) 0.1, 3.1; P = 0.04] higher. There was a weak inverse association between vitamin B12 intake during the second trimester and PPVT-III scores [-0.4 points per 2.6 µg/day; 95% CI -0.8, -0.1; P = 0.01]. We did not find associations between choline, betaine or methionine and cognitive outcomes at this age. Results of this study suggest that higher intake of folate in early pregnancy is associated with higher scores on the PPVT-III, a test of receptive language that predicts overall intelligence, at age 3 years.
Araujo de Carvalho, Elias Cesar; Batilana, Adelia Portero; Claudino, Wederson; Lima Reis, Luiz Fernando; Schmerling, Rafael A.; Shah, Jatin; Pietrobon, Ricardo
Background With the exponential expansion of clinical trials conducted in (Brazil, Russia, India, and China) and VISTA (Vietnam, Indonesia, South Africa, Turkey, and Argentina) countries, corresponding gains in cost and enrolment efficiency quickly outpace the consonant metrics in traditional countries in North America and European Union. However, questions still remain regarding the quality of data being collected in these countries. We used ethnographic, mapping and computer simulation studies to identify/address areas of threat to near miss events for data quality in two cancer trial sites in Brazil. Methodology/Principal Findings Two sites in Sao Paolo and Rio Janeiro were evaluated using ethnographic observations of workflow during subject enrolment and data collection. Emerging themes related to threats to near miss events for data quality were derived from observations. They were then transformed into workflows using UML-AD and modeled using System Dynamics. 139 tasks were observed and mapped through the ethnographic study. The UML-AD detected four major activities in the workflow evaluation of potential research subjects prior to signature of informed consent, visit to obtain subject́s informed consent, regular data collection sessions following study protocol and closure of study protocol for a given project. Field observations pointed to three major emerging themes: (a) lack of standardized process for data registration at source document, (b) multiplicity of data repositories and (c) scarcity of decision support systems at the point of research intervention. Simulation with policy model demonstrates a reduction of the rework problem. Conclusions/Significance Patterns of threats to data quality at the two sites were similar to the threats reported in the literature for American sites. The clinical trial site managers need to reorganize staff workflow by using information technology more efficiently, establish new standard procedures and manage
Dixon, B; Rifas-Shiman, S L; James-Todd, T; Ertel, K; Krieger, N; Kleinman, K P; Rich-Edwards, J W; Gillman, M W; Taveras, E M
Among US racial/ethnic minority women, we examined associations between maternal experiences of racial discrimination and child growth in the first 3 years of life. We analyzed data from Project Viva, a pre-birth cohort study. We restricted analyses to 539 mother-infant pairs; 294 were Black, 127 Hispanic, 110 Asian and 8 from additional racial/ethnic groups. During pregnancy, mothers completed the Experiences of Discrimination survey that measured lifetime experiences of racial discrimination in diverse domains. We categorized responses as 0, 1-2 or ≥3 domains. Main outcomes were birth weight for gestational age z-score; weight for age (WFA) z-score at 6 months of age; and at 3 years of age, body mass index (BMI) z-score. In multivariable analyses, we adjusted for maternal race/ethnicity, nativity, education, age, pre-pregnancy BMI, household income and child sex and age. Among this cohort of mostly (58.2%) US-born and economically non-impoverished mothers, 33% reported 0 domains of discrimination, 33% reported discrimination in 1-2 domains and 35% reported discrimination in ≥3 domains. Compared with children whose mothers reported no discrimination, those whose mothers reported ≥3 domains had lower birth weight for gestational age z-score (β -0.25; 95% CI: -0.45, -0.04), lower 6 month WFA z-score (β -0.34; 95% CI: -0.65, -0.03) and lower 3-year BMI z-score (β -0.33; 95% CI: -0.66, 0.00). In conclusion, we found that among this cohort of US racial/ethnic minority women, mothers' report of experiencing lifetime discrimination in ⩾ 3 domains was associated with lower fetal growth, weight at 6 months and 3-year BMI among their offspring.
Kimbro, Rachel Tolbert; Brooks-Gunn, Jeanne; McLanahan, Sara
Objectives. We estimated racial/ethnic differences in overweight and obesity in a national sample of 3-year-olds from urban, low-income families and assessed possible determinants of differences. Methods. Survey, in-home observation, and interview data were collected at birth, 1 year, and 3 years. We used logistic regression analyses and adjusted for a range of covariates in examining overweight and obesity differentials according to race/ethnicity. Results. Thirty-five percent of the study children were overweight or obese. Hispanic children were twice as likely as either Black or White children to be overweight or obese. Although we controlled for a wide variety of characteristics, we were unable to explain either White–Hispanic or Black–Hispanic differences in overweight and obesity. However, birthweight, taking a bottle to bed, and mother’s weight status were important predictors of children’s overweight or obesity at age 3 years. Conclusions. Children’s problems with overweight and obesity begin as early as age 3, and Hispanic children and those with obese mothers are especially at risk. PMID:17194857
Jefferies, Steven R; Pameijer, Cornelis H; Appleby, David C; Boston, Daniel; Lööf, Jesper
A clinical validation study was conducted to determine the performance of a new bioactive dental cement (Ceramir C&B, Doxa Dental AB) for permanent cementation. The cement is a new formulation class, which is a hybrid material comprised of calcium aluminate and glass-ionomer components. A total of 38 crowns and bridges were cemented in 17 patients; 31 of the abutment teeth were vital and seven were non-vital. Six restorations were bridges with a total of 14 abutment teeth (12 vital/ two non-vital). One fixed splint comprising two abutment teeth was also included. Preparation parameters were recorded, as well as cement characteristics such as working time, setting time, seating characteristics, and ease of cement removal. Baseline data were recorded for the handling of the cement, gingival inflammation, and pre-cementation sensitivity. Post-cementation parameters included post-cementation sensitivity, gingival tissue reaction, marginal integrity, and discoloration. All patients were seen for recall examinations at 30 days and 6 months. Fifteen of 17 subjects and 13 of 17 patients were also available for subsequent comprehensive 1- and 2-year recall examination, and 13 patients were available for a 3-year recall examination. Restorations available for the 3-year recall examination included 14 single-unit full-coverage crown restorations, four three-unit bridges comprising eight abutments, and one two-unit splint. Three-year recall data yielded no loss of retention, no secondary caries, no marginal discolorations, and no subjective sensitivity. All restorations rated excellent for marginal integrity. Average visual analogue scale (VAS) score for tooth sensitivity decreased from 7.63 mm at baseline to 0.44 mm at 6-month recall, 0.20 mm at 1-year recall, and 0.00 mm at 2- and 3-year recall. Average gingival index (GI) score for gingival inflammation decreased from 0.56 at baseline to 0.11 at 6-month recall, 0.16 at 1-year recall, 0.21 at 2-year recall, and 0.07 at 3
Joo, Jenna (Ji Eun)
This dissertation presents an ethnographic study of an instructor's design logic and thinking underlying a global, multi-country undergraduate engineering design course. The study analyzed how, in what ways, and for what purposes, he continually defined and reformulated what counted as (Heap, 1991) "new" learning opportunities and outcomes for engineering design thinking in the 21st century, through his interactions with globally distributed groups of students and teaching teams (i.e., US, India, Israel, China and South Korea). By examining what was discursively made present to students in moment-by-moment and over-time, I identified the processes and practices that members of the class needed to know, understand, produce and engage in (Heath & Street, 2008) to develop their capacities to work in intercultural contexts on local design problems. Discourse analysis guided by an Interactional Ethnographic logic-in-use (Birdwhistell, 1977), grounded in a social construction of knowledge perspective (i.e., Green, Skukauskaite, and Baker, 2012; Castanheira, Crawford, Dixon and Green, 2001), framed the ways in which I examined the work of participants, what they oriented to and were held accountable for, and how what counted as this "new" instructional approach was socially constructed (Heap, 1991; Bloome & Egan-Robertson, 1993, Castanheira et al, 2001). This inquiry process required consideration of multimodal texts available to students in different technology-enabled educational contexts, public (re)presentations of this developing program as well as the construction of transcripts. From this perspective, texts were spoken, written and/or published works (Bakhtin, 1986) constructed by key actors (the designer, the support team, a teaching assistant and students). The analyses made visible how the instructor's discourse focused students on taking a problem-oriented approach to resolving challenges in working interculturally on a common task (e.g., the design thinking
Hashimoto, M; Ohno, H; Kaga, M; Endo, K; Sano, H; Oguchi, H
The longevity of resin restorations is currently an area of great interest in adhesive dentistry. However, no work has been conducted to investigate the durability of resin-dentin bond structures using human substrate in vivo. The purpose of this study was to investigate the degradation of the resin-dentin bond structures aged in an oral environment for 1, 2, or 3 years. Cavities were prepared in primary molars, and an adhesive resin system (Scotchbond Multi-Purpose) was applied to the cavity. After 1 to 3 years, following the eruption of the succedaneous permanent teeth, the resin-restored teeth were extracted. Immediately after extraction, those teeth were sectioned perpendicular to the adhesive interface and trimmed to produce an hourglass-shaped specimen. Then, a micro-tensile test was performed at a crosshead speed of 1.0 mm/min. The mean bond strengths were statistically compared with one-way ANOVA and Fisher's PLSD test (p < 0.05). Further, all fractured surfaces were observed by SEM, and the area fraction of failure mode was calculated by means of a digital analyzer on SEM photomicrographs. There were significant differences in tensile-bond strength among all 3 groups (p < 0.05), with mean values ranging from 28.3 +/- 11.3 MPa (control), to 15.2 +/- 4.4 MPa (1 to 2 years), to 9.1 +/- 5.1 MPa (2 to 3 years). Moreover, under fractographic analysis, the proportion of demineralized dentin at the fractured surface in specimens aged in an oral environment was greater than that in control specimens. Furthermore, degradation of resin composite and the depletion of collagen fibrils was observed among the specimens aged in an oral environment. Analysis of the results of this study indicated that the degradation of resin-dentin bond structures occurs after aging in the oral cavity.
Salcuni, Silvia; Di Riso, Daniela; Mabilia, Diana; Lis, Adriana
Few studies have investigated the outcomes and process of psychodynamic psychotherapies with children. Among the limited number of studies, some only paid attention to play and verbal production, as they are fundamental aspects in assessing the psychotherapy process. This paper focuses on an empirical investigation of a 3-year, once-a-week psychodynamic psychotherapy carried out with a 3-year-old girl. A process-outcome design was implemented to evaluate play and verbal discourse in in the initial, middle, and final parts of 30 psychotherapy sessions. Repeated measurements of standardized play categories (the Play Category System and the Affect in Play Scale—Preschool version) and verbal discourse (Verbal Production) were analyzed. To increase the clinical validity of the study, data from the assessment phase and vignettes from the sessions were reported to deepen the patient’s picture during the unfolding therapy process. Parent reports before and after the therapy were also included. Empirically measured changes in play and verbal production were fundamental in evaluating the young patient’s psychotherapy process. Verbal production and discourse ability progressively increased and took the place of play, which instead became more symbolic. Developmental issues as well as psychotherapy’s influence on the patient’s change, were discussed in relation to the role of play in enhancing the development of verbal dialog and the expression of the child’s emotions, needs, and desires. PMID:28101070
Foo, Valencia Hui Xian; Verkicharla, Pavan Kumar; Ikram, Mohammad Kamran; Chua, Sharon Yu Lin; Cai, Shirong; Tan, Chuen Seng; Chong, Yap-Seng; Kwek, Kenneth; Gluckman, Peter; Wong, Tien-Yin; Ngo, Cheryl; Saw, Seang-Mei; on behalf of the GUSTO study group
Purpose This study investigated the association of axial length (AL) to corneal radius of curvature (CRC) ratio with spherical equivalent (SE) in a 3-year old Asian cohort. Methods Three-hundred forty-nine 3-year old Asian children from The Growing Up in Singapore towards Healthy Outcomes (GUSTO) birth cohort study underwent AL and CRC measurements with a noncontact ocular biometer and cycloplegic refraction using an autorefractor. The ratio of AL to CRC (AL/CRC) was calculated for all the participants, and subsequently AL, CRC, and AL/CRC were analyzed in relationship to SE. Results The SE showed better correlation with AL/CRC (Spearman's correlation coefficient, ρ = −0.53; 95% confidence interval [CI]: −0.66; −0.49; P < 0.001) compared to either AL or CRC alone ([ρ = −0.36; 95% CI: −0.51 to 0.51; P = 0.01] and [ρ = 0.05; 95% CI: −0.04 to 0.17; P = 0.34], respectively). Mean AL/CRC was 2.91 ± 0.06 among myopes and decreased to 2.79 ± 0.06 among hyperopes. Axial length to corneal radius of curvature was strongly correlated with SE in myopes (ρ = −0.78; 95% CI: −3.76; −0.79; P = < 0.001), but not in emmetropes and hyperopes ([ρ = −0.39; 95% CI: −10.73; −0.57; P = 0.01] and [ρ = −0.18; 95% CI: −17.28; 12.42; P = 0.38], respectively). Linear regression adjusted for gender and ethnicity showed a 0.74-diopter shift in SE towards myopia with every 0.1 increase in AL/CRC ratio (P < 0.001, r2 = 0.33). Conclusion The correlation between SE and AL/CRC is stronger than that between AL or CRC alone. This suggests that in a research setting, when cycloplegic refraction is difficult to perform on 3-year-old children, AL/CRC may be the next best reference for refractive error. Translational Relevance In the research setting, AL/CRC may be the next best reference for refractive error over AL alone when cycloplegic refraction is unavailable in 3-year old children. PMID:26929885
Purpose: At present, transformative learning is one of the most important issues in medical education, since a conventional learning environment is prone to failure due to changing patterns among students. Ethnographic edutainment is a concept that consists of reward, competition, and motivation strategies that be used to effectively engage with learners. Methods: A total 321 first-year medical students took part in ethnographic edutainment sessions in 2011. We defined four preset learning objectives and assigned a term group project using clouding technologies. Participatory evaluation was conducted to assess the delivery of and attitudes towards this method. Results: Career lifestyles in the general population and expected real-life utilization of the final product were used as motivating factors, with competition and rewards provided through a short film contest. Nineteen out of twenty groups (95%) achieved all learning objectives. Females were more satisfied with this activity than males (P<0.001). We found statistically significant differences between lecture-based sessions and field visit sessions, as well as ethnographic edutainment activity sessions and other instructional approaches (P<0.01). The results were consistent in male and female groups. Conclusion: Ethnographic edutainment is well accepted, with higher satisfaction rates than other types of teaching. The concepts of health promotion and the social determinants of health can be learned through ethnographic edutainment activities, which might help train more humanized health professionals. PMID:25043927
Zabaneh, Rachel; Smith, Lynne M; LaGasse, Linda L; Derauf, Chris; Newman, Elana; Shah, Rizwan; Arria, Amelia; Huestis, Marilyn; Haning, William; Strauss, Arthur; Della Grotta, Sheri; Dansereau, Lynne M; Lin, Hai; Neal, Charles; Lester, Barry M
We examined the effects of prenatal methamphetamine (MA) exposure on growth parameters from birth to age 3 years. The 412 subjects included (n = 204 exposed) were enrolled at birth in the Infant Development, Environment and Lifestyle study, a longitudinal study assessing the effects of prenatal MA exposure on childhood outcomes. Individual models were used to examine the effects of prenatal MA exposure on weight, head circumference, height, and weight-for-length growth trajectories. After adjusting for covariates, height trajectory was lower in the exposed versus the comparison children (p = 0.021) over the first 3 years of life. Both groups increased height on average by 2.27 cm per month by age 3 years. In term subjects, MA exposure was also associated with a lower height trajectory (p = 0.034), with both the exposed and comparison groups gaining 2.25 cm per month by age 3 years. There was no difference in weight, head circumference, or weight-for-length growth trajectories between the comparison and the exposed groups. Children exposed prenatally to MA have a modest decrease in height growth trajectory during the first 3 years of life with no observed difference in weight, head circumference, or weight-for-length trajectories.
Livingston, Karina; Padilla, Mark; Scott, Derrick; Colón-Burgos, José Félix; Reyes, Armando Matiz; Varas-Díaz, Nelson
This paper focuses on a mixed-method approach to quantifying qualitative data from the results of an ongoing NIDA-funded ethnographic study entitled “Migration, Tourism, and the HIV/Drug-Use Syndemic in the Dominican Republic”. This project represents the first large-scale mixed method study to identify social, structural, environmental, and demographic factors that may contribute to ecologies of health vulnerability within the Caribbean tourism zones. Our research has identified deportation history as a critical factor contributing to vulnerability to HIV, drugs, mental health problems, and other health conditions. Therefore, understanding the movements of our participants became a vital aspect of this research. This paper describes how we went about translating 37 interviews into visual geographic representations. These methods help develop possible strategies for confronting HIV/AIDS and problematic substance use by examining the ways that these epidemics are shaped by the realities of people’s labor migration and the spaces they inhabit. Our methods for mapping this qualitative data contribute to the ongoing, broadening capabilities of using GIS in social science research. A key contribution of this work is its integration of different methodologies from various disciplines to help better understand complex social problems. PMID:27656039
Livingston, Karina; Padilla, Mark; Scott, Derrick; Colón-Burgos, José Félix; Reyes, Armando Matiz; Varas-Díaz, Nelson
This paper focuses on a mixed-method approach to quantifying qualitative data from the results of an ongoing NIDA-funded ethnographic study entitled "Migration, Tourism, and the HIV/Drug-Use Syndemic in the Dominican Republic". This project represents the first large-scale mixed method study to identify social, structural, environmental, and demographic factors that may contribute to ecologies of health vulnerability within the Caribbean tourism zones. Our research has identified deportation history as a critical factor contributing to vulnerability to HIV, drugs, mental health problems, and other health conditions. Therefore, understanding the movements of our participants became a vital aspect of this research. This paper describes how we went about translating 37 interviews into visual geographic representations. These methods help develop possible strategies for confronting HIV/AIDS and problematic substance use by examining the ways that these epidemics are shaped by the realities of people's labor migration and the spaces they inhabit. Our methods for mapping this qualitative data contribute to the ongoing, broadening capabilities of using GIS in social science research. A key contribution of this work is its integration of different methodologies from various disciplines to help better understand complex social problems.
Zur, E; Kaczmarski, M
Dietary elimination is a treatment of first choice in food hypersensitivity. Such therapy is not always enough to stop the disease and introduction of pharmacological treatment is necessary. In prevention and long term treatment antiallergic drugs are recommended. The aim of the study was to assess efficacy and safety of oral sodium cromoglycate in treatment of food hypersensitivity in the youngest children. In our study we examined: the group of 25 children aged 6 months-3 years treated with oral cromolyn sodium during the period 4-20 weeks and 29 children aged 6 months-3 years treated with ketotifen. Symptoms from skin, digestive and respiratory tract, behaviour status were evaluated for drugs efficacy. Cromolyn and ketotifen effected a significant decrease in total symptoms score. The treatment was well tolerated. No serious side effects were noted. The incidents of skin rash, disquiet during the night, diarrhoea and urticaria were only 8 percent. Sodium cromoglycate is safe and effective drug in treatment of food allergy in children; specially in symptoms from gastrointestinal tract and multi-organs allergy.
Barkoukis, V; Taylor, I; Chanal, J; Ntoumanis, N
Enhancing students' academic engagement is the key element of the educational process; hence, research in this area has focused on understanding the mechanisms that can lead to increased academic engagement. The present study investigated the relation between motivation and grades in physical education (PE) employing a 3-year longitudinal design. Three hundred fifty-four Greek high school students participated in the study. Students completed measures of motivation to participate in PE on six occasions; namely, at the start and the end of the school year in the first, second, and third year of junior high school. Students' PE grades were also recorded at these time points. The results of the multilevel growth models indicated that students' PE grades increased over the 3 years and students had better PE grades at the end of each year than at the beginning of the subsequent year. In general, students and classes with higher levels of controlling motivation achieved lower PE grades, whereas higher levels of autonomous motivation were associated with higher PE grades. These findings provide new insight on the associations between class- and individual-level motivation with objectively assessed achievement in PE.
Raine, Adrian; Yaralian, Pauline S; Reynolds, Chandra; Venables, Peter H; Mednick, Sarnoff A
Previous studies have repeatedly shown verbal intelligence deficits in adolescent antisocial individuals, but it is not known whether these deficits are in place prior to kindergarten or, alternatively, whether they are acquired throughout childhood. This study assesses whether cognitive deficits occur as early as age 3 years and whether they are specific to persistently antisocial individuals. Verbal and spatial abilities were assessed at ages 3 and 11 years in 330 male and female children, while antisocial behavior was assessed at ages 8 and 17 years. Persistently antisocial individuals (N = 47) had spatial deficits in the absence of verbal deficits at age 3 years compared to comparisons (N = 133), and also spatial and verbal deficits at age 11 years. Age 3 spatial deficits were independent of social adversity, early hyperactivity, poor test motivation, poor test comprehension, and social discomfort during testing, and they were found in females as well as males. Findings suggest that early spatial deficits contribute to persistent antisocial behavior whereas verbal deficits are developmentally acquired. An early-starter model is proposed whereby early spatial impairments interfere with early bonding and attachment, reflect disrupted right hemisphere affect regulation and expression, and predispose to later persistent antisocial behavior.
Neuhaus, John M.; Foster, Diana G.
Objectives. We set out to assess the occurrence of new depression and anxiety diagnoses in women 3 years after they sought an abortion. Methods. We conducted semiannual telephone interviews of 956 women who sought abortions from 30 US facilities. Adjusted multivariable discrete-time logistic survival models examined whether the study group (women who obtained abortions just under a facility’s gestational age limit, who were denied abortions and carried to term, who were denied abortions and did not carry to term, and who received first-trimester abortions) predicted depression or anxiety onset during seven 6-month time intervals. Results. The 3-year cumulative probability of professionally diagnosed depression was 9% to 14%; for anxiety it was 10% to 15%, with no study group differences. Women in the first-trimester group and women denied abortions who did not give birth had greater odds of new self-diagnosed anxiety than did women who obtained abortions just under facility gestational limits. Conclusions. Among women seeking abortions near facility gestational limits, those who obtained abortions were at no greater mental health risk than were women who carried an unwanted pregnancy to term. PMID:26469674
Hoffman, Patricia; Dahlman, Anne; Zierdt, Ginger
This article details a strategic planning model and concurrent 3-year research study focusing on the benefits of preK-16 professional development school learning communities for the participating preK-16 educational leaders in a midwestern school-university partnership network. Results of the study, along with the strategic plan's success at…
Dahl, Jonna J.; Kingo, Osman S.; Krøjgaard, Peter
In a seminal study Simcock and Hayne (2002) showed that 3-year-olds were unable to use newly acquired words to describe a "magic" event experienced 6 or 12 months earlier. In the reference study the children's verbal recall was tested without props being present. Inspired by recent evidence, the original design was replicated, testing…
Klossek, Ulrike M. H.; Dickinson, Anthony
Previous studies failed to find evidence for rational action selection in children under 2 years of age. The current study investigated whether younger children required more training to encode the relevant causal relationships. Children between 1 1/2 and 3 years of age were trained over two sessions to perform actions on a touch-sensitive screen…